Byline: Rakesh. Chadda, Koushik. Deb
Indian society is collectivistic and promotes social cohesion and interdependence. The traditional Indian joint family, which follows the same principles of collectivism, has proved itself to be an excellent resource for the care of the mentally ill. However, the society is changing with one of the most significant alterations being the disintegration of the joint family and the rise of nuclear and extended family system. Although even in today's changed scenario, the family forms a resource for mental health that the country cannot neglect, yet utilization of family in management of mental disorders is minimal. Family focused psychotherapeutic interventions might be the right tool for greater involvement of families in management of their mentally ill and it may pave the path for a deeper community focused treatment in mental disorders. This paper elaborates the features of Indian family systems in the light of the Asian collectivistic culture that are pertinent in psychotherapy. Authors evaluate the scope and effectiveness of family focused psychotherapy for mental disorders in India, and debate the issues and concerns faced in the practice of family therapy in India.
The term family is derived from the Latin word 'familia' denoting a household establishment and refers to a "group of individuals living together during important phases of their lifetime and bound to each other by biological and/or social and psychological relationship". [sup] The group also includes persons engaged in an ongoing socially sanctioned apparently sexual relationship, sufficiently precise and enduring to provide for the procreation and upbringing of children. [sup] Unlike the western society, which puts impetus on "individualism", the Indian society is "collectivistic" in that it promotes interdependence and co-operation, with the family forming the focal point of this social structure. The Indian and Asian families are therefore, far more involved in caring of its members, and also suffer greater illness burden than their western counterparts. Indian families are more intimate with the patient, and are capable of taking greater therapeutic participation than in the west.
In a situation where the mental health resource is a scarcity, families form a valuable support system, which could be helpful in management of various stressful situations. Yet, the resource is not adequately and appropriately utilized. Clinicians in India and the sub-continent do routinely take time to educate family members of a patient about the illness and the importance of medication, but apart from this information exchange, the utilization of family in treatment is minimal. Structured family oriented psychotherapy is not practiced in India at most places in India, except a few centers in South India. Research publications on family therapy from India are also few. Thereare some evidence from published "family intervention studies", but whether all non-pharmacological interventions with family members can be considered as "family therapy" is a matter of theoretical debate.
Sholevar [sup] defines family therapy as any use of a family-focused intervention to bring out behavioral and/or attitudinal changes in one or more family members" Although the "family" may be involved in many schools of psychotherapy, "family therapy" represents the most direct branch of psychotherapy that deals with the family system as a whole.
This paper discusses the features of Indian family systems in the light of the Asian collectivistic culture that are pertinent in psychotherapy and family therapy as used in India, and its further scope.
Understanding the Indian family from a psychotherapeutic standpoint
Role of culture and collectivism in shaping the family
Families do not exist in isolation and family dynamics are often best interpreted in the context of their societal and cultural background. …