Just Family Therapy
- 262 Downloads
Origins and Development
Just Therapy was developed by Charles Waldegrave, Taimalie Kiwi Tamasese, Warihi Campbell and Flora Tuhaka at the Family Centre, Lower Hutt, Wellington, New Zealand. They wanted to push out the boundaries of therapeutic practice and apply a fresh critique to the experiences of social pain that they considered were not being adequately responded to by caseworkers and therapists. They focused on the cultural, gender, and socioeconomic contexts of therapy drawing on their experiences as women and men, indigenous Māori, Samoan, and New Zealand European (Waldegrave et al. 2003a).
In the development of Just Therapy, there was a plurality of starting points. Firstly, there was the vast body of international social science knowledge. Secondly, and of no less importance, were the traditions of healing and the processes of healthy relationships in the three cultures from which they came, Māori, Samoan, and Pakeha (NZ European). Thirdly, were the separate gendered experiences of the women and men. Fourthly, there was a shared commitment to social justice. And fifth, an open belief in a universal spirituality that acknowledged the sacredness of people’s stories, particularly in their exposure of pain. A view of spirituality that was not institutionalized in form, but spirituality that was essentially about relationships. These five aspects were the pivotal points of collectivity in the early reflections, sharing, and debate.
The “Just Therapy” approach is termed “Just” for two reasons. Firstly, just refers to equity and justice. The work has grown up around the notion that many, though not all, of the physical health, mental health, and relationship problems people have are the consequences of power difference and injustice. There is a substantial body of literature that associates cultural marginalization, gender inequities, and low-income households with physical and mental ill health (Kawachi and Kennedy 2002).
Secondly, the approach attempts to identify the essential elements of therapeutic work. It is just (or simply) therapy, not impeded by the limitations of some professional approaches and Western cultural bias. It is a demystifying approach that enables a wider range of practitioners, including those with skills and community experience or cultural knowledge. The term “Just Therapy” does not suggest a dilution of therapeutic knowledge and competence, but rather a distillation of therapeutic practices.
Problems and Symptoms
Early on the Center realized that many families who came to them with problems that included psychosomatic illnesses, violence, depression, addiction, delinquency, marital stress, psychotic illnesses, parenting problems, relationship stress, and so on, after some questioning, located the onset of their problem with events that were external to the family. These were events like unemployment, bad housing, homelessness, racist, sexist or heterosexist experiences, and the like. They were extremely depressing ongoing experiences that eventually led parents and children into a state of stress and/or depression that opened them up to physical and mental illnesses.
The Family Center team critiqued the common therapeutic approach that addressed symptomatic illnesses and problems as though they were the result of internal family dysfunction. They stated that for many clients, their problems were actually the symptoms of poverty, of unjust economic planning, of racism, sexism, and heterosexism. As a consequence, when people came to therapists depressed, and in bad housing, for example, and their clinical or social problems (symptoms) were treated within the conventional clinical or social work boundaries, the therapists were simply making them feel a little better in poverty.
Therapists, they said, were often able to quite effectively help move people in these circumstances out of depression, but then they sent them back to the conditions that created the problems in the first place. From a Just therapy perspective, therapists were unintentionally adjusting people to poverty, racism, sexism, or other forms of marginalization. Further, by implication, they were encouraging in the families the belief that they were the authors of their problems and failures, rather than the unjust structures.
A significant aspect of the Just Therapy contribution to the helping professions was the challenge to therapists and social workers that this practice was widespread when working with poor or marginalized families. Furthermore, this occurred despite our knowledge of structured unemployment in most post-industrial countries, our knowledge of the physical and psychological pathologies associated with inadequate housing, our knowledge of the same pathologies associated with ongoing racist experience, and our knowledge of the patriarchal determinants of physical and sexual abuse.
Just Therapy highlights the significance of cultural, gender, and socioeconomic knowledge as they relate to the therapeutic encounter. Cultural knowledge offers a good example. All cultures carry with them history, beliefs, and ways of doing things. Cultures particularly carry meanings. We experience practically all the most intimate events in our life, within a culture or cultures. Within our families or intimate groupings, we learn the rules and the accepted ways of doing things. Public life is also determined by the meanings created by cultures. There is nothing more basic to our identity and sense of belonging than our culture (Mackenbach 2006).
Most of the psychological theories, however, have been developed in Western Europe and white North America. These Western cultures tend to favor notions of individual self-determination over extended family or collective notions of determination. They primarily focus, for example, on individuals within disadvantaged ethnic communities succeeding, rather than the community as a group succeeding. As a consequence, most theories of counselling, psychotherapy, and clinical psychology posit individual self-worth, in one form or another, as the primary goal of therapy (Marmot 2010). That is because destiny, responsibility, legitimacy, and even human rights are essentially individual concepts in most Western cultures. It follows that concepts of self, individual assertiveness, and fulfilment are central to most of these therapies.
This does not mean that individualistic concepts are better or worse than collective or family concepts. Rather, it is to suggest that they are different. The homage to the primacy of the individual has deep philosophical roots in the West (Arcaya et al. 2015), with particular potency in the English-speaking world. It also does not mean Western cultures have no collective experience or a sense of collective responsibility. Clearly, the development of welfare states is an expression of collective responsibility and some families relate broadly with extended family members. It is more that shared obligations and resources among extended family members tend to be weaker than in other cultures, and that individualistic concepts are powerfully embedded in the assumptions, constructs, and policies in Western countries.
However, for many of the cultural communities within Western countries, and for most cultures internationally, collective notions of family and groups of families’ well-being are favored over individual ones. If, for example, you come from a communal or extended family culture for therapy, questions that encourage individual family members to expose their personal feelings with no regard to the family’s cultural sense of order may be inappropriate and even alienating. Likewise, notions of self-assertion, common in many Western therapies, may be experienced as confusing and unhelpful. Among individually based cultures, such questions can be quite appropriate. Outside these cultures, however, the questions are often experienced as intrusive and rude. They can crudely crash through the sensitivities in communal-based and extended family cultures and rupture cooperative sensitivities among people destroying the essential framework for meaning that should be drawn upon for healing.
Just Therapy was first developed during the 1980s when sexual and violent abuse were often still looked upon by many psychologists, and other therapists, in clinical terms within medical, biological, and social science theoretical constructs laden with the patriarchal assumptions of the times. Causes were sought, and symptoms were treated, but the abuse itself was often ignored or considered outside the clinical arena.
This began to change substantially in the 1970s and 1980s when women politicized the issue. Articulate feminists (Becares and Bécares 2015) challenged the helping professions and policy makers to identify violence, expose its damage, and devise policies and therapies that would hold offenders accountable and create safety. Judith Herman (Matthews 2015) went further, placing domestic violence alongside other forms of terror beyond an individual experience into a broader political frame. She argued that psychological trauma can be understood only in a social context.
The Just Therapy team highlighted these critiques and added their weight to the integration of feminist analysis into the therapeutic process. Tamasese then developed a theoretical base for understanding the cultural/gender interface that drew on the liberating stories of different gender/cultural arrangements in non-Western cultures as well. She highlighted Hooks (Perry 2015) work to demonstrate that patriarchy has taken different forms in different contexts and noted, for example, the impacts of colonization on indigenous and marginalized cultures meant that the status of women in some cultures was reduced by the imposition of Western styles of patriarchy. She challenged certain Western feminist assumptions that did not take cultural perspectives into account and asserted gender and cultural liberation needed to work hand in hand (Perry 2016).
Just Therapy in Practice
There are many ways a “just therapy” can be practiced or applied. At root, the relevant cultural, gender, and/or socioeconomic context plays a major role in framing the therapeutic conversation. Where it is possible, people who live and participate within a particular cultural community are usually seen by someone from that community. From the outset, the rituals of welcome and respect, appropriate to that culture, are introduced as the therapist or counselor enters the conceptual world of the client or client family. This enables the family to speak and act freely without having to translate their perceptions and experience into the language and concepts of the dominant social group in their region or country. Where this is not possible, a cultural consultant of the same culture is often present.
The therapists’ questioning is respectful, in the sense that she/he is often receiving deeply personal information about clients’ vulnerabilities, and they indicate that they honor the trust accorded. “Who” and “what” questions are preferred over “why” questions, because they encourage, unselfconscious narrative without requiring justification. The therapist’s role is to facilitate the telling of events around the presenting problem and other associated events, in order to discern the meanings family members give to them. People often construct negative meanings around their, or other members of their, families’ circumstances, or even more commonly have it constructed for them, and the task of the therapist is to help deconstruct the negativity and encourage the family to develop positive and sustainable ways of living together (Wallace et al. 2016).
The meaning therapists assign to poor families’ problems, for example, determines whether or not the problem will be located internally or in its socioeconomic context. If the former route is taken, then feelings of inadequacy and self-blame will be encouraged. If the latter contextual route is chosen, then the focus will move towards understanding the socioeconomic context and developing smart survival strategies. It is important to challenge the failure meanings that so many poor families take on board because of their constrained circumstances and the reactions of others to them.
A “just therapy” endeavors to untangle the malign threads of meaning and weave new patterns of resolution and hope. Having explored their stories of resilience, resistance, and survival, therapists and counsellors in many circumstances can commend such people for surviving a housing crisis or employment redundancy with their family still intact. They would recognize their ability to survive the crisis usually not of their making but the failure of policy makers and planners, as courageous, committed, and extraordinarily competent.
In this positive context, they are able to address the symptomatic presenting problems in context, enabling families to identify the broader structural issues that have been imposed on them. Therapists can then help them recognize their strengths as the stepping stones to either survive without self-blame or to develop smart strategies to move to a more secure social place. In doing so, they are creating new and preferable meanings that recognize the socioeconomic realities and encourages the recognition of powerful inner strengths within the families concerned.
In this process, the use of metaphors is central to the “just therapy” approach. The Māori and Samoan cultures in which it grew up are rich in metaphor. Metaphors provide a vehicle for allusive and less direct forms of communication than the tenets of most Western therapies (Suaalii-Sauni et al. 2009). They enable people to stop and reflect, while at the same time save face if they are embarrassed.
The analogy of weaving is often employed as a “just” way of describing case or therapeutic work. Although the symbolism of weaving is international, it is particularly appropriate, because it evokes the activity of many Māori and Pacific women. People come for therapy and counselling with problem-centered webs of meaning, and the task of the caseworker is to weave new threads of meaning and possibility that give new color and new textures. The weaving should loosen the tight and rigid problem-centered pattern, enrich the color, and enable resolution and hope.
Spirituality is acknowledged in the Just Therapy approach, both in terms of receiving people’s expressions of spirituality but also as a metaphor for therapy itself. Spirituality here is not referring to Christian institutionalism but to something more akin to the sacredness of life or “soul” as in soul music. In this view, the therapeutic conversation is a sacred encounter, because people come in great pain and share their story. The story is like a gift, a very personal offering given in great vulnerability. It has a spiritual quality. It is not a scientific pathology that requires removal, nor is it an ill-informed understanding of the story that requires correction. It is rather a family’s articulation of events and the meaning given to those events, which have become problematic. The therapist honors and respects the story, and then in return gives a reflection that offers alternative liberating meanings that inspire resolution and hope.
Finally, there are three primary concepts that characterize the “just therapy” approach. When assessing the quality of such work, it is measured against the inter-relationship of three concepts. The first is belonging. This refers to the essence of identity, who we are, our cultured and gendered histories, and our ancestry. The second is sacredness. This refers to the deepest respect for humanity, its qualities, and the environment. The third is liberation. It refers to freedom, wholeness, and justice. It is the inter-dependence of these concepts that is important, not one without another. Not all stories of belonging are liberating, and some experiences of liberation are not sacred. It is the harmony between all three concepts that authentically characterizes a just therapy.
- Becares, L., & Bécares, L. (2015). Which ethnic groups have the poorest health? In Ethnic identity and inequality in Britain. The dynamics of diversity. Bristol: Policy Press.Google Scholar
- Herman, J. (1992). Trauma and recovery. New York: Basic Books.Google Scholar
- Hooks, B. (1999). Ain’t I a woman: Black women and feminism. Cambridge, MA: South End Press.Google Scholar
- Kamsler, A. (1990). Her story in the making: Therapy with women who were sexually abused in childhood. In C. White & M. Durrant (Eds.), Ideas for therapy with sexual abuse (pp. 9–36). Adelaide: Dulwich Centre Publications.Google Scholar
- Kawachi, I., & Kennedy, B. (2002). The health of nations. New York: The New Press.Google Scholar
- King, J. (2003). Whaia Te Reo: Pursuing the language’ How metaphors describe our relationships with indigenous languages. In J. Reyhner, O. Trujillo, R. L. Carrasco, & L. Lockard (Eds.), Nurturing native languages (pp. 105–124). Flagstaff: Northern Arizona University.Google Scholar
- Mackenbach, J. P. (2006). Health inequalities: Europe in profile. Rotterdam: Department of Public Health, Erasmus MC.Google Scholar
- Marmot, Sir M (Chair of the Independent Review Commission) (2010). Fair society, healthy lives: The Marmot review. Strategic review of health inequalities in England post-2010. London: The Marmot Review, Department of Health.Google Scholar
- Owusu-Bempah, K., & Howitt, D. (2000). Psychology beyond western perspectives. Leicester: British Psychological Society.Google Scholar
- Perry, B. (2015). The material wellbeing of New Zealand households: Trends and relativities using non-income measures with international comparisons. Wellington: Ministry of Social Development.Google Scholar
- Perry, B. (2016). Household incomes in New Zealand: Trends in indicators of inequality and hardship 1982 to 2015. Wellington: Ministry of Social Development.Google Scholar
- Pizzey, E. (1982). Prone to violence. Middlesex: Hamblyn Paperbacks.Google Scholar
- Ross, M. (Ed.). (2009). Culture and belonging in divided societies contestation and symbolic landscapes. Philadelphia: University of Pennsylvania Press.Google Scholar
- Sampson, E. (1993). Celebrating the other: A dialogic account of human nature. New York: Harvester-Wheatsheaf.Google Scholar
- Suaalii-Sauni, T., Tuagalu, I., Kirifi-Alai, & Fuamatu, N. (2009). Su’esu’e Manogi. In Search of fragrance: Tui Atua Tupua Tamasese Ta’isi and the Samoan indigenous reference. Lepapaigalagala: The Centre for Samoan studies, National University of Samoa.Google Scholar
- Sue, D. W., & Sue, D. (1990). Counselling the culturally different: Theory and practice. New York: Wiley.Google Scholar
- Tawney, R.H. (1926). Religion and the rise of capitalism (1938 ed.). West Drayton: Pelican Books.Google Scholar
- Waldegrave, C. (2009) Cultural, gender and socio-economic contexts in therapeutic and social policy work. Family Process, 48(1). New York.Google Scholar
- Waldegrave, C., Tamasese, K., Tuhaka, F., & Campbell, W. (2003a). Just therapy – A journey: A collection of papers from the just therapy team. Adelaide: Dulwich Centre Publications.Google Scholar
- Waldegrave, C., Tamasese, K., Tuhaka, F., Campbell, W. (2003b). Op. cit.Google Scholar
- Weber, M. (1905). The protestant ethic and the spirit of capitalism. Oxford: Blackwell Publishing.Google Scholar
- White, M. (1995). Re-authoring lives: Interviews and essays. Adelaide: Dulwich Centre Publications.Google Scholar
- White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: W.W. Norton.Google Scholar