Science in Christian Perspective
It was my privilege to stop at the University of Texas Medical Center in Galveston on the way to Europe or a year's sabbatical leave. In the Youth Development Project, a device of psychotherapy called "Multiple-Impact Therapy" is being used. As further information about it was needed, a special visit was scheduled.
Dr. Robert MacGregor, Research Director, and Mrs. Agnes Ritchie, Psychiatric Social Worker, were kind enough to brief me on the process, and to play some tapes of actual interviews. Dr. Alberto Serrano, the psychiatrist, was also present at many of the discussions, and provided opportunity to sit in on an intake interview.
The method in brief, is a short-term treatment procedure. The entire family is brought to the Center. They are interviewed about two days only following this plan:
1. Total family meets together with an equal number of therapists. In this session, attempts are made to create further tension and desire to alleviate the problem. When this tension has reached almost explosive dimensions sometimes, members of the family are separated for the next period.
2. Each member goes into an individual session with a separate therapist to release tensions and talk out the problem.
3. Some individual sessions are longer than others, and as a result, one therapist may come to another session not finished. He is briefed on what has gone on by the continuing therapist, and tells what he has learned from his interview. This breaks down what is called 11 privileged communication"- (the holding of information told to a therapist in strict confidence). The reason given for violating this cardinal rule of therapy is that as the session is very short, they must impress upon all that honesty is a necessity, and that all information given will be checked by others in the family, so they might as well be truthful to begin with.
4. At lunch, members of the team confer with each other, to find discrepancies or air general impressions.
5. After lunch, the problem adolescent is usually
given psychological tests, while the other members continue the "cross-ventilation interviews" described above,
with different therapists. In these sessions directive suggestions are often made, capitalizing on positive forces
noted in the previous sessions.
6. The following day is similar to the first day.
7. A final conference, with all present, attempts to bring to a head all problems noted, and provides some suggestions for procedure when the family gets home.
This is not intended to be a thorough discussion of procedures, but only a survey. For those interested in further information, see the bibliography for a more complete presentation.
Many concepts in this approach are of interest. One question raised was that there no doubt was plenty of tension already present in the family, and no more need be engendered. The r e p I y to this was that for such short-time treatment, the more tension the better. This no doubt has merit.
Another objection raised was the violation of privileged communication which could create suspicion of the therapists. They felt this didn't happen, and was a very important part of the whole process.
The multiplicity of therapists in the group session tends to overpower the clients in my own experience. There was no good explanation as to how this was handled. The taped interview gave some evidence of the above problem occurring.
Another factor, the reviewing of the material that has gone on in therapy for the n e w I y arrived therapist, seems to rob time which might be better spent in therapy itself.
In the lunch sessions, a neutral moderator who has not been in the session presides. In practice, this session becomes in effect, group therapy (much needed in this concentrated approach!). This allows the individual to become more objective about his ideas, and as such is a very helpful procedure.
This method is still new. As such, its effectiveness cannot be reliably ascertained. However, follow-up studies show improvement "as good as in regular therapy approaches." As such it certainly merits further study and practice.BIBLIOGRAPHY
1. Ritchie, Agnes. "Multiple Impact Therapy: An Experiment," 1. Soc. Wk., pp. 16-21, July, 1960.
2. Schuster, F. P. "Summary Description of Multiple Impact Therapy," Texas Reports on Biology and Medicine, v. 17, No. 3, pp. 426-430, Fall, 1959.
3. Further information may be had by writing to: Dr. Robert MacGregor, Research Director, Youth Development Project, Medical Branch, University of Texas, Galveston, Texas.