APA Book Notes
"The therapy brought to life in these pages is decidedly not magical," writes Evan Imber-Black, PhD, director of the Center for Families and Health at the Ackerman Institute for the Family, about the recently published "Casebook for Integrating Family Therapy: An Ecosystemic Approach."
That's not to say the cases described aren't illustrative, educational or unique. More importantly, says Imber-Black, they're decidedly real: "The family stories in this casebook help the reader to connect with the nonlinear progression, the fits and starts of real therapy," she notes.
The book, a companion casebook to the already popular volume, "Integrating Family Therapy," illustrates in-depth the principles of ecosystemic theories described in the first book.
"It makes the process of ecosystemic therapy transparent," says Susan H. McDaniel, PhD, one of the editors.
The book features more than 30 cases, using different models and illustrating seven broad categories--couples; families in transition; culture, religion, social class and ethnicity; gender; physical illness; serious mental illness; and supervision. But despite the many models used, all cases are bound together by the therapists' ecosystemic perspective while working with families.
"Like family therapy, ecosystemic therapy is more an attitude than a technique of therapy," say editors McDaniel, Don-David Lusterman, PhD, and Carol L. Philpot, PhD. According to McDaniel, ecosystemic therapy begins with the systems focus of family therapy and "extends it to include the effects of health, behavior and relationships with larger systems such as work systems, health-care systems, social systems and large group factors like gender, religion, ethnicity and culture."
Ecosystemic therapists recognize that individuals are part of many systems and take into account the possible relevance of each system to another as well as to the patients' presenting problem. This recognition could mean collaborating with physicians or social services, for example, or bringing more people into the therapy room.
"Ecosystemic therapy is not simply a way of doing therapy, but foremost a way of thinking about human beings, their systems, their pain and their triumphs," says Imber-Black. And ecosystemic therapy is rooted in the positive belief that families and individuals are competent--the job of the practitioner is to understand the individual, the family and the larger systems that may create barriers, or bridges, to that competency.
Throughout the book, authors represent how larger issues are central to the therapeutic process. Jaime Inclan, PhD, shares how immigration, culture and socialization have profound impacts on family functioning. He describes his work with the Gonzalez family--and other families--and their struggles to build bridges between their Puerto Rican and American values, and recounts his own story of immigration from Puerto Rico to the United States to attend school.
"Perhaps nowhere is the ecosystemic model of family intervention more relevant than in cases of physical illness, where multiple systems are, by the very nature of the problem, involved," the editors write. Seven chapters illustrate the creative ways in which practitioners work with these systems to help patients and families adjust to very different illnesses and how these illnesses affect family or couple life in different stages. Anne E. Kazak, PhD, describes the treatment of a couple with two young children, one who had just been successfully treated for cancer. Thomas C. Todd, PhD, shares his work with a family in which an adolescent diabetic girl has developed an eating disorder. And David B. Seaburn describes couples work with a chronic-pain patient.
Perhaps the most important aspect of the casebook, according to McDaniel, is its inclusion of each author's thinking and decision-making in relation to each case.
"Somehow now, reading a case without understanding who the therapist really is feels quite incomplete to me," adds McDaniel.