Tapio Malinen.: Now I want to change the subject a little bit. I am a school psychologist and somewhere I read you have some experience with treatment of ADHD (attention deficit hyperactivity disorder).

Could you speak something about that?

Dr. Wendel Ray: Dick Fisch, a psychiatrist, founder and head of the Brief Therapy Centre (still active, still going) and I, and a couple of other people, decided to do a research project a few years ago in which we were going to apply purely the MRI brief therapy model, which is still a very active model, to working with Attention Deficit Disorder. We decided to do it in my hometown of Monroe, Louisiana because there was a smaller population. It was more controllable we thought and was cheaper. We created some advertisements to go on the radio and TV and we ran an ad that said, 'If you have a child who's been diagnosed with ADD and they're getting help, either pharmacologically or in therapy, and you're satisfied - great, that's wonderful and we're happy for you. But if you have any concerns about how your child's being handled and how things are going, then we have a model that we've had some success with and why don't you give us a call.' We ran these two or three times on late night TV and radio and we got 300 calls like that! (snaps his fingers) Out of that, we had about 100 clients. There were four of us working in a team, Dick was the clinical supervisor in the background. What we did was develop protocols in essence for how to approach the talking to the parents about the problem and with the child and basically how to sort...these are very bad and clumsy words because I've never written it up, but we would try to figure out what are the more or less useful ways of having conversations with parents about the possibility of coming into therapy with their child to look at this trouble. Around issues like, 'Does it evidence itself more in school?', or 'Is it more of a problem at home?', or 'Is there a combination of the two? Very simple things. Then we would develop a protocol for how to ask those initial questions and set the scene so the parents would say, "yes, I want to do this, this would be very helpful", and we were very successful. We were seeing people always under 10 sessions. That's an arbitrary number but it never took that long. We almost always helped people by taking each case as a unique particular and getting specifically into what people were doing in their best efforts to help their child grow up. There's a lot more that can be said here but in my opinion ADD, if approached thoughtfully, can be a very manageable problem. If you can engage the parents in engaging their child differently, the child's difficulties diminish. At a conceptual level it is simple, not even complicated. I hadn't prepared to talk about it, but if we've got the data from research... We always counsel in terms of research because we're trying to figure out how to talk to people in ways that are going to facilitate the development of a broader range of requisite variety in terms of how to handle their child so the child doesn't experience themselves as problematic or other people experience them as problematic so they can get on with their lives growing up. That's what they are supposed to be doing.

We were quite successful and by successful, let me be very clear - the problem behaviours being complained of would diminish to the extent to which the parents would say were satisfied. Things would be much better or they would say, "You know the school isn't complaining about this at all anymore". We would do simple things for instance, we would have the parent go to the school and tell the teacher,

"You know we really appreciate you letting us know our child's having this trouble and we wanted to let you know that we are taking this very seriously and we are working with a professional and we're doing mainly most of our work at home. What the professional has asked us to do was to ask you to begin to notice any exceptions to the times when my boy's having trouble and let us know about them because we're trying to track that as one of the indicators as we start to improve".

 Our theory was, by simply introducing the idea that we're doing something to address the problem, so we're taking you seriously, and then introducing the idea of 'search for positives that you can then feed back to us', it shifted the interaction between the teacher and the child and noticing one exception would lead to the teacher acting different to the child, which in turn would result in a 'preferred behaviour' in a child. The next thing you know, things were better.

T.: Kind of get the snowball rolling?

W.: Exactly! That's exactly right!

T.: Because everything's connected.

W.: That's exactly right. Taking cybernetics and connection seriously and do the same thing at home. It was remarkable. We always thought of it in terms of the attempted solution framework, that's is central to the MRI Brief Therapy framework.

T.: Are you still doing it?

W.: No. We ran out of money and time. I never got around to writing it up but I've got the data and tapes, so one of these days, I will try to find time to write a report.

Past Interview From Millennium Conference 2001.

Ian Bennett: Is it important for therapists to look at the history of psychotherapy, and if so why? What does it lend to the future? 

Dr. Wendel Ray: I think that the history of ideas is important to look at and has total relevance to the future. A lot of mistakes have been made in the past that people found ways to deal with for one thing. If you are unaware of it, and haven't read the literature, it puts you in the position of having to go out and make the same mistakes.  We do not avail ourselves of ideas and avenues out of problems that people have already found and that have been articulated in certain parts of the literature. One might not be aware of these because there is such an emphasis now on the present. It's as though what we are doing now is so superior to what was done in the past, that anything visits, in my mind, this bias of 'if it was done in the past it's part of that mechanistic way of thinking and those people didn't understand the way we understand' in our post modern world we live in.  They didn't really understand the important lessons of the more recent literature.

  I don't disagree with that in certain respects but I think it is extremely myopic and also incorrect. If you go back and delve into some of the earlier literature you find that these very same people were having these very same "post modern ideas" and articulating them very well in their literature 30, 40 or 50 years ago. I don't want to bore you with the names but I could sure give you a few like Gregory Bateson and Don Jackson and others that were very clear on some ideas that now are considered cutting edge. They are cutting edge but they were cutting edge in 1955 or 60.  So it's not only just a hobby or just seen anecdotally, some of these people really knew what they were doing and what they were about and thank God because of modern technology, a computer and so forth, and the existence of early books and early recordings we can go back and investigate, mine this ore.  It's like living right next to a gold mine and never picking up a shovel and walking in there and grabbing some.  Now you don't want to spend your whole life shoveling the past, but at the same time there is gold there!

(Ian):   How come not too many therapists own shovels then?

WR:  Because we are told that&ldots;  Honestly, I am an academic, I teach academically and if you ever try to get published in a journal now a days, if you make reference to something more than five years old you get a nasty note from the editor saying you have to update your references. This is difficult for me because I don't even read anything unless it is five years old.  (laughter)  I'm only partially making a joke there.  It is so undervalued.  Let me tell you another reason. The model that we have embraced, which I embrace, is a 'right now" model. It is what is going on in the interaction in the present moment that is the focus of attention  and so we intentionally in the models walked away from looking at history, a past of how problems got the way they were.  That fell away from the practice models and so I think that was just a natural extrapolation of that preference for here and now into "well therefore there is no sense in reading about what people thought back then".      END

Q: What are your concerns for the future of therapy and what are your hopes? 

Steve de Shazer:  I don't have any hopes! Most of the United States, I think, is the victim of mismanaged uncare and so becoming a therapist today is a lot different proposition than it was 30 years ago in the states.   

(Caroline):   How so?

SdS:  Well, we make as much money as we did 20 years ago and then are asked to see at least twice as many clients in a week. Therefore you get so there is no energy or time left for research and writing.

C:  That is very true.

SdS:   And then the fact that there is the biochemical approach as "one a day" and so it looks cheaper to give a pill and so you have chronic repeat. Chronic repeat pill takers who chronically see the doctor who chronically give them pills. To me, at least in the United States, I think therapy in general is more tied up in the system, the unmanaged care that is going to be marginal at best. You have to get outside the system in order to do something but outside the system there are a few you look at and the depictions of what therapists are on television it is quite a battle. I don't know if you have ever seen the therapist on the Ali McBeal show? - Betty White when she was the therapist with her lab coat and opened it up.  And all the other stuff that goes with it.  I've seen a few episodes where she was involved and that's the picture.   You misbehave and you get a zap and so on. 

C: It's very true!

SdS:  And so how therapists can do something about this is not clear to me. 

C: What words of advice would you have for the next generation of therapists?

SdS: Do something different! In order to really be able to do therapy as I see it then they are going to have to be outside the system, take cash only. That is the only way you can be free enough to do good work and study it. You have to be prepared to be independent and get cash only. This may be different -  and call it something else. Give it a new name - a makeover. A new name, a new image, and so on. In Canada this may be very different, and it is different in Europe. 

C:  How so?

SdS:  I don't think that this mismanaged uncare is going to get there. It may get to Germany but I don't think the therapists are organized enough politically speaking that they will be able to fight it. In the United States anyway, the professional organizations all failed therapists by essentially instead of fighting this mismanaged uncare, instead of fighting, they tried to figure out how to go to sleep with the enemy so to speak and it completely co-opted to professional organizations who were absolutely useless when they should have been fighting this. Instead of doing that they did something else.

C:  Thank you so much for answering a few of our questions.  END

KENNETH V. HARDY, Ph D.  is an Associate Professor of Marriage and Family Therapy at Syracuse University in New York.  He is the co-editor of the book Minorities and Family Therapy.  Our roving interviewer Caroline caught up with Dr. Hardy following a very interesting keynote address titled New Visions Of Psychotherapy: Challenges & Strategies at the Millennium Conference in June.  If you ever have an opportunity to see Dr. Hardy present his workshops it would be time well spent.

Q: You introduced the concept of "Healers vs. Jailers" in your address today, what  do you see in the future that makes you feel hopeful for our profession? 

(Dr. Hardy):  Everywhere I travel I continue to run into therapists who are often described as idealistic, out of touch, and these are still people who have some hope.  It sounds corny but you know, they have some hope for humanity and are still doing work that is designed to bring people together, who will place principles over profit, who are in this not just because they want to make a quick buck and line their pockets  and are less concerned about having licenses and all those things that are critical  to one's survival.  They are more concerned with those things that are much more germane to the soul and so that keeps me hopeful.  I think it only takes one person like that to keep it alive.  As long as there are one or two people out there who are still committed to those ideals it is not going to go away.  I keep thinking this is a very appropriate role for therapists and in particular therapists of today.  We don't have to look for work.  All corners of society are inundated by individuals, groups, nations where there is some strain in relationships and I think that is a very critical role for us to play.  That keeps me hopeful. 

(Caroline):   Is that a big change for you in terms of when you first started out in therapy?  How did you evolve to the place where you are now in your thinking and your presentation today?

(Dr. Hardy):  I think that philosophically it's not a major shift.  I think that one of the things that threw me into family therapy initially was that I grew up in Philadelphia and I grew up just a few blocks away from the&ldots;.                         Clinic, and at the time when it was at the apex of that institutions existence.  Minuchin and Marion Watts and people like that were there and a bunch of people who were concerned about, you know, not just therapy but also this critical interface between therapy and the human condition.  A lot of Minuchin's work with poor families was very impactful in my own way of thinking so I think I always had that interest.  Yet I think that I did get derailed along the way where I became more preoccupied with my own survival, getting a degree, and getting a job and those types of considerations took precedence over these other concerns.  So I think some pieces of it have to do with simply finding a way to get centered in one's own life then the more I could stay focused on the things that I really believe in.  I think it is sad to say but it is an honest answer.  END