Family therapy training: Current issues, future trends - Springer Link

Family Therapy Training: Current Issues, Future Trends Howard Arthur Liddle

ABSTRACT: This article extends the previous literature review of the

family therapy training and supervision field (Liddle & Halpin, 1978) by organizing and discussing some of the dimensions most relevant to family therapy teachers. The five domains of focus include: (1) Personnel: who should teach and be taught family therapy? (2) Content and skills: what should be taught? (3) Methodology: how should the content and skills be taught? (4) Context: how do the setting and the training enterprise influence each other? (5) Evaluation: how should training be assessed? Finally, the article brings into focus several key aspects of family therapy training likely to have relevance for current and future trainers. The family therapy field is enjoying its most rapid period of expansion. Training opportunities have increased dramatically over the past decade as the field has become an international phenomenon. The increase in European and other worldwide training sites has been surpassed only by the proliferation of independent family institutes in the United States (Framo, 1976). Universities have also become involved in the business of family Parts of this paper were presented at the Inaugural Meeting of the American Family Therapy Association, April 1979, Chicago, Illinois. The author wishes to acknowledge the helpful comments of George Saba, Doug Breunlin and Dick Schwartz on a previous draft of this paper. Howard A. Liddle, Ed.D., is Director, Family Systems Program, Institute for Juvenile Research, 907 South Wolcott, Chicago, Illinois 60612 and is also affiliated with the Department of Psychiatry, Abraham Lincoln School of Medicine, University of Illinois at the Medical Center, Chicago, Illinois. International Journal of Family Therapy 4(2), Summer 1982

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therapy training. In the past five years especially, departments of psychology, psychiatry, social work, family studies, and pastoral counseling have included family therapy as an acceptable curricular component (Liddle, Vance & Pastushak, 1979). A recent comparative review of over 100 references in family therapy training and supervision (Liddle & Halpin, 1978) led to the identification of some basic content areas relevant for all teachers of family therapy. The present article expands some of these contemporary issues. Specifically, five generic training questions are considered:

1.Personnel. Who should teach and be taught family therapy? 2.Content and Skills. What should be taught? 3.Methodology. How should the content and skills be taught? 4.Context. How does the setting influence training, and how does training influence the setting? 5.Evaluation. How should training be assessed? PERSONNEL

Little has been written on the topic of trainee selection in family therapy. Variables such as previous clinical experience (in terms of amount and populations served), life experience (age, marital status), and previous training in family therapy or individual psychotherapy seem relevant to consider. The question of what kind of therapist is best able to learn family therapy at both the conceptual and pragmatic levels similarly has not yet been addressed. The point in this regard is related to the question--to what degree are family therapists "made" or "born"? Of course, the answer to this lies in our view of reality; yet in the everyday practice of training, the most common answer must exist somewhere between these polarities. Just as it is not enough to say thatany therapist can learn and independently reproduce the skills of a competent family therapist, it is similarly insufficient to believe this statement's opposite--family therapists are not trained as much as they are predisposed to this kind of endeavor, perhaps through their family origin. More work in this area is required to further clarify the boundaries and interconnections between these two dualistically presented and "irreconcilable" positions. Further, issues concerning what kind of people become

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family therapists and whether different schools of thought attract therapists of differing cognitive, affective and personal styles remain to be explored. Also in need of attention is the question, who should be the teachers of family therapy? Since the skills of the family therapist are beginning to be advanced in a school-specific fashion, a similar effort seems feasible with the skills of family therapy supervision. 1 In the past, this point has been irrelevant due to the virtual nonexistence of training in family therapy training/supervision. However, as family therapy training continues to become more available, the time seems near when increased training opportunities will exist for family therapy trainers. 2 Finally, questions regarding the clinical and personal competence of trainers need to be generated and examined. For example, at what clinical level should the family therapy trainer be functioning, and who (or what professional organizations) if anyone, should assess and monitor this level?

CONTENT A N D SKILLS

To begin answering questions concerning what sets of skills and content need to be taught requires a reminder about the interrelated and interdependent nature of a theory of therapy and theory of training. The content areas and skills we teach are clearly related to our training objectives, which in turn are linked to the trainer's therapeutic orientation (Liddle, 1980). Bowen trainees, for example, are expected to successfully complete family of origin work as part of their training. Georgetown's family training programs are designed on the premise that reduction of anxiety and promotion of better levels of differentiation in a clinical family are primarily dependent on the therapist's ability to manage his/her own anxiety and maintain his/her own differentiation when dealing with a clinical family. So, in addition to didactic sessions about theory and the techniques of therapy, much of the training program is focused on helping the trainee work on his/her own emotional functioning, particularly his/her own family. (Kerr, 1981, p. 262) The other extreme of the training model spectrum would be the Structural and Strategic schools which openly devalue trainee


family of origin work but utilize live observation of a therapist's sessions. In this regard, the Structural view is clearly stated in the following passage. It does not make sense, for instance, to supervise a therapist by asking him to describe a session if he is unaware of being inducted into the family system. It seems ineffective to train a therapist by having him role-play his position in his family of origin at different stages of his life, if what he needs is to expand his style of contact and intervention so that he can accommodate to a variety of families. And it seems inadequate to require a therapist in training to change his position in his family of origin, when his goal is to become an expert in challenging a variety of diverse systems. (Minuchin & Fishman, 1981, p. 5) In Haley's (1976) strategic therapy, ...group exercises involving students having experiences together or sculpting their own family problems would not be done, since that would distract the student from the real issue, which is how to change a family. {p. 176) This issue, the extent to which a trainee's personal/family life is considered necessary to include in the training process, remains a controversial and unresolved matter for trainers. A progressive trend in the content and skills area of training is the definition of specific learning objectives. This direction is exemplified in the work of Cleghorn and Levin (1973), Constantine (1976), Tomm and Wright (1979) and Falicov, Constantine and Breunlin (1981). As the schools of therapy themselves become more defined and sophisticated, the task of applying model-specific learning objectives t o training will follow more expeditiously. First, however, we must determine the differential skill clusters of these various approaches. The latest volume on structural family therapy illustrates the genre of effort needed. Family Therapy Techniques (Minuchin & Fishman, 1981) details the spectrum of therapist skills within the structural approach and serves as a pragmatic extension of the previous text Families and Family Therapy (Minuchin, 1974). The work of Garrigan and Bambrick (1977) also serves as a model of the degree to which expected therapist behaviors can be articulated within schools of

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thought--this time as the skills pertain to Zuk's (1981) approach to therapy. Similar efforts from other schools capable of this degree of specification are needed. Over a decade ago, Toffler's (1970) Future Shock warned us that "there comes a point where choice becomes overchoice." This caution, originally posed as a futuristic caveat, seems applicable to the current and future family therapy field. Prospective consumers of family therapy training are now faced with an increasing array of schools or models from which to choose. Clearly, the field's success has brought with it a new dilemma for trainers. Not only must we decide on the conceptual content, skills and methods of our teaching; but we are now faced with the concomitant problem of helping our trainees clarify and decide upon their theoretical/therapeutic epistemology. The training issue thus becomes whether to expose students to the variety of existing models or only to a particular school of thought. Regarding the former, the aesthetic and pragmatic problems associated with eclecticism in therapy have been outlined elsewhere (Liddle, 1982). However, the argument can now be briefly reviewed as it applies to training. Perhaps a prerequisite in helping trainees clarify and develop a personal therapeutic perspective is for trainers, themselves, to be precise about their own orientation. Confusing, disorganized and theoretically inconsonant training is frequently billed under the amiably amorphous rubric--eclectic. At its worst, an eclectic system can lead to conceptual and therapeutic inconsistency and contradiction. While drawing concepts and techniques from conflicting frames of reference, eclectic therapy and training can itself be conflicting. A smorgasboard model can be an excuse for failing to develop a sound rationale for systematically adhering to certain concepts with the techniques as the extension of those concepts. The training issue becomes whether eclecticism can exist as an orderly, consistent combination of differing systems' compatible features, rather than a conglomerate of incompatible models--each with incongruous theories of normality, dysfunction, and change. Before integration will be possible, increased attention must focus on the definition and differentiation of the concepts and principles (and their interconnections) as well as the previously mentioned expected therapist behaviors. Trainers need to have the capacity to teach trainees how to think clearly about the similarities and differences among models. Two recent papers can serve as useful prototypes


for therapists and trainers alike in their struggle with building integrative therapy paradigms (Fraser, in press; Stanton, 1981). The final issue in this section transcends the theoretic content of the particular schools of therapy. This topic has been referred to as the teaching of the interpersonal paradigm shift (Liddle & Saba, 1982). Perhaps the most essential element of training family therapists is the degree to which we teach or facilitate trainees' capacity to perceive, conceive of, and experience the world from a transactional, contextual or ecosystemic perspective. And conversely, this issue concerns our capacity to help trainees unlearn rigidly monadic, lineal epistemologies of therapy and life. Sluzki (1974) referred to this process as training to think interactionally. He believes this shift occurs with trainees "as a byproduct of their training experience more than as the result of specific content or sequence of instruction" (p. 484). The question for trainers then becomes--can we teach interactional thinking? Stated another way, can we directly facilitate a systemic attitude, or does it spontaneously occur (or not occur) at a crucial point in the training without attention specifically focused on its attainment? Finally, perhaps more basic is further work in defining the precise nature of the systemic view and the confusion which can ensue when, as Keeney has said, " . . . o n e thinks linearly and still attempts to identify and explicate a relationship system" (Keeney, 1979, p. 119). METHODOLOGY

One's teaching methods are inextricably linked to the theoretical orientation of the adopted training. The model of training will have parallels betwee.n itself and the therapy approach which is taught. This issue of the isomorphic nature of the training and therapy domains has been alluded to in the literature (Haley, 1976, 1980; Minuchin & Fishman, 1981) and represents a fertile area of creative exploration and concept development (Liddle & Saba11982, in press). The main point in this regard is the reminder that content, goals, methodology, etc., must always be seen as interdependent and interrelated parts of the training whole-- embodied by the theory of family therapy and family therapy training. Beyond the principle of the parallels between a training and therapy theory, however, lie many other

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issues confronting family therapy trainers in the area of methodology. Erickson (Haley, 1973), Bandler and Grinder (1975), and more recently Watzlawick (1978), have applied the frontier findings in the area of the human brain's hemispheric specialization to the conduct of therapy. Briefly reviewed, the left hemisphere controls language, thinking, reading, writing, counting, computing, etc., and is concerned with, what Bateson called, digital communication. The right hemisphere represents the world of metaphor and analogy, allowing us to perceive patterns, wholes, relationships between elements, spatial proportions--the gestalten of our existence. Research in this ground-breaking area has direct implications for the teaching and learning of therapy, and family therapy in particular. That is, systems theory is concerned precisely with developing a world view sensitive to wholes, patterns, structure, organization, and relationships. Along these lines, it could be argued that achieving and facilitating the interpersonal paradigm shift is primarily a "right-hemispheric" operation, rather than a content (digital) oriented process. Thus, when trainers teach the schools of family therapy, it cannot be assumed that a capacity to think interactionally has been achieved. Indeed, the definition and differentiation of the major schools of thought could be classified as digital skills; while the ability to adopt a systemic attitude might be a combination of this informational input along with more analogic, pattern-oriented skills. At this stage of our knowledge of these matters, the methodologic issue seems to be how trainers can organize learning contexts which develop and assess both aspects of human functioning--the digital and analogic. We are in an early developmental stage in understanding and using this kind of innovative and, potentially, highly applicable body of work. ~ Related and unexplored topics for consideration are the areas of individualistic trainee learning styles, 4 trainer styles and trainertrainee teaching/learning patterns. In research on the live supervision process, trainee learning styles and preferences and patterns of supervisor-student-family interactions have been identified (Liddle, Davidson & Barrett, Note 1) and found useful in developing a model of live supervision/consultation (Liddle & Schwartz, Note 2). This research uncovers the need for further work in an area Bateson termed "deutero-learning" and what Harlow referred to as "learning sets." These concepts,


exemplifying the principle of learning to learn, should be of significant value for teachers of family therapy. Future research seems fruitful, therefore, in the specification of processes whereby trainees learn to learn--about the interpersonal paradigm shift, about a context-oriented therapy and about families in their journey toward the designation "family therapist." Developed within the counseling psychology field, the microcounseling approach (Forsyth & Ivey, 1980) offers a rich area of untapped conceptual influence. This teaching model carefully defines the behaviors to be taught, while using measurement, feedback and reinforcement of the therapeutic skills with trainees. Microcounseling has been used to separate and define the ingredients of beginning level therapy skills and teach skills through didactic, modeling and videotape techniques (Kagan, Schauble, Resnikoff, Danish & Krathwohl, 1969). Beginning efforts at the application of this paradigm to family therapy have begun (Street & Treacher, 1980) but more experimentation of this kind if needed. Along these lines, work in the area of specifying the therapist behaviors/skills in a school-specific manner would assist in determining the applicability of microcounseling/microtraining to family therapy. A potential problem in the transferability of the microcounseling model to family therapy might be in the area of skill levels. The more advanced aspects of certain schools, or perhaps entire models of therapy may not be amenable to instruction in this form. The less structured and goal-specific therapies, such as Whitaker's Symbolic-Experiential approach, might apply in this regard. For instance, in discussing therapist behavior within this approach, Keith and Whitaker (1977) have proclaimed, The question "What are the techniques?" does not seem answerable.... Our methodology is peculiarly nonstrategic. We share our own impulses, anxieties, and associations and do not attempt to structure an hour. (p. 123) A more general issue concerning the microcounseling model is the question of whether a training approach which emphasizes the digital aspects of behavior can teach what Minuchin has called, the broader strokes (e.g., developing a theme) of a therapist? Simply stated, can a training model which emphasizes microevents incorporate the gestalten of any therapeutic approach? This refers to the parts of a model, for example, which

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focus on clusters of skills and interrelationships between these clusters. Perhaps the findings in the area of the brain's hemispheric specialization have potential value here. The left brain-right brain metaphor is a way of explaining, in a holistic manner, the complexity and range of human functioning which a microcounseling model, because of its potentially narrow digital focus, might miss. The final point under methodology is, by this juncture, a familiar one. Our training techniques, like the training content, skills and goals are inextricably woven into the fabric of the particular therapy being taught. The theory of change, for example, within Structural family therapy relies heavily on the principle of enactment. This refers to the procedure by which the therapist "asks the family to dance in his presence" (Minuchin & Fishman; 1981, p. 79), thus constructing an interpersonal scenario in the session which observes these usual, but narrow and rigid relational repertories of family members and interdicts these patterns to construct new realities--new ways of experiencing each other. When applied to the training domain, this theory of change becomes translated in the following way. The supervisor is, optimally, in a context which permits direct observation of the "dance" (interaction) between therapist and family--the therapeutic system. The cyclical, unproductive, "more of the same" sequences between therapist and family are observed and tracked by the supervisor who can then intervene into and guide the process of the therapeutic system. This broadens the range of behaviors available to the therapist who has been inducted into the family's narrow and familiar range of patterned response. New experiences of reality can thus be created for the thera~ pist-in-training. At their best, these experiences emphasize competence and success, and reflect the therapeutic model being taught. Therapists and supervisors alike challenge their families' and trainees' views of reality and introduce behavioral complexity into repetitive, overly narrow systems. In this regard, teaching family therapy effectively seems to necessitate attention to the principle of connections and patterns and eventually to "patterns of patterns" (Bateson, 1979). Our efforts to understand and use the parallels between therapy training have just begun (Haley, 1979; Liddle & Saba, Note 3; Liddle & Saba, in press), but this line of inquiry offers a conceptually and practically fertile field of study for family therapy trainers.

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CONTEXT

Systemically-oriented therapists constantly strive to remember how individuals are always influenced by (and influence) surrounding contexts. Supervisors with a similar orientation apply this principle to their training contexts as well. The context in which training occurs cannot help but influence and be influenced by the training system. Along these lines, more work is needed in defining these subsystem processes, their boundaries and hierarchical structure as well as the interrelationships between them. Training systems (e.g., a training program) and supervisory systems (e.g., supervisor + therapist-trainee + observing group + family) must be assessed and tracked in the same ways we work with family systems. Programs which will train supervisors must attend to the ways in which this principle of context sensitization can be facilitated. A body of literature is developing which describes some of these interaction effects. This work, which might be considered under the category, politics of family therapy, details the contextdisturbing effects of family therapy and family therapy training in a multitude of settings. The move to adopt a systemic, familyoriented perspective within a context which previously held a more individual orientation disturbs the equilibrium of delicately balanced, naturally change-resistant systems. Again, the principles of therapy can guide an increased understanding and effectiveness with larger systems. The reverberations of change to an ecosystemic epistemology (Keeney, 1979) have been recorded in a variety of clinical and training contexts including community mental health centers (Framo, 1976; Haley, 1975), medical settings (Miyoshi & Liebman, 1969; Shapiro, 1975), school systems (Tucker & Dyson, 1976) and academic departments within universities (Liddle, 1978). The foregoing discussion of context leads us to two central issues for trainers. The first concerns our ability to make an interactional/structural assessment of the training system and the ecosystem in which it functions. In this regard, are we able to define which contextual constraints are givens, those "coming with the territory," which might be less available to intervention and change? Conversely, which aspects of our context do seem amenable to planned, strategic intervention? The challenge would be to apply our expertise in diagnosing and changing family systems to the settings in which training occurs.

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The second issue addresses how we prepare trainers and trainees for the personal and political consequences of adopting the systemic view. Families, from certain theoretic orientations, are prepared in therapy for the consequences of change within their system. Since change is at least equally threatening and unsettling in other systems, trainers and trainees might similarly be prepared for the consequences of the interpersonal paradigm shift. In practice this preventative model might prove impractical or unnecessary. At this time however, experimentation in this regard will begin to answer the question of the usefulness of educating trainers and trainees on systemic fallout.

EVALUATION

This area of the training and supervision field has largely been neglected and only recently begun to be explored. In this sense it is an area of the field which is perhaps the most ready for creative exploration. The few papers which do exist on this topic cover a wide band of interests. Flomenhaft and Carter (1977) reported on the content and results of a statewide family therapy training effort which successfully influenced the degree to which trainees worked with families. The training group at the Family Institute in Cardiff, Wales (Dowling, Cade, Breunlin, Frude & Seligman, in press) conducted a retrospective study of students' views of their training. They found trainees willing and able to utilize their newly developed family skills in their work settings which were not always in accord with a family-oriented philosophy. The trainees also set up independent resource/support groups and eventually used their training to become involved in teaching and supervision. The issue of the degree to which the context supports a systemic philosophy remains a crucial variable to consider in evaluating training. A series of studies by Garrigan and Bambrick (1975, 1977a & b) which investigated outcomes of Zuk's Go-between therapy for families in which the identified patient is a child or adolescent, discussed the effects of teaching this particular therapeutic orientation to novice'therapists. More studies of this nature, in which the dependent (acquisition of skills) and independent (specification of skills) variables are capable of high degrees of articulation are needed for the evaluation domain to advance.

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Tucker and Pinsof (Note 4) have also investigated trainees' acquisition of family therapy skills. They are among the first to evaluate on a pre- to post-basis the effects of family therapy training on trainees' level of skill attainment. Along similar lines a videotape (Breunlin, 1981) and evaluation instrument (Breunlin, Schwartz, Selby & Krause, Note 5) has been developed, capable of evaluating the conceptual and intervention-generating capacities of a broad range of trainees. Another level of research on the training process--effects of live supervision--has also begun but is still an open area of exploration. One study investigated the effects on over 60 trainees of being supervised in a live supervision]consultation format (Liddle, Davidson & Barrett, Note 1). This research found positive trainee response to the variety of live supervision methods--phone-ins, consultations and use of a peer team of observers. A predictable series of stages have been enumerated through which trainees journey in the process of being supervised in this way. Wright and Tomm (Note 6) of the University of Calgary have also completed research on the live supervision model. Their pragmatically useful findings have emphasized specification of the phone-in process and the consequent effects of telephone interventions on the trainee and family. Finally, an anecdotal report from two trainees evaluates their experience in a live supervision format emphasizing how their reactions to the training model evolved in a more positive direction over time (Gershenson & Cohen, 1978). A broader paper, also published by family therapy trainees similarly addresses issues of development and stagespecific learnings. The most comprehensive and useful paper to date on family therapy evaluation examines the status, issues and directions of this area of the field (Kniskern & Gurman, 1979). This publication discusses the implications of family therapy research for family therapy training, examines current models of family therapy training and identifies important and researchable questions regarding training family therapists. In this latter regard, questions concerning selection, didactic and experiential training methods, and supervision have been generated. Kniskern and Gurman's helpful, broadly based research question: "What types of training experiences are especially potent in producing effective therapists within a particular model of therapy?" {p. 90) naturally leads to other areas of inquiry. The principles essential in other research endeavors--reliability and valid-

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ity--perhaps can have relevance in our attempts to evaluate training. Regarding the first, is our training model reliable? That is, to what degree is it predictable, dependable and consistent? Is the training model replicable across contexts, trainers and different trainee groups? Or, as Kniskern and Gurman warn, are our training effects specific to one site, especially to the one in which the model was developed? The second issue, validity, raises the question of whether we teach trainees what we believe we teach them. Further, what kinds of assessment criteria and instrumentation are useful in this regard? This final point, the criteria used to evaluate training, represents another major training issue. For example, if evaluation is model-specific, do we evaluate each model on the same or different criteria? Can we determine generic evaluation criteria which transcend differences in schools of thought? The Kniskern and Gurman paper begins work in this regard. They identify four dimensions upon which family therapy training evaluation can be based: 1.conceptual knowledge of families; 2.trainee's in-therapy behavior; 3.trainee's personal life; 4.outcomes of the families treated by the trainee. This final point seems to lie at the heart of evaluation. Supervisor and trainee ratings have been used most frequently in evaluating training effects. However, if the sine qua non of training is to produce effective therapists, then therapeutic outcome should be the ultimate evaluation criterion--the bottom line. If trainers agree with this position, their sensitivity to and knowledge of the work of those involved in family therapy outcome must be cultivated. A loosening of the rigid boundaries between the subsystems of our field, in this case between outcome research and training, will allow trainers to do competently what must become a matter of course for family therapy supervisors--to evaluate the outcome of trainees' cases. In sum, several variables seem crucial to consider in any training assessment. These include the number and kinds of individuals being trained, trainer level, length of available time, type of training/teaching (concepts, supervision, etc.), s the contextual constraints and resources, type of client population, and the theoretical orientation and expectational set of supervisors.


CONCmS'ON

This article has attempted to organize and briefly discuss some of the training dimensions most relevant to family therapy teachers. A number of research and practice areas have emerged which have significant potential for creative development and use. The identification of individual learning styles specifying different ways of learning to learn, the human brain's hemispheric specialization and the implication of these research findings for teachers of therapy, the comparative effects of innovative supervision models such as live supervision upon trainees, understanding more fully the interrelated parallels between therapy and training, and descriptions of the training process through multilevel evaluation (supervisor, trainee, client(s)), all seem fruitful areas of attention. Finally, the decade ahead should be an exciting time for teachers of family therapy as the field continues its increasing sophistication in the political, theoretical, empirical and pragmatic spheres. Although there is an increase in the number of programs offered in training/supervision at both national and regional meetings, an even greater and more overt commitment to this area is appropriate and necessary. Since the clinical and research subsystems of our field have recently achieved increased sophistication through articulating schools of therapy and producing studies of outcome, the training area might now be able to advance to a similar evolutionary level. REFERENCE NOTES 1. Liddle, H.A., Davidson, G., & Barrett, M.J. Live supervision/consultation, llh An outcome study of trainees' perceptions. Institute for Juvenile Research, Chicago. Submitted for publication. 2. Liddle, H.A., & Schwartz, R. Live supervision/consultation II: Conceptual and pragmatic guidelines for family therapy trainers. Presentations at the 38th Annual Conference of the American Association for Marriage and Family Therap% November, 1980, Toronto and at the 58th Annual Meeting of the American Orthopsychiatric Association, March, 1981, New York City. Submitted for publication. 3. Liddle, H.A.~ & Saba, G.W. Live supervision/consultation I: Conceptual and pragmatic parallels between training and therapy. Presentations at the National Council on Family Relations Annual Meeting, October, 1981, Milwaukee, Wisconsin and at the 59th Annual Meeting of the American Orthopsychiatric Association, March, 1982, San Francisco. Submitted for publication. 4. Tucker, S.J., & Pinsof, W. The evaluation of family therapy training. Research in progress, Center for Family Studies, Department of Psychiatry, Northwesterrt University Medical School, Chicago, Illinois, 1979.

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5. Breunlin, D., Schwartz, R., Selby, L., & Krause, M. Development of an evaluative instrument to measure acquisition of a family systems perspective. Institute for Juvenile Research, Chicago. Submitted for publication, 1981. 6. Wright, L., & Tomm, K. Analysis of phone-ins in live supervision. University of Calgary, Calgary, Alberta, Canada, 1979. 7. Liddle, H.A., Breunlin, D., Constantine, J., Schwartz, R., Barrett, M.J., Karrer, B., Mackey, S., & Stone Fish, L. Toward a model of training family therapy supervisors. Presentation at the 39th Annual Conference of the American Association for Marriage and Family Therapy, October, 1981, San Diego. 8. Prosky, P. Teaching family therapy. Paper presented at the 56th Annual Meeting of the American Orthopsychiatric Association, April, 1979, Washington, D.C.

REFERENCES Bandler, R., & Grinder, J. The structure of magic, Vols. I and II. Palo Alto, Ca.: Science and Behavior, 1975. Bateson, G. Mind and nature: A necessary unity. New York: Dutton, 1979. Breunlin, D. A family interview: A training manual in family therapy. Chicago, Illinois: Center for Educational Development, University of Illinois at the Medical Center, 1981. Cleghorn, J, & Levin, S. Training family therapists by setting learning objectives. American Journal of Orthopsychiatry, 1973, 43, 439-446. Constantine, L. Designed experience: A multiple, goal-directed training program in family therapy. Family Process, 1976, 15, 373-396. Dow[ing, E., Cade, B., Breunlin, D., Frude, N., & Seligman, P, A retrospective survey of students' views on a family therapy training programme. Journal of Family Therapy, in press. Duhl, B., & Duhl, F. Integrative family therapy. In A. Gurman & D. Kniskern (Eds.) Handbook of family therapy. New York: Brunner/Mazel, 1981. Falicov, C., Constantine, J., & Breunlin, D. Teaching family therapy: A program based on learning objectives. Journal of Marital and Family Therapy, 1981, 7, 497-506. Flomenhaft, K.~ & Carter, R. Family therapy training: Program and outcome. Family Process, 1977, 16, 211-218. Forsyth, D., & Ivey, A. Microtraining: An approach to differential supervision. In A. Hess (Ed.) Psychotherapy supervision. New York: Wiley, 1980. Fraser, S. Structural and strategic family therapy: A basis for marriage or grounds for divorce? Journal of Marital and Family Therapy, in press. Framo, J. Family institutes and organizations offering ongoing training in family and marital therapy. Family Process, 1976, 16, 443-445. Garrigan, J., & Bambrick, A. Short-term family therapy with emotionally disturbed children. Journal of Marriage and Family Counseling, 1975, 1, 379-385, Garrigan, J., & Bambrick, A. Family therapy for disturbed children: Some experimental results in special education. Journal of Marriage and Family Counseling, 1977a, 3, 83-93(a). Garrigan, J., & Bambrick, A. Introducing novice therapists to "go between" techniques of family therapy. Family Process, 1977b, 16, 237-246(b). Gershenson, J., & Cohen, M. Through the looking glass: The experiences of two family therapy trainees with live supervision. Family Process 1978, 17, 225-239. Haley, J. Uncommon therapy. New York: Norton, 1973. Haley, J. Why a mental health clinic should avoid family therapy. Journal of Marriage and Family Therapy, 1975, 1, 3-12.


Haley, J. Problem-solving therapy. San Francisco, Ca.: Jossey-Bass, 1976. Haley, J. Leaving home: The therapy of disturbed young people. New York: McGraw Hill, 1980. Kagan, N., Schauble, P., Resnikoff, A., Danish, S., & Krathwohl, D. Interpersonal process recall. Journal of Nervous and Mental Disease, 1969, 148, 365-374. Keeney, B.P. Ecosystemic epistemology: An alternative paradigm for diagnosis. Family Process, 1979, 18, 117-130. Keith, D., & Whitaker, C. The divorce labyrinth. In P. Papp (Ed.) Family therapy: Full length case studies. New York: Gardner Press, 1977. Kerr, M. Family systems theory and therapy. In A. Gurman & D. Kniskern (Eds.) Handbook of family therapy, New York: Brunner/Mazel, 1981. Kniskern, D., & Gurman, A. Research on training in marriage and family therapy: Status, issues, and directions. Journal of Marital and Family Therapy, 1979, 5, 83-94. Liddle, H.A. The emotional and political hazards of teaching and learning family therapy. Family Therapy, 1978, 5, 1-12. Liddle, H.A. On teaching a contextual or systemic therapy: Training content, goals and methods. American Journal of Family Therapy, 1980, 8, 56-69. Liddle, H.A., & Halpin, R. Family therapy training and supervision literature: A comparative review. Journal of Marriage and Family Counseling, 1978, 4, 77-98. Liddle, H.A. On the problems of eclecticism: A call for epistemologic clarification and human scale theories. Family Process, 1982, 21, (1). Liddle, H.A., & Saba, G.W. On teaching family therapy at the introductory level: A conceptual model emphasizing a pattern which connects training and therapy. Journal of Marital and Family Therapy, 1982, 8(1), 63-73. Liddle, H.A., & Saba, G.W. Isomorphs in Structural-Strategic family therapy and training. In J. Schwartzman (Ed.) Macrosystemic approaches to family therapy. New York: Guilford, in press. Liddle, H.A., Vance, S., & Pastushak, R. Family therapy training opportunities in psychology and counselor education. Professional Psychology, 1979, 10, 760-765. Minuchin, S. Families and family therapy. Cambridge, Mass.: Harvard, 1974. Minuchin, S., & Fishman, C. Techniques of family therapy. Cambridge, Mass.: Harvard, 1981. Miyoshi, N., & Liebman, R. Training psychiatric residents in family therapy. Family Process, 1969, 8, 97-105. Montalvo, B. Aspects of live supervision. Family Process, 1973, 12, 343-359. O'Hare, C., Heinrich, A., Kirschnor, N., Oberstone, A., & Ritz, M. Group training in family therapy: the student's perspective, loumal of Marriage and Family Counseling, 1975, 1, 157-162. Shapiro, R. Some implications of training psychiatric nurses in family therapy. Journal of Marriage and Family Counseling, 1975, 1, 323-330. Sluzki, C. On training to think interactionally. Social Science and Medicine, 1974, 7, 483-485. Stanton, M.D. An integrated Structural/Strategic approach to family therapy. Journal of Marital and Family Therapy, 1981, 7, 427-440. Street, E., & Treacher, A. Microtraining and family therapy skills--towards a possible synthesis. Journal of Family Therapy, 1980, 2, 243-257. Toffler, A. Future shock. New York: Random House, 1970. Tomm, K., & Wright, L. Training in family therapy: Perceptual, conceptual and executive skills. Family Process, 1979, 18, 227-250. Tucker, B.Z., & Dyson, E. The family and the school: Utilizing human resources to promote learning. Family Process, 1976, 15, 125-141. Watzlawick, P. The language of change. New York: Basic Books, 1978. Zuk, G.H. Family therapy: A triadic-based approach. New York: Human Sciences Press, 1981 (revised edition).

97 HOWARD A. LIDDLE

'Our own group has begun work in this regard in attempting to articulate the skills of supervision from a structural-strategic perspective (Liddle & Schwartz, Note 2; Liddle & Saba, 1982). ~The Family Systems Program of the Institute for Juvenile Research in Chicago offers a one-year training program in family therapy supervision--the Supervisor Extern Program (Liddle, Breunlin, Constantine, Schwartz, Barrett, Karrer, Mackey & Stone Fish, Note 7). 3Phoebe Prosky (Note 8) of the Ackerman Institute in New York delivered a paper at the 1979 American Orthopsychiatric Association Meeting which laid some conceptual groundwork for teaching family therapy trainees to perceive and intervene on the basis of data from both hemispheres. 4Duhl and Duhl (1981) have contributed in this regard. They define learning styles as "the different ways people have of processing information--taking it in, sorting it, storing it, connecting it, and putting it out in words and behavior" (p. 502). Again, Bandler-Grinder's (1975) neurolinguistic programming also has similar relevance in our eventual understanding of differential learning/teaching styles. 51n this regard, a distinction can be made between teaching family therapy and training family therapists. The former connotes exposure to systems concepts and schools of family therapy while the latter infers more intensive work of a clinically supervised nature.