Introduction and Overview

The Theory and Practice of Systemic Therapy and Clinical Case Studies and Tools 

Advanced has been designed for practitioners who wish to develop a stronger theoretical understanding of their clients and the array of presenting difficulties through the lens of the Bower Place model. It has been organized according to both presenting symptom categories, for example anxiety and sleep difficulties but also systems categories, children, adolescents, schools. Another major category of Service Delivery and Practice Theory draws together writing about the theoretical underpinning of systemic change. It includes thinking about change, constraint and other key ideas that inform systemic practice. Some papers appear in more than one category as they reference symptoms, ideas about therapeutic practice and particular systems. 

Another feature of Advanced is clinical case studies which aim to orient practitioners to the application of the Bower Place Method and BowerNote by summarizing the understanding of the case and the application of theory to practice and resolution. It draws on tools and visual explanations that may be used as part of the enquiry process and Advice. The cases are composites of clients seen at Bower Place who have presented with specific difficulties and who have given consent for the material to be used for teaching. No cases studies specifically describe a single client. 

 Each case summary includes a description of the presenting symptom and context with reference to the ecogram and time-line followed by a theoretical analysis through the four metaframes of the Bower Place Method. The practitioner’s intervention and advice are described. In some cases, specific tools are included that were used in either the analysis, explanation or intervention. Unique aspects of the Bower Place theoretical and conceptual understanding are highlighted. In some instances, this may be accompanied by a short video of a practitioner discussing the issues. 

It is important to understand that when working from a systemic perspective it is impossible to simply transfer advice from one presenting problem to the next. That is the point about systemic practice, very different symptoms may present as a result of similar relational and systems circumstances. However, it is also true that some symptoms are often underpinned by predictable family dynamics. A good example is eating disorders where the early work done by Salvador Minuchin which identified specific family dynamics has been supported by later research. It is debatable whether these precede the onset of the disorder or are a function of trying to save a severely ill child, but at one level it doesn’t matter. 

At Bower Place we have developed original conceptualizations and intervention that have produced consistently positive outcomes. These range through work with clients with an ASD diagnosis, dysregulated children and families, substance misuse and couple difficulties. 

In reading these case studies we suggest you consider the clients you have seen and where the dynamics are similar and whether the path taken by the clinician and tools used may aid your practice.