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Limitations

One of the basic ethical principles in health care is the principle of nonmaleficence – that is, "above all, do no harm." To carry out this ethical principle, practitioners must make themselves aware of the limitations of each counseling or therapy approach contained in this book. To that end, the following two important limitations to the family therapy approaches are presented.

First, the early language chosen for describing family systems was "combative and bellicose, often suggesting willful opposition: double bind, identified patient, family scapegoat, binder, victim, and so on" (Nichols, 1987, pp. 18-19). The choice of language emphasized the destructive power of families and contributed to an assault on the family by several pioneers in family therapy (Cooper, 1970). This assault has continued to the present because many family therapy educators and practitioners have overread this language and adopted a directive, manipulative approach to treatment. This overreading led to unfortunate consequences. For instance, Green and Herget (1991) discovered that at their family therapy clinic many families found "paradoxical prescriptions as signs of therapist sarcasm or incompetence, that engender massive resistance, sometimes destroying all together the clients' faith and cooperative attitude in therapy" (p. 323). Also, Patterson and Forgatch (1985) uncovered, in their study of families in treatment, a direct relationship between client resistance and frequency of counselor or therapist directives.

Second, family therapists have ignored the different socialization processes operating for men and women. Thus, family therapists have not adequately considered how these socialization processes have disadvantaged women (Friedlander, Wildman, Heathering- ton, & Skowron, 1994). Walters, Carter, Papp, and Silverstein (1988) called for family therapists to review all family therapy concepts through the lens of gender socialization to eliminate the dominance of male assumptions. Their hope was that such a review would promote the "recognition of the basic principle that no intervention is gender-free and that every intervention will have a different and special meaning for each sex" (p. 29).

 
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