Prelude In spite of its novel and progressive origins during the mid-20th century, family therapy tends to be fairly conservative. Understanding that psychotherapy generally has very few absolutes, which themselves are hallmarks of conservatism, the school “tends toward” rather than “ is always”. Conceptually, the basic approach leans more toward the adaptivity model than the … Continue reading #40 – LEARNING AND EXPERIENCE Re: #38, 39


Loss and escalating tensions in the context of divorce can create potent emotional reactions. The venerable Holmes Scale lists divorce and prolonged separation from a mate # 2 and #3 on the scale’s 43 identified adult stressors, following only the death of a spouse. For children, an exacerbated insecurity at some point can merge into … Continue reading #38 – HARD CASES – INTRO AND TWO VIGNETTES

#37 – Holding At Bay – Analysis and Comments

The therapies for these three cases had a few basic similarities. They were all relatively long, each being more than thirty sessions and lasting more than eighteen months. The anxiety and depression symptoms were largely resolved. The clinical processes all began with conjoint formats that included their siblings, and moved into split-session formats where the … Continue reading #37 – Holding At Bay – Analysis and Comments


Continuing the examination of cases involving divorced parents where at least one within the couple appeared to have Axis II issues, in these three situations the contentiousness over child care continued well beyond the divorce itself. The inter-parent struggles involved custody, child support, living arrangements, educational decisions, and/or healthcare authorizations that included those for mental … Continue reading #36 – HOLDING AT BAY – THREE VIGNETTES


Note:   As a reminder, systematically analyzing the impacts and case management considerations of parental Axis II defense mechanisms occurred recently and not during the practice itself. An awareness of the general problem in each case was certainly there at the time of treatment, and decisions were made during case management in their regard. Nevertheless, … Continue reading #35 – WORKING THRU ADULT AXIS II INVOLVEMENTS

#34 – Working Through Adult Defenses – Introduction

Introduction A major thrust of family therapy processes that treat youth mental health problem(s) is the use of the parents as therapeutic surrogates. In essence, the therapist enables the parents to effect and maintain changes for the child via three basic influencers. They include psycho-educational information, conditioning, and modeling. The educational component includes any information … Continue reading #34 – Working Through Adult Defenses – Introduction


Note:  Just as a forewarning, this is a particularly long post with a considerable amount of practical practice content concerning a complicated topic, so please take your time. In a paper summarizing research psychologist Stanton Samenow’s work on conduct disorder, my colleague and a psychologist himself, Dr. Steven Taylor, wrote that the diagnostic term ‘Conduct … Continue reading # 33 – CONDUCT DISORDER(S)

#32 – TRAITS – Part 2

More Intractable Traits Note:  The following ten traits seemed more inured to change as a function of common therapy, at least in my experience. Coincidently, they are equally divided between the three DSM groupings of the ten personality disorders. Colloquially and in order, they have been known as the Immature, Anxious, and Odd personality disorders. … Continue reading #32 – TRAITS – Part 2

#31 – Working With Traits, Part 1

Introduction This post presents an example of integrating a new tool or paradigm into an existing process or structure. As indicated in the previous post, the development of the relatedness trait list occurred over the last few months of the practice, during the inception period of the outcome study. The compilation of adult Axis II … Continue reading #31 – Working With Traits, Part 1