Family Therapy Slides.pdf

FA M I LY T H E R A P Y PSYC348 LECTURER: JENNA VAN DEURS QUESTIONS: VEVOX.APP (ID:183-070-161) FA M I LY T H E R A P Y A broad term, which refers to numerous therapeutic approaches. These approaches will often be differentiated due to their focus on one of the following: 1) problem-maintaining b...

FA M I LY T H E R A P Y PSYC348 LECTURER: JENNA VAN DEURS QUESTIONS: VEVOX.APP (ID:183-070-161) FA M I LY T H E R A P Y A broad term, which refers to numerous therapeutic approaches. These approaches will often be differentiated due to their focus on one of the following: 1) problem-maintaining behaviour patterns 2) problematic and constraining belief systems, and 3) historical and contextual predisposing factors The most important point of differentiation from all other psychotherapeutic endeavours, is that all family therapy approaches are primarily concerned with context/systems H I S T O RY • Sigmund Freud believed it was best to keep patients away from their toxic families • During 40s & 50s therapeutic approaches focused on the individual in the family who was the ‘problem’ (e.g., psychoanalytic, behavioural, cognitive behavioural theories) • Family therapy developed later out of an increased awareness of limitations of an individualised approach in fields such as child behaviour, intimate partner relationships • Ludwig Von Bertalanffy and Gregory Bateson made significant contributions to the theoretical foundations of family systems • Development of Mental Research Institute in 1959 (first formal training program in family therapy) FA M I LY S Y S T E M S Family systems approaches differ from individual counselling in that: • They focus on the person within their context • They believe that individuals do not exist in a vacuum, that their problems develop in the context of their relationships with others • In other words, that the individual will be shaped by his/her system or family and that the system, in turn, will be influenced by the individual G E N E R A L S Y S T E M S T H E O RY ’ S A P P L I C A B I L I T Y T O FA M I LY S Y S T E M S Parent Parent Parent Parent Parent Parent Parent Child Child Child Child T H E B E H AV I O U R O F E AC H FA M I LY M E M B E R I S D E T E R M I N E D BY T H E PAT T E R N S O F I N T E R AC T I O N S T H AT C O N N E C T A L L FA M I LY MEMBERS Grandparent Grandparent Grandparent Grandparent Parent Parent Child Child C I RC U L A R C A U S A L I T Y • Interactions occur in cycles –not lines • Causality occurs in a relationship context and through a network of feedback loops • Past experiences matter Parent behavior Child behavior Child A behavior Parent behavior Child B behavior Parent behavior S O M E FA M I LY T H E R A P Y THEORETICAL MODELS • Bowenian • Structural • Systemic BOWENIAN FA M I LY THERAPY • Developed by Murray Bowen (1913 – 1990) • Concerned with how families transmit difficulties to one another and the ongoing impact of this • Intergenerational lens F U N D A M E N TA L A S P E C T S O F T H E MODEL Differentiation of the self (a) Internal separate thinking from feeling (b) Interpersonal separate one’s own thinking and feeling from others’ thinking and feeling Family emotional processes (a) Projection locating one’s own problems in other people (b) Triangulation when two people have issues with one another they bring in a third person (c) Multigenerational Transmission Processes children grow up and choose partners at the same level as themselves Bowenian Family Therapy Techniques Promotion of differentiation Detriangulation The Genogram STRUCTURAL FA M I LY T H E R A P Y • Major contributor Salvador Minuchin (1921 – 2017) • Every family has a structure “an invisible set of functional demands that organizes the ways in which family members interact” (Minuchin, 1974) • Family structure is characterised by clear intergenerational boundaries between parent and child. • Boundaries should be neither rigid nor diffuse F U N D A M E N TA L A S P E C T S O F T H E MODEL • Patterns of interaction • Basic structure and organization of the system • Key premise: “problematic family organisational structures may compromise the family’s capacity to meet the demands of life-cycle changes, or unpredictable intrafamilial or extrafamilial stresses.” (Carr, 2000) FA M I LY LIFE C YC L E T H E I N T E RV E N T I O N • Assessment and treatment occur concurrently • Structural family therapists attempt to avoid being drawn into problem-maintaining patterns • Families theorised to want to lose their symptoms, but be resistant to changing their “dysfunctional” structure • If symptomatic behaviour is to be permanently eliminated, problem-maintaining behaviour will also need to be addressed • Structural family therapists avoid being recruited by the family into dysfunctional behaviours S T R U C T U R A L FA M I LY T H E R A P Y TECHNIQUES • Joining • Restructuring • Enactment • Unbalancing • Boundary-marking M I L A N S Y S T E M I C FA M I LY THERAPY • Developed in 1971 by Mara Selvini-Palazzoli, Luigi Boscolo, Gianfranco Cecchin, & Giliana Prata • "Systems theory purports that living organisms can be seen as a group of elements in interaction with one another, forming stability over time, with boundaries within itself and between itself and the environment" (Cottrell and Boston, 2002, p.574). • Division in the Milan team - two sub-branches F U N D A M E N TA L A S P E C T S O F T H E MODEL • Family as a system • Presenting problems - Homeostatic Function • Obtain multiple sources of information - from linear to Circular • Family Beliefs - maps of reality • Problems generally arise: • When the family's maps of reality cease to be useful • When important relationships within the family change • Where a solution creates further problems • Focus on repetitive interaction patterns • Focus on process and the history of family patterns • Examination of relationships between beliefs and behaviours T H E I N T E RV E N T I O N • Look for family connections or interaction patterns that perpetuate dysfunction • Facilitate change in the family belief systems • Bring an end to the symptom-maintaining interaction patterns • Develop the context for change • Therapist as part of the system of therapy M I L A N FA M I LY T H E R A P Y TECHNIQUES • Hypothesising • Circular Questioning • Neutrality • Reflecting Team C I RC U L A R Q U E S T I O N I N G • Linear: How are you feeling? • Circular: If I was to ask you partner how you have been feeling, what would s/he say? • Linear: How is your relationship with John? • Circular: Lisa, what do YOU see happening between your Mum and John? Circular Present: How does your Mum react when your Dad doesn’t get involved? Circular Past: What did Dad do on those days when your brother used to push your Mum around? Circular Future: Dad, explain to me why you think your daughter and wife both agree a divorce is likely should your wife return to study? A P P L I C AT I O N • Family Therapy has been slow to develop in Australasia. • Now very established in Australia, but didn’t have a strong foothold there until the mid 1980’s. • NZ is still waiting for this to occur. Although Narrative Therapy is now longestablished, systemic family therapies generally have a low profile, and are not taught in depth in academic settings. • Training opportunities remain limited in NZ • Several NZ universities offer couples and family therapy post-graduate papers • In Christchurch, multisystemic therapy offered by Emerge Aotearoa, Family Therapy available to families under CAF, ACC funds family & couple sessions; private therapy options C U LT U R A L C O N S I D E R AT I O N S • Caution regarding pathologizing the values & characteristics of families e.g., a therapist from an individualistic culture may classify family behaviours in collectivist cultures as enmeshment if they don’t recognise their own cultural bias/lens • Family therapists need to explore whether the approach they are using is biased in favour of certain cultures • Need to consider wider ecological perspective (e.g., societal forces such as racism may have contributed to family “disorganisation)