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Orientation to Family Therapy

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Saw family as the critical social unit and focus of intervention ... in-depth focus on the psychology of the individuals than family therapy does. ... – PowerPoint PPT presentation

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Title: Orientation to Family Therapy


1
Orientation to Family Therapy
  • PSY 660, Dr. Katz
  • Presented by Alyssa Rylander

2
Group Therapy
  • Group dynamics are relevant to family therapy
    because group life is a complex bind of
    individual personalities and superordinate
    properties of the group
  • Process vs. content of messages
  • Listening to how families talk as to the content
    of their discussions
  • Expectations that roles carry bring regularity to
    complex social situations

3
Child-Guidance Movement
  • Blamed parents for psychological problems in
    children
  • Schizophrenogenic Mother
  • Family was emphasized, but mother and child
    treated separately
  • Interaction between parent child problem
  • John Bowlby (1949)
  • Family meetings adjunct to real treatment only if
    (11) therapy was not going anywhere

4
Influence of Social Work
  • Saw family as the critical social unit and focus
    of intervention
  • Families must be considered as units
  • 1917 Mary Richmond, Social Diagnosis
  • Treatment of the whole family and warned against
    isolating family members from their natural
    context
  • The degree of emotional bonding between family
    members was critical to their ability to survive
    and flourish
  • Once family therapy movement was launched, social
    workers were one of most important contributors

5
Role of Schizophrenia in Family Therapy
  • Researchers drawn to families with schizophrenic
    members because of their patterns of interaction
  • Never actually conducted family therapy sessions,
    but observed the families patterns of
    interactions/communication
  • 1927 Harry Stack Sullivan
  • hospital family hospital staff substituted
    patients real family

6
Role of Schizophrenia in Family Therapy
  • Freida Fromm-Reichmann also believed in the
    hospital family however treated the real
    family as an environment from which the patient
    must be removed
  • 1940s 1950s research on the link between
    family life and schizophrenia led to the work of
    early family therapists

7
Research on Family Dynamics
  • Gregory Bateson (Palo Alto)
  • 1952 Grant to study the nature of communication
    in terms of levels
  • Two levels of communication Report and command
  • Metacommunication convert and often goes
    unnoticed
  • 1954 Grant to study schizophrenic communication
  • Group turned to developing a communication theory
    that might explain origin and nature of
    schizophrenic behavior, particularly in the
    context of families
  • Never actually thought about observing families
  • Homeostasis
  • Double bind

8
Research on Family Dynamics
  • Theodore Lidz - Yale
  • 5 patterns of pathological fathering
  • Defects in marital relationships
  • Role reciprocity balancing your role with your
    partners
  • Marital schism failure to achieve role
    reciprocity
  • Marital skew serious psychopathology in one
    partner dominates the other
  • Saw father as weaker partner/spouse
  • Unhappy children were torn by conflicting
    loyalties and weighted down by trying to balance
    their parents marriage

9
Research on Family Dynamics
  • Lyman Wynne - NIMH
  • 1952 Examined the effects of communication and
    family roles, but focused on how pathological
    thinking is transmitted in families
  • Joined by Murray Bowen at NIMH
  • Both shared belief that family should be unit of
    treatment
  • 1954 started seeing parents of schizophrenics
    twice-weekly
  • Pseudomutuality, pseudohostility, rubber fence
  • Saw schizophrenic family as a sick little society
    by itself

10
Research on Family Dynamics
  • John Spiegel (Role Theorist)
  • Described how individuals were differentiated
    into social roles within family systems
  • 1951 GAP Committee formed
  • Research emphasized roles as primary structural
    components of families
  • Every role has a reciprocal role
  • Explained that roles serve as a link between
    intrapersonal and interpersonal structures
  • Spiegel described observations in psychoanalytic
    terms children identify with unconscious wishes
    of parents and act our their emotional conflict.
  • R.D. Laing (1965) mystification

11
Research on Family Dynamics
  • Bela Mittleman
  • 1948 first account of concurrent marital therapy
  • Saw that it was possible to reexamine their
    irrational perceptions of each other
  • Without insight, unconscious motivation may
    dominate marital behavior, leading to reciprocal
    neurotic actions and reactions
  • Believed that 20 of the time one therapist could
    handle all family members, but in other cases
    separate therapists would for each member would
    be better
  • Couples therapy allows for more in-depth focus on
    the psychology of the individuals than family
    therapy does.

12
Pioneers of Family Therapy
  • John Bell
  • Began treating families in 1951
  • Family group therapy relied primarily on
    stimulating an open discussion to help families
    solve their problems
  • Acted as a group therapist, intervening to have
    others speak up and interpreted reasons for
    defensiveness
  • Structured treatment in a series of stages
  • Later became less directive and allowed families
    to evolve

13
Pioneers of Family Therapy
  • Palo Alto (Bateson Group)
  • Don Jackson (1954)
  • Family homeostasis families are units that
    resist change
  • Patients symptoms preserve stability in their
    families
  • Behavioral redundancy all people in continuing
    relationships develop set patterns of interaction
  • Made an effort to develop a language of family
    interactions, but focused primarily on spousal
    relationships thus ignoring children in treatment

14
Pioneers of Family Therapy
  • Palo Alto (Bateson Group)
  • Jay Haley (1963)
  • Explored how covert messages are used in the
    struggle for control in relationships
  • Symptoms represent an incongruence between levels
    of communication
  • Brief therapy zeroing in on the context and
    possible function of the patients symptoms
  • Coalitions cooperative arrangements between two
    parties, not formed at the expense of the third.
  • Most coalitions were cross-generational (one
    parent ganging up with the child against the
    other parent)

15
Pioneers of Family Therapy
  • Palo Alto (Bateson Group)
  • Virginia Satir
  • Saw troubled family members as trapped in narrow
    family roles that constrained relationships and
    sapped self-esteem
  • Major focus was always on the individual
  • Concentrated on clarifying communication,
    expressing feelings, and fostering a climate of
    mutual acceptance and warmth
  • Known for turning negatives into positives
  • 1964 publication of Conjoint Family Therapy

16
Pioneers of Family Therapy
  • Murray Bowen (NIMH)
  • Hospitalize whole families with schizophrenic
    members (included role of fathers) and led to the
    concept of triangles
  • Separate therapists for individual family members
  • 1955 began holding large group therapy sessions
    for the entire project staff and all the families
  • Therapists pull in different directions ? put one
    therapist in charge and put the others in
    supporting roles ? families pull in different
    directions ? families had to take turns
  • As therapist, he would just try to get families
    to talk ? soon realized unstructured family chats
    were very unproductive
  • Emotional reactivity
  • Had family members speak to the therapist instead
    of directly to each other

17
Pioneers of Family Therapy
  • Nathan Ackerman
  • Always concerned with what goes on inside people
    as well as between them
  • Never lost sight of self in the system
  • Role as therapist was to stir things up and bring
    family secrets into the open
  • Became emotionally involved with families
  • Carl Whitaker
  • Pioneered use of cotherapy, freeing therapists to
    react spontaneously without fear of
    countertransference
  • Eschewed theory in favor of creative spontaneity
  • Created tension by teasing stress necessary for
    change

18
Pioneers of Family Therapy
  • Ivan Boszormenyi-Nagy
  • Network therapy as may people as possible
    invited to therapy session to help support
    patient change
  • Added ethical accountability to therapeutic goals
    and techniques
  • Salvador Minuchin
  • 1960s family problems are resistant to change
    becase theyre embedded in powerful but unseen
    structures (structural family therapy)
  • Enmeshed chaotic and tightly connected
  • Disengaged isolated and seemingly related
  • First and second order change

19
Structural Family Therapy
  • Therapist must accommodate family in order to
    join them
  • Start by trying to understand family instead of
    challenging their preferred mode of relating
  • Use restructuring techniques active maneuvers to
    disrupt dysfunctional structures by strengthening
    diffuse boundaries and loosening rigid ones.

20
Family Therapy
  • 1960s Look at this!
  • 1970s Look what I can do!
  • 1970-1985 development of famous schools of
    family therapy as the pioneers established
    training centers and worked out the implications
    in their models
  • Structural therapy proved to be most influential,
    providing a simple yet meaningful way of
    describing family organization and a set of easy
    to follow steps to treatment

21
Discussion Questions
  • Why did the pioneering psychologists, trained in
    psychoanalysis, ignore the individual in the
    beginning stages of family therapy?
  • What is it about Schizophrenia that encouraged
    research and eventually led to a systems
    approach? Do you think it was a good starting
    point?
  • What do role reciprocation, homeostasis, double
    bind rubber fence, mystification, and coalitions
    all have in common? Why do you think there was
    such a recurring theme throughout research?
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