ABSTRACT
Strategies for a Japanese child to accept his position as the eldest brother are described through cases involving spitting and bedwetting. The techniques of paradoxical ordeal, behavior modification, and metaphor were used to change symptomatic behavior in both cases. The therapy was respectful of the child’s dignity and the unique family system. The strategic approaches of focusing on symptomatic behavior, while also considering family organization and sibling hierarchy, resulted in both symptom amelioration and family reorganization. In this regard, some relevant characteristics of Japanese family lifestyle are noted.
