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Family Therapy: Terminable and Interminable

Royal Alexandra Hospital for Children, Sydney, Australia, JocelynK{at}mail.kids.usyd.edu.au

Families who terminate therapy, but subsequently return for `another dose' are examined in the light of Freud's question as to whether psychoanalysis can ever be completed and effectively terminated. The expectations of families in relation to therapy, the contributions to discontinuation and continuation of therapy and the assessment of outcome, each shapes the answer to the Freudian quandary. `Recidivism' is reformulated as returning for `top-up' or booster sessions in the same way the immune status is restored or reinvigorated through remuneration at regular intervals. A number of outcome studies of family therapy are considered. Several clinical vignettes are provided to illustrate some of the issues surrounding the question of returning families. In particular, persisting till satisfied, returning because satisfied and pursuing deeper and lasting satisfactions are illustrated. Finally Freud's quandary as to the possibility of completing family therapy is answered with a wholeheartedly ambiguous response. Families do not progress beyond problems but they may or may not feel more equipped to handle them.

Key Words: dropout • family therapy • recidivism • relapse • termination

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