TRANSGENERATIONAL THEORIES OF FAMILY THERAPY

(1)

Journal of Marital and Family Therapy 1993, Vol. 19, NO. 3,253-266

BASIC FAMILY THERAPY SKILLS, IV:

TRANSGENERATIONAL THEORIES OF FAMILY THERAPY

Thorana S. Nelson Gabriella Heilbrun Utah State University Purdue University

Charles R. Figley Florida State University

This paper focuses on the basic skills and competencies of transgenerational approaches to family therapy, the fourth report of a program of research surveys by the Basic Family Therapy Skills Project. In the first survey, a panel of family therapy educators listed the most critical or basic skills or competencies of begin- ning family therapists with a transgenerational orientation. In the third survey, self- selected respondents rated these items according to degree of importance for beginning family therapists. Rankings of the items according to mean scores of the Likert responses indicate that transgenerational family therapy skills are founded in theory and can be identified behaviorally. The most important skills are those that use the self of the therapist to understand and utilize transgenerational family therapy skills for both therapist and clients. Also listed are skills that many raters deemed “generic ’’ rather than specifically related to transgenerational family therapy. Other findings and their implications for the future training of family therapists are discussed. Although the paper is intended for family therapy edu- cators interested in their colleagues’ ideas about critical skills in trans-genera- tional family therapy, theorists and clinicians may also find it useful.

INTRODUCTION

Transgenerational theories of family therapy are typically associated with the works of Murray Bowen (Bowen, 1978), Ivan Boszormenyi-Nagy (e.g., Boszormenyi-Nagy &

Krasner, 1986), James Framo (Framo, 1982), and Don Williamson (e.g., Williamson, 1981).

Family therapy texts include these approaches among the major family therapy theories.

These theorists use the terms transgenerational, intergenerational, and multigenerational as well as family systems theory to classify their theories, each term having its own particular

Thorana S. Nelson, PhD, is Associate Professor of Family and Human Development and Director Gabriella Heilbrun is a doctoral student in Family Studies, Purdue University, 1269 Family Charles R. Figley, PhD, is Professor of Family Therapy, School of Social Work, and Director,

of the Marriage and Family Therapy Program, Utah State University, Logan, UT 84322-2905.

Research Institute, West Lafayette, IN 47907.

Interdivisional PhD Program in Marriage and Family Therapy, M l T Clinic, Sandels Building, Florida State University, Tallahassee, FL 30306-2033.

July 1993 JOURNAL OF UARITAL AND FAMILY THERAPY 253

(2)

connotation. While we claim no prejudice, for the purposes of this paper, the term trans- generational is used. Family therapy texts are often unclear as to the methods for translating transgenerational theory into practice. Behavioral skills are not always evident or easily inferred from the abstract concepts of the theories.

Transgenerational models of family therapy are similar in that they (a) value historical information, @) believe in the influence of the past on the present (and the future), and (c) strive to accomplish more than simple symptom reduction. These approaches are systemic in that they conceptualize emotional pain as arising out of interactional, human systems, primarily families of origin. Psychic dynamics dwell within the context of interactions, relationships, and myths (value and belief systems). These models focus on family-of-origin and transgenerational dynamics as the unit of analysis. The models differ in the particular lan- guage used (e.g., loyalties, personal authority, or differentiation) and the particular clients seen in therapy (an individual, a family, or subsets of a family). But how do the transgenerational family therapy approaches translate to actual training? More specifically, what are the basic, fundamental skills or competencies of those who practice this approach?

Transgenerational Family Therapy Skills

According to the Manual on Accreditation (Commission on Accreditation for Marriage and Family Therapy Education [COAMFTE]; 1988), students in

AAMFT

accredited programs are expected to begin seeing clients early in their programs. For many students, particularly those with no prior counseling experience, this can be a highly stressful situation.

From the perspective of Bowen’s (1978) theory, the ensuing anxiety and emotional intensity can inhibit thinking and thus diminish therapy for both the clients and the therapist. Bowen (1978) stresses that intervention emanates primarily from the differentiated, calm therapist rather than from technique. This requires a focus on the self of the therapist as a crucial com- ponent of training. Students attracted to the concepts of transgenerational therapy do not always wish to wait for their self-work to be complete before using the ideas with clients;

simultaneous self-work and therapy training could enhance both processes. Therefore, an understanding of some of the basic skills and competencies of transgenerational family therapy, empirically derived, could be used to guide the training and self-exploration of beginning family therapists. The skills could also serve as valuable markers when assessing trainees for their readiness to advance as therapists or as evidence that they need more training or self- work. In addition, if research is to uncover some of the truths of transgenerational therapy, abstract as they are, we must have operational definitions of the skills used in therapy. Iden- tification of the skills associated with transgenerational therapy will assist in both outcome and process research.

The Basic Family Therapy Skills Project

The Basic Family Therapy Skills Project (BFTS) was established in 1987 to begin the process of meeting the need for an empirically identified set of basic skills for beginningfam- ily therapists (Figley & Nelson, 1989). We recruited a large group of experienced family therapy educators to identify and rate a set of basic skills. By first identifying the skills through the eyes of those who teach and practice them and, with their help, reducing the list to the most essential, the list can then be used simultaneously in research on effective therapy and in training. Through a recursive process, the list can then be modified over time with additional study and application experiences.

254 JOURNAL OF MARITAL AND FAMILY THERAPY July 1993

(3)

METHODOLOGY Sample

Participants were recruited from two lists that, together, represented an identifiable group of experienced professional educators in the field of family therapy: AAMFTApproved Supervisors and AFTA members. Lists of 1234 Approved Supervisors and 903 AFTA members were obtained in late 1987. After reducing the lists by 245 to remove duplications, invitations were sent to 1892 potential participants. The invitations outlined the purpose of the study and the criteria for participation (willingness to respond to the surveys and recent experience with beginning level trainees). A total of 744 (39%) invitations were returned, many indicating that the respondent was not eligible or able to participate in the study. A final list of 688 (36% of original 1892) volunteers was included in the study. The criteria for inclusion in the study were strict. This reduced the eligible pool considerably since many supervisors work with trainees after they have finished graduate school and their initial experiences with families in therapy. The number of

AAMFT

Approved Supervisors and AFTAmembers who were not eligible or who were eligible and did not respond is not known.

However, we make no claims that this is a random or representative sample. Our purpose was to generate a useful list of basic skills. Therefore, we considered the 688 respondents to be our sampling pool for identifying the most salient skills.

A series of survey questionnaires was sent to the study participants. The first survey, conducted in early 1988, requested the respondents’ demographic information and nominations of both generic (theory-free) and theory-specific family therapy skills essential for beginning family therapists, that is, the important entry level skills. Volunteers were in- formed that they would be requested to respond to several questionnaires in what could be considered a modified Delphi study (Dalkey, 1969). In such a study, exploratory in nature with limited generalizability, qualitative rather than quantitative results are the initial focus.

To receive qualitative data from such a large number of respondents is both a blessing and a curse. On the one hand, researchers can be more confident that data are comprehensive and representative of a field. On the other hand, temptations to quantify the results and do fine- grained analyses with concomitant conclusions are overwhelming. Such was the nature of this study. The reader is cautioned regarding the accuracy of such conclusions as generalizable to family therapy educators as a whole. Although we can assume that members of the professional organizations used in this study are, perhaps, the most serious educators, interested enough in marriage and family therapy education to respond faithfully to our frequent and lengthy questionnaires, we all know what assumptions are. We hope that we are not so grandiose as to think that our study was intriguing enough to attract all interested people. A total of 429 (62%) completed questionnaires were returned, a very satisfying response.

Nominated Items

The response rate amazed us given the length of the questionnaire. It also resulted in an overwhelming number of nominated items (frequently, a dozen or more per questionnaire).

It was clear to us that there was considerable overlap and redundancy. We therefore decided upon a qualitative method for determining a reasonable number of skills that would later be rated by the panel according to degree of importance for entry-level therapists. By using items nominated by those who identified themselves as primarily teachers/supervisors (rather than clinicians who supervise), we hoped to include the most salient and important

July 1993 JOURNAL OF MARITAL AND FAMILY THERAPY 255

(4)

skills. Items were sorted for both generic and theory-specific skills nominated by 208 respondents who indicated their primary occupation as teacherhrainer. Each respondent also indicated a primary theoretical orientation for his/her own clinical practice, allowing us further to validate the theory-specific items.

After sorting the theory nominations from the first survey, 77 skills emerged that were identified by the transgenerational nominators as primarily related to transgenerational family therapy. Many items emerged that could be considered personal attributes rather than behavioral skills. Although this did not meet with our initial conceptualizations or purposes, it did fit within the conceptualizations of the theories. We did not define “essential” or “basic”

for our volunteers, wanting to give them as much freedom to respond as possible. We con- jectured that many respondents nominated skills or traits that represented deficits or super- visee behaviors that had recently been frustrating for them. Others may have been more theoretically minded while they were nominating the items. In all cases, we wanted thepaneE to tell us what was most important for beginning level family therapists. Our theoretical biases (structural/strategic/transgenerational and behavioral) also flavored the selection and wording of items.

As

much as possible, however, we attempted to reduce such bias by using the wordings of the nominators rather than attempting to interpret, extrapolate, or infer meaning.

The second survey requested ratings for generic family therapy skills. For the third survey, the 688 original volunteers were asked to choose the theory-specific skills they would like to rate as appropriate for beginning family therapists. They were given choices of structural, strategic (Haley, MRI, Milan), StructuraVstrategic, brief, behavioral, cognitive behavioral, functional, experiential, communications, social learning, educational, psychodynamic/

object relations, and transgenerational (Bowen, Framo, Nagy) family therapies. Bowen, Framo, and Nagy were suggested since they are the basic transgenerational theorists discussed in major family therapy texts. This was in no way meant to slight eminent theorists Don Williamson and Norman Paul. Many respondents chose more than one set of items to rate.

The results of the ratings for the generic skills have been reported elsewhere (Figley &

Nelson, 1989). The results of analyses of data received related to structural family therapy (Figley & Nelson, 1990) and strategic and brief family therapies (Nelson & Figley, 1990) have likewise been reported.

Transgenerational Family Therapy Sample Description

A total of 221 respondents requested the 77-item transgenerational survey; 112 (51%) returned the survey and 103 (47%) were complete enough for analyses. Again, the response rate pleased us. The questionnaires were lengthy and a number of people requested all 13 theories, a daunting package indeed, perhaps leading to decisions not to return them. Demo- graphic information about the respondents is found in Table 1. The mean age of the sample was 46.2, half of whom were males. The sample was overwhelmingly white (95%). The degree most represented was the PhD (44.1%). Most of the sample (55.3%) identified themselves as primarily family therapists, with social workers and psychologists having substan- tial representation. Nearly one half of the sample (48.6%) indicated their primary professional identification as teacher/trainer/supervisor. A total of 27.5% of the respondents identified themselves as using a primarily transgenerational orientation in their clinical practices. Many others, however, included transgenerational family therapy as part of an integration of models.

256 JOURNAL OF M4RiT.M AND FAMILY THERAPY July 1993

(5)

Table 1

Transgenerational Family Therapy Demographic Description of Respondents

N

^{= 103)}

Frequency %

Sex Male Female Missing Caucasian Black Hispanic Other Missing Highest degree

PhD MSW Master’s

Other Doctorates MD

MFT Missing Family therapist Social worker Psychologist Minister

Counseling psychologist Psychiatrist

Professional counselor Nurse

Other Missing Teacherttrained

supervisor Clinical practitioner Administrator Researcher Other Missing Ethnicity

Primary professional identity

Primary occupation

Theories

Transgenerational Other

Missing

51 51 1 97

1 1 3 1 45 25 13 14 4 1 1 57 13 12 4 3 2 2 1 7 2

49 47 3 1 1 1

45 38 20

50.0 50.0

95.1 1

.o

1.0 2.9

44.1 24.5 12.7 13.7 3.9 1.0

55.3 12.6 11.7

3.9 2.9 1.9 1.9 1

.o

6.8 1.9

48.0 46.1 2.9 1.0 1

.o

44.0 37.0 19.0

-

July 1993 JOURNAL OF MARITAL AND FMILY THERAPY 257

(6)

Ratings ’ Process

Respondents were asked to rate each item in terms of its importance on a 1-5 Likert scale, 1 being very important as a transgenerational technique for beginning family therapists and 5 being very unimportant as a transgenerational technique. In addition to the Likert responses 1 through 5, respondents were given alternative choices: (6) “inappropriate transgenerational skill for a beginning therapist,” (7) “appropriate for a beginning therapist, but as a generic skill (not a transgenerational skill),” (8) “inappropriate for family therapy,” and (9) “don’t know what this means.” This last option was necessary since responses to our initial survey of generic skills indicated that many respondents had not clearly understood their colleagues’

nominations.

RESULTS Qualifications of the Sample

While it would have been better to have an exclusive sample of transgenerational therapists, one half of the sample was composed of participants who were primarily teachers/

trainers of family therapy. Thus, it could be legitimately hypothesized that these family therapy educators were familiar with transgenerational family therapy concepts and issues in teaching beginning-level therapists. This was so, even though they may not use this approach as their primary clinical orientation.

To test this hypothesis, chi-square analyses of all questionnaire items were performed.

A nonparametric test was chosen since part of the data responses were categorical. We wanted to be sure that the groups (transgenerationally oriented therapists vs. other-oriented therapists) were not judged similar if they were indeed dissimilar, and so we took a conservative approach to the analyses. If 15% or more of the items were responded to differently at the p < .05 level, we would reject the hypothesis of similarity. The two groups were different at thep < .05 level for only 6 of the 77 items on the survey. Since this was less than 8% of the items, we believed it was due to chance. Items were then compared with the nominations of the remainder of the sample (non-teacher/trainers); this check revealed that the items nominated by the teacherbrainers were indeed complete and representative of those of the entire sample. Thus, the two groups were combined for further analysis.

Analyses

After examination for evenness of distribution of response choices, data were analyzed to determine the mean ratings for each of the 77 nominated skills using the Likert scale responses. Since response 3 of the Likert scale indicated indecision rather than importance, this response was removed from the Likert-scale analyses and included in a frequencies tabulation with choices 6 through 9. Thus choices 4 and 5 were recoded and means computed for the new four choices. The items were then rank ordered according to mean ratings. Table 2 lists the rank-ordered items that received Likert responses from at least 75% of the sample, their means and standard deviations, and tabulations for alternatives that received more than 10 preferences. The numbers listed in the “W column refer to the total number of respondents who answered one of the four choices on the Likert scale. Items for which at least one fourth of the sample selected an alternative response rather than one of the four choices of the Likert scale are listed in Table 3 along with tabulations of the alternatives. (Rankings are the originals rather than renumbered for each table.) We suggest caution in interpreting the

258 JOURNAL OF MARITAL AND FAMILY THERAPY July 1993

(7)

rankings of items receiving Likert responses from fewer than 75 respondents (approximately three fourths of the sample).

Table 2

Transgenerational Family Therapy Skills Rank ^Ordered Means, Standard Deviations

Items receiving Likert responses from >3/4 of the Sample Tabulations of non-Likert Responses

Likert Responses

1 - very important as a transgenerational technique for beginners 2

-

somewhat important as a transgenerational technique 3

-

unimportant as a transgenerational technique

4 - very unimportant as a transgenerational technique for beginners Alternative Responses

Inappropriate transgenerational skill for a beginning therapist

Appropriate for a beginning therapist, but as a generic skill (not a transgenerational skill) Inappropriate for family therapy

Don’t know what this means

2 3 4 7

8 9 10 13 15 16 17 18

20

Understand own family of origin Recognize triangled relationships Awareness of own issues

n(generic skill) = 26

Helping clients focus on change in self vs. changing others

Ability to stay out of triangles n(generic skill) = 14

Utilize historical data Do genograms

Assist with detriangulation Clarify client’s personal sense of responsibility with family of origin Define relationships in the family n(generic skill) = 6

A basic ability to take an I-position n(generic skill) = 25

Keep boundaries clear between client and therapist

Coach clients in changing behaviors with family-of-origin members

99 105 80 87

92 100 98 100 97 87 82 79

98

1.22 1.23 1.26 1.33

1.35 1.36 1.37 1.41 1.42 1.42 1.43 1.43

1.46 Original

Rank Item N ^Mean

SD

July 1993 JOcrRNAL OF ^MARITALAND ^FAMILYTHERAPY

.49 .46 .59

.58

.54 .63 .71 .62 .63 .64 .86 .67

.73

259

(8)

Original

Rank Item

N

^Mean SD

21 23 24 25 27 28 29 30 31 32 33 35 36

37 40 41 42 45 46 48 49 50 51 53 55 56 58 60

Take extended family history Clarify relationships in family n(generic skill) = 18

Assess family loyalties

Motivate family members to work on their families of origin

Pinpoint transgenerational conflict Use family of origin to assist clients in differentiating

Assess individual differentiation Flexibility in separating from family n(generic skill) = 14

Assign tasks aimed at differentiation Comfortable with consulting rather than

“expert” role n(generic skill) = 21

Interpret past relationship to present behavior Willingness to include expanded systems Ask questions around redundancies of interactional patterns

Verbally distinguish between emotional and intellectual systems

n(generic skill) = 16 Do not keep family secrets n(generic skill) = 15

Join with each family member n(generic skill) = 26

Reframe

Develop transgenerational homework tasks Anticipate reactions to clients’ changes n(genenc skill) = 25

Psychoeducation for coping with emotional challenges of family of origin

Interrupt patterns n(generic skill) = 22

Desensitize family to past events Role-model

Assign tasks aimed at unresolved grief Use of insights

Defocus intense feelings during sessions Use position reversals

n(inappropriate for beginners) = 16 Knowledge of structural theory n(generic skill) = 14

95 1.49

83 1.52

96 1.53

105 1.55

99 1.57

98 1.57

95 1.58

77 1.65

103 1.65

75 1.68

98 1.70

97 1.75

86 1.76

90 1.80

79 1.91

78 1.92

82 1.94

96 2.02

76 2.03

84 2.07

79 2.08

77 2.08

77 2.10

92 2.12

79 2.19

75 2.28

95 2.34

.89 .63 .75 .83 .77 .96 .88 .70 .81 .90 .95 -87 .99 .96 .94 1.18 1.02 1.04 1.01

1.05 1.08 .96 1.08 1.07 1.09 1.19 1.07 1.10

260 JOURNAL OF ^MARITALAND ^FAMIL.Y THERAPY ^July¹⁹⁹³

(9)

Original

Rank Item N ^Mean ^SD

62 Get family members present for therapy 63 Understanding of object relations theory

64 Expedite discussion of strong emotional feelings

66 Reconstruct the “child within” from family- of-origin information

67 Teaching skills n(generic skill) = 19 72 Sculpt

n(inappropriate for beginners) = 11 75 Prescribe rituals

n(inappropriate for beginners) = 16 77 Work as a team in cotherapy

~

94 89 79

2.37 1.23

2.38 1.15

2.39 1.22

84 77 84 79 77

2.45 1.25

2.45 1.14

2.79 1.24

3.05 1.23

3.26 1.26

Table 3

Transgenerational Family Therapy Skills Items with fewer than 75 Likert Responses

n(Alternative)>20% of sample Means, Standard Deviations Tabulations of non-Likert Responses

Likert Responses

1

-

very important as a transgenerational technique for beginners 2 - somewhat important as a transgenerational technique 3

-

unimportant as a transgenerational technique

4

-

very unimportant as a transgenerational technique for beginners Alternative Responses

Inappropriate transgenerational skill for a beginning therapist Appropriate for a beginning therapist, but as a generic skill

(not a transgenerational skill) Inappropriate for family therapy Don’t know what this means

Original Likert Responses

Rank Item N ^Mean ^SD

1 Listen 49 1.10 .31

5 Respect integrity of family’s values 73 1.33 .62 n(generic skill) = 57

July 1993 JOURI?’ OF UARITAL AND FAMILY THERAPY 261

(10)

original

Rank Item

Likert Responses

N

^Mean ^SD

6 Observant

11 Transcend feelings of one right perspec n(generic skill) = 32

n(don’t know) = 11

12 Openness to consultative feedback n(generic skill) = 43

14 Begin to organize data n(generic skill) = 36 19 Self-observation

22 Aware of others’ emotional states n(generic skill) = 38

26 Empathy

34 Bringing the session to a close n(generic skill) = 69

38 Use of multidirectional partiality n(generic skill) = 57

39 Ability to integrate levels of theory n(generic skill) = 32

43 Willingness to allow silence n(generic skill) = 46

44 Assess alcohol-related problems n(generic skill) = 48

47 Restrain advice giving n(generic skill) = 3 1

52 When in doubt, don’t [do something]

n(generic skill) = 35 54 Deal with resistance n(generic skill) = 37 57 Goalsetting

n(generic skill) = 40 59 Set a general contract n(generic skill) = 37 61 Process countertransference

65 Capacity for imaginary alternatives n(generic skill) = 26

68 Manners

n(generic skill) = 37 69 Noninstrumentality

n(generic skill) = 75 70 Comfortable with play

60 :tive 59

61 70 48 64 57 41 39 66 58 54 66 35 65 67 68 65 72 38 26 69

1.33 1.39

1.39 1.41 1.44 1.5 1.56 1.71 1.9 1.91 2.02 2.02 2.03 2.11 2.14 2.19 2.32 2.34 2.44 2.55 2.65 2.67

262 JOURNAL OF UARITAL AND FAMILY THERAPY

.51 .59

.56

.69 .68 .71 .91 .64 1.1

.91 1.16 1.14 1.09 30 1.13 1.20 1.10 1.24 1.15 1.20 1.02 1.32

July 1993

(11)

Original

Rank Item

Likert Responses

N ^Mean - SD

71

73 74

76

Organize symbolic experiences which resolve 69 2.78 1.23 past traumas

Create metaphors 72 2.83 1.32

Use abstract formulations with supervisor 48 2.90 1.24 n(generic skill) = 19

n(don’t know) = 24 n(generic skill) = 25

Capacity for fantasy 71 3.06 1.21

DISCUSSION Theory-based Skills

The results of this study appear to be consistent with established theory. Twenty-three of the items were clearly related to transgenerational theory, using terms such as dem%nguZution, family loyalties, and object relations. Sixteen of these were ranked among the top 25 items listed in Table 2. The most important skill listed in Table 2 was “Understand own family of origin;” “Awareness of ownissues” was ranked third. This is in keeping with transgenerational theories, which emphasize the therapist’s understanding of hisher own self. It also highlights the opinion of the sample that the self of the therapist is important, not simply the behavior (e.g., “joining”).

Four of the items in Table 2 related to issues of the therapist’s self, and all of them were in the top 25 ranked items receiving Likert ratings from more than three fourths of the sample.

Similarly, many of the items were skill-oriented, but with theory as context. For example,

“Assign tasks aimed at unresolved grief,” and “Helping clients focus on change in self vs.

changing others” have transgenerational theoretical foundations. Differentiation of the therapist is crucial in transgenerational family therapy; therapists who get “hooked into their clients’ issues are likely to be ineffective. One item specifically addressed this issue: “Keep boundaries clear between client and therapist.”

Generic Transgenerational Skills

Many other highly rated skills were more general, such as “Role model” and “Clarify relationships in family” and are listed in Table 3. Interestingly, this survey results in fewer items related to personality characteristics than our previous surveys (Figley &Nelson, 1989, 1990; Nelson & Figley, 1990), particularly the generic survey (Figley & Nelson, 1989). Over 36% (n ⁼28) of the items were considered generic by more than one fourth of the sample.

This would suggest that generic skills used by transgenerational therapists are essential components of family therapy in general. From this list of nominated and ranked items, it appears that the client-therapist relationship with clear boundaries between a client and a therapist who is able to utilize the concepts of theory constitutes effective transgenerational therapy.

July 1993 JOURNAL OF ^MARITALAND FAMILY THERAPY 263

(12)

Behaviorally Based Skills

Given the abstract nature of transgenerational concepts, it is quite interesting that so many items related to theory translate into behavioral skills. It is generally thought that transgenerational therapy flows from the differentiated, calm therapist and these characteristics are not easily operationalized. Therapists who have trained primarily in these models are very clear themselves about what they do in therapy; their skills are evident to them. Graduate students in academic programs, however, often complain about the lack of clinical material in transgenerational literature. This survey indicates that beginning family therapists can indeed be introduced to clear (though theory-grounded) therapeutic skills.

Implications

Previously published analyses of structural, strategic, and brief family therapy (Figley

& Nelson, 1990; Nelson & Figley, 1990) indicate that, for those theories, personality characteristics and in-therapy behaviors are critical for beginning family therapists. The results of the current analysis, in contrast, suggest several differences:

(1) attention to the self of the therapist is central;

(2) attention to the therapist’s family-of-origin dynamics and how they relate to therapy is critical for transgenerational family therapists; and

(3) attention to clearly theoretical concepts, the dynamics of therapy processes that exemplify them, and the techniques that flow from them is important.

The translation of transgenerational family therapy into practice appears, from these data, to be more possible than is often inferred from family therapy texts: many behavioral skills emerged. While the panel nominated, rated, and effectively ranked transgenerational skills, at the same time they opened the world of empirical research onto thepractice of transgenerational family therapy. We now have a list of behaviors that can be defied. Training therapistscanbevideotaped and theirbehaviorscoded accordingto thislist. Transgenerational therapy emanates from the center of the therapists and from theory. The results of this study indicate that transgenerational skills can be taught to and learned by beginners. Training programs that integrate transgenerational therapies into their teaching and practice should find these results encouraging. And while certain theorists, for example, strategic and brief, may find these ideas dull, students of family theory many find them intriguing and be encouraged to dialogue about theory and theories.

The results of this research suggest that training programs would do well to ground their students in theory. Results also indicate, for those using transgenerational theories, that work on one’s own family is crucial. This is important for programs to consider since this work can take many forms. Bowen coaching, for example, is usually considered less “therapeutic”

than other forms of self-work. However, coaching is at least quasi-therapy; it uncovers personal issues and should be approached with caution within programs and kept separate from supervision of therapy. Most students of transgenerational theories, wishing to use the concepts in therapy, are open to and often eager for their own family-of-origin work. Others, however, may be more interested in using the ideas as an adjunct to other models.

The list generated in this study does not give the field very much in terms of operational definitions of transgenerational theoretical concepts. For example, “assign tasks aimed at differentiation” assumes that the therapist already knows ^{about and}^canrecognize diff‘eren- tiation. In some ways, this list seems more appropriate for intermediate than for beginning family therapists who attend to their own family-of-origin work before conducting therapy.

“Clarifying relationships” is a good thing to do. It is probably a complex skill, however, and

264 JOURNAL OF MARITAL AND FAMILY THERAPY July 1993

(13)

deserves examination for splitting into learnable pieces. Others (e.g., Bray, Williamson, &

Malone, 1984; Hovestadt, Anderson, Piercy, Fine, & Cochran, 1985) have worked on defin- ing these concepts and their validation in the theories as well as researching their usefulness in family therapy. This study, however, has produced a list of therapeutic skills. We leave it to future studies to refine and further validate it.

Limitations

Nominators of the items in this survey were chosen from those who qualified as family therapy educators and supervisors, only a portion of whom are primarily practicing clini- cians. It is possible that those who were primarily clinicians would have nominated items that were more relationship oriented; educators may be more attuned to theoretical and tech- nical issues of transgenerational theories. However, these are our supervising colleagues who are entrusted with educating future family therapists. Thus, they should be familiar with concepts and issues of the conduct of therapy. Additionally, they chose to nominate and rate skills related to transgenerational theories, and thus one could infer they have knowledge and interest in such skills.

Respondents who rated the items, contributing to the mean rankings listed in Tables 2 and 3, were self-selected. Of the original 1892 invited to participate in the project, 1463 did not respond; 1204 of them were either not eligible for the study or chose not to participate.

Since this study’s purpose was to generate an initial list of skills, not produce a finely tuned measurement instrument, those who were eligible and responded were deemed the sampling pool. The preponderance of doctoral degree holders (57.8%) represented in the sample indicates that this group perhaps has studied theory and theories rather extensively. Approxi- mately half were primarily teacherbrainers and half primarily clinicians. This indicates a balance which might not be representative of the field of family therapy in general. The findings, however, provide a consensus view of a group of highly committed professionals interested in contributing to the research and education of beginning family therapists. Had this list resulted from random sampling of clinicians as well as supervisors, it would be more generalizable to transgenerational therapy. The purpose of this study, however, was to generate empirically a list of skills useful for teachers and trainers of beginning family therapists.

It is hoped that, after operationalizing these skills and devising ways of evaluating them, a random sample of clinicians as well as educators can be used to test their validity.

In conclusion, initial steps at empirically determining skills for such a diverse field are flawed. We believe, however, that our findings provide important directions for both educators and research and some interesting insights for practitioners.

REFERENCES

Boszormenyi-Nag, I., & Krasner, B. R. (1986). Between give and take. New York Brunner/Mazel.

Bowen, M. (1978). Family therapy in clinicalpractice. New York Aronson.

Bray, J. H., Williamson, D. S., & Malone, P. E. (1984). Personal authority in the family system:

Development of a questionnaire to measure personal authority in intergenerational processes.

Journal of Marital and Family Therapy , l o , 167-178.

Commission on Accreditation for Marriage and Family Therapy Education. (1988). Manual on accreditation (rev. ed.). Washington, D C American Association for Marriage and Family Therapy.

Dakey, N. (1969). The Delphi method: An experinrental study of group opinion. Santa Monica, CA:

July 1993 JOURNAL ^OF^MARITALAND FAMILY THERAPY 265

(14)

RAND Corporation.

findings. Journal of Marital and Family Therapy, 15,349-365.

of Marital and Family Therapy, 16,225-239.

Figley, C. R., ^&Nelson, T. S. (1989). Basic family therapy skills, I: Conceptualization and initial Figley, C. R., &Nelson, T. S. (1990). Basic family therapy skills, 11: Structural family therapy. Journal Framo, J. (1982). Elcplorations in marital and family therapy. New York Guilford.

Hovestadt, A., Anderson, W., Piercy, F., ^Fine,^M.,^&Cochran, S. (1985). A family-of-origin scale.

Journal of Marital and Family Therapy, 11,287-298.

Nelson, T. S., & Figley, C. R.(1990). Basic family therapy skills, 111: Brief and strategic schools of family therapy. Journal of Family Psychology, 4,49-62.

Williamson, D. S. (1981). Personal authority via termination of the intergenerational hierarchical boundary: A"new" stage in the family life cycle. J o m l ufMarital andFamily Therapy, 7,441- 452.

Martin Rossman,

MD &

David Bresler,

PhD JULY 9- 1 I , 1993 ---PORTLAND,

OR

SEm 17-18,1993--- -%N FRANCISCO,

M ~ 8-

1 0, 1993---

u

WASHINGTON, Dc

m u m - 3 1 1993 ^_^-^I--ATLANTA, ^-^-GA ^-^-^-^-^-^-^-

+

Provides ropid, direct occess to unconscious process,

+

^Corn

+

Enhances ropport & empowers clients ond theropisk.

+

^{A deep?.}o k t i v e , richly ossociotive, experiential opprooch.

motivation & insight.

brieKropies.

tible with all therapeutic approoches, including

EARLY REGISTRATION FEE!

$1 95

(one month in odvonce)

16 CEU's Available Call for information about our annual

Hawaii conference.

November 28-Decemkr ^2,¹⁹⁹³ For more information call t h e

Academyfor Guided Imagery

(a

1 /800-726-2070 Ca

^Visionsof Health:

Mind/Body Medicine

Comer of

Age

266 JOURNAL OF MARITAL AND ^FAMILY^THERAPY ^{July 1993}