Family Therapy Lecture Notes PDF

what is the main focus of family therapy? The main focus is lessen anxiety. And how do we lessen the anxiety by looking at the relationship styles and communication patterns? So the questions you ask will be aimed at getting information on how people are relating. looking for fusion, looking for und...

what is the main focus of family therapy? The main focus is lessen anxiety. And how do we lessen the anxiety by looking at the relationship styles and communication patterns? So the questions you ask will be aimed at getting information on how people are relating. looking for fusion, looking for undifferentiation, looking for triangulation, and then trying to stop that. a family counselor is the MOST ACTIVE role APSS5630 in all of the approaches that we've seen. You need to be extremely active. You need to be very, very quick and very Lecture 9 awake. requires very strong ability to confront The Family Systems Perspective  Basic Concepts The whole is greater than the sum of its part (family is seen as a functioning unit) Actions by one affect the whole An individual may carry a symptom for the whole family Family members participate in the creation of the symptom The client’s problem is seen in the context of family’s transactional pattern  Basic Concepts Individuals: are best understood through assessing the interactions within an entire family. Symptoms: are viewed as an expression of a dysfunction within a family. Cl’s Problematic behaviors: Serve a purpose for the family. May be unintentionally maintained by family dynamics. Are a function of the family’s inability to operate productively. Are symptomatic patterns handed down across generations. A family: is an interactional unit and a change in one member effects all members.  Difference between Systemic & Individual Therapy models Individual Therapist Systemic Therapist Obtain accurate diagnosis DSM Explore System for family IV process & rules e.g. use genogram Begin Therapy right now Invite in parents, siblings in therapy Focus: causes, purposes, Focus: family relationships processes Concern with individual Concern transgenerational experience & perspective meanings, rules Intervene to help individual learn Intervene to change context to cope within family system Multigenerational Family Therapy (Murray Bowen) Bowen was one of the developers of mainstream family therapy Evolved from psychoanalytic principles and practices A family can be best understood when it is analyzed from at least a three-generational perspective… Unresolved emotional reactivity (“pushing your buttons”) and attachment to one’s family must be addressed to achieve maturity  Multigenerational Family Therapy Basic assumption: The cause of an individual’s problem can be understood only by viewing the role of the family as an emotional unit: Unresolved emotional fusion to one’s family must be addressed. The application of rational thinking to emotionally saturated systems A well-articulated understanding is considered to be essential With the proper knowledge the individual can change Change occurs only with other family members Differentiation of the self A psychological separation from others and separation between intellect and emotion (observe your emotional reactions instead of acting on them) This leads to individuals taking responsibility for thoughts, feelings, etc. and becoming less reactive Triangulation A third party is recruited to reduce anxiety and stabilize a couples’ relationship  differentiation of the self is a little bit like externalization of the problem Differentiation of the Self A psychological separation of intellect & emotion & independence of self from others. Differentiated self : Being able to choose to be guided by thoughts or emotions – separateness. Undifferentiated: Difficulty separating self from others- fused with dominant family emotional patterns- physical but not emotional leaving. If your “buttons” still get pushed, you are not fully differentiated. Unproductive family dynamics of previous generation transmitted by marriage of undifferentiated individuals.  the mature, healthy thing to do is avoid triangulation. Speak to the person you have a conflict with. You, feel anxious about, instead of hiding and distracting with a 3rd situation. Try to address it as best as you can. You don't need to be perfect. Triangulation Under stress, 2 people may recruit a third into the relationship to reduce tension A third party is recruited to reduce anxiety and stabilize a couple’s relationship. Underlying conflict not addressed & worsens. Once the 3rd person is resolved the balance achieved is off again. Change in one part of family system affects the whole system. Awareness: Therapist must be highly differentiated so as not to get caught up in triangulation with couple.  Therapy Goals To lessen anxiety and relieve symptoms Offers clients a rational understanding of the nuclear family emotional systems, and the transmission process over several generations With the proper knowledge the individual can change Change occurs only with other family members. To change the individuals within the context of the system. To end generation-to-generation transmission of problems by resolving emotional attachments. To increase the individual member’s level of differentiation (therapy session as rehearsals for becoming differentiated).  Therapist’s Role Objective researcher who aims to help individual in the family assess and understand their relational styles within the family system Teacher, coach and neutral observer Help to differentiate and de-triangulate  Techniques Genogram work: Look at family over three generations: Look for critical turning points in family emotional process. Characteristics of family members. Evolutional picture of family: tools for assessing individual’s degree of fusion to their family. Asking Questions: designed for clients to think about the role they play in relating with members of their family What role did you play with that person in the family? Looking for fusion within the family and helping clients differentiate.  Human Validation Process Model: Virginia Satir positive regard, genuine, empathy Congruence, unconditional, Her approach emphasizes: Communication and family connection to boost self-esteem in individuals Emotional Experiencing Strong and nurturing relationship based on interest and fascination for clients Stresses the involvement of the therapist with a family the importance of recognizing each individual's uniqueness and value in the family unit, because her focus is on validating everyone's experience Goals of Conjoint Therapy Open Communication Individuals are allowed to honestly report their perceptions Enhancement of Self-Esteem Family decisions are based on individual needs Encouragement of Growth Differences are acknowledged Transforming extreme rules into useful and functional rules Families have many spoken and unspoken rules  the 4 different styles of trying to protect yourself with a defensive attitude that doesn't encourage authentic relating. Major Communication Stances under stress 溝通姿態? First goal is to identify the stance and then to see how this is not functioning. how this is creating problems and then identify ways to change that. The Bowen approach is maybe interactional patterns, transgenerational patterns. The satir model is what are the communication stances and styles. Right? So in other words, how do people communicate together? Blaming stance 溝通姿態: 指責 shifting responsibility Self Others to preserve self Behavior – control, dictate, Environ- judge, 吹毛求疵 ment (nitpick) Thoughts – This is all your fault! Placating stance 溝通姿態: 討好 Taking blame to protect someone else 「I’m not important。I’m not lovable。」 Self Others 「I must always be nice。」 「I should never irritate others。」 「I should never infringe on others。」 Environ- 「It’s all my fault。」 ment Behavior - Yield, beg for pity, ask to be forgived Thoughts - Everything is my fault!  So the super reasonable person has great difficulty dealing with emotions. Super-reasonable stance 溝通姿態: 超理智 Self Others keep control of one’s feelings Behavior Cold/Superior/control/give Environ- advice/rigid inflexible ment positions Thoughts -you must be logical, rational!  taking a step away from really relating behave like clowns or uninterested people, because they want to keep a distance from others. Irrelevant stance 溝通姿態: 打岔 distractions to Self Others avoid feeling Behavior -interrupt/disturb/divert attention/overactive/ Environ- ment Thoughts - preoccupied/avoid individual or emotional topics 溝通姿態: 表裡一致 Being Congruent: emotional honesty Loyal to oneself Care for others Concern for Self Others environment Share feelings Environ- and ask for what ment is needed  Family Rules 「家醜不外揚。Don’t wash dirty laundry in public」 「我們不會批評我們的父母。Never criticize your parents」 「如果我們認為對方沒有東西給我們，就不要 開口。If others are of no use to us we don’t engage」 「除非有人做了些值得一提的事，否則我們不 會表露愛意。Don’t show love unless deserved」  Overall… Basic assumption An individual’s problematic behavior grows out of the interactional unit of the family, community, and societal systems. Focus of family therapy Short term, solution-focused, action-oriented, and here-and-now interaction. Focus on how current family relationships contribute to the development and maintenance of symptoms.  Overall… Role of goals and values Specific goals are determined by family and therapist. Global goal is to reduce family’s distress. How family changes Cognitive, emotional, or behavioral changes. Change needs to happen in relationships, not just within the individual.  Overall… Techniques of family therapy Techniques are tools for achieving therapeutic goals. Empathy, touch, communication; sculpting, role playing, family-life chronology Personal characteristics (respect, empathy, sensitivity) are even more important than techniques. VERY HUMANISTIC APPROACH Always consider what is in the best interest of the family. It's more about developing a strong relationship with the counselor so strong that you learn through the counseling relationship how to communicate more effectively and to be more authentic, congruent, and genuine in the relationship with the counselor, the same as with Pct. But this is done with family members present so very similar to CBT, so general techniques here and now, always about here. General Techniques (1) Here and Now interventions (behavioral change) Reenactment and enactment Reframing / positive connotation Restructuring the family in session/sculpting Between session homework Therapist’s use of self (humor, self-disclosure, metaphors, etc)  General Techniques (2) Transgenerational Interventions (insight oriented) Addressing the past helps the present, for ex. Dealing with opposite sex parent might help with current spouse Genogram Trips home Inviting extended family into therapy Symbolic inclusion of family of origin  Contributions Inclusion of all parts of the system rather than being limited to the “identified patient”. Rather than blaming either “identified patient” or the family, the entire family has an opportunity (1) to examine the multiple perspectives and interactional patterns that characterize the unit and (2) participate in finding solutions.  Limitations An overemphasis on the system may result in the unique characteristics of the individual family members being overlooked Concern with the well-being and function of the system may overshadow the therapist’s view of the needs and functioning of the individuals in the system Practitioners are cautioned not to assume that Western models of family are universal and must be culturally competent Therapists with a Westernized view of the family may inadvertently overlook the importance of extended family when working with families from other cultures