This article aims to clarify balance of power and improvement of communication patterns (verbal and nonverbal) in family members during the last session of family therapy. This was done through an analysis on quantity of utterance, objects of utterance and objects of glance in the Storytelling Scene with the Diagram Method.

　In family "A", the mother possessed the greatest power, while the IP had the least power during the first session of family therapy, however, power distribution among members was balanced during the last session of family therapy. Family "B"’s power distribution among members was also balanced in the last session of family therapy.

　As for objects of utterance and glance, family "A"’s parents directed most of their utterances and glances toward their sister during the first session of family therapy, but they were balanced during the last session of family therapy. The IP didn’t direct utterances towards the father during the first session, but these utterances were balanced between both parents during the last session. Family "B"’s parents directed most of their utterances towards the therapist and didn’t communicate with the family members during the first session, but the objects of utterance were balanced during the last session, while objects of glance didn't balance. It is estimated that family "B" had unsolved problems.

　Power distribution and objects of utterance were balanced during the last session

　This comparative study analyzes clinically the psychological aspects of school refusal in relation to parent-child relationship between Korean and Japanese cases.

　The subjects of this study are Case J and Case K, which are most typical and representative of school refusal in both countries.

　The psychological responses of children to their roles as the cause of school refusal were the focus of this study.

　With regard to psychological aspect of school refusal, Japanese children refuse to go to school from anxiety and fear despite their willingness to, revealing the seclusive and a-social tendency. In contrast, Korean children refuse school attendance from reluctance, showing the delinquent and antisocial tendency. It was the common characteristic of the two cases that both of them have the senses of inferiority and injustice resulting from the experience of interpersonal frustration at school.

　In the parent-child relationship of the cases, it is assumed that Case J lacks the frustration tolerance and autonomy from the loss of control of the father's side and from the overprotection of the mother's part. Case K is assumed to indulge into delinquency from the resistance to father’s despotic control and mother’s neglect.

　In short, the common characteristic of the both cases is the lack of guidance and affection from parents.

　We have turned our attention to therapeutic system in the case that therapist treated the family with an anecdote or a metaphor. And we have regarded it as the available indicator for therapy to change the context of therapeutic system, in order to keep the confusion of family resisting against change to the minimum. There is the higher therapeutic possibility that family system goes to change spontaneously, if therapist could present an anecdote to the scene of session.

　In this paper, we examin the effect about treatment when therapist uses an anecdote in order to make a change. Then we call it "therapeutic-bind" such a moving of therapeutic system as don't allow to keep equiblium of family, and we attempt to define this new concept.

　The presenting problem of the identified patient, a 13 years old boy were school refusal, stealing, and violent behavior toward his grandmother. We administered 13-session of family therapy during the period of 6 months. The result indicated improvement of intra-family communication patterns, especially, parental coalition, and the problems of IP. The father of IP was a dealer of wine and provision, who the mother was also busy assisting her husband job. Evidently, she had a sense of guilt as she could not take good care of IP during the childhood. IP was taken care by his grandmother, who was overprotective and controlling toward IP. Inevitable conflict frequently occurred between mother and grandmother over the care of IP, which resulted in difficulty of relations of patrent of IP.

　At the time of the intake interview, IP could be diagnosed as "Conduct disorder, socialized, aggressive 312.23 (axis I)" and "Narcissistic personality disorder 301.81 (axis II)" according to DSM II. He was dependent and aggressive toward his mother and showed symbolic ambivalent feelings.

　IP had a sister (11 years old) who was a compliant good girl. The family’s relatives frequently made intervention with family problems.

Hypothesis

　Based on the above outlined date we hypothesized the following behavior sequences might have caused vicious cycle in this family, and set up intervention plan accordingly

　(1) IP’s symptoms (stealing, school refusal)→Father’s scolding→Grandmother’s protection→IP’s symptoms.

　(2) IP’s symptoms→Mother’s scolding→IP resists and attacks her→Mother gets angry with him→IP’s symptoms.

　(3) IP’s symptoms→Father shows concerns with his family.

Process of change

　IP’s symptoms were improved in line with the following changes of his family.

　(1) His grandmother decided to live in a separate house for 6 months.

　(2) Parent cooperated one another to improve IP’s symptoms. (=strengthened parental coalition)

　(3) His father prevented interference by the relatives and confirmed family boundaries.

　(4) By the use of microbehavior change method we encouraged each family member to evaluate, positively the other members. Consequently, parent changed their attitude to IP into more positive one.

　6 months later, IP began to go to school occationally and other behavior problem disappeared. Family communication patterns became open and flexible. The conflict between mother and grandmother was reconciled. The relation between IP and grandmother also got better.

　The case study concerning one healthy family system was conducted. This family has been confronted by a lot of family crises which are the death of the first child caused by medical accident, the abortive birth of the second baby, immatuarity of the forth baby, living with the grandmother who has been suffering from chronic schizophrenia and so forth. In spite of such crises, the family has overcome them. As the result, no clinical problems of adolescents was apparent by the time of this research.

　The purposes of this study are as follows,

(1) to present multi-generational family patterns of healthy family system

(2) to clarify the factors contributing to overcome various family crises

(3) to compare the characteristics of dysfunctional family system with those of healthy family system

　The interviews and psychological tests as follows were conducted.

(1) MMPI, KSCT and Ego-Identity Status Interview for children

(2) Genogram Interview for each parent

(3) Family Life Cycle Interview for both parents and children

　It can be pointed out that there exist eight factors contributing to overcome family crises mentioned above.

(1) Problem resolution and healthy family pattern has been transmitted down.

(2) Strong marital coalition has been existed.

(3) Each family member has been able to communicate openly one another.

(4) Father has positively involved in family life and Mother has participated in social systems.

(5) Family members have had common sense of value.

(6) The individuality of each family member and the wholeness as the family has been balanced.

(7) The family has been open to social systems.

(8) Some of the situational crises occurred at the stable period of the family life cycle.