Clinical teams reflect family dysfunction

Abstract

Therapists frequently have strong negative reactions to their patients. The view is put forward in this paper that such reactions may be harmful to patients if they are not acknowledged. However, when we, as therapists, are able to recognize our own reactions, they could prove to be a valuable source of information about those people we are trying to help. Three cases are described in which clinical teams behaved in negative ways towards families, who, as a result, did not receive the appropriate treatment. These descriptions are an attempt to show how t h e teams' behaviour mimicked that of the family. It is suggested, firstly, that these reactions should be recognized so they cannot hinder treatment and, secondly, that they be used as a source of information about the interaction within the family. This phenomenon of reflecting family dysfunction may, if properly approached, be of potential value to those who work in teams and deal with families.

Intregrating family therapy into in‐patient paediatric settings: a model

“…The aim of reconvening the meeting, besides imparting information, is to ensure that the team continues to have a shared view of the problem and way forward. As was found in the R family, it is not unusual for Family therapy in paediatric settings 22 1 splits to develop in teams, which can mirror the processes occurring in the family (Berkowitz and Leff, 1984). The meeting allows for tensions between professionals to surface, be recognized and worked through.…”

“…With reference to the ward team, we felt that splits were occurring over how John should be managed, owing to differing perceptions of the aetiology to the problem. These splits appeared to be undermining any effective intervention and we hypothesized that this could be the result of the team reflecting dysfunctions within the family (Berkowitz and Leff, 1984). The involvement of the ward psychologist (A.M.J.)…”

Family therapy with ‘invisible families’

“…In this context counter-transference reactions on the part of the network are likely to reproduce the dynamics of the original family relationships. Berkowitz & Leff (1984) described the power and concreteness of these unconscious influences and the importance of being able to understand and cope with them if the professionals are to be effective.…”

“…3. As a method of exploring how the deficiencies of the professional network can sometimes exacerbate the placement difficulties (Berkowitz & Leff, 1984) Our professional setting is an out-patient based NHS Child Psychiatric Clinic with a long-standing, stable, multidisciplinary team from a variety of professional and theoretical backgrounds. Over many years we have developed a shared way of working which amalgamates psychoanalytic ideas with family therapy concepts.…”

Rapprochement in Sight? Postmodern Family Therapy and Psychoanalysis

“…Exceptions include those papers already mentioned and a few others such as Berkowitz and Leff (1984), who have focused on the reactions of clinical teams to families and emphasized the value of these reactions as providers of information about relationships in the family. This is in similar vein to Palazzoli et al (1978Palazzoli et al ( , 1980 and to Cecchin (1987), who have suggested that how the therapist 'feels' provides information not only about the family but more particularly about the therapist-family relationship.…”