• By Dartington SRU
  • Posted on Tuesday 19th October, 2010

Finding the right note

For a man who is now one of the foremost experts on family functioning, Jim Alexander had an adolescence that might have seen him as the subject of his own kind of studies: he was nearly ejected from Duke University, North Carolina, for his drinking. However, he sees two other adolescent interests – playing in a rock band and working in the university’s psychiatric centre to earn some cash – as having a related influence. "I was fascinated," observes Alexander, founder of Family Functional Therapy, “by patterns in mental ill-health. When you are playing in a band there is no right note or mode of music but you have to be in the same key as the rest of the band. It’s not the note, it is how it fits".And the work taught Alexander about “re-framing”. He explains: "Re-framing is a great way to meet whacky people.” By re-framing Alexander refers to the FFT technique of looking at the motivations behind people’s behaviors instead of trying to stop those behaviors directly.At the time he was training, drugs and electric shock treatment were much in vogue in psychology for the treatment of mental illness. Alexander was not unimpressed by what was being achieved. While he was uncomfortable with the techniques, he got interested in whether the same results could be achieved by different means and with less relapse.He began a master's program at California State University at Long Beach and was introduced to social work in highly economically deprived neighborhoods."I learned about the eco-systems of families and communities. Some might call it 'all that bleeding heart social work stuff'. Maybe. But I could see that people felt abandoned. They wanted something therapeutic,” he remembers.The next stop was the PhD program at Michigan State University. In the 1960s psycho-dynamic training was in fashion. "We were reaching into people and dredging out all that 'stuff'", Alexander reflects. "It was about relations so I got that. And it dealt in metaphors and I was drawn to the intellectual intrigue. But when it came to dealing with the externalizing behavior of adolescents, it just didn't work.” Disillusioned, Alexander got interested in systems theory and the building blocks for FFT were almost assembled, unknowingly, in his head.He says: “I was attracted to systems theory because it struck a chord, if you will excuse the pun, with my idea the note not mattering as much as the way it fits with the way other people in the band are playing. But for some reason the leaders of systems thinking, people like Sal Minuchin, they stopped doing research so it all became a little mysterious.” But then there was behaviourism, which had a stronger empirical basis, and a natural appeal to Alexander. Complex ideas like Albert Bandura’s reciprocal determinism explained ordinary events, like a child not liking school, acting out, getting a negative response from his teacher, producing worse behavior, prompting the school to bring the parents in, leading to acting out at home. Alexander saw these ideas in his studies, and he remembered it from his own childhood.Suddenly, the raw outline of FFT began to form. “You had the empiricism of behaviorism and you had the relational aspects of systems theory. That’s what FFT was in the beginning: systems behavioural”.The proven model was born of the synthesis of expertise available in the 1960s, and the context in which Alexander’s studies took place. Lots of people lauded Bandura, and almost as many spoke up for Minuchin. But not many people saw a connection between these giants of psychology. Alexander did.He also drew heavily, as have other architects of evidence-based programs, on the work of Gerry Patterson. “Gerry taught me that kids were the designers of their own fate”. He also points to the work of University of Utah colleague his colleague Holly Waldron, at the University of Utah, who helped him to make more use of understanding and changing the meanings people attribute to problem behaviors.Many academics might have made a name by devoting themselves to writing about these ideas. But Alexander was struck by the lack of plausible treatment models available in the 1960s, especially for poor children and young people.The need for FFT was clear. The first prototypes were produced at the end of the 1960s, and the first experimental trial took place in 1971.So Alexander discovered the value of getting people to sing in tune, even if the tune was uncomfortable for some listeners. He applied this idea to families. And he developed it by drawing on the best available knowledge about the origins of adolescent acting out. A score was written. • Continued in tomorrow’s edition of Prevention Action

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