Defining the Terms of Go-Between Process

Andrew F. Bambrick

ABSTRACT: Science asks that a theory state its basic terms and operations with economy and precision. Twenty-two terms and op- erations of Zuk's Go-Between Process are defined. It is desirable in science also to carefully distinguish among related theories. Go- Between Process and Structural-Strategic Family Therapy are related theories, and differences are described.

A BRIEF C H R O N O L O G Y

Go-Between Process was developed over a 20-year span. During the early 1960s, Zuk defined pathogenic relating in a series of papers dealing with such symptoms in schizophrenics as laughter, babbling, and silence. In the mid-1960s, he de- scribed the roles of go-between and side-taker as elements of Go-Between Process. In subsequent papers published in the 1960s, he described how change was a product of the therapist's management of the Go-Between Process against the interest of the family to control the process.

In the early 1970s, Zuk turned his attention to the problem of family readiness for therapy and to those factors that limffed readiness, such as culture (e.g., ethnic or religious background or socioeconomic status) and intercurrent familyconditions (e.g., a crisis). In Family therapy: a triadic-based approach (1971), he focused on the importance of the engagement phase as a means to discourage premature family withdrawal from therapy. In a second book, Process and practice in family therapy (1975), he introduced the celebrant role and also the two-value systems which he labeled the "continuity" and the "discontinuity."

Andrew F. Bambrick, M. Div., is Catholic Chaplain at Al lentown State Hospital, Allentown, PA 18103. Reprint requests should be addressed to the author.

International Journal of Family Therapy, Vol 2(2) Summer 1980 99 0148-8384/80/1400-0099 $00.95 �9 1980 Human Sciences Press

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Recent papers (e.g., Zuk, 1979) have refined the definitions of the value systems and broadened the discussion of family readiness as related to culture and intercurrent living con- ditions.

EMPIRICAL RESEARCH

The Go-Between Process was developed by Gerald Zuk after joining the Department of Family Psychiatry at Eastern Pennsylvania Psychiatric Institute in Philadelphia in 1961; EPPI is the chief research and training center for it. Other major advocates are Andrew F. Bambrick and James J. Garrigan, who have conducted extensive empirical research on Go-Between Process.

Garrigan and Bambrick (1977a, 1977b, 1979) teamed up in a 6 year study which showed that Go-Between Process was help- ful to emotionally disturbed children and their families, and that it was readily teachable to novice therapists. Several significant findings emerged from the 1979 follow-up study: Treated children were more likely to have returned to the public school system than untreated, and to have had less involvement with the courts and police. The Garrigan-Bambrick research is be- lieved the most thorough available in family therapy. It involved replications of a basic research design; its method was clearly laid out; a control group was consistently used; it was inde- pendent of the setting at which the originator of Go-Between Process was employed; it concentrated on behavior problems which are very common in children; and it spelled out areas in which intervention by means of Go-Between Process seemed relatively ineffective.

DEFINITION OF TERMS

Zuk's definition of family therapy as the technique to dislodge and replace pathogenic relating is commonly used in the field. The recent text by Barnard and Corrales (I 979) cites it not once but twice (pp. 95 and 244). Go-Between Process is a theory of family group process rather than a personality theory. The therapist attempts to introduce new attitudes, ideas, or activities into the family arena. Emotional catharsis and insight are part of the change process, but not central to it--typically

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they follow and reinforce change. Go-Between Process, like all interpersonal theories of function and dysfunction, owes much to Harry Stack Sullivan.

Of the 22 definitions underlying Go-Between Process that will be offered here, six seem most crucial to understanding the theory. They are (1) the go-between role, (2) the side-taker role, (3) the celebrant role, (4) pathogenic relating, (5) "continuity" values, and (6) "discontinuity" values. The relationship among these six may be described as follows:

Family conflict (husband-wife, parent-child, family-com- munity) involves the polarization of values. Two sets of values are discernible; they are not randomly assumed by one party or the other in family conflict, but rather certain parties character- istically assume one value set vis-a-vis other parties. For in- stance, wives characteristically assume the "continuity" values, husbands the "discontinuity," although there are numerous exceptions to this rule. Characteristically, children assume the "continuity" value set in conflict with parents, who assume the "discontinuity" set.

At a point of intensity of the polarization of values, the parties may engage in pathogenic relating as another means to resolve the conflict and reduce tensions. The therapist inter- venes with Go-Between Process in the roles of go-between, side-taker, and celebrant to reduce pathogenic relating and depolarize the clash of values.

A GLOSSARY

The 22 terms of Go-Between Process may be spelled out as follows:*

1. Family Therapy: the application by the therapist of Go- Between Process to dislodge and replace pathogenic relating.

2. Go-Between Process: transactions of therapist and family in which therapist manages roles of go-between, side- taker, and celebrant to produce therapeutic change he deems desirable.

*Definitions cited here are from the revised edition of G. Zuk's Family therapy: A triadic-based approach (1980, in press) and used here with permission from the author and the publisher, Human Sciences Press, New York.

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3. Go-Between: preferably the therapist acting in inter- views to set the rules of communication.

4. Side-Taker: preferably the therapist in interviews who takes sides with or against family members as a leverage for change.

5. Celebrant: preferably the therapist in interviews who certifies and celebrates important family events as leverage to stabilize the family after a crisis.

6. Readiness for Engagement: therapist's assessment of family values and expectations which may limit readiness to undergo therapy.

7. Engagement Phase: the first four interviews which test the family's readiness to explore conflict and allow therapist time to assess pathogenic relating.

8. Pathogenic Relating: a component of family psycho- pathology which is determined by the therapist in interviews in such processes as silencing, double binding, or intimidation.

9. Silencing Strategies: a form of pathogenic relating in which a member is encouraged systematically to remain silent and is thus scapegoated.

10. Family Psychopathology: the coexistence in a family of symptoms of disturbed behavior, pathogenic relating, and deep-seated value conflict.

11. Continuity Values: as expressed in conflict, the setting of a high value on emotional expressiveness, egalitarianism, humanitarianism, and holism.

12. Discontinuity Values: as expressed in conflict, the set- ting-of a high value on rationality, analytical thinking, rules and regulations, orderly procedure, and efficiency.

13. Crisis-Resolution Family Therapy: Go-Between Process conducted at the time of crisis with family in a disorganized state, with the primary goal being tension reduction in one to six interviews.

14. Short-Term Family Therapy: the modal form of therapy for working-class families, this is Go-Between Process con- ducted in 15 interviews directed primarily at symptom re- duction in members.

15. Middle-Range Family Therapy: well accepted by mid- dle-class families, this is Go-Between Process conducted in 30 sessions directly primarily to improve understanding and co- operation among members.

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16. Long-Term Family Therapy: extending more than 40 interviews, this is Go-Between Process usuallywith more sophis- ticated families to gain better acceptance of members' needs and aspirations while enhancing family solidarity.

17. Contraindication: an unacceptable risk which is incur- red only in the special case where the therapist is deemed to be serving as an agent for another institution to carry out a disciplinary action, such as in the case of a referral from a probation department.

18. Negotiation: in family therapy an exchange among members, including therapist, to set forth or clarify positions with respect to an issue at conflict.

19. Bargaining: in family therapy an exchange among the conflicted parties which contains proposals for change in their respective positions.

20. Power: in family therapy the capacity of any party to influence or determine the outcome of conflict through apply- ing such leverage as taking the role of go-between, side-taker, or celebrant.

21. Conflict: the polarization of "continuity" and "discon- tinuity" values in a family produced by an issue which has become a focal point of tension.

22. Therapeutic Change: discernible to the therapist as a reduction of tension or symptoms in members, or a greater degree of cooperative activity, or an increased awareness and/or use of creative skills in members.

CO NTRAST WITH STRUCTU RAL-STRATEGIC FAMI LY TH E RAPY

In two recently prepared chapters Stanton (in press, 1980) provides a valuable comparison of Go-Between Process, Struc- tural Family Therapy (Minuchin), and Strategic Family Therapy (Haley). Stanton is more directly familiar with the structural and strategic viewpoints through working in the same setting as the originators, and less so with Go-Between Process. In my judg- ment, he fails to provide a sharp distinction between Go- Between Process and the others. Because Structural and Stra- tegic Family Therapy share more elements in common, I shall refer to them as Structural-Strategic for the sake of simplicity

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here. Stanton is correct when he judges the three theories to be the major systems approaches in the field, and does an excellent job in describing the features they share in common.

A more acute presentation of the differences between Go- Between Process and Structural-Strategic would, I believe, run as follows:

1. Go-Between Process, more than Structural-Strategic, relates cultural factors (e.g., ethnic and religious background, and socioeconomic status) to the process-outcome of family therapy.

2. Go-Between Process more specifically relates intercur- rent family conditions (e.g., crisis, the multiproblem, and single- parent family) to process-outcome in family therapy.

3. Go-Between Process places a much greater emphasis on the readiness of families for therapy and on the engagement as a crucial phase and critical for success.

4. Go-Between Process stresses the therapist's acquisition of skill in managing a role (go-between, side-taker, and cele- brant), rather than in managing task assignment or paradoxical instruction.

5. Go-Between Process is significantly less symptom cen- tered.

6. Go-Between Process employs a functional concept of family pathology such as pathogenic relating, in contrast to a structural concept such as family enmeshment (the enmeshed family, more precisely), or the family with a"perverse triangle."

7. Go-Between Process attempts to influence familyvalues, whereas Structural-Strategic attempts to influence family boundaries or hierarchy.

Go-Between Process was developed in a psychiatric out- patient clinic specialized for family therapy, whereas Structural- Strategic was developed in a child guidance setting, which may have somethingto dowi th the method of supervision favored by each. Go-Between Process favors the more traditional teaching format of small-group supervision for trainees bringing in pre- pared case material. Structural-Strategic favors a novel instruc- tional method whereby supervisors have access to trainees conducting f~mily interviews by means of a telephone hook-up. Supervisors phone in their instructions to the trainees while observing through a one-way mirror.

Despite Stanton's claim to the contrary, there is a dearth of empirical research on Strategic Family Therapy. The empirical

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research on Structural Family Therapy is limited in scope in that it is mainly focused on relatively uncommon children's dis- orders.

REFERENCES

Barnard, C.P., & Corrales, R.G. The theory and technique of family therapy. Springfield, IL: Charles C. Thomas, 1979.

Garrigan, J.J., & Bambrick, A. F. Family therapy for disturbed children: Some experimental results in special education. Journal of Marriage and Family Counseling, 1977a, 3, 83-93.

Garrigan, J.J., & Bambrick, A.F. Introducing novice therapists to 'go-between' techniques of family therapy, Family Process, 1977b,/6, 237-246.

Garrigan, J.J., & Bambrick, A.F. New findings in research on go-between process. International Journal of Family Therapy, 1979, 1, 76-85.

Stanton, M.D. Family Therapy: Systems approaches. In G.P. Sholevar, R.M. Benson, and B.J. Blinder (Eds.), Treatment of emotional disorders in children and adolescents. New York: Spectrum, 1980 (in press).

Stanton, M.D. Strategic approaches to family therapy. In A.S. Gurman and D. Kniskern (Eds.), Handbook of family therapy. New York: Brunner-Mazel, 1980 (in press).

Zuk, G.H. Family therapy: A triadic-based approach. New York: Behavioral Publications, 1971.

Zuk, G.H. Process and practice in family therapy. Haverford, PA: Psychiatry and Behavioral Science Books, 1975.

Zuk, G.H. Value systems and psychopathology in family therapy. InternationalJoumalof Family Therapy, 1979, 1(2), 133-151.