John J. Schwab – författare

A careful reading provides family therapists and researchers with won­ derful opportunities to examine the ways in which history, socio­ economie and politieal contexts, and epidemiology can be used to in­ crease understanding of the family.

The pivotal importance of the family in society has been confirmed by the reciprocal effects of individual/family/community interactions. Those interactions determine the soundness or malaise of each of the three levels of biosocial organization and thus influence the individual's character formation and personality development, the integrity of the family unit and its functioning and societal well-being. The authors argue that the family is now in crisis and at a turning point toward either vitality or debilitation. As such, this text addresses the status and fate of the family; extreme suffering produced by divorce and the pathologies associated with children who receive inadequate parenting and care; the apparent increased frequency of mental disorders, some of which are products of family life; and, the mental health functions of family life that promotes well-being and provides refuge against despair.

The family, that most fundamentalof human groups, is currently perceived to be changing in response to social, biological, cultural and technological developments in our postmodernsociety. While the observed changes in families have been considered by some sociologists to be evidence of adaptation and, therefore, normal, the authors of this volume, consider them maladaptive. Viewing society from the point of view of clinical psychiatry, they point to greatly increased numbers of children born to single mothers, soaring rates of divorce, a statistically confirmed increase in mental disorders, increase in reported incest, high rates of depression in younger people and escalation of the amount of reported family violence as evidence that the family, as a social institution, is in crisis and can either move toward renewed vitality or continued deterioration. Perceiving a need to obtain information about family functioning that might lead to the increased stability and well-being of this critically important type of system, Dr. John Schwab and his associates designed and camed out a research program that began with a thorough review of relevant literature beginning with LePlay’s study of 300 families in the 1850’sand including important recent statistical studies. They found that although these studies represent advances in understanding the family system, some serious problems with the research remain, one of which is confounding variables such as family function and mental or substance abuse disorders so that if a family member has a problem, such as drug abuse, the family is classifiedasdysfunctional.

The family, that most fundamentalof human groups, is currently perceived to be changing in response to social, biological, cultural and technological developments in our postmodernsociety. While the observed changes in families have been considered by some sociologists to be evidence of adaptation and, therefore, normal, the authors of this volume, consider them maladaptive. Viewing society from the point of view of clinical psychiatry, they point to greatly increased numbers of children born to single mothers, soaring rates of divorce, a statistically confirmed increase in mental disorders, increase in reported incest, high rates of depression in younger people and escalation of the amount of reported family violence as evidence that the family, as a social institution, is in crisis and can either move toward renewed vitality or continued deterioration. Perceiving a need to obtain information about family functioning that might lead to the increased stability and well-being of this critically important type of system, Dr. John Schwab and his associates designed and camed out a research program that began with a thorough review of relevant literature beginning with LePlay’s study of 300 families in the 1850’sand including important recent statistical studies. They found that although these studies represent advances in understanding the family system, some serious problems with the research remain, one of which is confounding variables such as family function and mental or substance abuse disorders so that if a family member has a problem, such as drug abuse, the family is classifiedasdysfunctional.

At the time of this writing, there is much uncertainty about the form of this country''s future healthcare system and the role of psychiatry and other mental health disciplines in that system. Current experience with various managed healthcare programs is not encouraging. Most often patients with severe psychiatrie disturbances receive, at best, so me form of crisis intervention or brief treatment. Marital and family approaches to treatment receive even less support. This discouraging socioeconomic context makes the work of John Schwab and his colleagues even more important than it would be in more favorable times. Their message is clear: The family is crucial to an understanding of psychiatrie disorders and must often be the major focus in the treatment of these disorders. This book is unique in its direct reflection of the senior author''s long-term professional interests-the family, epidemiology, and history. A careful reading provides family therapists and researchers with won­ derful opportunities to examine the ways in which history, socio­ economie and politieal contexts, and epidemiology can be used to in­ crease understanding of the family. This his tory of the family is unusually thorough; in particular, I found fascinating the information about early Egyptian families (3000 B.C.) and their accordance of high status of women.