In this paper, the necessity of family therapy for the family with a physically handicapped child is reported. The family which has a physically handicapped child usually creates a special family system suitable for a handicapped child and functions as having taken him or her under its protection. However, the handicapped child starts becoming independent as he or she grows and conquers his or her disability. By that time, the family system which has taken the handicapped child under its protection and has come to control him or her had become a fixed system, and as a result, interferes with his or her independence, author calls this state “the fixed family with a physically handicapped child” and urge the need for the family to change the fixed family system by family therapy.

　　As a concrete approach in such therapy, author makes note of the expectations of the parents. Allowing for the surplus intervention and protection, in that he or she is physically handicapped child, or the surplus expectations over what he or she could do if he or she did his or her best, author distinguish between those things which he or she is able to do, and those things which he or she cannot do, given his or her present capacity, author tells his or her parents that it is constraining for him or her, when they expect too much from him or her regarding those things which he or she is unable to do. As a result, the parents should expect their child to conform according to his or her capacity.

　　They can now begin to resign themselves to "waiting" for his or her behavior, rather than expecting too much just for their own satisfaction. Only then, for the first time, can the child establish change for himself or herself and behave according to his or her own decision within the family system.

　　It is not rare that an epileptic child uses symptoms to manipulate its family members. The epileptic child can easily find out that it can utilize its illness by stimulating parent's sense of guilt, and may become a tyrant in the family. It is a paradoxical situation that a young and helpless child has the biggest power over the family members. The effort of the parent to stop the symptoms of the child often brings adverse results. Family members begin to take parts of the drama triangle, persecutor, victim, and rescuer. The roles are changed by members, but they can never stop this game within the family.

　　The presenting problem of the identified patient of this case, a 12 years old epileptic girl, were talking deleriously after the attack, calling forth vicious ghosts, and cursing her parents. Most of her symptoms were thought to be hysterical ones.

　　Her medical records indicate following episodes. She got severe head injury at the age of 14 months old when she was cared in a day nursery. It was reported that she fell down into the bathtub accidentally. However, the nurse who was in charge seemed to have abused her and gave her severe injury. Aftereffect of head injury included partial paralysis of her right side of the body, loss of sight in the right eye, and narrowing of her range of sight. The paralysis of the body recovered through 4 months physical rehabilitation at the hospital.

　　At the age of 8, she had her first attack of epilepsy, and 3 years later she was reffered to our educational counceling center. She controlled her family members by using symptoms, claiming to be manipulated by vicious ghosts.

　　The therapist gave this IP and parent family therapy for 3 years, by using paradoxical intervention approach. The therapist gave them a positive reframe by stating that it was very effective for the family to admit her ghosts, and praised IP's power of inspiration. She also encouraged them to cope with ghosts through praying to God. A conjoint family interview was conducted for disclosing the facts of injury caused by the accident. IP was released from her suspicion to the parent who might have covered from her an important truth.

　　The family began to show more intimacy each other and restored loving relationship. Parental coalition became strong and each member showed their warm and kind consideration to others. IP increased her tolerance against using hysterical symptoms, and began to establish her autonomy.

　　The authors present the Poststructuralist Model, the therapeutic model integrated with MRI and Milwaukee Brief Therapy and White/Epston's Narrative Model. The Poststructuralist Model doesn't estimate the pathological structure underneath the problem (e. g. unconsciousness or pathological family system), but focuses the present human interactions. The Poststructuralist Model in the context of child psychotherapy is characterized of 4 steps: 1) decision of the complainant(s) by asking the kid “do you have any problem?” [If the answer is “no”, other member(s) of his family will be examined.], 2) decision of the problem by asking the complainant(s) “what is your problem?”, then two alternatives are prepared. The first is the problem-focused course, and the second is the solution-focused one: 3a) decision of the attempted solution, 4a) prescription of 180° reverse behavior, on the other hand, 3b) looking for the exceptions or Unique Outcome, 4b) re-authoring questions.

　　With introducing the cases of Trichotillomania and Alopecia areata, the therapeutic process, especially concerning how to decide the chief complaint and therapeutic goal, is disclosed.

　　In discussion we closely examine the step 1) and 2), and emphasize the importance of adequate intervention making just small change.