Generalist Practice: Micro Interventions

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Generalist Practice Micro Interventions

• Family Systems Theories of Helping
• Heath B. Walters, MA MSW LICSW ACS
• Lewis Clark State College

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General Systems Theory

• Provides social workers with a conceptual
  framework that shifts attention from a
  cause/effect relationship of paired behaviors, to
  a broader environmental etiology of behavior
• Observes the following
• A person is only a piece of their entire life
  situation
• Dynamic interactions between person, systems and
  environments
• Functionality as an individual and a system
• It is not enough for the social worker to simply
  assess the client and then the environment, but
  the dynamic processes must be integrated into a
  biopsychosocial hypothesis that reflects the
  presenting behavior within the context of
  ecological systems

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General Systems Theory

• One of the Best Ways to view General Systems
  Theory is in the context of family life a
  subsystem of the larger community system
• The whole is greater then the sum of its parts
• Changing one part of the system, results in
  changes to other parts of the system
• Families become organized and developed over
  time. Families are always changing and, over the
  life span, family members assume different roles
• Families are generally open systems in that they
  receive information and exchange it with each
  other with people outside the family. Families
  vary in their degree of openness and closedness,
  which can vary over time according to
  circumstance
• Individual dysfunction is often reflective of an
  active emotional system. A symptom in one family
  member is often a way of deflecting tension way
  from another part of the system and hence
  represents a relationship problem (I.E. the
  identified patient)

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General Systems Theory

• Four key Domains of Environmental Interactions
• Situation The part of the environment that is
  accessible to an individuals perception at any
  given moment of time
• Micro The part of the physical and social
  environment that the individual has direct
  contact with and can interact with in daily life
• Mezzo The part of the environment that in some
  way or other influences and determines the
  character and functioning of the micro
  environment
• Macro Common to most members of groups living
  in it and involves physical, social, cultural,
  economic, and political structures of the larger
  society

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General Systems Theory

• Rules Roles in General Systems Theory
• Rules can be conscious and unconscious
• Often times the unconscious rules have more
  impact on social exchange
• Boundaries Both physical and unconscious
• Roles Adopted within the family systems in
  order to maintain equilibrium
• Role Contiguity Whether Peters expectations of
  Peters behavior is the same as Susans
  expectations of Peters Behavior
• Role Competency Does one have the skill or
  knowledge to meet prescribed role expectations
  and does the person understand their role
• Role Conflict Demands of two roles conflict with
  each otherexample being a mother and a
  full-time student

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General Systems Theory

• Other Key Terms
• Open versus Closed Systems
• Entropy The process by which order of a system
  is lost
• Negative Entropy Increase in order (example
  evolutionary theory)
• Homeostasis A fixed or optimum state
• Equifinality All roads lead to Rome

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Structural Family Theory (Minuchin)

• Basic Goal By changing the structure of the
  family, both the behavior and intrapsychic
  processes of the family will be changed.
• This theory is very concrete, based upon the here
  and now, and a very involved social worker
• It Consists of Seven Basic Premises
• Focuses on Concrete Issues
• Located in the Present
• Mediated through Clients Experience
• Based on Reorganizing the Structure of Family
  Relationships
• Built upon Client Strengths
• Aimed at Palpable Outcomes
• Active Involvement of the Social Worker

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Structural Family Theory (Minuchin)

• Focused on Concrete Issues
• The social worker addresses the most urgent issue
  that has the families attention first
• This is considered the most compelling concern.
• Success breeds success
• The concrete issue can be anything as long as it
  is of the utmost concern to the family
• Look for motivations behind actions and tie these
  motivations into interventions as they will
  increase the likelihood of success
• Spirituality, Existential Meanings, Key
  Relationshipswhatever works.think practical.

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Structural Family Theory (Minuchin)

• Located in the Present
• The past is accessible through the present, as
  current behaviors are related to past
  interpretationsthere is no need for regressional
  work
• The client issue contains the focal point of
  todays concern, the dynamics currently
  generating the distress, and traces the family
  history that explains the why and how of the
  problems birth.
• Be remedying and changing the current structure,
  past memories, perceptions, and psychological
  residue are alleviated.

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Structural Family Theory (Minuchin)

• Mediated through the clients experience
• The primary model of intervention is enactment of
  their issue in sessionthere is less focus on
  the verbal recount of a situation as noted in
  traditional family therapy.
• The structural family social worker seeks to
  understand the unique experience of each
  individual within the context of the presenting
  concern and looks for areas of convergence and
  divergence in experience.

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Structural Family Theory (Minuchin)

• Based upon Reorganizing the Structure of
  Relationships
• The social worker pays close attention to the
  structure of the family in context of the
  presenting concern
• Boundaries What defines who is in or out of a
  family relationship in the context of the focal
  issue, as well as what their roles are in this
  interaction
• Alignment Who is with or against the other in
  the transactions generating the problem
• Power What the relative influence is of the
  participants in the interactions that contributes
  to the presenting problem
• Alignments, Coalitions, Disengaged Families,
  Enmeshed Families
• Look for the etiology of problems
• Conflicting feelings and needs
• Weakly organized relationships
• Both
• Encourage adaptive structures in family dynamics.

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Structural Family Theory (Minuchin)

• Built Upon Strengths
• Identify current and underutilized family
  strengths/ resources to assist in alleviating the
  presenting concern.
• Integrate these strengths and resources within
  the family structure or relating
• Look to draw the good out of the bad

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Structural Family Theory (Minuchin)

• Aimed at Palpable Outcomes
• Concrete change is manifested in an experiential
  method within session.
• These are practical methods for immediately
  addressing the family struggle and problem

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Structural Family Theory (Minuchin)

• Characterized by Active Social Work Involvement
• Join the family interaction in a carefully
  planned, goal directed way
• The social worker may purposefully draw attention
  to the area of conflict to increase the emotional
  dynamics of the family system
• The social worker may purposely block
  pathological interactions within the family
  systems and force the family members to develop
  new methods of communication/interaction
• Supports adaptive behaviors
• Intensive use of self in the therapy process
• Assignment of homeworkpracticing a specific
  skill to change family structure.

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Bowen Family Systems Theory

• The goal of this theory is to encourage the
  individuation of self from family
  relationships, while not disengaging entirely.
• Family problems arise when individuals are
  fused to other individuals in the family
  resulting in an emotional oneness
• This fusion both protects against threats to self
  (using the other persons identity/strengths to
  make you a whole person), while at the same time
  is threatening for if they change you lose a
  sense of yourself.
• Results in Triangulation to maintain power within
  the dyadic relationship.

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Bowen Family Systems Theory

• Bowen utilizes genograms to explore family
  functioning across three generations
• Identifies events that contribute to the present
  configuration of the family
• Notes important relationships, including tense
  and emotionally reactive relationships
• Identifies the particular kind of relationships
  patterns that characterize interactions from the
  family.

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Bowen Family Systems Theory

• Goals of Intervention
• Decrease anxiety
• Increase the functional differentiation of self
• Anxiety is decreased by utilizing cognitive
  processes to mitigate extreme emotional reactions
• Observe self, observe others, recognize anxiety,
  self-regulate
• Observe particular patterns in relationships and
  avoid fusion into those patterns
• Define and clarify relationships between two
  family members
• Maintain a neutral position
• Teach the functioning of emotional systems
• Think of the differentiated self and how the
  self cognitively chooses to respond.

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Bowen Family Systems Theory

• Disengagement doesnt mean leaving the family.
• Bowen argues
• Gain control over emotional reactivity
• Visit the family as often as possible
• Develop the ability to be an objective observer
• Develop person-to-person relationships in the
  context of the broader family.

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Human Validation Model

• Founder Virginia Satir
• Very intuitive, model that is based more on
  relationship then technique
• Originally called, Conjoint Family Therapy

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Key Concepts Human Validation Model

• Enhancement and validation of self-esteem-Human
  Validation Process ModelFamily rules
• Congruence and openness in communications
• Sculpting
• Nurturing triads
• Family mapping and chronologies

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Goals of Human Validation Model

• Open communications
• Individuals are allowed to honestly report their
  perceptions
• Enhancement of self-esteem
• Family decisions are based on individual needs
• Encouragement of growth
• Differences are acknowledged and seen as
  opportunities for growth
• Transform extreme rules into useful and
  functional rules
• Families have many spoken and unspoken rules

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Family Life Human Validation

• Children enter pre-existing systems which have
  rules
• Rules about living interaction
• Rules governing Communications-who says what
  under what conditions
• Rules spoken and unspoken shoulds and should
  nots
• Rules become absolutes often are impossible
  Never be angry with your father. Always keep a
  smile on your face
• As child accept rules for survival which are not
  useful as adult

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Functional vs. Dysfunctional Communication

• Functional each family member give chance to be
  individual, separate life lots of freedom and
  flexibility in family with open communications
• Dysfunctional closed communications, poor
  self-esteem of parents, rigid patterns-resists
  awareness, strained relationships, little
  individuality, incapable of autonomy or genuine
  intimacy Family members think, feel and act the
  same way family controlled by fear, punishment,
  guilt or dominance

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Defensive Stances in Communication

• Placating-enabler, people pleaser, rescuer
• Blaming-troubled person
• Super-responsible-looking good
• Irrelevant behavior-distracting- acting out,
  entertainer

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Human Validation Interventions

• Communicating Clearly
• Expanding awareness
• Enhancing potentials for growth in self-esteem
• Coping with demands process of change
• Identify new possibilities to the status quo
• Encouraging growth in each member
• Generating hope, courage to formulate new options
• Assess, strengthen, enhance coping skills
• Encourage members to exercise healthy options

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Social Worker Roles

• Focus on emotional honesty, congruence, systemic
  understanding
• Family sculpting position family members by
  roles they play in family
• Family reconstruction psychodrama reenactment
  significant event in 3 generations of
  family-unlock dysfunctional patterns stem from
  family of origin