Steinhauer P D, Tisdall G W
Can J Psychiatry. 1984 Mar;29(2):89-97. doi: 10.1177/070674378402900203.
For almost thirty years after the development of family therapy, the concurrent use of family and individual psychotherapy was seen as incompatible by leading proponents of each modality. Although recently the literature has revealed an increased willingness to utilize family and individual therapies concurrently, the decision for or against any such combination has been left largely to the intuition or bias of the individual clinician. This paper suggests the concurrent use of family and individual psychotherapies when disturbances of family structure and interaction co-exist with, reinforce, and are maintained by largely ego- syntonic internalized psychopathology (that is, the character defences of individual family members). It provides a rationale for integrating the concurrent therapies, and uses clinical examples to illustrate how each can potentiate the other. There is a discussion of indications and contraindications for the integrated use of concurrent family and individual therapy. From their attempts to apply these principles, the authors conclude that the experience for the family, the individual and the therapists is that the selective and integrated use of concurrent family and individual therapies can achieve more than can either therapy alone--the whole is greater than the sum of the parts.
在家庭治疗发展后的近三十年里,家庭治疗和个体心理治疗的同时使用被每种治疗方式的主要支持者视为不相容。尽管最近的文献显示出越来越愿意同时使用家庭治疗和个体治疗,但支持或反对任何此类组合的决定在很大程度上仍取决于个体临床医生的直觉或偏见。本文建议,当家庭结构和互动的紊乱与主要是自我和谐的内化精神病理学(即个体家庭成员的性格防御)共存、相互强化并由其维持时,同时使用家庭治疗和个体心理治疗。它为整合同时进行的治疗提供了理论依据,并使用临床实例来说明每种治疗如何增强另一种治疗的效果。文中讨论了同时进行家庭治疗和个体治疗综合使用的适应症和禁忌症。通过尝试应用这些原则,作者得出结论,对于家庭、个体和治疗师而言,同时进行家庭治疗和个体治疗的选择性和综合性使用所能取得的效果超过单独使用任何一种治疗——整体大于部分之和。