Treating Multidimensional Presenting Problems with a Mutually Integrative Approach Using the Genogram.

The present article introduces a case study and describes a mutually integrative approach to treating a complex presenting problem. This article examines the specific issues surrounding integration when a supervisor and supervisee hold different theoretical perspectives. On occasion, such a relationship demands that the supervisee adhere to the model being taught by the supervisor. Examining integration in this format presents many advantages for both treatment and training. The key to the mutual integration is that two schools of psychotherapy can be combined in a way that creates a synergy; in that, together they are more powerful than either may be in isolation. A genogram with symbols from each model is incorporated to focus the treatment and create a format for the mutual integration.

Este artículo presenta un caso práctico y describe un enfoque mutuamente integrador para el tratamiento de un problema complejo motivo de consulta. Se analizan los problemas específicos en torno a la integración cuando un supervisor y una persona supervisada tienen diferentes perspectivas teóricas. Ocasionalmente, dicha relación exige que la persona supervisada se ajuste al modelo que le enseña el supervisor. El análisis de la integración en este formato presenta muchas ventajas tanto para el tratamiento como para la capacitación. La clave para la integración mutua es que puedan combinarse dos escuelas de psicoterapia de una manera que genere una sinergia; es decir, que juntas sean más poderosas de lo que puede ser cualquiera individualmente. Se incorpora un genograma con símbolos de cada modelo para centrar el tratamiento y crear un formato para la integración mutua. El caso se conceptualiza utilizando una fusión de la teoría de sistemas y la teoría psicoanalítica sobre la base del modelo estratégico de sistemas familiares y de un modelo psicoanalítico tradicional influenciado por la psicología del yo del modelo freudiano (Hall, 1999; Fenichel, 1945) y McWilliams (2011). El genograma sistémico tradicional (con símbolos interaccionales) se transforma en un genograma "integrado", con la incorporación de símbolos nuevos para representar los mecanismos psicoanalíticos de defensa. Los problemas presentados en el caso son preocupaciones relacionales y problemas de autoestima en un "paciente identificado" adolescente, obesidad y antecedentes de trauma sexual. Se proporcionan las razones para la integración mutua en este caso específico junto con las razones para la intervención.

Till the ocean do us part: Italian and American therapists' representations of stepfamilies in treatment.

Research often focuses on the characteristics of stepfamilies and their differences with first-union families; however, few studies take into account the therapist's perspective with regards to the treatment of such families. Also, cross-cultural research on the topic is limited. To fill these gaps, a content analysis of responses from 125 Italian and 45 American therapists regarding their representations of stepfamilies and stepfamily therapy was undertaken. Results show that American therapists emphasized specific stepfamily characteristics (e.g., the lack of a shared family history, the occurrence of conflict between former spouses, the presence of unrealistic expectations towards treatment) to a greater extent if compared to Italian therapists. By contrast, besides being more general in their definition of stepfamilies, Italian therapists focused more on themselves, their theoretical models, and their professional and personal skills. The study provides insights on both the differences in the clinical cultures of the two countries and implications for stepfamily therapy and training.