Here Papp acknowledges that the criteria to be used when deciding to treat a couple rather than the entire family vary from therapist to therapist (p. 138). Papp focuses on martial therapy specifically, and suggests that the major criteria to be used in this case are the "definition of the presenting problem as a martial problem and a commitment and ability on the part of the couple to worn on their marriage" for at minimum 12 sessions (p. 139).
Further the central theme Papp focuses on is the notion that no matter what the problem in couples therapy the therapist must look for reciprocity in the relationship and the central notion around which this reciprocity is organized (p. 140). The ideas is that couples tend to choose partners where they are more likely to fall into patterns of over-adequacies and inadequacies that can normally be balanced, but often external events cause a shift in this balance which results in a problem. The idea is that for therapy to be effective in this case it must focus on a central emotional theme within the couple and analysis of how the couple negotiates to maintain their individual reciprocity (p. 141).
This makes sense, in essence Papp is suggesting that couples maintain a system of checks and balances by bargaining and engage in transactions meant to maintain balance.
Papp also introduces the notion of couples 'choreography' or a dance that married couples play to define their marital relationship in metaphors. She states that when these 'metaphors' or fantasies are acted out, and then the balance in a relationship can be disrupted (p. 163). Here systemic intervention may be helpful in addressing dilemmas.
Chapter 10: Case of Presentation, Anatomy of Violence
Here Papp attempts to discuss how a single approach can be applied to family members who habitually deal with violent behavior. Here Papp focuses on the conflict that occurs between therapist and the family over control, suggesting that the therapist can deliberately create a series of crises within the family in a manner that forces stress back into the family, which in turn compels the family to seek out ways (other than violent ones) to address the issue (p. 173).
This chapter makes approaching violence seem like very common sense business. She discusses how families tend to use 'ploys' to block change including violent threats and actions, and that the role of the therapist is to 'force' or compel the family to learn new methods for dealing with change.
Ultimately this makes sense, though the initial portions of therapy must be very volatile, particularly because Papp is suggesting that the therapist introduce more stress into an already volatile situation.
Chapter 11: Failures and Pitfalls
Papp concludes with this chapter that it is impossible to assess "all the elements that go into effecting change" because of their complex nature (p. 215). She emphasizes the central theme however that the role of the therapist is to set the stage for change. She also however points out how important it is for the therapist to never attempt to predict how change will take place or even if it will take place because of random elements that can't be accounted for (p. 215).
Papp also suggests that the therapist must work to correct false impressions which will usually lead to effective change. She acknowledges that failures in therapy are possible, but also that the key to overcoming them is acknowledging ones limitations and working toward a positive outcome. It seems that her primary point is that failures can occur in a judgmental environment, which ties back to her early theme that for therapy to be successful it must be non-judgmental.
Overall the work was very beneficial, providing accurate insight into proven methods for effective therapy. Papp presents may themes including the use of non-judgmental and individualized interventions for family therapy, while at the same time promoting a systems approach to healing. She also acknowledges room for error on the part of the therapist in her final chapter.
Papp suggests many common sense approaches, including analyzing the system in which a family operates, and discusses symptoms as the impetus for change. Papp also emphasizes throughout the work the central theme or notion that…