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Family Therapy and Philosophy: Inspiration and Frustration

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Routine Outcome Monitoring in Couple and Family Therapy

Part of the book series: European Family Therapy Association Series ((EFTAS))

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Abstract

In this article, the author makes a tour de force through his own education in family therapy in the beginning of the 2000 millennium. From a fascination of an offensive and optimistic approach to change work made possible through philosophical idealism and epistemological skepticism, he ends up raising questions about the clients and therapists’ meetings with reality. How can we measure effects in therapy if you cannot talk about both theory and fact? What about the use of the truth predicate and what about working diagnostic, as an expert, with an individual when always urging for a relational understanding? He challenges a relativistic position many family therapists seem to have under their skin, excluding other more scientific approaches. Then, he recommends a more open-minded education merging the two above-mentioned sides.

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Notes

  1. 1.

    “Linear” denotes causality and predictability and in family therapy is understood as a contrast to “circular.”

  2. 2.

    Norsk selskap for filosofisk praksis [Norwegian Society for Philosophical Practice].

  3. 3.

    I have chosen this expression from the 1974 film One Flew Over the Cuckoo’s Nest, starring Jack Nicholson.

  4. 4.

    This calls to mind proximity ethics and the courtesy phrase “After you” which Emmanuel Levinas insists contains the whole of his philosophy (Levinas 1996, p. 203).

  5. 5.

    The French philosopher René Descartes may be credited with founding what, in epistemology, is called skepticism. By systematically pointing out the existence of a mental–physical dualism, he created an epistemological gap between subjective mental phenomena and an external world. The only thing one can be sure of, according to Descartes, is that “I think.” Most philosophy since Descartes has centered on trying to close the gap he opened between res cogitans and res exstensa, popularly called mind and body.

  6. 6.

    Both Bjartveit and Kjærstad (2001) and Hårtveit and Jensen (2002) cite the philosopher Immanuel Kant in clarifying a constructivist position.

  7. 7.

    In the study of the history of ideas, a paradigm shift may be seen as the total replacement of one prevailing scientific view by another. The notion is thus poorly suited to conservatively minded people for whom change is seen primarily as a means to preserve. In politics, the concept is applicable to revolutionary changes, not reforms.

  8. 8.

    A solipsist “holds that all conceivable propositions concern his own experiences. The most extreme solipsist will only conceive of his own present experiences; more relaxed solipsists will take of their own present and past experiences, present and future experiences, or past present and future experiences” (Dancy 1996, p. 136).

  9. 9.

    “Postmodernism” belongs more to the history of ideas and literature than to professional philosophy, where it is little used. In family therapy, postmodernism and relativism can be spoken of as a pair of twins.

  10. 10.

    I see evidence-based practice as a compound of three parts: research communities, practice fields, and knowledge based on accumulated expertise. The clue is to make the research community cooperate with the practice field in a systematic way by picking up best practices and testing hypothesis drawn from what is working in therapy. Best practices can probably best be picked up by using standard client feedback systems on a broad scale.

  11. 11.

    The phrase “the latter part of his career” refers to what many philosophers call “the late Wittgenstein.” This latter phrase is used because Wittgenstein’s philosophical thinking can be divided into two main periods that many scholars see as contradictory: one of them (early Wittgenstein) positivistic and the other (late Wittgenstein) linguistic, with a particular orientation to usage.

  12. 12.

    The term is discussed and explained in footnote 8.

  13. 13.

    Trond Berg Eriksen, professor at the University of Oslo, often used this expression when lecturing about Plato.

  14. 14.

    A popular quote that criticizes this postmodern approach is taken from Alice’s Adventures in Wonderland. When Alice asks the cat in the tree, “Would you tell me, please, which way I ought to go from here?” the cat responds “That depends a good deal on where you want to get to.” This advice was paraphrased in a song by George Harrison as “If you don’t know where you are going, any road will get you there” and was later employed in mocking rebukes of postmodernism (Caroll 2013, p. 54).

  15. 15.

    I refer to Heidi and Bente-Marie Ihlen, who published a book by that title in 2003.

  16. 16.

    I assume here that in-person therapy sessions are required for a not-knowing position to be maintained.

  17. 17.

    The term comes from John B. Watson, the founder of classical behaviorism, which is arguably the antithesis of constructivism and not knowing.

  18. 18.

    The phrase is from the Norwegian philosopher Hans Skjervheim and his book Deltakar og tilskodar (1996) [Participant and spectator] and is cited by Tor Johan Ekeland in his discussion of the technification of interpersonal relations in therapy (Skauli 2009, p. 7).

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Nilssen, H.H. (2017). Family Therapy and Philosophy: Inspiration and Frustration. In: Tilden, T., Wampold, B. (eds) Routine Outcome Monitoring in Couple and Family Therapy. European Family Therapy Association Series. Springer, Cham. https://doi.org/10.1007/978-3-319-50675-3_4

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