Since the inception of field, theoreticians and teachers of family therapy have advocated for either problem-solving, skill-based training, or transgenerational training that emphasizes the therapist's own family-of-origin work. This article proposes an end to these polarized positions and argues for both-and, that is, a model of training that integrates the trainee's own family-of-origin work with live supervision and skills training. A family-of-origin curriculum designed for this purpose is described.
Important and common relational conditions, such as severe couple dysfunction and family violence involving child or elder abuse, have been omitted from DSM-IV, the authors believe. They argue that such conditions can exist independently of severe individual psychopathology and that these conditions should be described in relational terms, with specific diagnostic criteria. They outline a classification of relational disorders and propose its addition to axis I of DSM-IV. This classification scheme focuses on severe family dysfunction; problems of living usually treated by couple and family therapists are intentionally omitted. Descriptions of two relational disorders, written in DSM style, are provided. The authors discuss implications for the treatment and rehabilitation of patients, the future training of psychiatrists, and the direction of research.
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