Sunday 15 April 2012

Post 15: Minuchin & Narrative - an interesting read


Expert taken from 'Where's the Family in Narrative Therapy' Journal of Marital and Family Therapy

Volume 24, Issue 4, pages 397–403, October 1998.



"Practitioners share a penchant for a therapy of questions, on the assumption that questions are more respectful of the patient’s own framework than are comments, interpretations, or prescriptions. The social concern for liberating people from the dominant discourses that marginalize them leads these therapists to minimize therapists’ statements of expertise - to taking a stance of “not knowing.” Paralleling the social constructionist acceptance of diversity and multiculturalism, their interventions are oriented toward increasing diversity in the internalized voices of the patients. Unfortunately, in my view, that focus decreases attention to the patterns of interaction presently being played out by family members. "

Minuchins view here is fundamentally that contemporary approaches are missing the interactions between family members. The title of the article leads me to question more about how family interactions are indeed considered in todays therapeutic culture.

As a framework, deconstructing beliefs and cultural constraints etc is a sound approach - yet in my view, practically more applicable in a quiet, reflexive, patient manner and not in a volatile risk covert home or clinic based situation.

Minuchin & Structural therapy weighs in with lots of ideas that 'reality' does not exist and instead clients should be walked to alternative patterns of thinking & behaving - nothing new in our contemporary approaches then.

My view is it is the job of the therapist to judge what is required. It seem heretic to apply just a hermeneutic approach to all clients. A therapist working with a client 'taking with out consent' or 'joyriding' on a weekly basis may find themselves judging that a family need re-balancing before being curious about what holds them to their beliefs.

Perhaps "first order" CHANGE has been lost as the second order and third order APPROACHES come in to play. Many will have been tempted to offer solutions based on their 'common sense' (..or considering family of origin, aspects of self, inner dialogue etc etc), yet careful not to direct their 'power' on to others. Having worked in services that value first order changes, I can vouch for richer conversations about experiences rather than fear of experiences,

Having just read part of a CMM article, I like the following piece.

"Practical theories are intended to inform patterns of practice that make life better and are judged according to the pragmatic criterion of utility as opposed to an epistemic criterion of truth "

Barge, K. Articulating CMM as Practical Theory. Human Systems: The Journal of Systemic Consultation & Management.Volume No 15, issue X, 2044

Contemporary approaches....or perhaps the students, practitioners and trainees of..... have seemed to move in to this 'not knowing' position which in itself seems to hint at a criterion of truth....."I cannot assume....I must seem curious...I do not understand their experience" for instance. Following the above musing by Barge, I am more comfortable than ever to work in a systemic way and use some counter cultural approaches to guide my work, whilst reflexively using my work to inform my approaches - surely one of the most important tenants of systemic practice.









 

Sunday 8 April 2012

Post 14: CMM basics

Having to start an assignment on CMM and read the Cronen and Pearce handbook on using CMM, along with an article by Bruss on using CMM to understand more on Obesity (Mozhdeh B. Bruss, Joseph R. Morris, Linda L. Dannison, Mark P. Orbe, Jackie A. Quitugua & Rosa T. Palacios (2005): Food, Culture, and Family: Exploring the Coordinated Management of Meaning Regarding Childhood Obesity, Health Communication, 18:2, 155-175).

So far I find it reasonable user friendly so far. In my place of work I am taught to observe a) The context of conversations b) the process within the room c) Content & language of the conversation. The order of these may vary as they come in to focus but by enlarge, I am focussed on context & process.

CMM seems to take suggest this approach to communication and encourages clinicians to observe the context of the conversation and messages there within. Hopefully many a Supervision on detailed analysis of my work (conversations context, process and language) has prepared me for the task of understanding CMM.

The next challenge seems to be how is this applied? Is it an over arching broadbrush in which I operate? Do I share the theory with clients to help loosen their constructed contraints? Are there interventions within CMM to be used. Does it apply strictly to social constructionist theories or in more interventive approaches (MST, Family Functioning ala Tom Sexton?).

CMM seems to have cross overs to understanding the Domain theory of parenting (Discipline, Attachment, Exploratory, Safety).

More to come on all this....