Family Therapies Flashcards
Influences on Family Therapy
General Systems Theory: first described by the biologist Ludwig von Bertalanffy. It defines a system as an entity that is maintained by the mutual interactions of its components and assumes that the actions of interacting components are best understood by studying them in context. Consistent with systems theory, family therapists view the family as primarily an open system. In contrast to a closed system, an open system continuously receives input from and discharges output to the environment and is more adaptable to change. The influence of general systems theory is also evident in the family therapy concept of homeostasis, which is the tendency for a family to act in ways that maintain the family’s equilibrium or status quo. A consequence of homeostasis is that, if the problems of one family member improve, the disturbance is likely to reappear elsewhere in the family.
Cybernetics: was described by a mathematician in the 1940s and was subsequently applied to family communication processes. A key feature of cybernetics is its concept of the feedback loop through which a system receives information: A negative feedback loop reduces deviation and helps a system maintain the status quo, while a positive feedback loop amplifies deviation or change and thereby disrupts the system. Although positive feedback can lead to breakdowns(“runaways”), in some situations it has beneficial effects. In therapy, positive feedback promotes appropriate change in a dysfunctional family system.
What is Communication/Interaction Family Therapy Key Concepts?
Symmetrical vs. Complementary Communication
Symmetrical communications reflect equality between communicators but may escalate into a competitive “one-upsmanship” game in which each participant tries to outdo the other.
Complementary communications reflect inequality and maximize differences between communicators. A common complimentary pattern is for one participant to assume the dominant role while the other is submissive.
What is Communication/Interaction Family Therapy view of maladaptive behavior?
Communication/interaction family therapists accept a circular model of causality that regards a sx as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mindreading, and overgeneralizing.
What is Communication/Interaction Family Therapy goals and techniques?
The primary goal of therapy is to alter the interactional patterns that are maintaining the presenting sxs. This is accomplished using both direct techniques (e.g., pointing out to family members problematic interaction patterns as they occur) and paradoxical strategies such as prescribing the sx and reframing.
What is Extended Family System’s Therapy Key Concepts?
Murray Bowen’s extended family systems therapy extends general systems theory beyond the nuclear family, and it describes the functioning of the extended family and its members in terms of several interlocking concepts:
Differentiation of Self: Differentiation of self refers to a person’s ability to separate his or her intellectual and emotional functioning. The lower a person’s level of differentiation, the more the person is at the mercy of his/her emotions and the more likely that he/she will become “fused” with the emotions that dominate the family. The term undifferentiated family ego mass is used to describe a family whose members are highly emotionally fused. According to Bowen, people tend to choose mates whose level of differentiation is similar to their own.
Emotional Triangle: When a two-person system such as a husband-wife or parent-child experiences instability or stress, a third person may be recruited into the system to increase stability and reduce tension. The lower the level of differentiation in family members, the greater the probability that an emotional triangle will be formed.
What is Extended Family System’s Therapy view of maladaptive behavior?
For Bowen, behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
What is Extended Family System’s Therapy goals and techniques?
Goals: Primary goal of extended family systems therapy is to increase the differentiation of all family members.
Techniques: Bowenian therapy typically includes only two family members (usually the spouses so that the therapist can become the third member in a therapeutic triangle. As long as the therapist remains objective and neutral(does not become emotionally triangled), his or her presence helps family members reduce the fusion between them and achieve higher levels of differentiation. A Bowenian may also work with a family member who displays the greatest differentiation since increased differentiation by this person is likely to motivate other family members to self-differentiate.
Extended family therapy begins with an assessment to identify the history of the family’s presenting problems and includes construction of a genogram, which depicts the relationships between family members, the dates of significant life events, and other important information.During therapy therapist assume the role of active expert or “coach” who helps each partner achieve greater differentiation. Sessions are educative, cognitive, and controlled. To avoid conflicts and reduce tension, partners are encouraged to talk to therapist rather than to each other and to speak factual, calm manner. A key technique is questioning: The therapist frequently asks questions designed to defuse emotion and help the partners think clearly about their problems. Bowenians also send clients home for visits with their family-of-origin to help detriangle family members and increase their level of differentiation.
What is Structural Family Therapy’s Key Concepts?
Minuchin developed work with disorganized, lower ses families which suggested that these families respond best to interventions that use a here-and-now,directive,concrete approach. According to Minuchin, all families have an implicit structure that determines how family members relate to one another. One element of the family’s structure is its power hierarchies, which determine how members combine forces during times of conflict.Another element is the family’s subsystems, such as husband-wife and parent-child.Finally, a family’s structure is also defined by its boundaries, which are the ‘barriers’ or rules that determine the amount of contact that isd aslloweed between family members: When boundaries are overly rigid, family members are disengaged(isolated) from one another; when boundaries are too diffuse or permeable, family members are enmeshed (overly dependent and close).
Rigid Triads
Minuchin distinguished between 3chronic boundary problems or rigid Triads:
(1) Detouring occurs when the parents focus on a child either by overprotecting or blasming (‘scapegoating’) the child for the family’s problems.
(2) A stable coalition occurs when a parent and child form a cross-generational coalition and consistently ‘gang up’ against the other parent.
(3) Triangulation (also known as unstable coalition) occurs when each parent demands that the child side with him/her against the other parent. In this situation, the child is constantly being pulled in two directions.
What is Structural Family Therapy’s view of maladaptive behavior?
The result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.Ex: Minuchin found that ‘psychosomatic families’(those in which diabetes, anorexia, or other condition threatens the life of a child) often exhibit a high degree of enmeshment that limits individual autonomy along with low tolerance for conflict and overprotectiveness. In these families, the child’s sxs help diffuse family conflict by diverting attention away from it.
What is Structural Family Therapy’s goals and techniques?
Goals: Restructuring the family is the primary goal long-term goal of therapy. Therapy may also address sx relief and other short-term goals using techniques drawn from other forms of therapy. Behavioral techniques, for instance, are often used to get a child with anorexia to eat.
Techniques: Structural family therapy is based on premise that action precedes understanding and it emphasizes changing behaviors rather than fostering insight.3 overlapping steps:
1.** Joining: The therapist first task is to develop a therapeutic system by joining the family in a position of leadership. Joining involves ‘blending’ with the family and includes tracking (identifying and using the family’s values , life themes, and significant life events in conversations) and mimesis (adopting the family’s affective and communication style.
2.Evaluating the Family Structure: once the therapist has joined the family, he/she is in a position to evaluate the family’s structure, including its transactional patterns, power hierarchies, and boundaries.eval enables therapist to make a Structural dx from which goals of therapy can be derived (strengthening boundaries in an enmeshed family) and may include construction of a family Structural map that helps family interaction pattern.
3.Restructuring the family: techniques to unbalance stress, the family’s homeostasis in order to facilitate transformation of the family structure.Techniques include enactment, in which family members are asked to role-play their relationship patterns so that they can be identified and reframing which involves relabeling behaviors so that they can be viewed in more positive ways.
What is Stategic Family Therapy view of maladaptive behavior?
Jay Haley was influenced by communication/interaction and Structural schools therapy and Milton Erickson hypnotyic techniques as well as paradoxical directives.
Stategic Family therapists emphasize the role of communication in maladaptive behavior, especially how it is used to exert control in a relationship. For therapist, a sx is an interpersonal phenomenon that represents a ‘strategy, adaptive to a current social situation, for controlling a relationship when all other strategies have failed.’’ Although, when one or both parties denies the intent to control the other person and when this produces symptomatic behavior.
What is Stategic Family Therapy goals and techniques?
Goals: focus is on alleviating current sxs by altering a family’s transaction and organization, especially its hierarchies and generational boundaries. An underlying assumption is that behavior change results in changes in perceptions and emotions.
Techniques: Highly structured therapy, involves 4 stages:Social stage-therapists observes family interactions and encourages family interactions. Problem stage-therapist gathers info about reasons why family came to therapy. Interaction stage-family members discuss the identified problems and therapist observes their interactions to gather additional info. Finally, goal-setting in which therapist and family members agree on a contract that defines the goals of tx.
Techniques are tailored to family and problems. EX: A directive can involve a straightforward instruction. A father who always intrudes when his wife and son are arguing might be told to stop interfering. Alternatively, a directive mayb take the form of a paradoxical intervention* that alters the behavior of family members by helping them see a sx in an alternative way(i.e. by rersisting the directive, a family member ends up abandoning his/her dysfunctional behvaior).Ordeals one type of paradoxical intervention, are unpleasant tasks that the client must perform whenever a sx occurs. EX: a man who dislikes mother-in-law might be instructed to give her an expensive gift everytime he argues with her. Other paradoxical interventions include restraining(encouraging the family not to change); positioning (exaggerating the severity of a sx); reframing (relabeling a sx to give it a more positive meaning); and prescribing the sx(instructing a family member to deliberately engage in the sx).
What is Object Relations Family Therapy view of maladaptive behavior?
Maladaptive behavior is the result of both intrapsychic and interpersonal factors. A primary source of dysfunction is projective identification, which occurs when a family member projects old introjects onto another family member and then reaccts to that person as though he/she actually has the projected characteristics or provokes the person to act in ways consistent with those characteristics.
What is Object Relations Family Therapy goals and Techniques?
Primary goal is to resolve each family member’s attachment to family introjects. This entails interpreting transferences, resistances, and other factors in order to foster insight, which is considered essential to change. Object relations family therapists recognize and address multiple transferences in therapy, i.e., transferences of one family member to another;transferences of each member to the therapist; and the transferences of the family as a whole to the therapist.
