Setting the Stage for Family CounselingTherapy

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Setting the Stage for Family Counseling/Therapy

• Psychoanalysis Freuds acknowledged the role of
  family relationships in personality development
  (after World War II)
• General Systems Theory Biologist Bertalanffy
  and his study of components of a self-regulating
  total system in continuous change seeking a
  steady state. (1940s)
• Schizophrenic Studies Batesons work on double
  bind interactions (1950s)
• Child Guidance Centers brought parents into
  treatment (began in 1930s) Nathan
  Ackerman--grandfather of family therapy
• Group Therapy used small group processes for
  therapy (after World War II)
• Family therapists emerged in the 1950s and 60s

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Bowens Strategy of Family Counseling

• Differentiation of Self
• Triangles
• Nuclear family emotional system
• Family projection process
• Emotional cut off
• Multigenerational transmission process
• Sibling position
• Societal regression

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Bowens Theory provides a framework for
understanding how emotional ties within families
of origin influence the lives of individuals in
ways they often fail to appreciate.Family
Emotional Systems Theory (Murray Bowens Theory)
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Bowens theory and approach is generally
appropriate when the focus will be on the quality
of nuclear or extended family interpersonal
processes and on the desire for one or more
family members to become more differentiated.
Level III families often need help with issues
related to boundaries, enmenshment, and emotional
distance.
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Differentiation of Self

• Extent to which a person is able to distinguish
  between the intellectual process and the feeling
  process
• Striving for balance, achieving self-definition
  but not losing spontaneous emotional expression
• Fusion is when there is no balance between
  thoughts and feelings

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Emotion Reason
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Triangles

• Basic building block in a familys emotional
  system
• When a moderate anxiety level is reached between
  two family members, one of the family members may
  bring in a vulnerable third person.
• Triangles dilute anxiety

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Nuclear Family Emotional System

• Four relationship patterns that foster problem
  development. System anxiety can be passed to
  other generations.
• Marital conflict
• Problematic emotional functioning
• Functional impairment
• Emotional fusion

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Family Projection Process

• Projection is when one person attributes to
  someone else his or her unacceptable thoughts and
  feelings.
• Parental projection is a major source of
  transmitted family anxiety.

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Emotional Cutoff

• A persons attempt to emotionally distance him or
  herself from certain members of the family or
  from the entire family. Emotional cutoff is the
  result of a persons inability to directly
  resolve issues of fusion, which in turn prevents
  him or her from forming a unique identity or
  satisfying relationships with others.

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Multigenerational Transmission Process

• Severe dysfunction in a family is the result of
  the operation of the familys emotional system
  over several generations.
• Genogram major tool for assessment of families.
  Visual representation of a familys composition,
  structure, member characteristics, and
  relationships.
• Family Mapping depicts structures and patterns
  of family systems

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Bowens Family Intervention Techniques

• Reduction of anxiety and relief from symptoms
• An increase in each participants level of
  differentiation in order to improve adaptiveness.
• Meeting with two adults (I.e., parents) is of
  utmost importance.
• Calm questioning and focusing on ones role in
  the family problems is critical.
• Counselor takes on role of coach. She/he asks
  questions and makes suggestions that the family
  members discuss and enact with each other.
• Counselor may ask family members to talk to
  him/her to minimize interpersonal tensions.
• Genogram is used to gain insight.
• Detriangulation
• Increase insight

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Structural Family Interventions

• Salvador Minuchin presented the structural
  approach to working with inner city, poor
  families (with troubled youth).
• Interest in how the components of the system
  interact, how balance or homeostasis is achieved,
  how family feedback mechanisms operate, how
  dysfuntional communication patterns develop, and
  family transactional patterns.
• Most effective with families with level 1 and 2
  needs, single mothers, families overwhelmed by
  lifes circumstances.

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Structural Therapists Look For.

• Boundaries What defines who is in or out of a
  family relationship or the focal issue?
• Alignment Who is with or against the other in
  the transactions generating the problem?
• Power What is the relative influence of the
  participants in the interactions that create the
  problem?

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Structural Interventions/Techniques

• Joining the process of coupling that occurs
  between the counselor and the family, leading to
  the development of the therapeutic system. This
  is done by tracking (counselor following the
  content of the family facts), mimesis (counselor
  becomes like the family in the manner or content
  of communications), confirmation (using a feeling
  word to reflect an expressed or unexpressed
  feeling of a family member), and accommodation
  (counselor makes personal adjustments in order to
  achieve a therapeutic alliance).

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Structural Interventions/Techniques (cont.)

• Reframing changing a perception by explaining a
  situation from a different context. The meaning
  of a situation changes not the facts.
• Enactment families bringing problematic
  behavioral sequences into the counseling session
• Working with spontaneous interaction counselors
  point out the dynamics and sequencing of
  behaviors observed in session. Focus is on
  process not content.
• Restructuring changing the structure of the
  family. Example if a father dominates to the
  point of children feeling intimidated, the
  counselor may ask the rest of the family to
  uniformly refuse what the father requests, (the
  family behaving differently).

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Human Validation Process Approach (Virginia Satir)

• Grandmother of family counseling
• Offered the first training program in family
  therapy in 1955 at the Illinois State Psychiatric
  Institute
• Coined the term conjoint family therapy to
  describe her type of family therapy.
• Satirs approach is mainly concerned with the
  family as a balanced system. To Satir, the rules
  that govern a family system are related to how
  the parent/s go about achieving and maintaining
  their own self-esteem these rules, in turn,
  shape the context within which the children grow
  and develop their own sense of self-esteem.

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Satirs Communication Styles

• Satir contended that the way the family
  communicates reflects the feelings of self-worth
  of its members. Dysfunctional communication
  (indirect, inappropriate, unclarified,
  inaccurate) characterizes a dysfunctional family
  system.
• Placater acts weak, tentative, self-effacing,
  always agrees, apologizes, tries to please.
• Blamer dominates, invariably finds fault with
  others, and self-righteously accuses
• Super-Reasonable rigid stance, remains detached,
  calm, cool, maintaining intellectual control
  while not becoming emotionally involved
• Irrelevant distracts others and seems unable to
  relate to anything going on
• Congruent real, genuinely expressive,
  responsible for sending straight (not double
  binding) messages.

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Famous Inspirational Quotes by Virginia Satir

• Feelings of worth can flourish only in an
  atmosphere where individual differences are
  appreciated, mistakes are tolerated,
  communication is open, and rules are
  flexible--the kind of atmosphere that is found in
  a nurturing family.

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Strategic Family Counseling

• Jay Haley coined the term strategic therapy to
  describe the work of Milton Erickson.
• Strategic family counseling is short term
  treatment, about 10 sessions. Sometimes
  strategic family counseling is called brief
  family counseling.
• Erickson believed in the following
• Accepting and emphasizing the positive
• Using indirect and ambiguously worded directives
• Encouraging or directing routine behaviors so
  that resistance is shown through change and
  through normal and continuous actions.

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Strategic Family Counseling Dimensions

• Family rules the overt and covert rules
  families use to govern themselves, such as you
  must only speak when spoken to.
• Family homeostasis the tendency of the family to
  remain in its same pattern of functioning unless
  challenged to do otherwise.
• Quid pro quo the responsiveness of family
  members to treat others in the same way they are
  treated, that is, something for something
• Redundancy principle the fact that a family
  interacts within a limited range of repetitive
  behavioral sequences
• Punctuation the idea that people in a
  transaction believe that what they say is caused
  by what others say
• Symmetrical relationships and complementary
  relationships the fact that relationships within
  a family are both among equals (symmetrical) and
  unequals (complementary)
• Circular Causality events in a family are
  interconnected

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Strategic Interventions/Techniques

• Reframing different interpretation is given to a
  family situation or behavior
• Directive instruction from a family counselor
  for a family to behave differently. This is the
  basic tool of the approach. Directives may
  include nonverbal messages (e.g., silence, voice
  tone, posture), direct and indirect suggestions
  (e.g., go fast, you may want to talk slowly)
  and assigned behaviors (e.g., when you think you
  wont sleep, force yourself to stay up all
  night.).
• Paradox Gives permission to family to do
  something they are already doing and is intended
  to lower or eliminate resistance to change.
• Restraining counselor tells family that they
  are incapable of doing anything other than what
  they are doing.
• Prescribing family members are instructed to
  enact a troublesome behavior in front of the
  therapist.
• Redefining attributing positive connotations to
  symptomatic or troublesome actions.

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Multicultural Issues in Family Work

• Seven major factors that distinguish ethnic
  minorities from mainstream middle class white
  American families
• Ethnic minority experiences with racism and
  oppression
• The impact of external systems on minority
  cultures
• Biculturalism
• Ethnic differences in minority status
• Ethnicity and language
• Ethnicity and social class
• Ethnicity as a narrative identity