Eetstoornissen systemische aanpak Flashcards
(15 cards)
Linear causation for eating disorders
- problems are caused and maintained by the individual, through beliefs, biology, emotions, or other abnormal or unhelpful factors within the individual
- solutions are created and maintained by individuals changing their beliefs, emotions, or other abnormal or unhelpful factors within them, or their responses to these factors
Circular causation for eating disorders
- problems are caused and maintained in the system through unhelpful realtional dynamics and ongoing interactions
- solutions are created and maintained by individuals within the system changing their communication and interactions with, and responses to other members of the system
–> directed from a systemic treatment
The escalation ladder of coercion
Whenever someone refuses to eat you go down the ladder of coercion
- meallist
- family meal (parents responsible)
- involuntairy treatment (force fed, tubes)
- can be with physical restraint
Systemic treatment
Look at the situation with a wider lens. Some cases present themselves as one thing, while that is actually a secundairy outcome to what is actually going on.
- look at the circular causation
Attachment based family therapy
Need for care and need to care
1: relational reframe (where lies the problem)
2: alliance adolescent
3: parental alliance
4: corrective attachment experience
5: autonomy-support
Task 1 circular questions
- not-knowing stance (you don’t know them –> curious about them)
- invit participants in a conversation to consider relational aspects of the topic being investigated
–> helps to transform from linear to systemic/circular
Task 1: building up to the relational reframe
Smokescreens
People can say things that will make it seem they don’t want a connection, but we will assume the need for relational closeness
Task 1: assuming the need for relational closeness
Ask questions to take away from the smokescreen and still assume the need for relational closeness
Task 1: building up to the relational reframe by assuming circularity and using focusing
- ask curious questions
- sense what are you feeling yourself as the other is telling the story
- use emphathetic guessing in order to bring emotions to the surface and into the conversation
Task 2: Solar eclipse model in building alliances
Usually used for eating disorders –> hard to see if you are talking to the person or the eating disorder. See them as 2 seperate entities that can overlap like an eclipse
- try to get them as two seperates again
Task 3: building alliance
- iceberg model
- model emotional closeness
- giving hope
Ice-berg model
Ice berg visible from above water level, but most of it is under the water, so we need to look deeper
Task 4: corrective attachment experience
The adolescent expresses, directly and regulated, vulnerable attachment related feelings and needs <-enactment-> parent listens, sensitivly and responsively, to the adolescent’s experience and reacts with comfort, care, love, protection and respect
Treatment goals from an attachment perspective
- repairing breeches in trust in the caring parent-child relationship (task 4)
- enhancing trust in the caring parent-child relationship as a crucial developmental context (task 5)
–> creating corrective attachment experiences
Theoretical concepts
Minuchin: structural, hierarchy, coalition, subsystems, enactment, focusing, joinging
Watzlawick: communication theoretical, metacommunication
Haley: strategic, directive therapist, provocation, solution-focused
Boszormenyi-Nagy: intergenerational, relational ethics, loyalties, multiple partiality
Palazzoli: strategic-cybernetic, paradoxical interventions, hypothesizing, neutrality, circularity
