on the Razor's Edge
by Gwenelle O'Neal
Living on the
Razors Edge: Solution Oriented Brief Family Therapy
with Self-Harming Adolescents, by Matthew D. Selekman, MSW. W.W.Norton,
New York. 223 pages. $32.00.
This book presents
an interesting approach to working with self-harming adolescents,
their families, and friends. The author uses specific techniques
and examples of progress observed often in three to five sessions.
family assessment framework is presented as the foundation. The
macro perspective establishes important factors associated with
this approach: strengths within the social network, team work,
open dialogue, balanced perspectives, observation of behaviors
that maintain the problem environment, and options for transformation.
Mr. Selekman identifies a range of methods and techniques that
address the adolescents perspectives, those of the parents,
and other family members. He demonstrates how to bring others
in and uses innovative and creative conversation to help the
multi-system operate effectively. This solution-oriented brief
family therapy approach assists the participants in understanding
what people feel they can bring and contribute to the work situation.
The author makes the social work perspectiveperson-in-the-environmentcome
to life in therapy.
research indicates that many of the problems adolescents experience
derive from authoritarian parental practices, parents with little
time for nurturing their children and adolescents, parents who
dont keep their promises, and who dont talk to them.
The "longing for connection with and validation from parents
and significant others" (p 1) seems to be a consistent theme
for many adolescents demonstrating self-harming behaviors seeking
to feel better.
therapists to consider the pitfalls of practicing within limited
models and assumptions. He notes he has worked with "far
too many adolescents who, pushed by their previous therapists
to work through their past traumatic experiences, ended up increasing
their self-destructive behaviors or tried to kill themselves."
(p 3) He suggests that being therapeutically flexible, adopting
a kaleidoscopic view of clients unique problem stories
and interactions, and giving ourselves freedom to traverse model
boundaries will help professional growth. (p 15)
The range of
methods to select from in designing therapeutic strategies within
the systems context is impressive. Primary methods engage the
family and significant others through questions, imagination,
mood management, cognitive skills development, aerobic exercise,
Native American healing methods, connection building practices,
and interview techniquesimprovisational and creativethat
focus on changing the family dance. Internal and external therapeutic
experiments are presented.
The control or
power dynamic present in families can be addressed through many
of the therapeutic options. The Native American talking stick
allows opinions to be expressed without penalty. Visualization
focuses on observing and experiencing steps to understand what
hasnt worked and what can and will occur in the future.
Finally, the author discusses group membership and management.
The review of methods to inform collaborative practices with
others in the larger helping systems is welcome in its focus
on sharing power and leadership to move beyond the resistance
of the psychodynamic philosophy meeting the multisystemic. This
teamwork requires suspending assumptions about others in order
to critically analyze and learn new viewpoints.
This book proposes
structure and techniques to enhance the therapeutic process for
fluid consumer participation and evaluation. It is useful to
social workers, students, educators and clients.
Gwenelle S. O'Neal, DSW, associate professor, West Chester University,
Graduate Social Work Department, West Chester, PA.
© 2001, 2002
White Hat Communications