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Family Systems Therapy

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Carl Whitaker-Experiential Symbolic Family Therapy-therapist coach influences change ... Coach family how to get out of the turmoil ... – PowerPoint PPT presentation

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Title: Family Systems Therapy


1
Family Systems Therapy
  • James J. Messina, Ph.D.

2
Family Therapists Leaders
  • Alfred Adler-Rudolf Driekurs-open forum Child
    Guidance Clinics
  • Murray Bowen-Multigenerational Model-Triangulation
    , Differentiation of Self
  • Virginia Satir-Conjoint Family Therapy-Human
    Validation, Relational Family Therapy
  • Carl Whitaker-Experiential Symbolic Family
    Therapy-therapist coach influences change
  • Salvador Minuchin-Structural Family
    Therapy-create structural change
  • Jay Haley-Strategic Family Therapy-solves
    problems now
  • Cloe Madanes- Wife Haley-Strategic Family Therapy

3
The Family Systems Perspective
  • Individuals are best understood through
    assessing the interactions within an entire
    family
  • Symptoms are viewed as an expression of a
    dysfunction within a family
  • Problematic behaviors
  • Serve a purpose for the family
  • Are a function of the familys inability to
    operate productively
  • Are symptomatic patterns handed down across
    generations
  • A family is an interactional unit and a change
    in one member effects all members

)
4
Difference between Systemic Individual Therapy
models
5
Beliefs of Family Therapists
  • Individuals affiliations interactions have
    more power in persons life than a single
    therapist could ever hope to have
  • Working with family or community therapists sees
    how individual acts and serves needs of these
    systems
  • Seeing individual in active in a systems assists
    in developing types of interventions needed

6
Systemic Perspective
  • Individual may carry a symptom for the entire
    family
  • Individuals functioning is a manifestation of
    way family functions
  • Individual can have symptom existing independent
    of family structure
  • Symptoms always have ramifications for family
    members
  • Change the systems and individuals will change
  • Change dysfunctional patterns of relating
    create functional ways of interacting relating

7
Adlerian Family Therapy Outline
  • Key Concepts
  • Therapy Goals
  • Therapists functions

8
Adlerian Family Therapy Key Concepts
  • Adlerians use an educational model to counsel
    families
  • Emphasis is on family atmosphere and family
    constellation
  • Therapists function as collaborators who seek to
    join the family
  • Parent interviews yield hunches about the
    purposes underlying childrens misbehavior

9
Family Atmosphere
  • Unique conjunction of all the family
    forces-climate of relationships that exist
    between people
  • Family is a system each member exerts influence
    on every other member
  • Autocratic or permissive common in West
  • Parent role model of how genders relate, how to
    work, participate in world
  • Emotional role models for children as well
  • Family value value all members support cannot
    be ignored religion, education, money
    achievement, right and wrong

10
Family Constellation
  • Consists of parents, children, extended family
    members
  • Birth order
  • How member find place in family system how
    relate to one another to be unique
  • Alignment of family members
  • Develop genogram of family-starting point for
    client communication meaning of life

11
Role of Birth Order
  • Motivates later behavior
  • First-born favored, only, pseudo-parent-high
    achievers
  • Second-born rivalry competition
  • Last-born more pampered, baby-creative,
    rebellious, revolutionary, avant-garde

12
Birth Order
  • Adlers five psychological positions
  • Oldest child receives more attention, spoiled,
    center of attention
  • Second of only two behaves as if in a race,
    often opposite to first child
  • Middle often feels squeezed out
  • Youngest the baby
  • Only does not learn to share or cooperate with
    other children, learns to deal with adults

13
Mistaken Goals Interactional View
  • Four goals for childrens behaviors
  • Attention getting
  • Power struggle
  • Revenge
  • Demonstration of inadequacy
  • Short hand explanations, descriptions of
    consistent patterns
  • Describe childs misbehavior
  • Parents reaction to behavior
  • Childs reaction to parents attempt to
    discipline
  • Mistaken Goal recognition flex smile, twinkle
  • Goal recognition and disclosure

14
Adlerian Family Therapy Goals
  • Unlock mistaken goals and interactional patterns
  • Engage parents in a learning experience and a
    collaborative assessment
  • Emphasis is on the familys motivational patterns
  • Main aim is to initiate a reorientation of the
    family
  • Assist family member to have Social Equality- the
    sense that everyone has an equal right to be
    valued and respected in the family

15
Adlerian Therapist Functioning
  • Open forum
  • Parent Interview alone they are leaders
  • Problem Description parents concerns
  • Goal Identification What did you do about it?
  • Typical Day repeated patterns of interaction
  • Child Interview
  • Goal Disclosure Do you know why you do
  • Posit tentative goals Could it be that
  • Concluding Remarks to generate new approaches to
    end mistaken interactions to lead to more
    democratic, harmonious, effective living

16
Multigenerational Family Therapy Outline-Murray
Bowen
  • Key Concepts
  • Therapy Goals
  • Therapists functions

17
Multigenerational Family Therapy Murray Bowen 8
Key Concepts
  • The application of rational thinking to
    emotionally saturated systems. A
    well-articulated theory is considered to be
    essential
  • Differentiation of the self
  • Triangulation
  • Nuclear Family Emotional System
  • Family Projection Process
  • Emotional cutoff
  • Multigenerational transmission process
  • Sibling position
  • Societal regression

18
Differentiation of the self
  • A psychological separation of intellect emotion
    independence of self from others
  • Differentiated Being able to be guided by
    thoughts or emotions separateness
  • Undifferentiateddifficulty separating self from
    others-fuse with dominant family emotional
    patterns-physical but not emotional leaving
  • Unproductive family dynamics of previous
    generation transmitted by marriage of
    undifferentiated individuals
  • Need for self-identify while still belonging to
    ones family

19
Triangulation
  • A third party is recruited to reduce anxiety and
    stabilize a couples relationship
  • Underlying conflict not addressed worsens
  • Once the 3rd person is resolved the balance
    achieved is off again
  • Change in one part of family system affects the
    whole system
  • Therapist must be highly differentiated so as not
    to get caught up in triangulation with couple

20
Multigenerational Family Therapy Goals
  • With the proper knowledge the individual can
    change
  • Change occurs only with other family members
  • To change the individuals within the context of
    the system
  • To end generation-to-generation transmission of
    problems by resolving emotional attachments
  • To lessen anxiety and relieve symptoms
  • To increase the individual members level of
    differentiation

21
Multigenerational Family Therapy Therapist
Functioning
  • Genogram work look at family over three
    generations
  • Look for critical turning points in family
    emotional process
  • Characteristics of family members
  • Evolutional picture of family tools for
    assessment
  • Asking Questions What role did you play with
    that person in the family? Looking for fusion
    within the family.

22
(No Transcript)
23
Conjoint Family Therapy Outline
  • Key Concepts
  • Therapy Goals
  • Therapists functions

24
Conjoint Family Therapy Key Concepts-Virginia
Satir
  • Enhancement and validation of self-esteem-Human
    Validation Process ModelFamily rules
  • Congruence and openness in communications
  • Sculpting
  • Nurturing triads
  • Family mapping and chronologies

25
Conjoint Family Therapy Goals
  • 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

26
Family Life
  • 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

27
Functional vs. Dysfunctional Communications
  • 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

28
Defensive Stances in Coping with Stress
  • Placating-enabler, people pleaser, rescuer
  • Blaming-troubled person
  • Super-responsible-looking good
  • Irrelevant behavior-distracting- acting out,
    entertainer

29
Family Roles and Family Triads
  • Roles played in family based on ones behavior
  • Victim
  • Keeping the Peace
  • Stern Taskmaster
  • Disciplinarian
  • Hard-working caregiver
  • Nurturing Triad two parents and child where child
    is nurtured

30
Conjoint Family Therapy Goals
  • 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

31
Therapist Functions
  • Focus on emotional honesty, congruence, systemic
    understanding
  • Family sculpting position family members by
    roles they play in family
  • Family reconstruction psychodramtic reenactment
    significant event in 3 generations of
    family-unlock dysfunctional patterns stem from
    family of origin

32
Experiential Family Therapy Outline-Carl Whitaker
  • Key Concepts
  • Therapy Goals
  • Therapists functions
  • Techniques

33
Experiential Family Therapy Carl Whitaker
  • A freewheeling, intuitive, sometimes outrageous
    approach aiming to
  • Unmask pretense, create new meaning, and liberate
    family members to be themselves
  • Techniques are secondary to the therapeutic
    relationship
  • Pragmatic and atheoretical
  • Interventions create turmoil and intensify what
    is going on here and now in the family

34
Experiential Family Therapy Key Concepts
  • Subjective Focus subjective needs of the family
    members
  • Assumption all family members have a right to be
    themselves
  • Needs of family may be suppressing rights of the
    individual
  • Goal for authenticity, no right or wrong way to
    be

35
Atheoretical Stance
  • Pragmatic stance
  • Theory can be hindrance to clinical work
  • Often times theory is way for therapist to create
    distance from clients and control anxiety of the
    therapist to hide behind
  • Intensify present experiencing of family members
    to reach unconscious to understand what is really
    going on in the family
  • Process to help tap into Family secrets just
    keeping the secrets keeps the family crazy

36
Experiential Family Therapy Goals
  • Facilitate individual autonomy and a sense of
    belonging in the family
  • Help individuals achieve more intimacy by
    increasing their awareness and their experiencing
  • Encourage members to be themselves by freely
    expressing what they are thinking and feeling
  • Support spontaneity, creativity, the ability to
    play, and the willingness to be crazy

37
Therapist Function in Experiential Family Therapy
  • Create family turmoil
  • Coach family how to get out of the turmoil
  • Highly involved therapist model must be
    transparent, take risks, get involved with family
    in the sessions
  • Help family member experience the here and now by
    therapist BEING WITH the family
  • Three phases engagement (all powerful),
    involvement (dominant parent figure, adviser)
    disentanglement (more personal, less involved)

38
Structural Family Therapy Outline - Salvador
Minuchin
  • Key Concepts
  • Therapy Goals
  • Therapists functions

39
Structural Family Therapy - Salvador Minuchin
  • Focus is on family interactions to understand the
    structure, or organization of the family
  • Symptoms are a by-product of structural failings
  • Structural changes must occur in a family before
    an individuals symptoms can be reduced
  • Techniques are active, directive, and well
    thought-out
  • Focus on the how, when, and to whom family
    members relate

40
Key Concepts Structural Family Therapy of
Salvador Minuchin
  • Family Structure invisible set of functional
    demands or rules that organize way family members
    relate to one another-
  • Observe family to see the structure
  • who says what to whom,
  • in what way,
  • with what result

41
Family Subsystems
  • Spousal wife husband
  • Parental mother father
  • Sibling children
  • Extended grandparents, other relatives
  • Family member play a different role in each of
    the subsystems they belong
  • Structural difficulty when one subsystem takes
    over or intrude another

42
Boundaries
  • Emotional barriers that protect enhance the
    integrity of individuals, subsytems families
  • Extremes of boundaries
  • Disengagement-overly detached-rigid
  • Enmeshment-very involved as one-diffuse-fosters
    dependency on parents
  • Clear healthy boundaries-attain sense of personal
    identity yet allow sense of belongingness within
    family system

43
Structural Family Therapy Goals
  • Reduce symptoms of dysfunction
  • Bring about structural change by
  • Modifying the familys transactional rules
  • Developing more appropriate boundaries
  • Creation of an effective hierarchical structure
  • It is assumed that faulty family structures have
  • Boundaries that are rigid or diffuse
  • Subsystems that have inappropriate tasks and
    functions

44
Structural Family Therapist Function
  • To actively engage family as unit to initiate
    structural change by
  • Joining the family in a position of leadership
  • Mapping its underlying structure
  • Intervening in ways designed to transform an
    ineffective structure
  • The Therapeutic Endeavor is challenging rigid
    transactional patterns
  • Pushing for clearer boundaries
  • Increasing degree of flexibility in family
    interactions
  • Modifying dysfunctional family structures

45
Structural Family Techniques
  • Joining build maintain therapeutic alliance
    with family
  • Family Mapping draw map to identify boundaries ,
    transactional styles
  • Enactments family engages in conflict situation
    that would happen at home
  • Reframing new light or different interpretation
    on problem situation in family

46
Strategic Family Therapy Outline
  • Key Concepts
  • Therapy Goals
  • Therapists functions

47
Strategic Family Therapy Key Concepts
  • Focuses on solving problems in the present
  • Presenting problems are accepted as real and
    not a symptom of system dysfunction
  • Therapy is brief, process-focused, and
    solution-oriented
  • The therapist designs strategies for change
  • Change results when the family follows the
    therapists directions and change transactions

48
Strategic Family Therapy Goals
  • Resolve presenting problems by focusing on
    behavioral sequences
  • Get people to behave differently
  • Shift the family organization so that the
    presenting problem is no longer functional
  • Move the family toward the appropriate stage of
    family development
  • Problems often arise during the transition from
    one developmental stage to the next

49
Strategic Family Therapists Function
  • Therapist consultant, expert, stage
    director-change is therapists responsibility
  • Use of Directives designed to change the system
    advice, suggestions, coaching, giving
    ordeal-therapy assignment
  • Paradoxical Interventions exaggerate or perfect
    a problematic behavior
  • Reframing reinterpreting problematic behaviors
    which are entrenched-giving new meaning to
    behaviors may produce new behaviors that fit the
    new interpretation

50
Social Constructionism
  • The client, not the therapist, is the expert
  • Dialogue is used to elicit perspective,
    resources, and unique client experiences
  • Questions empower family members to speak, and to
    express their diverse positions
  • The therapist supplies optimism and the process

51
Social Constructionism Therapy Goals
  • Generate new meaning in the lives of family
    members
  • Co-develop, with families, solutions that are
    unique to the situation
  • Enhance awareness of the impact of various
    aspects of the dominant culture on the family
  • Help families develop alternative ways of being,
    acting, knowing, and living
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