The Narratives Which Connect…

Implications of the map of resonance for family therapy education and supervision

When we need to reflect upon the links between private life and professional practice, should we be asking for therapy, consultation or supervision, (Jones 2003)? This question is often supported by the idea of a strict division between what is private and what is professional. Today, this division between professional and private seems to confuse our understanding of psychotherapy. A more fruitful position could be to look for “...how to achieve an appropriate balance between the ‘private’ and ‘professional’?” (Graff, Lund-Jacobson and Wermer, 2003).

The family therapy education field in Norway does not have tools like “The Blue Book” or “The Red Book” (developed by The Association for Family Therapy and Systemic Practice) as in the UK, which regulates standards of training and family therapy education programmes. This means that we do not have any common standards to refer to regarding the content of a family therapy education programme in Norway.

My planning of this research project ran parallel to my being in charge of planning the Master degree in Family Therapy and Systemic Practice at Diakonhjemmet University College in Oslo. In the planning of the master degree, I visited several institutions in Belgium, USA, Spain, England, Ireland and Wales. As mentioned earlier, I asked about the Personal and Professional Development modules in some of these places. It became obvious to me early on that we needed to include a PPD module in our new plan for a master degree. Inspired by some of these programmes and from preparing my own proposal for a doctorate, we included a 100-hour training module as part of the curriculum.

PPD was not a part of family therapy education in Norway. All participants in this research project had finished one or more of the family therapy education programmes in Norway. Most of them had few reflections and theoretical ideas on how to understand relations between personal and private life and their therapeutic practice when they connected these ideas to their family therapy education programme. There had been little or no work of this kind in the education programmes. In Orlinsky and Rønnestad’s research on how psychotherapists develop, “experience with patients” ranks as the major positive influence (89%). However, “getting formal supervision” (80%) and “getting personal therapy” (77%) follow immediately after (Orlinsky and Rønnestad, 2005, p. 137).

This research project indicates that working and reflecting on the relations between personal and private life and therapeutic practice is necessary and advisable to increase the potential for understanding and developing therapeutic practice and to educate even more qualified systemic family therapists in Norway.

The multicultural society

Therapeutic ideas are not outside culture and society. We are all subject to social discourses. Therapeutic ideas are a part of culture and come forward in a culture. For example, the idea of the “self” is of another kind and much weaker in some eastern cultures. In his book “Rewriting the self. History, Memory, Narrative.” Mark Freeman claims that “...a life history, rather than being a ‘natural’ way of accounting for self, is one that is thoroughly enmeshed within a specific and unique form of discourse and understanding” (Freeman 1993, p. 28 in Johansson 2005, p. 230). Personal stories like biography or personal narratives are nothing natural or universal but they are culturally constructed.

In the same way, many of the western and Protestant ideas about God and religion seem to change in meeting with clients for whom religion is central to their lives. The Protestant doctrine of the two regiments has made some of us keep a division between church and society, between religion and professional work. In a more cross-cultural society, religion will become more of an issue for systemic family therapists.

The cultural constructions of the self and religion and other cultural differences are among the issues that make it necessary to develop the map of resonance as a tool in family therapy education.

Dilemmas in Family Therapy Education

Introduction

We have several family therapy education programmes in Norway. When they started in the beginning of the 1970’s they were aimed to qualify family therapists mainly for work in the psychiatric field and in family counselling offices. In the 1980’s and 1990’s these education programmes grew both in numbers and in scale. More and more students attended the education programmes to use what they learned in their ordinary work as child protection workers, psychiatric nurses, in drug addiction work and so on. Most of these professionals did not practice family therapy in their daily work and some of them had problems fulfilling the family education programme demands when it came to practice and supervision.

Some of the education programmes also required that the students had to have a family therapy practice to attend the programme. At the same time the employers required family therapy training to let them practice. Many professionals found themselves in a “catch 22” situation.

To change this impossible situation some of the programmes widened their criteria for admission and changed the name of the education programme. Some programmes skipped “family therapy” as a part of the name of the programme. However, most programmes added an extra name to the family therapy education. After several attempts to find a good new name, most ended up with a name like “family therapy and systemic practice”.

This situation has created some new dilemmas in some family therapy training programmes. How should we now define practices that are approved to be a part of the education programme?³² How should “direct supervision” be defined when almost every type of clinical and pedagogical practice is included as approved in the programme? It seems as if many students designate their practice as “family therapy” regardless of what they do as long as they can connect it to the family therapy education programme. How does this situation affect our understanding of psychotherapy?

Personal therapy

Most of the participants in this research project have been in personal therapy themselves to help with their own life problems. Some of them directly refer to these experiences as very important steps in their own development as family therapists (Karen, Adam and Elisabeth). Freud recommended therapists resume their own therapy every fifth year.

When Orlinsky and Rønnestad carried out their comprehensive research on how psychotherapists develop, 3 in 10 of the Western therapists actually were in personal therapy when they participated in the study. They also found that “Clinicians with no experience of personal therapy showed the lowest rate of felt progress and the highest rates of regress and stasis. By contrast, practitioners who were currently in therapy showed the highest rate of progress and the lowest rate of stasis” (Orlinsky and Rønnestad, 2005, p. 121).

The question is if, in addition to PPD work, the time is right to re-introduce discussion and reflection over the need for and benefits of having personal therapy as a compulsory part of the education programme for a student who wants to qualify as a family therapist.

The structure of family therapy training programmes

To illustrate the dilemmas that have occurred in family therapy education in Norway it is necessary to look at some common elements in the education programmes. All education programmes require both clinical practice and both direct and indirect supervision. When clinical practice was defined as family therapy, this model worked fine. When clinical practice was widened to include all kinds of health- and social work and pedagogical practice, it has been more difficult to use a common framework in describing and understanding practice in family therapy education.

The map of resonance is meant to add language and reflections to the understanding of systemic family therapy. Some of the concepts used in the map of resonance will not be useful in the same way in, for example, child protection work and pedagogical work. For example when we name a process as “therapeutic colonization” in the therapy room, a similar activity seems to be beneficial and necessary work in child protection. In child protection work personal and private experiences may go together with what is professional practice in a different way than in the therapy room. In that sense, the map of resonance may be helpful to draw distinctions between systemic family therapy and other forms of clinical and pedagogical work. However, practitioners in child protection work and pedagogical work can be at risk of being misled by personal values.

In a domain of reflection, the map of resonance may clarify which values that guide practice and it may offer help to sort out the difference between our own values and the values the therapist should administer.