Weeks 1-6 Flashcards
(122 cards)
1
Q
Problem Centered Guideline
A
All interventions should be linked, in some way, to the client system’s presenting problems or concerns.
2
Q
Strength Guideline
A
Until proven otherwise, it is assumed that the client system can utilize its strenghts and resources to lift constraints and implement adaptive solutions with minimal and direct input from the therapist.
3
Q
Assessment and Intervention Inseparability Guideline
A
Assessment and intervention are two inseparable and coocurring processes that span the course of therapy and lead to increasingly refined hypotheses and therapeutic plans that facilitate problem resolution.
4
Q
Sequence Replacement Guideline
A
The primary task of the therapist is facilitating the replacement of the key problem sequences with alternative, adaptive sequences that eliminate or reduce the problem.
5
Q
Empirically Informed Guideline
A
The practice of psychotherapy must be continually informed with empirical/scientific data in order to be maximally effective and efficient.
STIC
6
Q
Educational Guideline
A
Therapy is an educational process in which therapists give away their skills, knowledge, and expertise as quickly as clients can integrate them.
Empowering clients, reduce likelihood of future trouble (preventive)
7
Q
Cost Effectiveness Guideline
A
Therapy begins with less expensive, more direct, and less complex interventions and moves to more expensive, indirect, and complex interventions as needed.
8
Q
Interpersonal Guideline
A
When possible and appropriate, it is always better to do an intervention, regardless of its nature, within an interpersonal as opposed to an individual context.
9
Q
Temporal Guideline
A
Therapy generally begins with a focus on the here-and-now and progresses to a focus on the past as more complex and remote constraints emerge within therapy.
Address proximal before remote constraints.
10
Q
Failure Driven Guideline
A
Therapeutic shifts occur when the current interventions fail to modify the Web sufficiently to permit implementation of the adaptive solution to the presenting problem.
Feedback to try something different.
11
Q
Alliance Priority Guideline
A
Growing, maintaining, and repairing the therapeutic alliance takes priority over the principle of application (matrix arrow) unless doing so fundamentally compromises the efficacy and/or integrity of the therapy.
12
Q
1950’s Paradigm consisted of:
A
- Scientific method dominated science.
- Logical positivism dominated philosophy. (Dismiss concepts that can’t be verified empirically)
- Biomedical reductionism dominated medicine (devoid of context, study in isolation)
- Psychoanalytic therapy (problem located inside of person)
- Mechanism = Nature works according to mechanical laws (linear causality)
- Mind/body dualism
13
Q
Emergence of importance of family:
A
- Hospital movement: a. as patients got better, other family member got worse as if needed symptomatic member, and b. patients frequently improved in hospital but got worse when went home
- Small group dynamics: Similar = boundaries, complementarity (resistant to change), dependency, pairing. Different = continutiy, commitment, shared distoritions.
- Child Guidance Movement: preventing adult neuroses (Adler); still ignored fathers
14
Q
Systemic view emerged in various fields:
A
- Physics = challenged reductionism, objectivism, mind/body dualism, & mechanism because of theory of relativity and quantum mechanics
- Medicine = refute reductionism with biopsychosocial model
- Biology = von Bertalanffy’s general systems theory (whole greater than sum of parts)
- Cybernetics = Weiner study of communication and control through self-regulation, feedback
15
Q
4 Stages of Emerging FT
A
- Family Therapy Tracks
- Model Development
- Questioning & Consolidation
- Integration, EST’s, and Common Factors
16
Q
Pure Systems Track
A
- West Coast
- Threw baby out with bath water
- Bateson, Macy Conferences, Theory of Logical Types
- Equilibrium Black Box Model
- key take away: work with whole family
17
Q
Theory of Logical Types
A
Whatever involves all of a collection must not be one of a collection.
Bateson applied to communication double binds and hypothesized it played a role in the development of schizophrenia.
First time put psychology in context. (Schizophrenia made contextual with communication between parents and pateint)
18
Q
Equilibrium Black Box Model
A
Self-regulated feedback model wherein the problem serves as feedback to regulate equilibrium (homeostasis) of the family; problem located in family, not individual.
Therapy goal: Dsirupt the family homeostasis and disrupt the symptom from the equilibrium-preserving negative feedback loop.
19
Q
Feedback (in Black Box model)
A
Part of system’s output (the problem) is fed back into the system as information.
20
Q
Homeostasis
A
Problem is used to maintain the homeostasis of the system; problem serves a function
21
Q
Black Box
A
Only need consider the inputs and outputs and can ignore what goes on inside of black box (i.e. the mind); emphsis on ACTION (as opposed to psychoanalytic emphasis on meaning and emotion)
22
Q
Psychoanalytic Track
A
- Preserve psychoanalytic prespective but make it interpersonal
- Not drive reduction but human striving for connection
- Disturbances in interpersonal processes create fixations in individual development & limit person’s ability to relate interpersonally
- Object Relations Theory
- Attachment Theory
- Goal of Therapy = Close gap between experienced and actual motivation.
23
Q
Battle of the Brand Names
A
Pure Systems vs. Psychoanalytic
Differences magnified, centers emerged to offer training
24
Q
Stage of Questioning and Consolidating
A
- Open the black box in Pure Systems and reintroduce meaning, emotion
- Shift from expert stance to collaboration
- Failure Driven
- Questioning centrality of homeostasis
- 2nd order cybernetics = changing rules of system rather than change within the rules
25
Common mechanisms of change common to ALL therapies:
- Client factors
- Therapist effects
- Therapeutic relationship
- Expectancy effects
- Nonspecific treatment variables
26
Common factors unique to couple and family therapy:
- Conceptualizing difficulties in relational terms
- Disrupting dysfunctional relational patterns
- Expanding the direct treatment system
- Expanding the therapeutic alliance
27
What is a system?
A **rule governed**, **self-regulating** entity consisting of parts or **subsystems** that are interrelated so that change in one part leads to changes in the other parts that ultimately impact the part that initiated the change process.
Essential nature of a system is the set of relationships among the parts that constitute the whole.
28
Cybernetics
Study of feedback mechanisms in self-regulating systems
29
Negative feedback & pathology
Indicates how far off the mark a system is straying and the corrections needed to get it back on course.
Ex. guilt, punishment, symptoms
Pathology when prevents family from making necessary changes, too rigid.
30
Positive feedback & pathology
Info that confirms and reinforces the direction a system is taking.
Ex. self-fulfilling prophecy, bandwagon effect
Pathology when left unchecked leading to **runaway** process (ex. phobia)
31
General Systems Theory (von Bertalanffy)
1. Wholistic
2. Organismic (permeable boundaries)
3. Perspectivistic
4. Organization rules (equifinality)
5. Non-summativity (whole greater than sum of parts)
6. Levels
7. Recursiveness
8. Circularity
32
Characteristics of Human Systems
1. Negentropy (violate 2nd law of thermodynamics)
2. Equifinality
3. Develop and change over time.
4. Exhibit active behaivor that occurs independent of external stimuli
5. Employ symbolism to creat meaning
6. Recursive
7. Teleological (goal-directed)
8. Perspective
9. Levels
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Stability and change in systems
Systemic adaptation to internal and external changes requires ongoing regulation of balance between positive and negative feedback processes.
1. Morphostatic vs. Morphogenic
2. 1st order vs. 2nd order change
3. Epigenesis = progressive development, influenced by internal/external environment
4. Differentiation
5. Telic Decentralization = personal goals diverge from those of the family system
34
1st and 2nd Order Change
1st Order: Change within the rules of the system; not a cure but possible therapeutic goal of acceptance
2nd Order: Change in the rules of the system/a change in the system itself; purpose of therapy
35
Morphostatic vs. Morphogenic
Morphostatic = homeostatic; deviation minimizing processes (error activated); negative feedback/constraining loops
Morphogenic = deviation amplifying processes; change when necessary to adapt; positive feedback
36
Causality in Systems
1. Multiple: events influenced and determined by multiple factors.
2. Differential: factors involved in causality vary in their influence
3. Recursiveness: factors (behavior, belief, emotion) consisently and reciprocally influence one another, even though the **order**, frequency, and intensity with which they appear may vary
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Therapeutic System
Interaction of client (direct/indirect) and therapist (direct/indirect) systems
Context for The Blueprint
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Theoretical Pillars of IPCM
Presuppostions that answer questions about human nature; how problems created/maintained (constraints) and how change takes place (constraints identified and lifted)
1. Epistemiological
2. Ontological
3. Differential Causality
4. Constraint Theory
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Epistemiological Pillar
Perspectivism: there is an objective reality but humans can never know it.
Human knowledge becomes more accurate over time but never complete.
Some achieve closer reality than others.
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Ontological Pillar
General Systems Theory = levels of systems
Hierarchies, wholeness, self-regulation, feedback, homeostasis
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Differential Causality Pillar
Web of mutual influence with systems contributing differently to process/outcome.
42
Constraint Theory Pillar
Problems exist because some factor(s) constrain(s) problem resolution; **"negative explanation"**; Problem becomes entrenched over time as people despair in trying to solve it
Therapy = Identification and removal of constraints that prevent problem solving
Isomorphism
As probability for one event/belief increases, probability for other events/beliefs decreases
NOT CAUSAL EXPLANATION
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Isomorphism (in Constraint Theory)
Levels of biopsychosocial system are governed & therefore can be understood with one set of similar principles:
Ex. Organization, development, patterning/sequences, internal process/mind, gender, culture
Power of small/short family transactions to represent and change larger family structure
44
Hallmarks of IPCM
1. Comprehensive: applicable to wide range of problems that clients present and to various modalities.
2. Integrative: across modalities and models/orientations; underlying and unifying principles (Guidelines); identifying common factors
3. Multi-Systemic: focus on problems and solutions within the biopsychosocial system at all levels
4. Empirically Informed: supported by randomized clinical trials and use STIC throughout therapy to provide feedback about client functioning and progress
45
Core Concepts of IPCM
1) Therapy Guidelines
2) Problem-Centered Contract: get everyone's perspective and strenght-based
3) Problem-Centered Context: sequences of action, meaning, and emotion; most concrete, accessible, & changeable aspects of a problem; includes PS and AAS
4) Therapy System
Blueprint operates within context of core concepts
46
Essence of IPCM (therapeutic steps)
1) Define the problem = primary outcome criterion
2) Locate the problem in a problem sequence
3) Identify an alternative adaptive sequence (collaborative)
4) Implement AAS
5) Identify constraints to AAS
6) Lift constraints
7) Repeat (lifting additional constraints, identifying new problem)
47
Delineating the Problem Sequence (recursive collaborative goals):
1) _Identifying Presenting Problem_: each perspective/agreement vs. disagreement patterns; history (onset, context, vicisstudes/oscillations/**ebb and flow**, precipitating circumstances); consensual problem priority list
2) Identifying Attempted Solutions: what, who, when, outcome/reactions; identify strengths, motives, link to problem
3) Identifying Biological System: failure in presenting problems to vary consistenty with context
4) Identifying Meaning (Emotional): facilitate (ex. anger) or inhibit (ex. depression) problem solving; interrupt sequence at turning point
5) Identifying Meaning (Cognitive): Intentions attributed to own and others behavior; empathy (or lack)
6) Identifying AAS: develop an understanding of what is different; contextual determinants; provide leadership/expertise; build off of client values, ideas, strengths
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Blueprint for Therapy
Hypothesizing
Planning
Conversing
Feedback
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Hypothesizing
Adequately accurate, "good enough", leads you to constraints
Constraints found in levels of system (person, dyad/triad, family, community, social/public, civilization)
Constraints ARE metaframeworks (recursive) = sequences, organization, development, mind, culture, gender, biology, spirituality
what x where = Web of Constraints
50
Sequences Metaframework
Recursive systemic (multi-level) patterning (behavioral, emotional, cognitive) classified according to periodicity (S1, S2, S3, S4)
Symptomatic manifestations of the presenting problem and provide the most concrete, accessible, and changeable aspect of the problem
Problem-Centered Context
Problem = repeated interaction patterns
51
Organization Metaframework
The essence of a system is how the parts **fit** together as a whole, structure/hierarchy, and **function** of each part serves for the whole
System and subsystem boundaries
Leadership, balance, harmony (vs. power/control in structural FT)
Invisible **rules** of organization. Exist at **all levels**, but some easier to access, some need to change simultaneiously, and some may be overridden by lack of change at other levels
**_Goal_**: Depolarize the system and release resources for effective leadership
52
Development Metaframework
Competencies resulting from genetics and environmental resources; can result in escalating spiral of devleopmental constraints at other levels
Macro-transitions = family life cycle transitions
Micro-transitions = oscillation in transition process, smaller leaps
53
Mind Metaframework
Meaning, emotion, and intentionality (will) that can become polarized or result in leadership/harmony.
Varying levels of complexity of models of mind (M1 simple, M2 models, M3 sense of self-wholeness)
Sequences, organization (components = internal representations on a continuum of integration/fragmentation), development of self (at all levels)
54
Culture Metaframework
Membership in multiple contexts influences **identity**, beliefs, and behaviors.
Acculturation, immigration.
Specify normative beliefs and prescribe how to react in specific situations.
55
Gender Metaframework
Biopsychosocial construct constituting **traits**, **roles** (may be too rigid), and **power** (may be imbalance)
Stereotyping, prejudice, poor fit between gendered expectations, capacities, and preferences.
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Biology Metaframework
Recursiveness of mind and body.
Neurobiology
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Spirituality Metaframework
Relationship with Ultimate that fosters sense of meaning, purpose, and mission in life.
Resource for strength/resilience or constraint.
58
Planning
Generates an intervention or therapeutic Plan to address the hypothesized constraints that acknowledges the Web and builds on client strengths and resources.
1) Sequence Replacement
2) Educational
3) Interpersonal
4) Cost-Effectiveness
5) Failure Driven
6) Alliance Priority
59
Planning Metaframeworks
_Here and now (present and immediate past)_:
1) Action
2) Meaning/Emotion
3) Biobehavioral
_Historical_:
4) Family of Origin
5) Internal Representation
6) Self
60
Action Metaframework
Primarily targets patterns of action/interaction (behavior). Assume client healthy enough to do this. Either lead to adaptive action or better reveal problem sequence.
Addresses constraints of Sequence, Organization, and Development
Includes interventions from structural, behavioral, functional, and strategic
61
Meaning/Emotion Metaframework
Focuses primarily on meaning, emotion, and intention (i.e. experience). Either increases client's awareness about constraining effects of maladaptive cogntive/emotional sequences or replace with AAS.
Targets constraints in Culture, Gender, Development, Spiritual, and Sequences of Mind
Includes interventions from cognitive, narrative, experiential, emotion-focused, dialectical behavior therapy, and psychoedcation models
62
Biobehavioral Metaframework
Focuses primarily on biological constraints and calming/soothing strategies.
Ex. medication, meditation
Want to know what's happening in client's system before jumping to medication and take side effects into account.
63
Family of Origin Metaframework
Primary goal: Differentiation of self within FOO by either "in-session" strategy or "back home" strategy
Planned campaign of confrontation with FOO in which differentiating adult changes his/her codependent behavior.
May address multi-generational patterns of enmeshment, codependency, and enabling
Interventions: Bowenian, structural, and addiction treatment models
64
Internal Representation Metaframework
Targets constraints resulting from internalized representations of self, others, and important experiences.
Representations derive from childhood (ex. attachment) or traumatic events.
Organization and Sequence of Mind
Interventions: psychodynamic, object relations, internal family systems
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Self Metaframework
Targets the self, the core of identity, and the container of object relations.
Narcissitic vulnerability, insecure, sensitive.
Interventions: repeated unintentional/nontraumatic tearing and repairing therapeutic relationship, self psychology, psychoanalysis
Other techniques:
1) Grace = in which client receives or experiences a transcendent and enlivening connection
2) Surrender = to higher power and/or sense of greater connection to others
66
Conversing
What therapy fundamentally is, **co-created** by therapist and client systems through which the Plan is realized.
**1. Complementary** roles of therapist and client.
2. Questions, Statements, Directives.
3. Problem-intervention link
4. Authentic personal style.
5. Focus on action, meaning, AND emotion.
6. Discuss STIC data.
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1. Questions
2. Statements
3. Directives
1. Most common at beginning of session. Obtain information.
2. Invitation to agree or disagree with viewpoint; communicate information; identify PS and AAS
3. Continuum from gentle (have you ever thought of trying...) to more direct (do this). (least common)
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Feedback
1. Referral and intake process = 1st source
2. Direct observations in session, including **gut** feelings of therapist and client **reactions** following intervention
3. Client system's reports about events outside of session, and therapist's feelings/reactions
4. STIC: 4-6 weeks of no change in problem sequence areas indicates time to shift down Matrix
Therapist must integrate feedback and utilize it to hypothesize what constrains problem resolution.
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Integrative Psychotherapy Alliance
Content: Tasks, Goals, Bonds
Interpersonal Sub-dimensions: Self-Therapist, Other-Therapist, Group-Therapist, Within-system (ex. hopeful for change)
Most acknowledged common factor in psychotherapy.
Important to detect tears or ruptures (ex. 2 point drop on STIC)-- two session repair period
Subsystems with more power contribute more to variance of total alliance.
70
Alliance Content Dimensions
Tasks, Goals
Sense that we are on the same page, need therapist-client agreement. Needed first to achieve bond.
Bond
Level of connection, therapist-client attachment; most common change in "good" therapy is increase in bond component
71
What is a sequence?
Series of events among two or more people that recur in **roughly** the same order which save **time/energy**, and provide **stability/predictability**
**Recursiveness** challenges whether in same order. Ex. increases probability of some while decreasing probability of others.
Repeated **ebb and flow** decreases resilience so one or more parties may contemplate giving up.
72
Adaptive Sequence
Supports growth and development of members.
73
Constraining Sequence
Important needs of family members are not met.
74
Periodicity
Events are related in same sequence.
Sequences are related from different periods.
Shorter sequences rest in longer ones.
75
S1
Brief verbal/nonverbal interactions, face to face (seconds to hours)
Can inform of family's organization.
76
S2
Aspects of daily/weekly routine (ex. church, degree of autonomy) that contextualize S1's.
Anticipation and recovery from event.
Not observed but learned through disclosure or tracking 1. typical day/week or 2. incidence of symptom throughout day/week
77
S3
Longer term ebb and flow of condition or symptom (several weeks to a year) that may develop to divert tension when S1 and S2 don't effectively meet **needs** of family
Two types:
1) Marked by crucial **intermittent event** (imposed or voluntary)
2) Reflecting ebb and flow of significant **variable** (ex. intimacy)
Memories can set affective tone of relationship.
May become less resilient after each ebb/flow.
78
How do you hear about S3?
Ride it out.
1. Exploring history of problem (onset, vicissitudes, chronicity, periods of remission, contextual factor associated in variation in problem incidence and/or severity)
2. **Tracking** reported changes in problem incidence/severity over the course of therapy
79
Interventions for S3
1) Describing it, co-construction, explore how it works, what it means, and what to do about it.
2) Develop insight through self-reflection and interpretation.
3) Reframing - therapist offers new view of sequence.
4) Preparation - prediction of S3
5) Modify S1's and S2's to make S3 less needed to calibrate them.
6) Deal with the **recurrent event** that generate the S3
80
Interventions for S1
1) Block sequence
2) Describe sequence, ask about alternatives
## Footnote
3) Coach a new S1
4) Communication rules (ex. I statements)
5) Behavioral techniques (ex. time out)
6) Developing new meaning about sequence
7) Intervene in key emotional turning point
81
Interventions for S2
## Footnote
1) Directives to modify S2 (ex. strategic) such as through homework or changing daily/weekly routine.
2) Help family see how S2 constrains the S1 that concerns them. (what they want to do about it/what keeps them from modifying the S2)
82
S4
Transgenerational patterns, including ways of **thinking, doing, and feeling** (aka values, rules, beliefs)
Coding **manua**l of how to construct a reality that is activated whenever a corresponding fragment of history is activated.
Two types:
1) Fairly specific replication of events (ex. cut-offs)
2) Transmission of values, beliefs, fears which are then applied to life events (ex. perfectionism)
83
How do you hear about S4?
1. Language, views, and stories
2. Exploring history or doing a genogram
3. May pop out when exploring constraints
84
Interventions for S4
1. **Clarifyin**g transgenerational nature of behaviors, relational patterns, beliefs, attitudes, myths
2. Exploring how S4's constrain other sequences
3. Deciding to break with tradition
4. Reinterpreting a family tradition
5. Considering adaptive sequences that fit with a tradition
6. Utilizing techniques from Bowen, Nagy, Milan, & Narrative
85
Relationships Among Sequences
Embeddedness = fallen snowman
Deeper embeddedness may correlate with intractability of presenting problem
Two ways:
1) Can generate another sequence
2) Can calibrate another sequence
86
What is Organization?
The essence of how a system's components **fit** together and **function** so that each part serves the whole.
Invisible **rules** preserve relationship among parts.
Exist at all levels, some easier to access, some need to change simultaneously, and some may be overrident by change at other levels.
87
Salvador Minuchin
Structural Family Therapy
Provided 1st map of organization at family level.
Used **intensity** to shake things up so change could happen.
88
Family Structure
Invisible set of functional demands that organizes the ways in which family members interact.
89
Boundaries
the rules (systems theory) defining who participates and how
Maintain invidivdual problems.
Spatial metaphor: how close (connected/involved); who is on top (in charge); organismic (permeable)
90
Proximity
The level of interpersonal relatedness and information exchange that exists between individuals (or other levels of the system)
1. Time in contact
2. Physical proximity
3. Emotional differentiation
4. Information sharing
5. Decision making
Must balance autonomy/relatedness.
Permeable.
91
Interpersonal Boundary -- Proximity
rigid -- disengaged
clear -- functional
diffuse -- enmeshed
NOT monolithic; need to be flexible
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Hierarchy
Relative amount of power and responsibility of various members to decide what happens in the family (Haley)
Functional = clearly defined and accpeted
Generational boundaries should protect children from adult business.
Minuchin often downplayed nurturance and favored control.
93
Problematic Triads
1) Triangulation = each parent expects the child to side with him or her against the other parent
2) Detouring = child serves to maintain the relative harmony in the marital subsystem as he/she is defined as the problem
3) Stable Coalitions = one parent joins the child in cross-generational coalition against the other parent (stable = doesn't change)
94
Structural FT Assessment
Observing interactions, S1's, to detect structure and hypothesize how structure is related to presenting problem.
95
Structural FT Intervention
1) Create workable reality: viewpoint that specifies how members can interact differently to solve the problem
2) Enactment: ask clients to interact, observe/hypothesize about structure, help restructure interactions (assessment, feedback, intervention)
3) Marking Boundaries: keeping an enactment within a particular system
4) Unbalancing: talking with one member in order to empower him/her; taking sides
5) Tasks: doing things at home to reinforce in-session changes
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Utility of Structural FT
1. Recognized family strengths
2. Sought to empower families
3. Provided useful concepts for hypothesizing and planning (ex. hierarchy, proximity)
4. Range of techniques
5. Linked meaning ("reality") with action
97
Cautions with Structural FT
1. Don't pathologize
2. Organization not static (oscillates and develops)
3. Importance of history
4. Cultural differences, gender bias (enmeshed vs. concerned)
5. Seek collaboration, balance, harmony
6. Read feedback
98
Boundaries of Proximity
Is system constrained at some level by enmeshment, disengagement, or alliance in relation to a particular function?
99
Concepts of Organization Metaframework
1. Boundaries of Proximity
2. Balance
3. Harmony
4. Leadership
100
Balance
Balanced when each holon (subsystem) is allowed the degree of **influence**, the access to **resources**, and the **responsibility** appropriate to its needs & roughly equal to other holons at same level
Is the system constrained from solving problems due to the **distribution of influence** or **imbalance of resources** among members/subsystems?
Does the **balance of responsbility** constrain problem resolution?
101
Symmetrical Escalation
disharmonious balance
102
Rigid Complementarity
stable imbalance
103
Harmony
When system balanced, harmony exists among holons in that they cooperate, **sacrifice** some individual interests for the system, **care** about one another, feel **valued**, and have **clear boundaries** that allow a balance of separateness and belonging.
Does polarzation between holons constrain resolution of the presenting problem?
104
Polarization
Shift in two holons relative to each other wherein each moves from flexible to rigid or extreme positions/roles opposite to each other
Organization Metaframework constraint
105
Leadership
Concept that expands, softens, and re-contextualizes hierarchy. REQUIRED for balance and harmony. **Complementarity**.
Functions:
- Mediating conflicts
- Assuring members feel valued and have needs met
- Fairly allocating resources/responsibilities/influence
- Providing firm, fair limits
- Encouraging growth while considering needs of system
- Representing system in interactions with other systems
- Coordinating plans or system's future
106
Goals of Organization Metaframework
1. Improve leadership (ex. release resources available for effective leadership)
2. Clarify boundaries
3. Improve balance
4. Reduce polarization
5. Help family consider history/origins of structure, how it fits current context, and upcoming challenges to it
107
Pendulum-swinging Phenomenon
Pure systems vs. psychoanalytic
Extremes produced tunnel vision gradually relieved through transitional stage to the ecological stage: open up but fear will lose unique qualities.
Begin to object to knee-jerk concepts of homeostasis and functional symptom (too pathologizing)
Haley thought up to therapist to save clients from themselves. (ignored complementarity of overfunction/underfunction)
108
Constructivism
Can know only subjective experience.
Create own constructs of environment = personal construct theory
FT technique: **reframing** behavior to shift how families respond to it; not interrupting patterns but finding new perspectives
109
Social Constructivism
Our interpretations are shaped by the social context in which we live
FT technique: **deconstruction** = freeing clients from entrenched beliefs; externalization
_Solution-focused FT_: best way to solve problem is discover what people do when not having the problem
Narrative Therapy: shape expectations
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Colonization
Occurs in therapy when our commitment to expert knowledge blinds us to the **experience** in the room resulting in:
1) rigidity
2) loss of alternative
3) subordination.
111
How to avoid colonization:
1. Acknowledge naive and unique **resources** in self and others
2. Remain **curious** and desire to empower
3. Get therapy to respond to client
4. Be **collaborative**
5. Identify client strengths
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Holon
Hierarchally-organized whole that cannot be reduced to its elementary parts but CAN be dissected into its constituent branches of holons/subsystems.
Semiautonmous = function at own levels but influenced by holons to which it is subordinate
113
Recursivness of Action/Meaning/Emotion
experience = affective impact
description = way individual recounts experience
explanation = meaning attributed to experience
Meanings become coordinated so that meaning for one member elicits **complementary** meanings for other members.
114
Primary Treatment Outcome Criterion
presenting problem
115
Who to see in first session?
All members of patient system who actually/potentially play central roles in maintenance or resolution of presenting problem.
Diminishes likelihood of coalitons.
Increases likelihood of each feeling allied with therapist.
116
Behavioral Permission
Obtain to move focus from "problematic child" to marital system if:
1. child feels sense of permission/safety from parents to open up
2. therapist & parents receive permission from child to focus on marital system
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Problem-Centered Context
- Sequences of action, meaning, and emotion
- Most concrete, accessible, & changeable aspects of a problem
- Includes PS and AAS
118
Problem-Centered Contract
- Get everyone's perspective and strenght-based
## Footnote
119
Goal of psychoanalytic track:
Close gap between experienced and actual motivation.
120
Client response to colonization:
1. malleable, absorb or embrace
2. just don't get it; same thing over and over
3. resistant, hold to their worldviews
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Common themes of S4 sequences:
1) survival/protection
2) attachment/loss
3) individuation/separation
4) spirituality
5) eating/drinking
122
What is the essential nature of a system?
The set of relationships among the parts that constitute the whole.
