One of the best things about being an editor is that it doesn’t matter if you are one neuron short of a synapse, or got into the gene pool when the lifeguard wasn’t watching, you are provided a platform from which to speak. For my penultimate editorial, and as a charter member of the Cassandra Institute (inspired by the daughter of Priam who was endowed with the gift of prophecy but fated never to be believed), I am taking advantage of this editorial privilege to speculate about the future. The major plank in my platform over the past 5 years has been an attempt to contribute to building the bridge between research, theory, and practice. To that end, I have tried to regularly publish papers in all three areas, in the hope that such a mix would cause each to more fully inform the other, and begin to challenge the polarizations prevalent in the family field. I hoped to increase our ability to contribute to the development of knowledge in the increasingly complex world of interacting behavioral, psychobiological, and contextual factors that influence the functioning of individuals and families, not to mention the functioning of our service systems and professions.

However, as I prepare to leave this editorial post, my perception is that the gap among these factors remains a profound one. Family Process publishes solid research studies, creative clinical interventions, and theoretical papers designed to make us question our current assumptions. But many clinicians tell me that they neither read nor value the research data being produced, and that they basically fail to see any relationship it has to the realities of their practice. Meanwhile, there is currently incredible support for research on families and family relevant issues, much of it very good, which many clinicians are missing. A search of CRISP, the National Institute of Health database, revealed 2284 currently funded proposals addressing, in one way or another, "families," another 843 on "family interventions," and 220 on "marriage."

Some of these study proposals are more directly targeted to the interests of family therapists than others. Nonetheless, this is an unprecedented amount of support for family studies and projects. For instance, a valuable body of information is developing that addresses the relationships between family/ marital variables and issues across the entire lifespan: antisocial children and adolescents, substance abuse, the hassles of poverty, and aging. There are studies of marital discord and violence, assortive mating, retirement, and caretaking, children of depressed mothers, intergenerational influences, the role of men in family formation, and parenting. There is research on the relationship between genes, the environment, and the adjustment of family members. There are studies designed to document the processes and outcomes of family interventions, such as studies of acceptance and change in marital therapy, the impact of premarital interventions, and parenting to improve child and adolescent outcomes. There are also studies of programs designed to enhance family relationships, improve communication and coping, and document the impact of brief treatment. Many of these projects have a genuine family systems orientation, and many could certainly inform family interventions.

But my guess is that most family clinicians and even those conducting family training programs are relatively unfamiliar with current family research. A brief and random examination of 50 of the research projects noted above showed that only one of the principal investigators was a member of either of the two major American family therapy organizations, and none were subscribers to this journal. I believe it is a problem that most of the interesting research on families is being generated by people who would not identify themselves as family therapists. These exciting research efforts are neither widely known nor recognized by those of us who have the responsibility for training new clinicians and providing the best possible interventions in practice, and yet, most clinicians have probably never heard of some of the systemic connections and creative interventions that should be, and in some cases are, having a major influence on practice with families "in the trenches." Certainly, it is legitimate to practice in the absence of knowledge, but it is not legitimate to practice in the face of knowledge that is available to us. It is legitimate to specialize in either research or practice, but it is not legitimate to be uninformed. It is not reasonable that most therapists stop reading when they leave graduate programs. If the responses I have received to articles in the journal over the past 5 years is any indication, it is primarily those from Europe and other countries who still actively read, challenge, study, and have a scholarly orientation. In the U.S., family therapists are reading less, and the response to the material published in this and other journals is most often a deafening silence. In our clinical fascination with stories within stories, dreams within dreams, lies behind lies, I worry that we are neglecting one necessary intellectual component of our field.

While clinicians ignore research, many investigators dismiss clinical knowledge and skills. Many admit that they do not seek to integrate the clinical wisdom of therapists and teachers, and do not believe such an integration would improve the quality and relevance of the research they conduct. It is a problem when researchers tend to devise oversimplified and under-relevant treatment manuals with interventions appropriate only for a select few who meet rigorous eligibility criteria, or those who devise fidelity scales based on what can be measured (ratios, percent of community contacts, the number of face-to-face contacts or cases), rather than what really matters. Measuring factors like the therapeutic alliance is more difficult, but also far more relevant. If researchers would collaborate with experienced clinicians, who often have an acute awareness of these specific research shortcomings, a more creative and relevant way of addressing issues may result. This might increase our ability to connect with the disempowered, who have a profound distrust of research, in some cases with good reason (witness Tuskeegee). These individuals are particularly sensitive to being "used" by researchers, even though most of the middle class knows there is better treatment to be had by participating in research projects than in accepting standard community care. A failure to make research relevant to community practice exacerbates this distrust of research by clinicians, and indirectly those in the communities most in need of effective services (especially those in poor communities where service needs are high and resources low). The result is our own peculiar version of the resistance to developing evidence-based treatments addressed by "Clinicians for the Restoration of Autonomous Practice" (CRAP) who took on the problem of cookbook medicine and blind faith in methodology to a modification of the Beatles song to say "all you need is trials."


Reasons why clinicians should be involved or at least informed about research

Moving Beyond Technique: I’m old enough to have lived through the heyday of family therapy, when everything about it was exciting and cutting-edge. The ideas were sufficiently powerful to generate mass attendance at workshops and conferences. The field maintained an aggressive proselytizing stance. We went independent; we could afford to. But reliance on terminal charisma and clever techniques is a slim diet for long-term survival. I’d like to be wrong, but I don’t think this is a safe place to be if we want to be a vital part of the future. The creative ideas will be lost as those who generated them move on with their lives. The most creative students will choose other disciplines and not be exposed to family systems ideas; the most talented researchers will seek to study other areas because family is too complex; and third-party payers will increasingly refuse reimbursement for family models. Without respect for research, clinicians are vulnerable to delusions of adequacy, to thinking we know things that we don’t. We would be less likely to end up with an over reliance on technique, and practices based on unexamined assumptions if clinicians would use research, make consistent efforts to conceptualize a rationale for their interventions, and struggle with making their notions of how change occurs explicit and concrete. Without these necessary steps, we find ourselves in the vulnerable position of offering treatments that randomly engage families or are randomly effective when they do. If we were actively involved in research for the benefit of families, we could use our systemic perspective to lobby for a genuine informed partnership between consumers of services, service providers, and researchers - one that is built on respect and collaboration.

Avoiding Marginalization: If we are not involved in cutting-edge research, we also lose an important opportunity to be a part of the current multidisciplinary effort to integrate mind, body, soul, and context. An ongoing commitment to research will also prevent families and family interventions from being marginalized, and prevent both practice and research from becoming oversimplified. And since the evolution of theory depends on contributions from both research and clinical work, theory also suffers. It cannot develop in a vacuum and without interaction with colleagues who have other ideas. This means overcoming the risk contributed by the evolution of independent family degree programs and freestanding family therapy institutes (i.e., the tendency that as we become independent of other professions we preach only to the choir, become marginalized, and lose the stimulation inherent in rubbing up against those with ideas and opinions that differ from our own). In recent years, family therapy is less frequently taught in the training programs of other disciplines and there is declining support for attendance at workshops and advanced training opportunities as agency and individual financial resources diminish. Some might ask how I can worry about marginalization when there are more family therapists, more people practicing family interventions, more independent family degree programs, than at any point in history? I worry because I fear we are becoming a large and visible profession with a guild orientation, without a specific body of knowledge or theoretical orientation. Without the rigor provided by research-based professional training, our contribution is less sophisticated, and generally seen as less relevant. In addition, we are not working to facilitate the integration of family notions in other biological and social systems. If we want a larger role, and I would say it is imperative we seek this role, we need to think more broadly. George Engel (1992) has noted that the current crises in both psychiatry and medicine in general come from their adherence to a model of disease that is no longer adequate for the work and responsibilities of either field. I would say the same is true for family therapy; that the family field is constricted by a too narrow, systemic model of family and family intervention, one that limits our relevance (Engel, 1992). We need thinking, theorizing, and research that accommodates the diverse living arrangements and socio-emotional structures that characterize our lives, retrieval and accommodation of the basic facts about who we live with, and who constitutes "family." We need to embrace complexity.

We need to expand our traditional views of therapy and how change occurs. We need to interact intimately with other health disciplines, and other systems (internal and contextual). There is a vitality that is central to settings in which both talented therapists and researchers practice and feed on one another"s ideas, thrive by having their assumptions and initiatives challenged. Yet providers and therapists distrust research, and the polarization between researchers and therapists is growing. As these two specialties become increasingly divorced, the quality of both suffers. It is crucial that therapists read or use research, contribute to its design and implementation. Good therapists could inform research priorities and could be informed by research results.

Avoiding the serious fallout of not developing an evidence base: There are also practical reasons for all of us to stay involved in research, particularly studies of effectiveness. In recent years, there has been a not so gradual decrease in support for mental health services, including family interventions, as resources for human service programs have diminished. We put ourselves in danger of extinction as resources diminish and the healthcare bureaucracy is left to determine what will and won"t be supported based on the data produced by those with other orientations. An alarming trend is already emerging as healthcare financing systems have put increasing pressure on the service delivery system, not only by insisting on the use of evidence-based models, but also by requiring high numbers of face-to-face contacts from overworked and underpaid clinicians. The result is that most community clinicians are not doing family work. In fact, many do not even see the parents of children being presented for care. It doesn"t appear to have been a conscious decision, but simply a response to demands to log high numbers of clinical hours, to complete incredible amounts of paperwork, and the lack of available time and money for family training and supervision. Family work, almost by definition more difficult and time- consuming, requiring more thought and supervision, just isn"t done. As the pressure for the use of only evidence-based approaches increases, some of the most creative models of family intervention will be left unsupported simply because they do not have a research base.

Inevitably practicing family therapists will become more vulnerable to the control of policy makers who make decisions based on the economic bottom line and what can be documented in mounds of paperwork. Having been a mental health care administrator in a former life before I became a higher life form, let me assure you that we should not leave the survival of the field to the sole province of these decision makers. "Administratium" will clog our creativity, and it is truly the heaviest element yet known to science (with 1 neutron, 12 assistant neutrons, 75 deputy neutrons, and 111 assistant deputy neutrons, particles held together by a force called morons, with an atomic mass of 312, which increases over time until it reaches a critical morass).

Defining our future: Mapping productive new territories

As one of my Spanish speaking friends is fond of saying "Camaron que se duerme, se lo lleva la corriente" (the shrimp that falls asleep is swept away by the current). We need to give ourselves a wake-up call so that events do not sweep us along. One key decision to be made is how narrowly or widely we want to choose to define our territory and our role. But what are the right territorial boundaries for those interested in family functioning, family research, and family intervention today? What role should we play in defining the issues that face us, or the priorities for the field? What information should be generated and made available to professionals and families alike? I would suggest that this is the time to position ourselves for relevance: to become a part of where the field is going and where it should be going. We could limit ourselves to a narrow focus, to family with a small "f"; we can define our territory narrowly. In so doing, we could be theoretically consistent, concentrate on weekly office sessions focusing on carefully defined and circumscribed problems brought by the worried well, the unhappily married, the stressed and distressed parent. We could design creative and clinically appealing interventions and largely feel good about them. We could study the impact and effectiveness of these therapies. Certainly, there will always be a place for this work. However, to choose only this as our mandate would be too limited. We need to address the impact of other systems - internal biological ones and larger social-political ones. One particularly cutting edge area of research involves a range of studies of the relationship between physical and mental disorders and family functioning. There is an increasing body of knowledge about the association between family factors, well-being and productivity, and the onset of and recovery from physical and mental illnesses. There is both a basic and practical side to this research.

We are ideally suited to be key players in increasing understanding of the interface between physical and biological/environmental genetic. For instance, there is a pressing need to fight for the relevance of interpersonal and family factors in depression and schizophrenia as the biological perspective and reliance on psychotropic medication becomes more and more prevalent. The devolution of healthcare system and shortened hospital stays has shifted a good deal of the burden of caretaking and chronic illness management to families. Awareness of the impact of family variables on health, combined with the assignment of caretaking tasks to families suggests a fertile ground for the development of family engagement and interventions in which families are routinely considered partners, members of the healthcare team. For instance, there are findings that demonstrate that bad marriages are associated with more depression (no surprise), but also with some pretty strange variables (i.e., gum disease and cavities, stomach and intestinal ulcers). There is evidence that marital adjustment causes changes in the endocrine and immune systems (Kiecolt-Glaser, Bane, Glaser, & Malarkey, 2003; Kiecolt-Glaser & Glaser, 2002), and is associated with the survival of heart patients (Coyne, Rohrbaugh, Shoham, et al., 2001)). We have an increasing chance to understand these relationships between mind, body, and soul, and we have an opportunity to help families as they encounter the cultural shifts that are increasing family burden. We have an unrealized opportunity to show that involving families helps to maximize health outcomes. But, to be available to help families become collaborators in the understanding and treatment of a range of disorders and problems, we need to be at the interface of medicine and our field, biologically and biomedically informed. We will not be heard if we cling to an upside down reductionism in which family interaction determines all.

There is another largely unrealized opportunity for those of us with a family orientation: the Services Research And Clinical Epidemiology Branch of the NIMH. Its current orientation is ideal for the development of culturally and clinically relevant studies of families in the real world. This branch is committed to funding projects that will actually improve the well-being and mental health of people in the community, and is supportive of both quantitative and qualitative work. Moving beyond carefully controlled clinical trials (which are important but often less relevant to the realities of family and individual functioning), the branch seeks to support studies that involve multiple domains, with specific attention to individual, family, contextual, and service system variables. Thus there is support for studies and interventions that address how families interact with larger social systems (McKay, Pennington, Lynn, & McCadam, 2001; Pescosolido & Rubin, 2000); how their well-being is impacted by mental illness and severe poverty without the support of financial benefits once provided by welfare (Danziger, Corcoran, Danzinger, & Heflin, 2000); how family interventions can be effectively combined with work in schools and communities (Atkins, McKay, Arvanitis, et al., 1998; Henggeler, 2001); how families can be helped as they manage chronically ill or aging members, and how families can be helped to understand and make decisions about the wealth of genetic information being produced that will clearly impact their lives. These are incredible opportunities to make a contribution to families and the field.

How significant a role we will play in the future is our choice. We can choose to stretch our vision and our skill. We can choose to interact with other disciplines, other levels of systems and make serious contributions to the expanding knowledge base about the role of families. We can artificially limit our contributions, or we can choose to be the best we can be. We will reap what we sow. A parable comes to mind: An old Cherokee is teaching his grandson about life. "A fight is going on inside me," he said to the boy. "It is a terrible fight and it is between two wolves. One is evil - he is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego. The other is good - he is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith. This same fight is going on inside you - and inside every other person, too." The grandson thought about it for a minute and then asked his grandfather, "Which wolf will win?" The old Cherokee replied, "The one you feed."

In closing, I am pleased to say that after the next issue, I will be turning over the reins of editor to the very capable hands of Evan Imber-Black, Ph.D., who has been selected to become the next Editor of this journal. Dr. Imber-Black is currently the Director of the Center for Families and Health at the Ackerman Institute for the Family, and Professor of Psychiatry at the Albert Einstein College of Medicine. Her long and distinguished career in family therapy, her many publications, and her highly respected international reputation in the field make her an ideal choice for this position. She has made significant contributions to the expansion and advancement of system-based clinical theory, training, and practice, and I am certain she will contribute significantly to the future of Family Process.



Reference(s):?

Atkins, M. S. McKay, M. M. Arvanitis, P. London, L. Madison, S. Costigan, C. Haney, P.Zevenbergen, A. Hess, L. Bennett, D. Webster, D. 1998, An ecological model for school-based mental health services for urban low-income aggressive children. Journal of Behavioral Health Services & Research, 25(1), 64-75

Coyne, J. C. Rohrbaugh, M. J. Shoham, V. Sonnega, J. S. Nicklas, J. M. Cranford, J. A.2001, Prognostic importance of marital quality for survival of congestive heart failure. American Journal of Cardiology, 88(5), 526-529

Danizinger, S. Corcoran, M. Danzinger, S. Heflin, C. M. 2000, Work, income, and material hardship after welfare reform. Journal of Consumer Affairs, 34, 6-30

Engel, L. G. 1992, How much longer must medicine"s science be bound by a seventeenth century world view? Families, Systems & Health, 10(3), 333-346

Henggeler, S. W. 2001, Multisytemic therapy. Residential Treatment for Children & Youth, 18(3), 75-85

Kiecolt-Glaser, J. K. Bane, C. Glaser, R. Malarkey, W. B. 2003, Love, marriage, and divorce: Newleyweds" stress hormones foreshadow relationship changes. Journal of Consulting & Clinical Psychology, 71(1), 176-188

Kiecolt-Glaser, J. J. Glaser, R. 2002, Depression and immune function: Central pathways to morbidity and mortality. Journal of Psychosomatic Research, 53(4), 873-876

McKay, M. M. Pennington, J. Lynn, C. J. McCadam, K. 2001, Understanding urban child mental health service use: Two studies of child, family, and environmental correlates. The Journal of Behavioral Health Services and Research, 28(4), 1-10

Pescosolido, B. A. Rubin, B. A. 2000, The web of group affiliations revisited: Social life, postmodernism, and sociology. American Sociological Review, 65(1), 52-76

To access the CRISP data base: NIH.gov.

Will Clytemnestra Kill Cassandra? Listen to the Next Chapter: A Comment on Carol Anderson's Editorial
Posted: 2/25/2003

Sociopolitical systems evolve perhaps at an irritating slower pace, but change they do, and quite dramatically, in resonance with socioeconomic variables. Belief systems and dominant ethic systems evolve in resonance with the prior ones -- frequently so as to reconstitute them, sometimes so as to facilitate their change. In turn, any living field that you may chose to analyze is are systems that morph, that slowly but steadily change shapes based on the dynamics of the larger systems of which they form part, that is, within which they are included. In sum, evolution and qualitative changes occur in any system we choose to observe. We can choose to complain about those changes, we can look at them with interest (with "curiosity," Cecchin would have said), or do some of both. But we cannot ignore them.

If we choose to analyze, for instance, the organizing principle of our field of practices, namely, the micro-social system that we call family, its shape, dynamics, function, and enactment in 2004 AD is in some essential aspect very similar to, but in so many other ways very different from, families 2004 BC, or from families 1950 AD, for that matter. And the same can be said of the field of healing -- comparison of substantive differences could be made between any 5 year period, and some qualitative jumps would allow for comparison between two consecutive months. By "healing" I mean whatever people --defined as specialist by whatever consensus -- did and do to treat diseases of the body and diseases of the soul.

Carol -- and, my, does she write elegantly and eloquently! -- is right in her persuasive call for family therapy clinicians to expand their grasp of the rich research literature. It would teach us, at least, humbleness, it would contribute to a hubris-ectomy of good part of our arrogantly self-congratulatory clinical practice... leaving aside the fact that, of course, much of that literature begs the question "And how do I apply this to my practice?" She acknowledges all that as she pleads also for the development of research on practices.

While all this is true (in the sense that I like it), I have somehow the sense that her message has as a background music the melancholic sounds of a ballad composed to honor a field --that of family therapy-- that is morphing itself away after a marvelous but short-lived existence.

While many, Don Bloch among others, date the birth of the field to the first paper by Ackerman on the subject in the late 30s, it is generally accepted that it became a legitimate discipline with its own boundaries in the 50s with the territory staked by Ackerman, Jackson, Lidz and Fleck, Wynne and Singer, Bowen, Satir and a few others. So we can attribute to it between 50 and 65 years of age, with an ebullient childhood and adolescence, and conflictive young adulthood, a self-congratulatory and rather narcissistic maturity...and a progressive popularization, erosion, dispersion, and decay. But all that relies on the metaphor of Family Therapy as a body in itself, while what we call "family therapy" may have been just a (necessary perhaps) figment of our imagination. What we may be lamenting is that the field of therapy is morphing away from our usual way of seeing it. We want to legitimize it, to make a stronger dent that may prove its existence, rather than accepting that family therapy, in all its glory, was a product of its time and is evolving into something else (whatever it may be), pushed by changes in the macro-systems of which it, as any system of practices and of beliefs, is a part...not that I like the ethics that sustain or the practices that dominate those changes -- not that I like reduced access to health care, reduced social responsibility, reduced respect and caring for others, increased impunity if not officialization of corruption, fraud and aggression (I'd better not start on this)... not that I like the callousness of managed care, or the blatant manipulation by the pharmacologic industry toward a biologization of paradigms of health care. But what affects the evolution of the field of family therapy can not be dealt with within the field, but at the most in the interface between our field and others, while all of them evolve. Ultimately, my view -- and my call, which I express every once in a while in my also impune platform as current Editor of the American Journal of Orthopsychiatry -- has more of a political overtone than Carol's. Perhaps it is just another version of the romantic expectation of becoming actors for social change. Because it happens that, when all is said and done, from within the field of family therapy I totally agree with her: clinicians should open up to the research literature, and, if possible, draw bridges; and clinicians should become researchers of their own practices, shifting the balance between imagination and rigor by enhancing the latter without endangering the former, pushing the envelope of their (our!) own ignorance... while the world changes around us.

To close, my homage to Carol Anderson: Under her steerage the journal managed to succeed in achieving the tall order that she had proposed when took the helm, that of making of Family Process a tribune where the best in clinical practices and the best in research, if not married as she would have liked, at least coexisted peacefully and was made accessible to the readers, leaving it up to them to do the bridging. As they should. Carol, chapeau!
--Carlos E. Sluzki MD (Family Process Editor 1982-1990)

On Building Bridges and Increasing Complexity in a Time-Pressed World: You Gotta Have Community!
Posted 2/28/2003

I am late in entering my comments to this terrific dialogue stimulated by Carol Anderson's landmark editorial. I was asked to be one of the original commentators on her piece, and had to beg Anne Bernstein for patience and a few weeks largesse. Why? Because I've been up to my chin in professional responsibilities -- starting a new semester at City College, reading applications to our clinical psychology program and conducting admissions interviews, getting my three community-based research projects/programs up and running after the semester break, tying up the loose ends and assembling the brochure of the program for the American Family Therapy Academy conference (I'm the Program Chair this year), reading 3 dissertations that suddenly are ready to defend in the next month (and must to graduate this spring), supervising family therapy (there's more, but I see you're getting bleary eyed), all economically undergirded by a private practice way too large for a full-time academic. And by the way, I'm writing this already-late contribution on Saturday, a day I usually preserve as sacred time for my family. I'll pay for that later.

You may ask, "Peter, what does your whining about your hectic professional life have to do with the question discussed in this on-line forum -- namely, the question of in what directions must the field go in order to survive and, dare we hope, thrive?" Just this -- most of us these days find ourselves severely time-crunched, doing more work than ever before (sometimes by choice, but often because we must). As someone who not only lives but studies and writes about the challenges of how to navigate the often competing time demands of work and family life (I dare not even add involvement in meaningful communities and friendships!), I believe we must move out of a "first order," distant observer position around this problem -- a problem so commonly mentioned by the couples and families we see in therapy -- to a "second order" perspective in which we recognize the incredible time constraints most of us family therapists, researchers, scholars, and larger systems practitioners operate under. I could not agree more with Carol Anderson's wise and powerful call for better integration and reciprocal influence of research and practice; her call for a broader vision of how family systems must interact with other disciplines, and must imbed itself in work on biological systems, school systems, sociopolitical systems, and others. Carlos Sluzki uses the term "bridges" to capture what we need to build, and I couldn't agree more -- indeed, the title of the upcoming AFTA annual meeting is "Building Bridges: The Challenges of Connecting," and the conference is an attempt to move forward the agenda Carol has set for the field. In her comments, Martha Edwards highlights these needs and concerns in the area of children and families. I couldn't agree more.

Yet Thomas Conran's opening comment illustrated my point about the constraints on our time that limit our capacity to "do it all" -- he notes that, as a person primarily engaged in clinical work and larger systems practice, he is in support of research, but hasn't the time to do it, nor for reading much research. He bemoans the lack of participants in this on-line dialogue, yet I think his own (and my own) personal admissions of limitation tell part of the story. We are at a time in the field in which our thinking, researching, and practicing must move towards greater complexity. We need this complexity in order to account for multiple perspectives both from within the family therapy field and from other disciplines concerned with similar phenomena. We need greater complexity in order to account for how the processes we wish to study or intervene with differ across different groups defined by race, gender, class, sexual orientation, and the like. We need to acknowledge the need for mixed method approaches to research that see the benefits and limitations of quantitative and qualitative research. And the list of possible (actually, necessary) bridges goes on and on. Yet with the need for more complexity, we also face cutbacks in the number of sessions the health care system will support, continued pressures on pre-tenure academics to publish a lot and quickly, all while we attempt to support our own families and see them once in a while.

So, what's my solution? Simply this: we cannot engage greater complexity alone. Most of us cannot do the research, read all the perspectives we should include prior to doing the research, translate the research into language that would help clinicians answer the question Carlos raises -- "How do I apply this to my practice?" -- and conduct the clinical work or community-based programs that then should inform the further development of the research. Not to mention, we need to find ways to take the implications of some of our research and shape public policy -- a whole profession of its own. Not to mention, writing that good quality popular book that would get research-based suggestions out to the general public.

Although I'm sure there are exceptions, my guess is that, despite our belief in multiple perspectives and the need for an interdisciplinary approach, many of us in the world of family systems operate alone. Or at best, we have a group of graduate students or colleagues who hold similar perspectives and skill sets to our own. I believe that if we are to further the ambitious vision Carol Anderson has offered for the field, we must create communities of endeavor that bring together persons who each specialize in one part of the whole. Research teams (which should be diverse in themselves in terms of methods represented) need clinicians, policy analysts, community workers, professional writer, and others to inform the direction, methods, interpretation, and dissemination of the research and its products. Likewise, clinical settings need researchers on staff to create process and outcome studies that just become part of how the clinical setting approaches its work. Persons attempting to mount programs in communities need researchers, clinicians...well, you get my point. In order to embrace complexity, we must create communities of endeavor. Otherwise, I read a piece like Carol's and rather than feeling inspired (as I do), I'm likely to feel pessimistic, even hopeless. Speaking for myself, I just can't do it all.

Gotta go now -- the kids are coming home.