Karl Tomm

... Parent-Children Conflicts David Epston, Cherelyn Lakusta and Karl Tomm Original version published as Epston, D., Lakusta, C. and Tomm, K., Haunting ... I had been invited by Tim Nichols, the then Director, Cheryl Jacques, the then clinical director, and Sallyann Roth, the then ...

Children are much more aware of and responsive to changes or distortions in family relationships and feelings than parents realize. An emotional problem in a particular child is frequently a reflection of emotional problems elsewhere in the family system. The simple act of bringing together the entire family to discuss these problems openly has significant therapeutic impact. An understanding of the systems model and familiarity with a few basic techniques greatly enhance the effectiveness of the family interview.

tions are authoritative, scholarly, comprehensive, and are clearly and lucidly written. It is a liability in that, perhaps, needing to be both authoritative and non-controversial, the authors have missed some of the most exciting and challenging ideas currently being put forward in the field of family evaluation and treatment. In a year which has seen the publication of several major and exciting works by internationally known family therapists, it is unlikely that this particular book will be widely read. A further problem with the book is that it is not at-all clear to what audience it is addressed. Experienced family therapists will find little either clinically or theoretically that is new or thought-provoking. There is not enough "how to" to make it a useful book for beginners. As indicated above, the overall flavour is sound and dull rather than exciting and challenging. However, because of its medical bias, strong clinical emphasis, its soundness and clarity, it could be useful basic recommended reading in family therapy for trainees with a strong medical or academic bias. The-contributions are divided into four sections. Section one is primarily devoted to psychosocial understanding of the modern family in health and illness. Section two has two contributions, presumably related to the basic sciences: the family as a system, and evolutionary aspects of the family, that is biology and anthropology. Section three relates more specifically to treatment issues. The Stanley R. Dean Award Lecture forms the fourth system and final chapter of the collection. This reviewer found parts 1 and 3 more interest-, ing and helpful than part 2. Of particular interest is the contribution by Theodore Lidz The Family and the Development of the Individual bridging as it does the gap between the intrapsychic psychoanalytic or developmental understanding of the individual and the socio-cultural systems perspective of the individual and his family. The contribution by Saul Brown Family Interviewing as a Basis for Clincial Management is also especially helpful in that he puts very clearly the difference between initial family interviews as an evaluative procedure and family therapy. Contributions to family treatment by Donald Bloch, Marshall Schechter and Harold Lief giveclear and readable accounts of the differences between various schools of family therapy and a vivid illustrative clinical example of family therapy in practice. As indicated above, this reviewer found part 2 disappointing, especially the concept of The Family as a System by James and Jessie Miller. The Millers attempt to utilize a neurobiological systems model, which involves the introduction of many new and bewildering terms. Although undoubtedly family evaluation and treatment rests firmly on general systems theory and a biosocial model, the complex version put forward here is unlikely to be found useful by many readers. The Stanley R. Dean Award Lecture, In Search of the Interactional Origin of Schizophrenia, by Yrjo O. Alanen, Professor of Psychiatry, University of Turku, Finland, forms the' concluding chapter in the book. It also suffers from an attempt to be over-inclusive. Some interesting research data from the author's own epidemiological studies are presented, but the concepts espoused and conclusions reached are presented in a style both scatty and condensed. In a running leap over various theoretical frameworks, concepts from such major theorists as Balint, Winnicott and Fairbairn in Great Britain, Kohut, Kernberg and Lidz in America, and Stierlin in Germany, appear in rapid and rather bewildering succession. Finally, the book is modestly and well-produced. It is not overpriced at $17.50 '

Karl Tomm has been the director of the Family Therapy Program in Calgary for more than 35 years. He has developed an international reputation not only as a family therapist, major innovator, theoretician, and trainer of family therapists but also as a leader in facilitating dialogues among many of the world's family therapists. He started his career applying the problem solving approach to family therapy, developed by Nathan Epstein (Part I). In the 1980s, Karl championed the work of the Milan Group (Part II). More recently, Karl has promoted the work of Michael White and David Epston in narrative therapy (Part III). Don Collins recently had the opportunity and pleasure to interview Karl about the evolution of his thinking and practice over the span of his career.

In many respects the management of diabetes mellitus in children differs from the management in adults. Guidelines for the short- and long-term management of the child with diabetes mellitus, particularly as it relates to clinical presentation, treatment of ketoacidosis, long-term therapy and psychological counseling, are presented. The specific aspects of diabetes management that are unique to the child are best met by an increased understanding of the problems by the child and the family and an integrated approach by the physician and allied health personnel.

This article introduces a series of articles that describe a sequence of research projects that we, as therapists, conducted collaboratively as part of our ongoing daily clinical practice at the Calgary Family Therapy Centre. We designed and completed a set of three formal research studies within the parameters of our work as therapists using an approach we call Research As Daily Practice. There is an intuitive appeal to Research As Daily Practice that comes from (a) privileging therapists' ideas, questions, and curiosities; (b) conducting research flexibly within the time parameters of the daily work of therapists; (c) seeing the processes of conducting research as resonant with the processes of therapy; and (d) showing that meaningful research can be conducted without external funding or resources.

glucose levels. One well-recognized challenge to the clinician is the relative lability of juvenile onset diabetes. Not only must he be concerned with the management of physiologic factors, but he must also deal with the psychologic mechanisms which affect these factors. The studies of Baker and associates’ clearly show that emotional problems significantly alter levels of blood glucose in children with dia-

Interpersonal conflicts are almost inevitable within families. The closeness and intensity of family relationships along with differences among family members in knowledge, desires, values, abilities, etc., account for much of this turmoil. Family members are often deeply hurt in the course of their conflicts and sometimes there is a significant breach of trust, Occasionally a family member will consider a certain offence unforgivable and will not seek reconciliation. Usually, however, family members try to recover a sense of personal and relationship wellbeing by endeavoring to forgive and reconcile. This can be a long and arduous process. Therapists are often consulted to facilitate such healing. My purpose in writing this paper is to share my understanding of some of the complexities involved. The perspective that I adopt is a social constructionist or ‘bringforthist’ stance. I assume that through caring conversation, it. is possible to bring forth preferred ways of thinking and interacting that can lead to forgiveness and reconciliation.

In my opinion, the AAMFT Ethics Committee and the AAMFT Board are attending to the wrong issue in actively discouraging dual relationships in the field of family therapy. The focus in the AAMFT Code of Ethics should remain centered on the avoidance of exploitation and not be shifted onto the avoidance of dual relationships. I acknowledge the importance of finding ways to protect the dependency and trust of clients. However, a more specific means of doing so is required than simply avoiding dual relationships. An ethical injunction to avoid duality not only fails to address the exploitation that occurs within professional relationships, it introduces some of its own problems.

Interpersonal conflicts are almost inevitable within families. The closeness and intensity of family relationships along with differences among family members in knowledge, desires, values, abilities, etc., account for much of this turmoil. Family members are often deeply hurt in the course of their conflicts and sometimes there is a significant breach of trust, Occasionally a family member will consider a certain offence unforgivable and will not seek reconciliation. Usually, however, family members try to recover a sense of personal and relationship wellbeing by endeavoring to forgive and reconcile. This can be a long and arduous process. Therapists are often consulted to facilitate such healing. My purpose in writing this paper is to share my understanding of some of the complexities involved. The perspective that I adopt is a social constructionist or ‘bringforthist’ stance. I assume that through caring conversation, it. is possible to bring forth preferred ways of thinking and ...

The IPscope (IP signifying Interpersonal Patterns), developed at the Calgary Family Therapy Center by Karl Tomm and colleagues, provides a way of understanding behavior in context. Building on our work using the IPscope to conceptualize the functioning of families, we have also used the IPscope to bring a relational ethos to CFT supervision. After describing the development of the IPscope and its use at the CFTC, we describe specific applications of the IPscope to several key foci of clinical supervision: cross-cultural issues; the supervisory working alliance, with specific reference to supervisee nondisclosure and informal supervision; supporting supervisees to develop case conceptualization skills with the IPscopic reflectogram; dealing with impasses in therapy or supervision, usually labeled intrapsychically as countertransference, and a practical approach to isomorphism. Finally, we address limitations and critique of the IPscope.