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Flashcards in Final Exam Deck (44):

Postmodern therapy

Collaborated with family members with self creating independent participants

Shared expertise, not just therapist

Concerned with how a family constructs their reality


Characteristics of social constructionist


Mutual inquiry

Client is expert in their lives

Assumptions are explored

Focus is cognition not behavior

Beliefs shape action
Culture shapes beliefs
Help clients explore Meanjbgs


Solution focused brief therapy

Focused on change rather than finding it why the family has problems


Skeleton keys

Interventions, that work with a variety of locks (don’t need to know why they door is locked or won’t open just need a key)

In sfbt

De shazer

Observe what works

Read write and burn thoughts


Types of therapeutic questions

1st session change questions

Miracle question

Exception question

Scaling question


1st session formula question

What is happening in your family that would want to continue? Have the explain Good hinges they want more of


Miracle question

What would tj be like if a miracle happens and the problems you have are solved?


Exception questions

When are there times that pieces of this miracle happen just a little? What’s the exceptions?


Scaling questions

Develop solutions based off the exceptions

Assess clients viewpoint and gauge perceptions


SfBT three types of client therapist relationships

Visitor host

Complainer listener

Customer seller


Visitor/host relationship

Client is the visitor who does have a problem and may be there against their will, don’t expect anything

Counselor is the host, sympathize with clients plight, compliment when possible, hosting activities make them comfortable, look for complainants



Client is the complainant, can describe the problem or goal, see the solution as external to their control and can overwhelmed with info and complaining

Counselor is he listener, listens and is accepting, accepts the clients world view, gives noticing or observing tasks at the end of session


Customer/seller relationship

Customer is the client, there’s a problem and the client states or understand that he/she is the one who has to do something, are ready to buy and do whatever is possible

Counselor is the seller, agreeing to work on the clients goal or problem, is active and more directive, may give a behavioral task, when helpers responses match client motivation and cooperation are enhanced


Solution oriented brief family therapy figures

O’hanlon and wiener-davis


Narrative family therapy founder

Michael white


Role of narrative therapists

Collaborating partners with clients

Honor the stories

Help clients re-examine the so called truths about themselves, imposed by others and culture

Help clients reconstruct a new narrative


Goals of narrative therapy

For families to create and internalize new stories

Make new assumptions

Open themselves to new views and future possibilities

Rewrite their future story lines

Actively changes or reshapes their lives


Thin descriptions

Problem stories are based on thin descriptions, using labels such as bad, selfish

Lead to thin conclusions, fail to remember times when these labels didn’t occur


Thick descriptions

Help clients talk about their life in rich, retelling of stories of ones history or identity

Not a replacement if stoy with a mother but help them view life as multistorued with options



The dominance of one meaning or one set of assumptions is an illusion

It’s possible to apply multiple meanings to understand the same event or experience

Help clients examine so called truths



Person isn’t the problem, problem is the problem


Unique outcomes

Search for instances events or thoughts contradicting their dominant problem saturated story, opens doors to explore alternative narratives



Tell or perform stories of their lives with outside witnesses, witnesses respond to provide thickening


Therapeutic letters

Variety of types, between sessions as summaries, ticked alternative story lines


Gender sensitive family therapy

Regardless of theoretical approach, attempts to overcome confining sex role stereotyping by therapists in any clinical intervention efforts


Impact of multiculturalism on family therapy

Avoid pathological assumptions of ethnic minority families whose behavior is unfamiliar, avoid ethnocentric views


Gender schema

What is considered masculine and feminine is developed early in childhood, this is reinforced and hamper both sexes


The women’s project

Marriane Walters,Betty carter, Peggy Pap, Olga silverstei


Ongoing examination of gender patterns in family relationships as well as patriarchal assumptions underlying classic classic family therapy approaches.

Thru workshops these family therapists offered female informed clinical perspective

The invisible web

Argued that family therapy relies on me dominant gender defined functions

Gender analysis.


Gender sensitive family therapy

Intended to liberate and empower both male and female clients, enabling them to move beyond prescribed roles determined by their biological status to ones in which they can exercise choice

Built upon feminist therapy

Attempts to overcoming confining sex role stereotypes

Therapist is attuned to common gender roles clients absorbed

Help confront sexist messages

Jean baker Miller and Sandra Ben


Cultural sensitive therapy

Recognizes that the whole middle class cultural outlook most therapies operate from (prizing individual choice, self sufficiency, independence)


Issues in family violence

Gender, asymmetrical power and control are used in family violence

Physical and Sexual violence

Using coercion and threats
Emotional abuse
Minimizing, denying, blaming
Use children
Make privilege
Economic abuse



Unique characteristics of a social grouping sharing national origin and linguistic/cultural traditions


Informed consent

Document outlining risks and benefits of counseling
Session structure, costs, assessment, treatment approach, confidentiality, policy on providing legal testimony, information on insurance/diagnosis



Protecting a clients privacy

Ensuring that info shared in therapy isn’t shared outside without clients prior consent


Limits on confidentiality

Client signs disclose agreement to talk with attorneys doctors etc

Therapist acts in court appointed capacity

Suicide or homocide

Mandated reporter, child abuse elder abuse

Therapist defendant or insurance billing


Under supervising confidentiality

Must inform you’re an intern and will share with supervisor

Supervisor info make and number

Indicate if you will record


Family and minor confidentiality

You lay out with family who is the client and then talk about their confidentiality

If you don’t come to an agreement, the whole family or couple is the client


Confidentiality with minors

Counselor informs parents and legal guardians about role of counselor and the confidential nature of counseling relationship

Collaborate relationship with parent but trust with client

Safety issues parents should be told, first session decide what will be shared and not shared with both


Advantages of licensure

Establishes minimum standards of service

Holds professionals accountable, protects the public

Increases likelihood that practitioners will be competent (ceu requirements)

Gather practitioners together, maintains commitment to high standards

Professional identity


Managed care

Benefits dependent upon in network vs out of network

Preauthorization often required

Treatment plans may be shared

Progress may be shared

Additional sessions must be approved

Only individual sessions, not family or couples

Generally requires diagnoses from DSM 5


Challeges with insurance

Often want short term problem solving therapy

Return clients to previous level of functioning vs optimum level

Clients must sign release to insurance company



Therapist fails to render services as a competent provider (standard of care generally accepted by other professionals and within the ethical standards of professionals

How to avoid malpractice, informed consent, diagnose correctly, practice within competence, don’t abandon instead refer, no sexual contact, protect clients and others, document)


Components of competent family therapy

Continuing education

Ethical code


Core components of competent family therapy

Admission to treatment

Clinical treatment and diagnosis

Treatment plan and case management

Therapeutic interventions

Legal issues ethics and standards

Research program evaluation

Conceptual skills, perceptual skills,executive skills, evaluative skills, professional skills