Journal of Marital and Family Therapy April 2000,VoI. 26,No. 2,143-152

THE EFFECTIVE USE OF ENACTMENTS IN FAMILY THERAPY: A DISCOVERY-ORIENTED PROCESS STUDY

Michael P. Nichols Stephanie Fellenberg College of William and Mary

In this investigation we examine the elements of enactments-in-session dialogues used to observe and modifi family interactions in structural family therapy. Twenty-one videotaped segments of 18 therapy sessions with diTerent families were used to compile detailed descriptions of therapist techniques and client responses. Enactments were analyzed as consisting of three distinct phases-initiation, facilitation, and closing-each of which required more numerous and complex interventions than are usually described in the clinical literature. Judges were able to reliably describe therapist interventions that led to successfil enactments as well as what therapists did or failed to do that led to unproductive outcomes. Clinical implications of these Jindings are discussed.

Enactments are among the most familiar tools in family therapy. Enactments are situations in which therapists direct family members to talk or interact together in order to observe and modify problematic transactions (Minuchin, 1974). However, although this technique is widely known, using it effectively may be more complicated than has generally been assumed (Nichols, 1997). Sometimes family members are angry and refuse to talk with each other. At other times their conversations repeat familiar and unproductive patterns. While beginners may have trouble taking charge to initiate productive enactments, experienced therapists may have trouble letting go to avoid overmanaging them (Nichols, 1997). As a consequence of these difficulties, many therapists give up on enactments or continue to use them ineffectively.

Although some clients are all too ready to argue among themselves, most are reluctant to discuss their conflicts directly with each other in family therapy sessions. They have tried in the past, but it has been painful and unproductive, so by the time they get to a therapist’s office, many people are ready to give up on each other and turn to the therapist for understanding. Therapists also may be anxious about pushing family members to talk over their troubles with each other. Thus, there is pressure to avoid enactments from all parties in the therapeutic encounter and to rely instead on the therapist’s interrogatories. As long as the therapist controls the conversation, the family members at least will not be fighting with each other.

Written descriptions (e.g., Minuchin, 1974; Minuchin & Fishman, 1981; Minuchin & Nichols, 1993) and teaching videotapes often create the impression that working with enactments is easy. (Just do what Minuchin does!) The artfulness of these carefully chosen exemplars may lead therapists in training to assume that generating enactments is simple. Unfortunately, when they find out otherwise, many clinicians abandon this potentially useful technique. Moreover, the lack of detailed instruction on enactments in the clinical literature may leave teachers and supervisors with the mistaken notion that all that is required to generate a productive enactment is to tell family members to talk with each other.

Why are some therapists able to work productively with enactments while others avoid or give up on this technique? How do effective therapists get family members to talk when they do not seem to want to? What can a therapist do when family dialogues become contentious or destructive? Are the specific interventions that lead to effective enactments a matter of instinct, or are there discoverable principles about how to use this valuable but underutilized technique?

If family therapy sessions are a place where families can hold conversations that belong at home but

Michael P. Nichols is Professor of Psychology, College of William & Mary, Williamshurg, VA, 231874795, Stephanie Fellenberg is a doctoral student in the Virginia Consortium Program in Clinical Psychology.

April 2000 JOURNAL OF MARITAL AND FAMLY THERAPY 143

do not take place there, two things are necessary. First, the therapist must encourage these conversations. However, because communication in troubled families is often difficult, therapists must also be able to help family members get past unproductive wrangling to more genuine two-way dialogues.

This study was designed to explore two related questions: (1) What do therapists do to promote the effective use of enactments? (2) What do therapists do or fail to do that make enactments ineffective?

METHOD

The first step in this discovery-oriented-process study was to define the therapeutic task and identify “markers” for its occurrence (Rice & Greenberg, 1984). Enactments are defined with little ambiguity in the clinical literature (e.g., Minuchin & Fishman, 1981) as family interactions directed by a therapist in order to observe and modify transactions that make up a family’s structure. Although these directed exchanges may consist of behavioral interactions (e.g., asking a parent to get children to play quietly in the comer), we chose to limit our focus to verbal dialogues, which are far more common.

Enactments are sometimes used primarily for assessment purposes (particularly in first sessions). They provide valuable information about a family’s functioning, even if nothing shifts in the process. We selected enactments used in subsequent sessions in order to study their use for therapeutic change.

As a diagnostic tool, enactments are relatively straightforward. Because the aim is simply to observe, little need be done other than direct family members to talk with each other. However, when family members have trouble talking, or do so unproductively, enactments become more difficult, both to initiate and to make constructive. Because using enactments therapeutically means addressing problems at their source, the difficulty of doing so should not negate the potential power of this technique.

The marker for the beginning of an enactment is unmistakable and consists of the therapist directing family members to speak with each other, either verbally (“Tell him how you felt when . . . ”) or by gesture. Defining the end of an enactment is a bit more complicated. Family members may break off their conver- sation, or the therapist may intervene, but the dialogue may be resumed shortly thereafter. Studying such an enactment at the point where it was interrupted might create a misleading impression about its eventual outcome. Therefore, in order to make our conclusions clinically relevant, we observed each session in its entirety in order to identify the point at which each enactment reached its definite conclusion (i.e., the point at which the conversation ended and was not resumed).

The second step in this investigation was selecting the clinical sample. Although it may be more convenient to obtain videotapes of therapists in training, we decided that in order to study the optimal use of enactments, it was important to secure tapes from experienced therapists. We were fortunate in being able to obtain 21 tapes of different cases from four senior therapists, each of whom had at least 15 years of clinical experience and was considered a leading practitioner of structural family therapy. Three therapists were male, one female; all four were Caucasian; two were North American; two were from Latin America.

Clients ranged across the socioeconomic spectrum and represented a variety of presenting complaints, though none was psychotic. The cases included both couples and families with children. The majority of clients were white, two cases included African-American clients; most clients were North American, although three cases included Latin-American clients.

In order to explore both positive and negative contributions to enactments, we selected a sample of successful and unsuccessful enactments from each of the participating therapists. Successful enactments were ones judged to produce a positive shift in the process of family interactions, while unsuccessful enactments were those in which no change occurred. These judgements were based on independent ratings by the two authors, with a 94.7% agreement.

Three of the total sample of 21 tapes were not used in the study: one did not contain a clear-cut enactment, in one much of the conversation was in Spanish, and in one the raters did not agree whether the enactment was successful or unsuccessful. Thirteen successful and eight unsuccessful enactments were included in the final sample: four successful and one unsuccessful for one therapist, three successful and three unsuccessful for the second therapist, and three successful and two unsuccessful for each of the remaining two therapists.

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The third step in this study was recruiting and training raters. We selected undergraduate students because it was convenient and because we thought that relatively naive observers might have few precon- ceptions to bias their observations and could more easily be trained to make concrete observations without resorting to theoretical inferences.

Six raters were selected from students in abnormal psychology classes who volunteered to assist in “a study of how family therapy is practiced.” The raters received ten 90-min training sessions. Tapes of family therapy sessions (other than those used for data collection) were shown to the students, and they were asked to observe carefully. The tapes were stopped at various points, and students were asked to describe what they saw happening. After two such practice sessions, we explained what enactments were and how they were used in therapy. At that point, raters were divided into client and therapist groups and told to concentrate only on either the therapist or the clients.

Next, the raters in each group were given the questions they would be asked in the data collection phase and asked to respond to them “as carefully and thoroughly as possible” in several practice sessions. The questions for the therapist group (N = 3) were What does the therapist do to initiate the enactment successfully? What does the therapist fail to do? What does the therapist do to facilitate the progress of the enactment? What does the therapist do (or fail to do) that hinders the progress of the enactment? What does the therapist do to close the enactment? What do you think was helpful and not helpful?

Client raters (N = 3) were asked to respond to the following questions: What did the clients do to initiate a successful enactment? What did the clients do that hindered the initiation of the enactment? What did the clients do that contributed to successful progress of the enactment? What did the clients do that hindered the progress of the enactment? How did the clients end the enactment (did they arrive at a solution, reach an understanding, etc.)? With these instructions in mind, the last and longest phase of the training was used to conduct trial runs of observing the elements used in enactments. Trainee raters watched videotaped enactments and answered the questions mentioned above, after which they discussed and compared observations. By the sixth of these practice sessions, raters’ observations seemed to have reached a high level of interrater agreement.

The fourth step in this study was developing a strategy for data collection. Raters were told to watch the videotaped enactments independently and to review each tape twice. They were instructed to observe all of either the therapist’s or clients’ responses and to answer the questions mentioned above as thoroughly as possible.

Following the data collection phase, the authors reviewed the raters’ written observations and translated them into general categories. These translations involved minimal inference and consisted of categorizing such responses as “The therapist tells the mother to talk with her son about missing school” as “Therapist directs participants (by word or gesture) to talk to each other.” After a sufficient number of responses were categorized to ensure that no new categories emerged, the categorizing process was deemed complete.

Following the development of these categories, both authors independently assigned each of the raters’ responses to categories. Only those responses that both authors agreed fit a particular category were included in the final analysis. Because the responses and categories were simple and concrete, it was relatively easy to reliably assign responses to categories. The exceptions to this were a few responses that were either vague (e.g., “the client was defensive”) or inferential (e.g., “the therapist was helpful”). These responses were dropped as uncategorizable. Only those responses that were observed by at least two of the three raters were scored for any particular enactment. Finally, these reliably observed items were rank ordered in terms of frequency of occurrence over the 21 segments.

RESULTS

Therapist Interventions for the Initiation of Enactments Raters observed seven categories of intervention in response to the question “What does the therapist

do to successfully initiate the enactment?’ Among the most frequently observed interventions were directing the participants to talk, leaning back to remove oneself from the dialogue, specifying how the conversation

April 2000 JOUEXAL OF M A R E 4 L AND F M I L Y THERAPY 145

TABLE 1 Therapist Interventions for Initiation of Enactments

Intervention Number of times observed by two or more raters

Successful: Directs participants by word or gesture to talk to each other 15 Leans back, moves own chair back, or otherwise shifts position to remove self from dialogue 12 Specifies how conversation should go (describes what the process should be, tells them to

10

3

1

listen to each other, instructs one to find out what the other feels, etc.) Specifies topic for conversation 5 Tums participants’ chairs to face each other or moves them closer together Emphasizes need for dialogue 2 Asks participants if they would be willing to talk or willing to talk in a certain way

Unsuccessful: Does not position participants to face each other (move their chairs, reposition them

in some way) 13 Does not specify topic 5 Does not specify how conversation should go (listen to each other, speak up,

Does not lean back, move own chair, or otherwise remove self from the dialogue talk about your feelings, etc.)

(remains central in some way)

3

3

Note. Two additional categories of unsuccessful intervention, “Does not make clear who should talk to whom (allows participants to address third parties or third parties to participate in a way that interferes with dialogue,” and “Does not pick topic with sufficient affect (conflict, meaning- fulness to both parties)” were also observed but only by one rater for any given enactment.

should go, specifying the topic of conversation, and turning participants’ chairs to face each other. See Table 1 for a complete list of productive interventions.

In unsuccessful enactments, therapists were observed to omit the kind of specific direction observed in successful enactments (Table 1). The most common failures included not positioning participants to face each other, not clarifying either the content of the discussion or suggesting how it should go, and not pulling back to remove oneself from the dialogue.

The successful initiation of enactments, then, seems to involve both a positive aspect-being quite specific about the topic for discussion and about how the conversation should go-and a negative element- removing oneself from the dialogue.

Therapist Interventions for the Facilitation of Enactments Getting family members to begin talking to each other may be the easy part. Helping them get past

unproductive patterns of communication seems to require a number of specific and well-timed interventions. Raters observed a total of 18 different interventions judged to facilitate productive enactments (Table 2). Among the most frequently observed things therapists did to be helpful were not interrupting family members once they began talking together and encouraging them to continue speaking to each other and not to the therapist. Simply by not interrupting and by directing family members to talk to each other, therapists were seen as exerting a powerful influence in keeping enactments going.

When enactments began to bog down, two kinds of intervention seemed helpful. One was simply pushing family members to keep talking or to explain themselves more fully. The other kind of intervention could be thought of as digging beneath the surface of defenses, for example, probing deeper into clients’

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TABLE 2 Therapist Interventions for Facilitating Enactments

Intervention Number of times observed by two or more raters

Successful: Does not interrupt or begin to speak when participants pause Remains leaning back (sits still, does not make eye contact with speaker) Directs participants to continue speaking to each other and not to the therapist Pushes participants to express themselves more forcefully or to explain their feelings Raises participants or offers encouragement Probes to inquire deeper into participants’ feelings or points of view Encourages participants to listen better (not get defensive, try harder to understand,

Asks one participant either to find out what other thinks or feels or to respond to what

Uses humor to lighten mood Blocks third parties from interrupting or participants from bringing third parties

Makes summary, restatement, or empathic comment to help bring out what

Blocks attacking Discourages participants from changing the subject or discussing third parties Stresses importance of a cooperative relationship Describes (interprets or confronts) nature of communication or relationship problem

not interrupt, etc.)

the other has said

into the dialogue

participants are thinking or feeling

Unsuccessful: Interrupts (to speak about participant in the third person, make lengthy or frequent

interpretations, emphasize own role or need to understand) in a way that derails the enactment

address each other

to himself or herself

Invites (or allows) participants to speak to the therapist or fails to redirect them to

Leans or moves closer or remains physically central in a way that draws attention

Does not encourage silent or reticent participant to speak up Confronts participants in a way that makes them defensive and participate less

13 12 12 11 8 5

5

3 3

2

1 1 1 1 1

5

4

3 2 2

Note. Three additional successful interventions, “Turns participants’ chairs to face each other or moves them closer together or has them hold hands,” “Selects a new topic to facilitate enactment,” and “Gives specific suggestions for how to express selves in order to be better understood,” and four additional unsuccessful interventions, “Does not encourage participants to face each other,” “Does not keep participants focused on a relevant subject,” “Fails to block intrusion of third parties,” and “Allows one participant to dominate or attack in a way that limits the other’s ability to participate,” were also observed but only by one rater for any given enactment.

feelings or points of view, and by encouraging family members to try harder to understand what each other was feeling.

Table 2 also lists therapist responses that were seen as counterproductive in facilitating enactments. By far the most common mistake was interrupting prematurely or therapists otherwise injecting themselves into the conversation before the clients had a chance to get through to each other.

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TABLE 3 Successful Therapist Interventions for Closing Enactments

Intervention

Describes (interprets or confronts) specific nature of problematic dynamic Gives advice or suggestion about how participants should continue to work on their

Number of times observed by two or more raters

6

communication or relationship 4 Praises participants for having a good dialogue (listening well, expressing their feelings) Summarizes or restates what was said Emphasizes need for continuing dialogue Emphasizes need for participants to work together to solve problems Emphasizes that each of them is involved in the problematic dynamic Emphasizes shared needs or experience

3 3 2 1 1 1

Note. One additional successful intervention, “Says something to calm angry emotion or detoxify conflict,” and one intervention that was the only one judged not to be helpful, “Simply ends enactment by changing the subject,” were also observed but only by one rater for any given enactment.

Therapist Interventions for Closing Enactments Years ago, Lieberman, Yalom, and Miles (1973) found that an emotionally expressive therapeutic

encounter is far more productive if it is followed by some kind of meaningful cognitive insight. Many experienced family therapists (eg., Taibbi, 1996) also believe that experience should precede explanation in effective therapy sessions. Thus, while the first requirement of a productive enactment may be the experience family members have of talking productively with each other, a second key element is how the therapist helps them achieve insight to understand and profit from that experience.

The single most frequently observed productive intervention to close an enactment was describing the problematic dynamic that took place when family members tried to talk to each other (Table 3). Other responses judged to be helpful included advising clients how to continue to improve their communication, praising them for expressing their feelings and listening well, and emphasizing the need for continued dialogue. The only response seen as not helpful in closing enactments was simply changing the subject without commentary.

Client Responses during the Initiation of Enactments Table 4 lists what were seen as productive client responses to the initiation of enactments. Clients were

seen as cooperating when they faced one another and began talking. In some cases, clients were uncertain about how to proceed and asked for direction. This response was seen as productive because it showed a willingness to cooperate and a search for an effective way to do so. Clients were seen as failing to cooperate with enactments when they refused to respond to each other and continued trying to talk to the therapist (Table 4).

Client Responses during the Progress of Enactments Once clients begin discussing their difficulties with each other, many get bogged down in repetitive

cycles of blaming and defensiveness. In this study, clients were seen as responding effectively to each other (Table 5) when they expressed their feelings without attacking and when they listened to each other, making an attempt to understand and to acknowledge what others were feeling. Showing appreciation for the other’s efforts and being willing to acknowledge one’s own role in problems were also seen as productive.

The client responses that were seen as unproductive were a continuation of the sorts of communication

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Table 4 Client Responses during the Initiation of Enactments

Response Number of times observed by two or more raters

Productive: Participants begin speaking to each other Participants face each other (make eye contact) Participants express uncertainty about how to begin dialogue (seek direction)”

Unproductive: Participants fail to make eye contact with each other Participants do not talk or respond minimally Participants talk to the therapist

21 16 2

7 5 3

a Responses such as “What am I supposed to say?’ were judged to be productive because they showed a willingness to cooperate and a search for an effective way to do so.

problems commonly brought to therapy (Table 5). Among these were: attacking, blaming, or putting each other down; insisting on talking to the therapist; not listening; not making eye contact with each other; not responding; denying a role in the family’s problems; expressing an unwillingness to change; distracting from the topic at hand; and dominating conversation without giving others a chance to respond.

Client Responses in the Closing of Enactments At the conclusion of successful enactments, raters described clients as having achieved some kind of

breakthrough or shift (Table 6). Breakthroughs included a significant advance of understanding or uncovering of feeling. Productive shifts in the process of communication involved such things as quiet members speaking up and dominant ones listening.

At the conclusion of unproductive enactments, clients were seen as not having listened to or attempted to understand each other (Table 6), continuing to argue and bicker, and failing to open up and express themselves.

DISCUSSION

Results of this study suggest that, far from being the simple procedure described in the clinical literature, productive enactments are complex operations requiring considerable therapeutic direction and guidance. Experienced therapists use as many as 2 dozen distinctly different interventions to initiate and facilitate enactments. Moreover, even highly experienced practitioners frequently intervene in counterpro- ductive ways. Both of these findings-the number of interventions required to promote effective enactments and the propensity of therapists to interrupt them-attest to the anxiety generated by dialogues between family members in conflict. By the time they come to therapy, family members are often ready to give up on each other and seek understanding from an expert. To break that set it may be necessary to intervene forcefully and to refrain from taking over too quickly when family conversations heat up or bog down.

Before further considering the clinical implications of these findings, it is important to recognize the methodological limitations of this study. The relatively small sample of enactments (N = 21) and therapists (N = 4) limit the generalizablity of the findings. Because these four therapists were highly experienced practitioners, it may be well to think of the conclusions developed from this study as representative of how

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TABLE 5 Client Responses during the Progress of Enactments

Intervention Number of times observed by two or more raters

Productive: Participants express their own feelings or point of view, or make a complaint or

Participants listen to and make an effort to understand each other (ask questions in an

Participants turn to face each other Participants respond directly to each other with their own point of view Participants acknowledge own role in problems Participants express love or concern (praise or appreciation) for each other Participants express willingness to take constructive action (change own behavior, work

Participants have a balanced conversation (both speak, take turns) Participants share relevant past experiences Participants talk about the process of their communication

request without attacking or putting each other down

effort to understand, acknowledge what the other has said)

together to solve problems)

Unproductive: Participants attack, blame, or put each other down Participants talk to the therapist Participants do not listen to each other Participants fail to make eye contact (do not face each other; look down, away,

Participants do not respond or respond minimally Participants reject or deny their own role in problems Participants express inability or unwillingness to change Participants laugh, giggle, make jokes, or otherwise distract from topic at hand One participant dominates conversation (or interrupts or cuts other off), making it

Participants argue over details or discuss third parties without directly expressing their own

Participants change subject or talk about third parties in a way that gets dialogue off track

or at therapist)

difficult for the other to respond

feelings or making requests

18

17 10 4 4 3

3 1 1 1

9 7 6

4 4 3 2 2

1

1 1

Note. Two additional productive responses, “Participants pay attention to and respond constructively to the therapist’s input,” and “Participants restate or clarify their point of view when the other fails to understand,” and one additional unproductive response, “Participants argue or bicker,” were also observed but only by one rater for any given enactment.

family therapy is optimally, not typically, practiced. As such, our findings suggest potentially useful guidelines for the skilled use of enactments in the process of change in family therapy.

Another important caveat is that while certain interventions were used frequently in productive enactments by expert practitioners, the design of this study does not prove that these interventions were responsible for making enactments successful. Further research and hypothesis testing is necessary to move beyond the discovery-oriented, hypothesis-generating nature of this investigation.

Although it was not the subject of this study, it should be noted that there are circumstances in which the use of enactments may not be advisable. Families with poor impulse control or excessive emotionality

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TABLE 6 Client Responses in the Closing of Enactments

Intervention Number of times observed by two or more raters

Productive: Participants achieve a breakthrough in understanding, resolution, or agreement 5 Participants achieve a breakthrough in feeling (one or both uncover and express strong feeling) 2 Participants achieve a clear shift in the process or dynamics of their communication

1 I 1 1

(quiet one speaks up, dominant one listens) Participants express love or concern for each other Participants promise to make changes Participants express selves without anger or attacking

Unproductive: Participants do not listen or attempt to understand each other’s point of view Participants argue, bicker, attack, or criticize with no sympathy or acknowledgment Participants fail to open up or express selves

2 1 1

Note. Four additional productive responses, “Participants listen to, acknowledge, or demonstrate understanding of other’s feelings or point of view,” “Participants acknowledge own role in problems,” “Participants speak up about what they want, need, or feel,” and “Participants listen to therapist’s summarizing comments without arguing or rejecting them,” and three additional unproductive responses, “Participants reject or deny own role in problems,” “Participants express unwillingness to change,” and “Participants continue to exhibit their usual problematic way of relating without any shift or change,” were also observed, but only by one rater for any given enactment.

may profit more from speaking one at a time to a calm and neutral therapist than from family dialogues thai have a tendency to get out of control.

The convergent observations of raters in this study do make possible tentative conclusions about the clinical implications of the techniques used to facilitate effective enactments. The number and complexity of interventions employed in the successful initiation of enactments can be summarized by saying that it is useful to make a production out of it. That is, rather than making a simple suggestion that family members talk something over, it appears desirable to begin with some form of preenactment preparation. After having heard and acknowledged individual family members’ points of view, the therapist might usefully ask if they have had chance to discuss the issue at hand and, if so, if these discussions have been productive. Asking if they would be willing to discuss the issue now may also be helpful. It may be worth noting that some of this preparation shifts therapists from an expert-in-charge position to a more collaborative stance.

Once this groundwork is laid, the therapist should specify the exact topic for conversation (likely topics emerge from complaints and often take the form of “She always . . . ” or “He never . . . ”), emphasize the need for dialogue, indicate how the conversation should go (‘‘See if you can convince her that you’re willing to listen to her feelings”), turn participants’ chairs to face each other, direct them to talk, and lean back to remove themselves from the dialogue. (Therapists who make eye contact with the speaker may draw the conversation to themselves.)

Once an enactment is underway, in the facilitation phase therapists seem to be most effective when they adhere to three principles. The first is not interrupting until they absolutely have to. The most important thing a therapist can do to put the burden of responsibility on family members to get through to each other is to resist interrupting their dialogues. It is not unusual for family members to say mean things, get their

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feelings bruised, or want to withdraw, but as long as they are stuck in the consultation room for an hour there is more opportunity and pressure for them to keep talking. Unless, of course, the therapist interrupts. While there may be times, for example, during abusive or destructive interactions, when it is necessary to interrupt, our observations suggest that even experienced therapists tend to interrupt more often than necessary.

In working with enactments, therapists were seen to be most effective when they resisted the urge to preach and teach clients to talk nice, make “I-statements,’’ or come up with solutions. The important thing is that family members test their resources, get past the point where they are tempted to give up, and feel the pressure to speak up and to listen until they get somewhere.

If it becomes necessary to intervene, the most useful interventions have the effect not of stopping the action but of keeping it going. It is the difference between taking the bat out of someone’s hand to give them a lecture on the science of hitting versus just telling them to choke up and swing a little easier.

Sometimes clients keep talking but just do not get anywhere. They accuse and defend, bicker and quarrel, and cannot seem to talk about their real feelings or listen to each other. Observations of experienced therapists suggest that a good way to help such weary wranglers get past unproductive bickering is to probe deeper into their feelings-for example, by asking a nagging father to talk about his own growing-up years, inviting an angry and attacking wife to talk about her hurt and loneliness, or asking a brooding adolescent if she thinks her parents understand the pressures she lives with in high school. Think of it as getting beneath the surface of their defensiveness. Once family members do open up, however, effective therapists give them back to each other.

The third principle of working effectively with enactments that emerged from this study was the importance of concentrating on the process of family discussions. Helping family members to improve their ability to communicate is often more important than whether they agree about the specific issue under discussion. When the subject of a discussion touches a nerve, even veteran therapists sometimes slip into taking sides on the basis of content. However, the interventions in this study that were judged to be most helpful in facilitating enactments had the effect of pushing family members to work harder on the process of communicating with each other. Therapists were seen as most effective when they resisted the urge to interrupt or comment on the specifics of the issues under discussion.

Among the most frequently observed ways that experienced therapists close enactments were describing the problematic dynamic and emphasizing the need for continued dialogue. These observations suggest two general guidelines for an effective closing commentary on enactments. Clients should begin to learn something about the problematic pattern of their interactions, and they should finish with a clear direction for continued improvement in their ability to communicate with each other.

REFERENCES

Liebeman, M., Yalom, I., & Miles, M. (1973). Encounter groups: First facts. New York Basic. Minuchin, S. (1974). Families andfamily therapy. Cambridge, MA: Harvard University Press. Minuchin, S., & Fishman, C. (1981). Family therapy techniques. Cambridge, MA: Harvard University Press. Minuchin, S., & Nichols, M. P. (1993). Family healing: Tales of hope and renewal. New York Free Press. Nichols, M. P. (1997). The art of the enactment. Family Therapy Networkel; 21(6), 23. Rice, L. N., & Greenberg, L. S. (1984). Patterns of change: Zntensive analysis of psychotherapy process. New York Guilford. Taibbi, R. (1996). Doing family therapy: Craft and creativity in clinical practice. New York Guilford.

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