Dth

, Volume 26, Issue 1, pp 32–46 | Cite as

Verstoorde gezinsverhoudingen, psychische stoornissen en gezinstherapie

De stand van zaken in het onderzoek
  • Alfred Lange
Article
  • 545 Downloads

Samenvatting

De auteur laat zien dat er in de afgelopen jaren forse vooruitgang is geboekt in de kwantiteit en kwaliteit van het onderzoek naar pathogeniserende processen binnen gezinnen en naar de resultaten van relatie- en gezinstherapie. Op bijna alle terreinen blijkt een meerwaarde. We zien dat de psycho-educatieve gezinstherapie vooral van belang is bij schizofrenie en de bipolaire stoornis, al zijn er ook goede resultaten mee geboekt bij depressie, angst- en eetstoornissen. Bij deze stoornissen is een combinatie met de cognitief-gedragsgerichte gezinstherapie echter van meer belang gebleken. De probleemgerichte aanpak (multisystemische gezinstherapie en functionele gezinstherapie) wordt met succes ingezet bij verslaving, en bij gedragsstoornissen en delinquentie. We zien ook dat verstoorde relaties een negatieve invloed hebben op het beloop van somatische klachten. Het betrekken van partners bij medische behandelingen vergroot de kans op verbetering.

Waar vroeger vooral de gedragsrelatietherapie werd onderzocht, zien we dat er de laatste jaren ook veel onderzoek is geweest naar de inzichtgeoriënteerde relatietherapie en de ervaringsgerichte relatietherapie. Zij komen als minstens zo goed uit de bus.

We plaatsen kanttekeningen bij het toepassen van geprotocolleerde behandelingen in het vergelijkend effectonderzoek, maar we kunnen meegaan met de conclusie van vooraanstaande onderzoekers dat er meer voordelen dan nadelen aan kleven. De protocollen vormen het gereedschap dat men flexibel kán, maar niet altijd hóéft te gebruiken.

Ten slotte zien we dat het onderzoek het belang van integratie onderbouwt. Individueel gerichte technieken horen thuis in gezinstherapie. Omgekeerd lijkt het wenselijk dat individueel behandelende therapeuten leren in hun behandelplannen rekening te houden met de wederzijdse beïnvloeding binnen gezinnen.

Abstract

This chapter shows us the increase in quantity and quality of research into the pathogenic processes within families and the results of research into the outcome of family and couple therapy. Psychoeducative family therapy appears to be important for schizophrenia and bipolar disorder mainly, although fairly good results are reported for depression, anxiety and eating disorders. Yet, for these disorders a combination of cognitive behavioral family therapy has been shown to be superior. The problem solving approach (multisystemic family therapy and functional family therapy) is successfully used with drug and alcohol dependency and with conduct disorders and delinquency. We also noticed that dysfunctional partner relationships negatively influence somatic complaints. Involving partners in somatic treatments increases the recovery rate.

In previous decades behavioral couple therapy was the main focus of research. In the past years many studies investigated insight oriented couple therapy and emotion focused couple therapy. They came out at least as good.

We critically discussed the emphasis on protocolled driven treatments in randomized controlled studies. Yet, we could share the conclusions of well-known researchers, that the benefits are larger than the negative aspects. The manuals provide tools that therapists may use but do not have to use always.

We have finally seen, that the bulk of research supports integration. Individual focused techniques do belong in family therapy. On the other side, therapists who mostly see patients individually should learn to reckon with reciprocal influences from within the family.

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Copyright information

© Bohn Stafleu van Loghum 2006

Authors and Affiliations

  • Alfred Lange
    • 1
  1. 1.

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