Family Therapy: Key Figures & Concepts

• Lyman Wynne coined the term "pseudo mutuality" to describe the facade of family harmony often seen in families with a member who has schizophrenia.
• Alfred Adler is recognized as the founder of family therapy in the U.S.

Freida Fromm-Reichmann's Concept

• Freida Fromm-Reichmann described the "schizophrenogenic mother".
• The "schizophrenogenic mother" is a domineering, aggressive, rejecting, and insecure mother.
• Pathological parenting by "schizophrenogenic mother" was believed to contribute to schizophrenia.

Social Workers' Role

• Social workers were the first to practice "family work" widely.
• Social workers focused on understanding and intervening with families within their social environments.
• Social workers laid the groundwork for family therapy.

Gregory Bateson's Role

• Gregory Bateson and his colleagues at Palo Alto studied family communication and schizophrenia.
• They introduced the "double bind" concept.
• "Double bind" is a situation where a person receives contradictory messages.
• The "double bind" concept was linked to to the development of schizophrenia.

Theodore Lidz's Concept

• Marital schism occurs when husbands and wives undermine each other.
• Marital schism is characterized by openly competing for their children’s affection.
• Marital schism arises when spouses fail to accommodate each other or achieve role reciprocity.
• Jackson's concept of family homeostasis describes how families resist change.
• Quid Pro Quo refers to a bargain between husband and wife, constituting an equal exchange in the relationship.

Techniques of Structural Family Therapy

• The therapist joins the family by adopting their affect, language, and style.
• The therapist takes a leadership role and accommodate the family.
• Techniques: maintenance, tracking, and mimesis.
• Evaluate family structure and setting therapy goals.
• Restructuring the family through: actualizing transactional patterns, marking boundaries, escalating stress, assigning tasks, utilizing symptoms, manipulating mood, providing support, education, and guidance.
• The group therapy model was not entirely appropriate for families because families have a shared history.
• Interventions in family group therapy focused on the process of interactions.
• Interventions in family group therapy were designed to confront family members with dysfunctional patterns of communication.
• Jay Haley's strategy to redefine family members' words or actions with a positive interpretation is known as reframing.
• Haley favored directives, while Satir sought change by making family rules explicit and teaching clear communication.
• The goal of family group therapy is to initiate a sense of belonging and relatability.
• A relationship in which husband and wife both pursue careers and share housekeeping and childrearing responsibilities is considered a symmetrical relationship.

Early Phase of Therapy

• Identify major conflicts
• Refine the hypothesis
• Keep the focus on the primary problem
• Identify family members
• Challenge family members to see their roles
• Assign homework
• Push for change

Therapist Attitudes

• Calmness means trusting clients' ability to solve problems.
• Curiosity means a genuine interest in understanding the family’s experiences.
• Empathy means active listening and reflective understanding.
• Respect means Honesty, truthfulness, and equality in the therapeutic relationship.

Red Flags for Unethical Practices

• Specialness: therapist believes they have a unique connection with a client, leading to a disregard for professional boundaries, resulting in favoritism and unhealthy dependency.
• Attraction: romantic or sexual feelings between a therapist and client compromise professional objectivity and violate ethical guidelines.
• Alterations in the Therapeutic Frame: changes such as extended session times or increased emotional intimacy that signal boundary violations.
• Violating Clinical Norms: breaching confidentiality, using inappropriate techniques, or offering unqualified advice
• Professional Isolation: avoiding supervision peer consultation, or review prevents therapists from gaining necessary feedback, leading to blind spots.

Ethical and Moral Behavior for Therapists

• Adhere to the American Association for Marriage and Family Therapy (AAMFT) Code of Ethics
• Engage in ongoing supervision and peer consultation
• Establish clear professional boundaries
• Maintain client confidentiality unless disclosure is legally required
• Practice self-awareness and seek professional development

Key Concepts

• Family homeostasis: families maintain stability and resist change.
• Pseudo mutuality: a facade of togetherness masks conflict and blocks intimacy.
• Pseudo hostility: superficial arguing obscures underlying relational issues.
• Rubber fence: flexible but impenetrable boundaries prevent true independence.
• Metacommunication: the underlying message behind verbal communication.
• Double bind: conflicting messages with no clear way to respond correctly.
• Quid Pro Quo: an equal exchange in a relationship.

Symmetrical vs. Complementary relationships

• Symmetrical: partners are equal and mirror each other’s roles.
• Complementary: partners take on contrasting but mutually reinforcing roles.
• Reframing: interpreting behaviors or statements positively to shift perspective.
• Paradoxical intervention: encouraging a client to continue a symptom to highlight its role in the system.
• Boundaries in Structural Family Therapy: clear, enmeshed, or disengaged family structures affect relationships.

Balanced vs. Unbalanced Family Systems

• Balanced families function more effectively.
• Extreme cohesion (enmeshment) or detachment (disengagement) can create dysfunction.

Exploration of key figures and concepts in family therapy, including Lyman Wynne's "pseudo mutuality" and Alfred Adler's foundational role. It also covers Freida Fromm-Reichmann's "schizophrenogenic mother" and Gregory Bateson's "double bind" theory.