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Systems of Family Therapy

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Title: Systems of Family Therapy


1
Systems of Family Therapy
  • William R. Herkelrath, Ed.D.

2
An Introduction to Family Therapy
Portions of the information contained in this
Power Point has been adopted fromFamily therapy
An overview(6th ed.) by Goldenberg Goldenberg,
Thomson Learning Australia.
3
Two Different Worlds
  • Individual Psychology vs.
  • Systems Psychology

4
Adopting a Family Relationship Framework
  • A family is far more than a collection of
    individuals sharing a specific physical and
    psychological space. While families occur in a
    diversity of forms today and represent a
    diversity of cultural heritages, each may be
    considered a natural social system.
  • In your small group compile a list of various
    forms that families take consider the great
    diversity of families today. Once you have your
    list go over each item and determine what defines
    that group as a family.

5
Adopting a Family Relationship Framework
  • A Paradigm Shift
  • Cybernetics the science of communication
  • Bateson deserves the major credit for seeing how
    cybernetic principles apply to human
    communication processes, including those
    associated with psychopathology.
  • First-order a view from outside of the system
    of the feedback loops and homeostatic mechanisms
    that transpire within a system
  • Second-order a view of an observing system in
    which the therapist, rather than attempting to
    describe the system by being an outside observer,
    is part of what is being observed and treated
  • Content vs. Process

6
Family Development Continuity and Change
  • Generations within a family have an enduring,
    life-shaping impact on one another as they move
    through family life cycle states. In this
    multigenerational view, continuity and change
    characterize family life as the family system
    progresses through transitions over time.
  • In your small group create a list of family life
    cycle development that is cognizant of the
    various forms of families from your previous
    list. Discuss the transitions that can be
    associated with these stages as well as the
    difficulty in progressing through these
    transitions for various family groups.

7
Gender, Culture, and Ethnicity Factors in Family
Functioning
  • In regard to gender, men and women are reared
    with different expectations, experiences,
    attitudes, goals, and opportunities, and these
    differences influence later culturally prescribed
    role patterns in family relationships.
  • Cultural diversity is increasingly a part of
    American life, and family therapists have widened
    their focus from the family to include larger
    socio-cultural contexts that influence behavior.
  • Ethnicity and social class considerations also
    influence family lifestyles.
  • As a small group define gender, culture, and
    ethnicity and discuss how these concepts impact
    the family system.

8
Psychodynamic Family Therapy
  • Theoretical Viewpoints
  • Unresolved conflicts from past continue to
    attach themselves to current objects and
    situations

9
Psychodynamic Family Therapy
  • Unit of Study Monadic
  • Individual intra-psychic conflict brought to
    current family relations

10
Psychodynamic Family Therapy
  • Time Frame
  • Past early internalized family conflicts lead
    to interpersonal conflicts within present-day
    family

11
Psychodynamic Family Therapy
  • Leading Figures
  • Ackerman
  • Scharff Scharff
  • Framo
  • Kohut

12
Psychodynamic Family Therapy
  • Major Concepts
  • Interlocking pathology
  • Scapegoating
  • Role complementarity
  • Introjects
  • Attachments
  • Projective identification
  • Splitting
  • Narcissism
  • Selfobjects

13
Psychodynamic Family Therapy
  • Role of Therapist
  • Neutral
  • Blank screen upon whom each family member
    projects fantasies

14
Psychodynamic Family Therapy
  • Assessment Procedures
  • Unstructured
  • Ongoing effort to uncover hidden conflict within
    and between family members

15
Psychodynamic Family Therapy
  • Key Methods of Intervention
  • Interpretations regarding the unconscious
    meaning of individual verbalizations and behavior
    and their impact on family functioning

16
Psychodynamic Family Therapy
  • Insight vs. Action
  • Insight leas to understanding
  • Conflict reduction
  • Individual, intrapsychic and system change

17
Psychodynamic Family Therapy
  • Goals of Treatment
  • Individual intrapsychic change
  • Resolution of family pathogenic conflict
  • Detriangulatuion
  • Removal of projections
  • Individuation

18
Experiential/CommunicationsFamily Therapy
  • Theoretical Viewpoint
  • free choice
  • self-determination
  • growth of self
  • maturity achieved by overcoming impasses in
    process of gaining personal fulfillment

19
Experiential/CommunicationsFamily Therapy
  • Unit of Study Dyadic
  • problems arise from flawed interactions and
    communication lapses between family members
  • husband and wife, etc.

20
Experiential/CommunicationsFamily Therapy
  • Time Frame - Present
  • here-and-now
  • immediate ongoing interaction

21
Experiential/CommunicationsFamily Therapy
  • Leading Figures
  • Whitaker
  • Kempler
  • Satir
  • Greenberg
  • Johnson

22
Experiential/CommunicationsFamily Therapy
  • Major Concepts
  • Symbolic factors represent familys internal
    world and determine meaning given external
    reality
  • Self-awareness of the moment
  • Self-esteem
  • Clarity of communication
  • Explore inner experiences and relationships

23
Experiential/CommunicationsFamily Therapy
  • Role of the Therapist
  • Egalitarian active facilitator providing family
    with new experiences through the therapeutic
    encounter

24
Experiential/CommunicationsFamily Therapy
  • Assessment Procedures
  • Unstructured search for suppressed feelings and
    impulses that block growth and fulfillment

25
Experiential/CommunicationsFamily Therapy
  • Key Methods of Intervention
  • Confrontation to provoke self-discovery
  • Self-disclosure by the therapist
  • Exercises to uncover previously unexpressed
    inner conflicts

26
Experiential/CommunicationsFamily Therapy
  • Insight vs. Action
  • Self-awareness of ones immediate existence leas
    to choice
  • Responsibility
  • Change

27
Experiential/CommunicationsFamily Therapy
  • Goals of Treatment
  • Simultaneous sense of togetherness and healthy
    separation and autonomy
  • Genuineness
  • Learning to express ones sense of being
  • Building self-esteem
  • Relieving family pain
  • Overcoming blockages to personal growth
  • Overcoming negative interactive patterns

28
Transgenerational Family Therapy
  • Theoretical Viewpoint
  • Emotional attachments to ones family of origin
    need to be resolved

29
Transgenerational Family Therapy
  • Unit of Study-Triadic
  • Problems arise and are maintained by relational
    binds with others

30
Transgenerational Family Therapy
  • Time Frame-Past and Present
  • Current marital relations assumed to result from
    partners fusions to their families of origin or
    to unpaid debts and obligations

31
Transgenerational Family Therapy
  • Leading figures
  • Bowen
  • Kerr
  • Friedman
  • Papero
  • Boszormenyi-Nagy

32
Transgenerational Family Therapy
  • Major Concepts
  • Differentiation of self vs. fusion
  • Triangles
  • Multigenerational transmission process
  • Family ledger
  • Ethics
  • Family legacies
  • Entitlements

33
Transgenerational Family Therapy
  • Role of Therapist
  • Coach
  • Direct but non-confrontational
  • Detriangulated from family fusion
  • Aids family in developing relational fairness

34
Transgenerational Family Therapy
  • Assessment Procedures
  • Family evaluation interviews with any combination
    of family members
  • Genograms
  • Attention to intergenerational indebtedness

35
Transgenerational Family Therapy
  • Key Methods of Intervention
  • Teaching differentiation
  • Individuation
  • Taking I stands
  • Reopening cutoff relations with extended family
  • Balancing family ledgers

36
Transgenerational Family Therapy
  • Insight vs. Action
  • Rational processes used to gain insight into
    current relationships and intergenerational
    experiences
  • Leads to action with family of origin

37
Transgenerational Family Therapy
  • Goals of Treatment
  • Anxiety reduction, symptom relief, and increased
    self-differentiation of individuals leads to
    family system change
  • Restoration of trust, fairness, ethical
    responsibility

38
Structural Family Therapy
  • Theoretical Viewpoint
  • Symptoms in an individual are rooted in the
    context of family transaction patterns, and
    family restructuring must occur before symptoms
    are relieved.

39
Structural Family Therapy
  • Unit of Study-Triadic
  • Family enmeshment and disengagement involve
    family subsystems and family systems as a whole

40
Structural Family Therapy
  • Time frame-present
  • Ongoing interactions are maintained by unadaptive
    family organization
  • Family is unable to deal with transitions in
    family life cycle

41
Structural Family Therapy
  • Leading figures
  • Minuchin
  • Montalvo
  • Aponte
  • Fishman

42
Structural Family Therapy
  • Major Concepts
  • Boundaries
  • Subsystems
  • Coalitions
  • Enmeshment
  • Disengagement

43
Structural Family Therapy
  • Role of Therapist
  • Active
  • Stage director
  • Manipulates family structure to change
    dysfunctional set

44
Structural Family Therapy
  • Assessment Procedures
  • Observe family transactional patterns for clues
    to family structure
  • Family mapping
  • Enactments
  • Tracking

45
Structural Family Therapy
  • Key Methods of Intervention
  • Joining
  • Accommodating
  • Reframing
  • Helping families create flexible boundaries and
    integrated subsystems

46
Structural Family Therapy
  • Insight vs. Action
  • Action precedes understanding
  • Change in transactional patterns leads to new
    experiences and corresponding insights

47
Structural Family Therapy
  • Goals of Treatment
  • Restructured family organization
  • Change in dysfunctional transactional patterns
  • Symptom reduction in individual members

48
Strategic Family Therapy
  • Theoretical Viewpoint
  • Redundant communication patterns offer clues to
    family rules and possible dysfunction
  • A symptom represents a strategy for controlling a
    relationship while claiming it to be involuntary

49
Strategic Family Therapy
  • Unit of Study-Dyadic and Triadic
  • Symptoms are interpersonal communications between
    at least two, and probably three participants in
    a reciprocal relationship

50
Strategic Family Therapy
  • Time Frame-Present
  • Current problems or symptoms are maintained by
    ongoing, repetitive sequences between family
    members

51
Strategic Family Therapy
  • Leading Figures
  • Haley
  • Madanes
  • Weakland
  • Watzlawick
  • Jackson
  • Keim

52
Strategic Family Therapy
  • Major Concepts
  • Symmetrical and complementary communication
    patterns
  • Paradox
  • Family hierarchy

53
Strategic Family Therapy
  • Role of Therapist
  • Active
  • Manipulative
  • Problem-focused
  • Prescriptive
  • Paradoxical

54
Strategic Family Therapy
  • Assessment Procedure
  • Unstructured
  • Search for familys repetitive, destructive
    behavior patterns and flawed solutions that
    perpetuate the presenting problem

55
Strategic Family Therapy
  • Key Methods of Intervention
  • Paradoxical interventions
  • Prescribing the symptom
  • Therapeutic double binds
  • Directives
  • Pretend techniques
  • Relabeling

56
Strategic Family Therapy
  • Insight vs. Action
  • Action-oriented
  • Symptom reduction and behavior change brought
    about through directives rather than insight and
    understanding

57
Strategic Family Therapy
  • Goals of Treatment
  • Symptom relief
  • Resolution of presenting problem

58
Milan Family Therapy
  • Theoretical Viewpoint
  • Dysfunctional families are caught up in
    destructive games and are guided by belief
    systems that do not fit the realities of their
    lives

59
Milan Family Therapy
  • Unit of Study-Triadic
  • Problems express connecting relationship patterns
    between family members

60
Milan Family Therapy
  • Time Frame-Present
  • Recognition of circular nature of current
    problems helps family abandon previous limited
    linear perspective

61
Milan Family Therapy
  • Leading figures
  • Selvini-Palazzoli
  • Boscolo
  • Cecchin
  • Prata
  • Tomm

62
Milan Family Therapy
  • Major Concepts
  • Paradox and counterparadox
  • Invariant prescriptions
  • Circular questioning
  • Second-order cybernetics

63
Milan Family Therapy
  • Role of Therapist
  • Neutral
  • Active therapeutic partner
  • Offers hypotheses as new information for family
    belief systems
  • Use of reflecting team behind one-way mirror

64
Milan Family Therapy
  • Assessment Procedure
  • Unstructured
  • Non-manipulative
  • Collaborates with family in developing systemic
    hypotheses regarding their problems

65
Milan Family Therapy
  • Key Methods of Intervention
  • Positive connotations
  • Circular questioning
  • Reframing
  • Paradox
  • Invariant prescription
  • Rituals

66
Milan Family Therapy
  • Insight vs. Action
  • Emphasis on family gaining new meaning rather
    than insight or action based on therapist choice
    of therapeutic outcome

67
Milan Family Therapy
  • Goals of Treatment
  • System change chosen by family because of new
    meaning given to their life patterns
  • Interruption of destructive family games

68
CBT Family Therapy
  • Theoretical Viewpoint
  • Personal functioning is determined by the
    reciprocal interaction of behavior and its
    controlling social conditions

69
CBT Family Therapy
  • Unit of Study-Monadic
  • Symptomatic person is the problem
  • Linear view of causality

70
CBT Family Therapy
  • Time Frame-Present
  • Maladaptive behavior in an individual is
    maintained by current reinforcements from others

71
CBT Family Therapy
  • Leading Figures
  • Patterson
  • Stuart
  • Liberman
  • Alexander
  • Falloon
  • Ellis
  • Beck
  • Meichenbaum
  • Gottman

72
CBT Family Therapy
  • Major Concepts
  • Conditioning
  • Reinforcement
  • Shaping
  • Modeling
  • Schemas

73
CBT Family Therapy
  • Role of Therapist
  • Teacher
  • Trainer
  • Model of desired behavior
  • Contract negotiator

74
CBT Family Therapy
  • Assessment Procedures
  • Structured
  • Reliance on formal standardized tests and
    questionnaires
  • Behavioral analysis before commencing treatment

75
CBT Family Therapy
  • Key Methods of Intervention
  • Reinforcement of desired behaviors
  • Skills training
  • Contingency contracting
  • Positive reciprocity between marital partners as
    well as parents and children
  • Self-regulated modification of thought and
    activities

76
CBT Family Therapy
  • Insight vs. Action
  • Actions taught to reward desired outcomes and
    ignore or punish undesired behavior
  • Unconcerned with insight

77
CBT Family Therapy
  • Goals of Treatment
  • Modification of behavioral consequences between
    persons in order to eliminate maladaptive
    behavior and/or alleviate presenting symptoms
  • Cognitive restructuring
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