1994 By Lewis N. Foster

William McFarlane, MD, of the Maine Medical Center has completed most of the research to date on multiple family therapy (MFT) with schizophrenic patients and their families. He says that his fifteen years of research indicates that multiple family group therapy (MFGT) is separate from group therapy and family therapy. It is in a category of its own.

John Howe, MSW, and his Social Work Team at the Boys and Girls Homes of NC say that when working with a MFT group, you have an outside mirror through the other families, and outside resources through the other families, and vicarious learning by imagined participation in others experience that takes place. You've got more resistance to each other and the therapist in individual family therapy that disappears in the MFGT setting. MFGT is different from doing individual group therapy where your focus is more on the individuals' internal stuff and helping the individual's learn about their interaction patterns with the group.

There is less mental masturbation (Peter Laqueur called it Narcissistic Self Talk, Fritz Pearls called it BS, and Lewis Foster calls it passing-time) in MFGT and it is more supportive and interactive than regular group therapy in a number of ways. (Laqueur said that there was less of this in MFGT than in group therapy.) There is much that goes on in MFGT that doesn't happen in individual group therapy, interaction possibilities and some learning possibilities, for example. "The staff is the least important ingredient in this healing process," says John Howe. "We get it (MFGT) started and provide a setting, but after that we're the least important, and that's probably different than marriage and family therapy or group therapy. The MFTG's become more of a self-help group, independent of the group facilitators in many ways. A lot of the help comes from people who are in the same shoes. Other families bring validity to the MFTG's that the staff can't. They will listen to each other before they listen to the therapist or agent of a social services system."

H. Peter Laqueur, MD, said that in individual therapy the patient and the therapist are alone together and everything else, the family and society, are on the outside. The therapist depends on what the patient tells him about what he has experienced. In peer group therapy we have patients and other patients and a therapist together and they derive better mutual understanding, but their families and society are still on the outside. In conjoint family therapy the patient, the therapist, and the patients' family are together, and there is a good build up of mutual understanding within the family, but the relationship to society is still unknown, because, society is on the outside. In Multiple Family Group Therapy we have four factors together. The patient and his family, the therapist, other families, and through the other families outside society is represented. The understanding that is brought about gives us the widest possible range of understand for future action. In MFGT for example, mothers respond to the deepest mutual feelings of the patients and get a deeper understanding of their own.

Inter-family codes (which exclude further communication) pass messages and sometimes block the expression of emotions. Daughter cries producing guilt in other family members letting them know not to express themselves, for example. Laqueur calls this a SECURITY OPERATION. It makes it clear to the family that vulnerable times must remain covered and must not be exposed to other people. The security operation is a sure way of avoiding the sleeping dogs, which can be awakened if the family is in contact with other families, and therapist's, in MFGT.

Paul K. Thorington, EdD, President of the H. Peter Laqueur Foundation, reminds us that the "Learning Through Identification and Identification Constellations" as defined by Laqueur is unique to MFGT. Having multiple families which includes, mother's, father's, husband's, wives, cousin's, son's, brother's, and grandparent's, etc., in MFTG's gives people an opportunity to redefine or enhance their specific generation and family roles that wouldn't take place in any other from of treatment. You don't find mother's identifying with mothers in individual therapy, in individual family counseling or in some cases regular group therapy.

Another separating characteristic, according to Thorington, is "Conjoint Tune-out" defined by Laqueur. Conjoint tune-out has less of a chance to happen in MFGT. A single family, all or one member, for example, can tune out what the therapist is trying to do. In MFGT when they turn away or tune-out the therapist's they are then face to face with other families.

Thorington says that of all the therapeutic modalities, MFGT resembles real society more accurately. It is a natural phenomenon that taps into a natural sociological resource. It is a more natural setting for therapy to occur. You've got access to families, peer cultures, more opportunities for prevention - through identification constellations, modeling, dialogue, and neutralizing the affective tone around hot issues (providing a way to get past the immediate emotional reactivity).

By bringing the issues to the middle of the MFTG, a technique used by Laqueur, serves to bring the concerns to a natural forum. It brings to the awareness of parents, spouses, children, etc., areas in which they need to do a better job. This empowers them to take charge and accept their roles.

When MFGT takes place in the home community (town, neighborhood, etc.) it helps families become proactive to traumatic events that may be happening in the community, for example, a rash of adolescent suicides, or trends in substance abuse, violence, or significant changes in the school system.

Multiple Family Group Therapy is separate from group therapy and marriage and family therapy. It is in a category of it's own. It is Multiple Family Group Therapy. Or to be grammatically correct, according to Tom M. Saunders, PhD, of Winter Park, FL, Multiple Families Group Therapy.

H. Peter Laqueur, MD, called it Multiple Family Therapy.

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