Working With the Dying and Bereaved: Systemic Approaches to Therapeutic Work

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Summary: this book brings theory and practice together in a new way
Review: Dr Peter Bruggen, Consultant child and adolescent psychiatrist and family therapist writes in the Child Psychology & Psychiatry Review, 4:1. 1999. .....I have come to dislike multi-author books.....but there is good news. In the most personally revealing chapter on the relevance of tears I found a fascinating and moving story around deaths among the original Beatles group, one of whom was the brother of one of the editors....don't miss the book.

Dr Matthew Hodes (Senior Lecturer in Child & Adolescent Psychiatry, Imperial College School of Medicine, London, UK) writes in the Journal of Family Therapy. 21:4. 1999.

....The aims of this book are to build on Living Beyond Loss: Death in the Family (Walsh and McGoldrick, 1991) by linking theory and therapeutic technique. Of particular importance is the aim to make more transparent the 'reasons behind the therapist's decision to make a particular intervention at a particular time'. To put this into context, the first chapter by Walsh and McGoldrick provides a very good overview of a family systems perspective on loss, recovery and resilience. It is broad, clear and coherent in the way that one might expect of a chapter written by experts in the field. The second chapter by Sutcliffe with Tufnell is very different. It provides a fascinating and gripping account that skilfully weaves together personal experience and reflection, ideas from systems theory, especially Minuchin's structural family therapy, and psychopathology. Sutcliffe describes the effect of the death of her brother, aged 21 years, on herself and her mother. He was an early member of The Beatles pop group, and a close friend of Brian Epstein and John Lennon who also died at a young age. Their early deaths resonated throughout their linked families, and the wider social system.

Some of the other chapters take up the theme of communications, renegotiations of relationships and meanings through therapeutic encounters. Chapters that provide full accounts of therapy are by Tufnell, Cornish and Sutcliffe regarding the death of a parent with young children, Cornish on the death of pupils in schools, and Levner on the deaths of a gay couple from AIDS. .... many of the authors describe how they have been influenced by Minuchin's structural family therapy. This serves as a useful rehabilitation for structural family therapy at a time when many writers influenced by social constructionism may regard it as passe and best avoided. Here structural ideas are given a postmodern twist by the inclusion of reflexive ingredients.

A second feature is the rather idiosyncratic choice of topics. For example, while death from AIDS-related diseases has received wide coverage in the family therapy literature, the importance for family life of more common causes of death such as cancer and heart disease are neglected. Inclusion of Asen's well-written chapter on managing adolescents following deliberate self-harm, a group who rarely complete suicide and usually have low suicidal intent, was surprising. A number of important topics are not mentioned, such as selection of families and efficacy of family treatments for bereavement, choosing between therapies or combining family therapy with other therapies, and some detailed accounts of therapy with culturally different families. However, given that this is the first book of its kind to be published in the UK it is to be welcomed, and deserves to be widely read.