Lecture 8: Family and Other Perspectives

Question 1

Beyond the Individual…

Answer 1

Urie Bronfenbrenner (1917-2005)

• Ecological systems theory including:
  1) microsystem
  2) exosystem
  3) macrosystem

Question 2

Family Systems Model

Answer 2

• Family therapy developed in 1950s - evolved into multiple models since then
• Some key figures:
  = Gregory Bateson -> Systems Theory and Cybernetics
  = Salvador Minuchin -> Structural Family therapy
  = Jay Hayley -> Strategic Family therapy
  = Michael White -> Narrative Family therapy

Question 3

Key principles of family therapy

Answer 3

• Moves away from individualistic focus of psychotherapy
• Problem is not inside a person - it is created in the interactions between people
• Focus is on the ‘whole system’
• Inter-connection - changes in any one part of system affects others

Question 4

Problems arising from family life cycle changes

Answer 4

• Adjusting to the changing demands of family ‘life cycle’
• No such thing as a ‘dysfunctional family’, just one that ‘failed to readjust its structure at one of life’s turning points’

Question 5

Life Cycle of Family (Carter & McGoldrick, 2005)

Answer 5

1. Leaving home = separate from family of origin
   = Time to be autonomous before joining another person
2. Joining families through marriage = commitment to a new couple
   = Linking up two families
3. Families with young children = making space for children
   = hold on to marital relationship
   = Working together as a team
4. Families with adolescents stage = supporting autonomy of children
   = open family boundaries, flexiblity
5. Launching children and moving on stage = parents must let their children go (take hold of their own lives)
   = time of midlife crisis
6. Families in later life = retirement, declining health, illness, death

Question 6

Contemporary Families (emerging adulthood)

Answer 6

Emerging adulthood = youth taking longer to end

• Changing employment patterns = increased demand for education, less certainty
• Shifting patterns in marriage
• Sexual freedom
• Ambivalence about adulthood

Question 7

Contemporary Families (Older Adults)

Answer 7

• Growing number of older adults

- ‘Sandwich generation’ = people looking after parents and children

Question 8

Contemporary Families (Maori families)

Answer 8

• Extended kinship
• Inter-generational support
• Peer kinship supports

Question 9

Role/Function problems affecting families

Answer 9

• Problems in role stereotyping and constraints e.g. ‘the quiet one’
• Keep people in a role

Question 10

Structural problems in families

Answer 10

Unhealthy alliance e.g. the parental child

• Problems in marital relationship
• Mother draws child into an alliance with her (breaking boundary between parent subsystem and child subsystem)
• Father displaced
• Child given inappropriate power in family system (breaking ‘normal’ hierarchy)

Question 11

Interactional problems

Answer 11

Circular causality

- One person’s behaviour intensifies the other persons to create a viscous cycle

Question 12

Family narratives

Answer 12

Stories about how families work that constrain and influence how people see things e.g. Mum is always nagging

• Stories are incomplete representations of reality
• We tend to leave aspects of reality out and shape stories in typical ways
• This becomes a dominant narrative
• The dominant narrative puts people in ‘boxes’
• The dominant narrative shapes how people behave
• The dominant narrative closes down alternative and more helpful stories

Question 13

Some interventions

Answer 13

• Point out dysfunctional interactional patterns (observe)
• Confront and challenge ‘taken for granted’ modes of interacting e.g. letting the man speak
• Training in new skills e.g. communication
• Re-framing = paraphrase angry words into feedback, see the care
• Paradoxical interventions = telling them to do something makes them do the opposite
• Re-create family narratives e.g. externalising psychological problems
• Looking for unique outcomes = find non=dominant narratives that describe a different outcome

Question 14

Strengths of family therapy model

Answer 14

• Families are a source of problems but also a source of support
• Particularly important in NZ - where importance of whanau makes family based interventions appropriate
• Contributed to effective therapy for psychoses, eating disorders, problems in childhood

Question 15

Weaknesses of family therapy model

Answer 15

• Doesn’t take sufficient account of broader social environment
• Difficult to get families to work together (huge drop out rates)
• Less research on this than individual forms of therapy
• Much research limited to nuclear, heterosexual, white, western families

Question 16

Social Systems Perspectives

Answer 16

Psychological problems are a product of the broader social environment e.g. depression is almost twice as high amongst women as men

Question 17

Social interventions to address mental health problems

Answer 17

• primary prevention (ambulance at top of cliff as opposed to bottom)
• Challenging social norms
• Advocacy: support and facilitate access to power for vulnerable groups

Question 18

The biopsychosocial perspective

Answer 18

The Diathesis-Stress model acknowledges that individual vulnerability and strength interact with factors in the social env. to produce psychological problems
- E.g. genetic predisposition to depression + low self-esteem + loss of job = depression