Treatment of the
IN THE YPIFS we classified 18% to 20% of the families as low-intensity ones; that is, families who combine positive attachment bonds with low levels of negative affect. Perhaps it was because we were studying patients with serious psychiatric disorder that so few families fit this category. However, even in other treatment settings, we have found that the number of families who initially have minimal problems with either attachment or negative affect is relatively low. In our work with patients who have psychotic disorders as well as personality disorders, we have found that the majority of families present with problems similar to those described for the high-intensity families or the disconnected ones. In previous chapters we pointed out that treatment approaches that focus on straightforward behavioral or problem-solving methods have not been well suited to high-intensity or disconnected families. Consequently, considerable preparatory work was often needed before the family could use interventions such as management techniques, skills training, and so on.
The low-intensity family enters therapy more emotionally available and ready to participate in the treatment immediately. The members of the family seem to be less angry, less anxious, and more easygoing. As indicated in chapter 4, the parents in these families appear to have more differentiated, balanced views of their own parents. They do not idealize their own parents, but rather express their appreciation for certain qualities or attributes of their parents. The low-intensity parents are less critical and hostile toward the patient in the family interactions. If they are excessively