Community mobilization
3. Christian presentation in society. This relates to the relationship between church and state and the role of Christianity outside of the
3.7 Contextual and narrative family therapeutic approaches in counselling families living with HIV/AIDS in the context of practical theology
3.7.1 Narrative Family Therapy
Michael White and his associates introduced post modern thinking into the field of family therapy. White‟s work was to a large extent based on the writings of the philosopher Foucault who stressed the de-centring of the subject and the ubiquity of power
pervading all human interaction. He saw these trends embodied in a pervading discourse, determined by those in power. White suggested that such powerful discourses would serve to maintain the status quo in problem families. Therapy should assist the person to separate from the problem behaviour and look for unique outcomes by escaping the tyranny of the dominant discourse that defined him or her as the problem. White recognized that people have many „selves‟ and have lived and owned many life stories (White 1992). Parry stressed another unique implication of working with families: all members of the family, through participation in the stories and sensibilities of the other family members, and through legitimizing their own stories by telling them in their own words, would be entitled to be part of and subjected to the influences of different worlds, different languages and different selves (Parry & Doan 1994).
Narrative therapy would set out to help people living with HIV/AIDS to live their
„preferred stories‟ and would be an important inclusion in the training model. This chapter revealed some of the discourses that may be dominating their lives, e.g.
patriarchy, domestic violence and through a process of deconstructing the power of these discourses, families living with HIV/AIDS are helped to deal with these injustices.
They are encouraged to (re)discover alternative perspectives on life and their own hidden strength. In this process, the therapist journeys along and enters a relationship of connective understanding and participatory consciousness (Kotze 2002).
3.7.2 Contextual Family Therapy
Parry and Doan (1994) refer to the obligation of family therapy to seek an ethical stance. In families the other, opposed to the same, is always present as challenge and opportunity. When family members tell their stories, an ethical demand is evoked in the relationship to recognize the mystery which is the other and embrace differences in others and ourselves.
Boszormenyi -Nagy (Nagy) was influenced by the writings of the philosopher Martin Buber, and his notions on the dialogue as foundation of human relationships. The quality of the relationship, the „I and Thou‟, is one of openness, directness, mutuality and presence. People give meaning to their world through these relationships (Buber 2002). Nagy added the intergenerational relationship to this concept of dialogue. Nagy‟s dialectical concept of „entitlement‟ in relationships describes the process of receiving through giving which then results in personal freedom (Van Heusden & Van den Eerenbeemt, 1992). Nagy did not specify a philosophical foundation for his approach in family therapy. He proclaimed he was more interested in whether it worked (Den Dulk &
Zock 2001). The contextual family therapists Meulink-Korf and Van Rijn linked Nagy‟s work with that of the philosopher Levinas, who saw man‟s ethical relation to „the other‟
as ultimately prior to his ontological relation to himself or to his relationship to the world.
“My ethical relationship of love for the other stems from the fact that the self cannot survive by itself alone, cannot find meaning within its own being-in-the-world, within the ontology of sameness” (Levinas & Kearney, 1986 in Parry & Doan 1994). Meulink-Korf
& Van Rijn elaborate on Levinas‟ focus on the „other person‟ and conclude that it is not about altruism, but about a responsibility for the wellbeing of the other person and in the wellbeing of our future world (Meulink-Korf & Van Rhijn 2005).
Contextual therapy places the dominant stories in a multi- generational context and helps the person living with HIV/AIDS to depict the influence of these stories in the life of the extended family. Through careful questioning the therapist and the person would discover how these dominant stories were kept in place and were fuelled throughout the life of the family. Contextual concepts as entitlement, loyalty, indebtedness, legacies are explored throughout the life of the family. Contextual therapy would also look for alternate stories and focus on purposeful identity, an awareness of who one is and would like to become (Van de Kemp 1991), these are important considerations for the development of the training model.
The counselling relationship would adhere to the relational ethic of mutuality and trustworthiness in relationships. “Relational ethics does not have specific moral content,
but rather is concerned with a balance of equitable fairness between people”
(Boszormenyi-Nagy & Ulrich 1981:160). Morgan (2000) refers to this aspect of the counselling relationship as engaging in expressions of experience and meaning. It exposes and critiques a person‟s identity and belief system, without looking at it as right or wrong, they merely exist.
Both contextual and narrative therapy practice multi partiality as a tool in family counselling. Parry and Doan (1994) mention the „talking stick‟, whereby each member of the family in turn is invited to express their view. The therapist will ask the binding questions and engage the family in a dialogue of mutual respect. Boszormenyi-Nagy and Spark (1973) relate to a mutual dialogue in family therapy where each generation is faced with the nature of present relationships, explore the nature of commitment and responsibilities of their involvement and increase their reciprocal understanding and compassion. Family members are helped to be freed of scape-goated or parentified roles.
The researcher is aware that multi partiality may not be a well tolerated approach to counselling both in Western and African culture. The presence of grandparents and the possibility for children to be heard may cause opposition in families. Nevertheless, when families come forward, this cultural dilemma can be „worked through‟ in the context of the counselling experience and would thus become important key elements of a good training model.