A data-based reply to Hare-Mustin on family therapy perils.

Abstract

Rachel Hare-Mustin (1980) concluded in her recent article that family therapy "may not be in the best interests of individual family members" (p. 935). In particular, she claims that the "required" involvement of individuals may deny them their rights, the "typical" working toward a goal of becoming the traditional ideal family may be sexist or stereotyping, and individuals may be "at risk" when individual needs conflict with the whole. This article will reply to Dr. Hare-Mustin's concerns by offering a brief review of the known empirical evidence on these issues.

A Systemic View of Family Therapy Ethics

“… Family therapists view particular problems nonsystemically (34). Many approaches such as those of Haley (13), the MRI brief therapists (32), most behaviorists (e.g., 24), and others tend to see the symptomatic behavior interactions themselves as the problem in toto. They fail to examine adequately either the broader context of other family members' behaviors beyond a dyadic or triadic level, the same pattern of behaviors in other content areas, or the behaviors of the therapist.…”

Ethics in marital and family therapy: A review of the literature.

“…Certainly, an area in need of further research attention is the divergent attitudes expressed by Hare-Mustin (1980) and Wendorf (1981). The contemporary literature is too limited to unequivocally endorse one viewpoint over the other.…”

“…In this view, normal family life and successful child rearing are equated with the preservation of stereotyped sex roles in the American family (Hare-Mustin, 1980). Citing a dearth of empirical support for this viewpoint, Wendorf (1981) argued that family therapists, even early on, have focused much of their attention on the nontraditional families that they more typically see.…”

“…This article also dealt with issues of confidentiality in family versus individual therapy and problems encountered when individual goals diverge from family goals. In a response to that article, Wendorf (1981) cited a lack of empirical support for Hare-Mustin's assertions in the literature. Wendorf expressed doubts about Hare-Mustin's concerns over involving the entire family in therapy primarily focused on one individual and Hare-Mustin's contentions that family therapists gravitate towards a stereotypic "ideal family" model when conducting therapy.…”

The Age of Accountability:* The Next Phase for Family Therapy

“…Traditionally, there was a belief that therapy was of some benefit to most clients and that at worst, it appeared to be an innocuous kind of experience, but certainly not detrimental to physical or mental health. Interestingly, the initial highlighting of the whole phenomenon of deterioration by Gurman and Kniskern (l978a) brought forth a flurry of various articles heralding some rather catchy titles (eg., see Becvar, Becvar, and Bender, 1982;Hare-Mustin, 1980;Wendorf, 1981). Kniskern (1978d, 1981) conclude that within family therapy, approximately 5-10% of patients or marital or family relationships worsen as the result of marital-family therapy, but that this figure is exactly comparable to the deterioration rate reported within individual psychotherapy.…”