| The objective of this study was to investigate the phenomena of dynamic shifts during time-limited, "marathon" family therapy encounters, with a primary focus on the family's participation in the process. The analysis was based on three families, each of whom moved into a treatment house for three days of intensive therapy. A team of therapists worked with the family, two at a time, while other members of the treatment team observed from behind a one-way mirror and, on occasion, communicated with a therapist or a family member by telephone-intercom. All sessions were videotaped and later transcribed in full; verbatim transcriptions included annotations of the visual text (i.e., structural and behavioural operations). The final analysis encompassed approximately 45 hours of therapy, with a total of 26 participants (16 family members and 10 therapists) accounted for in the categorization process. The transcripts were analysed according to the procedures of grounded theory methodology and methodical hermeneutics. As a means of further clarification and triangulation, secondary sources of data (i.e., clinical records and on-site therapist notes) were referred to during the latter phase of the analysis.;The resultant multidimensional representation is a developmental, three-stage, hierarchical portrayal of the therapy process, which depicts various elements that appear to constrain or enhance the possibility for therapeutic change in a family. For each of these progressive phases (i.e., The Impasse, The Challenge, and The Resolution), a number of distinctive modal behaviours were identified that characterized family members' participation and therapist activity. Movement from one stage to the next was frequently advanced by critical turning points, usually in the form of challenges to the family by the therapist or a family member. The core category, as the overall organizing construct induced from the phases and the properties that they subsumed, is entitled "Frameworld as Subtext". This category connotes the investigator's position that there are certain pivotal perspectives ("mainframes") that influence and delimit a participant's capacity for flexibility and openness in the consideration of family impasses; moreover, throughout the therapy, the "frameworlds" of key family members function as powerful "subtexts", or underlying forces, in the therapy process. Differing from-the manifest concerns regarding various identified issues which, potentially, are open to problem-solving approaches to solution, the subtexts appear to counteract the resolution of deadlocks. It is posited that the incidence of dynamic shifts is concomitant with an expansion and redefinition of these firmly established, self-delimiting frames that have supported ideational impasses in a family. Among the most potent precipitating shift factors, it would seem that concrete symbolization, either through reconstructive emotional experiencing or imaginal specification, acts as a trigger for intra- and interpersonal shifts. With the families in this study, although shifts occurred on an individual level, resolution of impasses resulted only when there was a perceptible intersection of the frameworlds of key family members. Moreover, participants always attested to a renewed sense of hope as a result of the shifts.;In discussing the findings of this analysis, the investigator underscores the constructive aspects of individual experiencing, the resultant impact of these constructions on the family unit, the apparent need for coherence in the members' personal narratives, and, in the event of a shift in their narrative constructions, the thrust for family members to publicly explain their former behaviour in light of their altered beliefs. |
