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EPPP B1: Clinical Psychology > 04_Family Therapies > Flashcards

04_Family Therapies Flashcards

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1
Q

General Systems Theory

A

Interacting components are best understood by studying them in their context

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2
Q

General Systems Theory:

Family as Open System

A

Receives input from environment

Discharges output to environment

Adaptable to change

Seeks HOMEOSTASIS

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3
Q

Homeostasis

A

Tendency for family to act in ways that maintain equilibrium / status quo

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4
Q

Consequence of Homeostasis

A

If the problems of one family member improve, the disturbance is likely to reappear elsewhere in the family

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5
Q

Family Therapy:

Main influences

A

General Systems Theory (Bertalanaffy 1968)

Cybernetics (1940’s)

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6
Q

Cybernetics

A

Originally developed by mathematician, subsequently applied to family education processes

Main Feature = FEEDBACK LOOP

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7
Q

Negative Feedback Loop

A

Reduces deviation

Helps the system maintain status quo

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8
Q

Positive Feedback Loop

A

Amplifies deviation or change

Disrupts the system, can lead to breakdowns “runaways”

*Can promote appropriate change in In some situations

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9
Q

Family Therapies: Characteristics

A

Reciprocal view of causality

Relational

Focuses on the Here-and-Now

Emphasizes freedom of choice

Contextual, relativistic perspective

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10
Q

Earliest contributors to family therapy

A

Ackerman, Bateson, Bowan

“Don’t be A BaBy!”
a-b-b

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11
Q

Nathan Ackerman

A

“Grandfather of family therapy”

Integration of psychoanalysis with systems approach

Saw family members together in therapy

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12
Q

Double-Bind Communication:

Who and What

A

Bateson

Schizophrenia due to contradictory “don’t” statements

Recipient is not allowed to comment or seek help from someone else

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13
Q

Bowen and theory of Schizophrenia

A

Development of Schizophrenia is due to repetition of certain family interactions over three generations

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14
Q

Communication/Interaction Approach:

3 Main Assumptions

A

All behavior is communication
(even when “doing nothing”)

All communication has a “report” and a “command” function

Communication/ interaction patterns are either symmetrical or complementary

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15
Q

Communication/Interaction Family Therapy:

“report” function

A

Content/informational aspect of communication

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16
Q

Communication/Interaction Family Therapy:

“command” function

A

Nonverbal

Makes a statement about the relationship between communicators

*Problems arise when report command functions are contradictory

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17
Q

Communication/Interaction Family Therapy:

Symmetrical communication

A

Reflects equality between communicators

May escalate into competitive “one-upsmanship”

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18
Q

Communication/Interaction Family Therapy:

Complementary communication

A

Reflects inequality and maximize differences between communicators

Results in dominant and submissive roles

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19
Q

Communication/Interaction Family Therapy:

View of Maladaptive Behavior

A

Circular causality

Symptom is both a cause and effect of dysfunctional communication patterns

E.g. blaming and criticizing, mind reading, overgeneralizing

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20
Q

Bowen’s Extended Family Systems Therapy:

Three Key Terms

A

Differentiation

Emotional triangle

Family projection process

“extend bow and arrow”
(Bowen, bow and)

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21
Q

Extended Family Systems Therapy (Bowen):

Differentiation (of Self)

A

Ability to separate one’s intellectual and emotional functioning

Low differentiation = more emotion mind = become fused with emotions that dominate the family

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22
Q

Extended Family Systems Therapy:

Undifferentiated Family Ego Mass

A

Low differentiation throughout family

Family members are highly emotionally fused

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23
Q

Extended Family Systems Therapy:

Emotional Triangle

A

When husband-wife or parent-child recruit third person to reduce tension / increase stability

Lower differentiation = higher likelihood of emotional triangle

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24
Q

Extended Family Systems Therapy:

Family Projection Process

A

Parental conflicts and emotional immaturity are transmitted to children

Results in child having lower level differentiation than parents

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25
Q

Extended Family Systems Therapy:

View of maladaptive behavior

A
  • Multi-generational transmission process*

Progressively lower levels of differentiation are transmitted from one generation to the next

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26
Q

Extended Family Systems Therapy:

Therapy Goals

A

Primary goal is to increase differentiation of all family members

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27
Q

Extended Family Systems Therapy:

Therapy Techniques

A

Usually includes only spouses

Therapist becomes third member in therapeutic triangle

Therapist presence reduces fusion and helps them to achieve higher differentiation

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28
Q

Extended Family Systems Therapy:

Genogram Graphic Depictions

A

Relationships between family members

Dates of significant life events

Any other relevant/important info

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29
Q

Extended Family Systems Therapy:

Role of therapist

A

Active expert/coach who helps each partner achieve greater differentiation

Key technique is questioning

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30
Q

Minuchin’s Structural Family Therapy: Main Concepts

A

Power hierarchies

Boundaries

Rigid Triads

Enmeshment

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31
Q

Bowen and mate selection

A

Bowen believed that people choose mates with similar differentiation levels

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32
Q

Extended Family Systems Therapy (Bowen):

Family Projection Process: Most affected child

A

Usually one of the following:

Oldest child

Child born during period of family stress

Child perceived to be “special”

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33
Q

Extended Family Systems Therapy (Bowen):

Rationale for only working with one family member

A

Work with family member with most differentiation

Goal is to reduce their influence on other members

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34
Q

Extended Family Systems Therapy (Bowen):

Therapeutic Communication

A

Partners are encouraged to:

Talk to the therapist rather than to each other

Speak in a calm, factual manner

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35
Q

Minuchin’s Structural Family Therapy:

Boundaries

A

Barriers or rules that determine the amount of contact allowed between family members

36
Q

Minuchin’s Structural Family Therapy:

Result of Rigid Boundaries

A

Disengagement / isolation

37
Q

Minuchin’s Structural Family Therapy:

Result of Diffuse/ Permeable Boundaries

A

Enmeshment = overly dependent / close relationships

38
Q

Minuchin’s Three Rigid Triads

aka, Chronic boundary problems

A

Detouring

Stable Coalition

Triangulation

39
Q

Minuchin’s Structural Family Therapy:

Detouring

A

Parents direct focus on child by either:

overprotecting

blaming (scapegoating) child for family’s problems

40
Q

Minuchin’s Structural Family Therapy:

Stable Coalition

A

Parent and child gang up against the other parent

41
Q

Minuchin’s Structural Family Therapy:

Triangulation

A

Each parent demands that the child side with them against the other parent

a.k.a. “Unstable coalition”

42
Q

Minuchin’s Structural Family Therapy:

View of Maladaptive Behavior

A

Inflexible family structure prohibits healthy adaptation to maturation and situational stressors

43
Q

Minuchin’s Structural Family Therapy:

“Psychosomatic Families”

A

Child’s symptoms (e.g. diabetes, anorexia) help diffuse conflict by diverting attention away from it

44
Q

Minuchin’s Structural Family Therapy:

Therapy Goals

A

Restructuring the family = primary long-term goal

45
Q

Minuchin’s Structural Family Therapy:

Therapy Techniques

A

Three overlapping steps:

Joining

Evaluating the Family Structure

Restructuring the Family

46
Q

Minuchin’s Structural Family Therapy:

Theoretical Approach

A

Action precedes understanding

Here and now, directive, concrete approach

Emphasis on changing behaviors rather than fostering insight

47
Q

Minuchin’s Structural Family Therapy:

Joining

A

Therapist develops therapeutic system by joining family in position of leadership and blending

Tracking: identifying family’s values, themes, life events

Mimesis: adopting family’s affective and communication style

48
Q

Minuchin’s Structural Family Therapy:

Evaluating the Family Structure

A

Once therapist has joined the family, they develop a structural diagnosis and treatment goals based on:

Transactional patterns (develop a structural map)

Power hierarchies

Boundaries

49
Q

Minuchin’s Structural Family Therapy:

Restructuring the Family

A

A variety of techniques are used to deliberately unbalance (stress) homeostasis in order to facilitate transformation of family structure:

Enactment

Reframing

50
Q

Minuchin’s Structural Family Therapy:

Enactment

A

Restructuring technique

Family members role-play relationship patterns

Patterns are identified and altered

51
Q

Minuchin’s Structural Family Therapy:

Reframing

A

Restructuring technique:

Relabeling behaviors so they can be viewed in more positive ways

52
Q

Minuchin’s Structural Family Therapy:

“Psychosomatic Families”: Three Characteristics

A

High enmeshment that limits autonomy

Low tolerance for conflict

Overprotectiveness

53
Q

Haley’s Strategic Family Therapy: Influences

A

Communication/Interaction and Structural Family therapies

Milton Erickson: Hypnosis to increase ability to manipulate client and control course of therapy

54
Q

Haley’s Strategic Family Therapy:

Paradoxical Directives

A

Techniques that use client’s resistance to change their behavior

55
Q

Haley’s Strategic Family Therapy:

View of Maladaptive Behavior

A

Communication is used to exert control

Symptom = strategy for controlling relationship when all other strategies have failed

Pathological struggle for control = when one or both parties denies the intent to control the other person

56
Q

Haley’s Strategic Family Therapy:

Therapy Goals

A

Alleviate symptoms by altering transactions and hierarchical organization

Behavior change results in changes in perception and emotions

57
Q

Haley’s Strategic Family Therapy:

Four Stages of Therapy

A

Social stage

Problem stage

Interaction stage

Goal-setting stage

“Haley wants some water, turn on the SPIGot”

58
Q

Haley’s Strategic Family Therapy:

Therapy Techniques

A

Therapist has and active, “take-charge” role

Therapist issues directives/assignments to be performed outside of therapy

Directive can be straightforward or paradoxical

59
Q

Haley’s Strategic Family Therapy:

Paradoxical Interventions

A

Alters behavior of family by:

Helping them see symptom in an alternative way

Using their resistance in a constructive way

60
Q

Haley’s Strategic Family Therapy:

Five Paradoxical Interventions

A

Ordeals

Restraining

Positioning

Reframing

Prescribing the Symptom

61
Q

Haley’s Strategic Family Therapy:

Ordeals

A

Unpleasant tasks that client must perform whenever a symptom occurs

62
Q

Haley’s Strategic Family Therapy:

Restraining

A

Encouraging the family not to change

63
Q

Haley’s Strategic Family Therapy:

Positioning

A

Exaggerating the severity of a symptom

64
Q

Haley’s Strategic Family Therapy:

Reframing

A

Relabeling a symptom to give it a more positive meaning

65
Q

Haley’s Strategic Family Therapy:

Prescribing the Symptom

A

Instructing a family member to deliberately engage in the symptom

66
Q

Milan Systemic Family Therapy: Origins

A

Mara Selvini-Palazzoli, child psychoanalyst

She altered her therapy techniques when she found a family systems approach to be more effective for treating children with Anorexia Nervosa

67
Q

Milan Systemic Family Therapy:

View of Maladaptive Behavior

A

Family system contains circular patterns of action and reaction

Pathology: Patterns become so fixed that family members are no longer able to act creatively or make new choices about their lives

68
Q

Milan Systemic Family Therapy:

Therapy Goals

A

Elucidate choices and assist family members in exercising their prerogative of choosing

69
Q

Milan Systemic Family Therapy:

Therapeutic Team

A

One or two members meet with family during sessions

Remaining team members observe sessions behind a one-way mirror

70
Q

Milan Systemic Family Therapy:

Strategy Conference

A

When one observer calls a therapist out of the session to share observations and make suggestions

71
Q

Milan Systemic Family Therapy:

Four Therapy Techniques

A

Hypothesizing

Neutrality

Paradox

Circular Questions

72
Q

Milan Systemic Family Therapy:

Paradoxical Strategies

A

Used to provide family members with helpful information (Not to elicit resistance)

Counter paradox = therapeutic double bind

Positive Connotation = reframing

73
Q

Milan Systemic Family Therapy:

Circular Questions

A

Questions that are asked of each family member to help them recognize differences and similarities and perceptions

E.g. “Who was more upset, mom or dad?”

*Implementation of question is circular–go around the room and ask everyone (question itself is not circular)

74
Q

Behavioral Family Therapy: Overview

A

Operant conditioning

Social learning theory

Social exchange theory

75
Q

Behavioral Family Therapy: subtypes

A

Behavioral marital therapy

Parent training

Conjoint sex therapy

76
Q

Behavioral Family Therapy:

View of Maladaptive Behavior

A

All behavior is learned and maintained by its antecedents and consequences

77
Q

Behavioral Family Therapy:

Therapy Goal

A

Alter environmental factors that are maintaining problematic behaviors

78
Q

Behavioral Family Therapy:

Therapy Techniques

A

Focus on observable behaviors

Ongoing treatment formulation / target identification

Contingent reinforcement

79
Q

Behavioral Marital Therapy:

Stuart (1969) Operant Interpersonal Therapy

A

Contingency contracts used to increase positive reinforcements exchanged by partners

80
Q

Object Relations Family Therapy:

View of Maladaptive Behavior

A

Unresolved intrapsychic conflicts in the family-of-origin are replicated in current relationships

81
Q

Object Relations Family Therapy:

Projective Identification

A

Dysfunction which occurs when a family member reacts to other member as through they actually possess projected characteristics

*Or provokes that person to act in ways consistent with those characteristics

82
Q

Object Relations Family Therapy:

Primary Therapy Goal

A

Resolve each family member’s attachment to family introjects

83
Q

Object Relations Family Therapy:

Therapy Techniques

A

Interpretation of transferences, resistances, and other factors in order to foster insight

Recognition and addressing of Multiple Transferences

84
Q

Object Relations Family Therapy:

Multiple Transferences

A

Transferences of :

One family member to another

Each member to the therapist

Family as a whole to the therapist

85
Q

Double-Bind Communication Example

A

“DO that and you’ll be punished”
“DON’T do that and you’ll be punished”

One is expressed verbally
One is expressed nonverbally

86
Q

Double-Bind Communication:

Mnemonic

A

Bateson / Bateman

“Arrested Development of schizophrenia”
(Jason Bateman)

double-bind
Picture GOB tying him up for magic trick

EPPP B1: Clinical Psychology (24 decks)

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