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EPPP B1: Clinical Psychology > 04_Family Therapies > Flashcards

04_Family Therapies Flashcards

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
Extended Family Systems Therapy: View of maladaptive behavior
* Multi-generational transmission process* Progressively lower levels of differentiation are transmitted from one generation to the next
26
Extended Family Systems Therapy: Therapy Goals
Primary goal is to increase differentiation of all family members
27
Extended Family Systems Therapy: Therapy Techniques
Usually includes *only spouses* Therapist becomes third member in therapeutic triangle Therapist presence reduces fusion and helps them to achieve higher differentiation
28
Extended Family Systems Therapy: Genogram Graphic Depictions
Relationships between family members Dates of significant life events Any other relevant/important info
29
Extended Family Systems Therapy: Role of therapist
Active expert/coach who helps each partner achieve greater differentiation Key technique is questioning
30
Minuchin's Structural Family Therapy: Main Concepts
Power hierarchies Boundaries Rigid Triads Enmeshment
31
Bowen and mate selection
Bowen believed that people choose mates with similar differentiation levels
32
Extended Family Systems Therapy (Bowen): Family Projection Process: Most affected child
Usually one of the following: Oldest child Child born during period of family stress Child perceived to be "special"
33
Extended Family Systems Therapy (Bowen): Rationale for only working with one family member
Work with family member with most differentiation Goal is to reduce their influence on other members
34
Extended Family Systems Therapy (Bowen): Therapeutic Communication
Partners are encouraged to: Talk to the therapist rather than to each other Speak in a calm, factual manner
35
Minuchin's Structural Family Therapy: Boundaries
Barriers or rules that determine the amount of contact allowed between family members
36
Minuchin's Structural Family Therapy: Result of Rigid Boundaries
Disengagement / isolation
37
Minuchin's Structural Family Therapy: Result of Diffuse/ Permeable Boundaries
Enmeshment = overly dependent / close relationships
38
Minuchin's Three Rigid Triads | aka, Chronic boundary problems
Detouring Stable Coalition Triangulation
39
Minuchin's Structural Family Therapy: Detouring
Parents direct focus on child by either: overprotecting blaming (scapegoating) child for family's problems
40
Minuchin's Structural Family Therapy: Stable Coalition
Parent and child gang up against the other parent
41
Minuchin's Structural Family Therapy: Triangulation
Each parent demands that the child side with them against the other parent a.k.a. "Unstable coalition"
42
Minuchin's Structural Family Therapy: View of Maladaptive Behavior
Inflexible family structure prohibits healthy adaptation to maturation and situational stressors
43
Minuchin's Structural Family Therapy: "Psychosomatic Families"
Child's symptoms (e.g. diabetes, anorexia) help diffuse conflict by diverting attention away from it
44
Minuchin's Structural Family Therapy: Therapy Goals
Restructuring the family = primary long-term goal
45
Minuchin's Structural Family Therapy: Therapy Techniques
Three overlapping steps: Joining Evaluating the Family Structure Restructuring the Family
46
Minuchin's Structural Family Therapy: Theoretical Approach
Action precedes understanding Here and now, directive, concrete approach Emphasis on changing behaviors rather than fostering insight
47
Minuchin's Structural Family Therapy: Joining
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
Minuchin's Structural Family Therapy: Evaluating the Family Structure
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
Minuchin's Structural Family Therapy: Restructuring the Family
A variety of techniques are used to deliberately unbalance (stress) homeostasis in order to facilitate transformation of family structure: Enactment Reframing
50
Minuchin's Structural Family Therapy: Enactment
Restructuring technique Family members role-play relationship patterns Patterns are identified and altered
51
Minuchin's Structural Family Therapy: Reframing
Restructuring technique: Relabeling behaviors so they can be viewed in more positive ways
52
Minuchin's Structural Family Therapy: "Psychosomatic Families": Three Characteristics
High enmeshment that limits autonomy Low tolerance for conflict Overprotectiveness
53
Haley's Strategic Family Therapy: Influences
Communication/Interaction and Structural Family therapies Milton Erickson: Hypnosis to increase ability to manipulate client and control course of therapy
54
Haley's Strategic Family Therapy: Paradoxical Directives
Techniques that use client's resistance to change their behavior
55
Haley's Strategic Family Therapy: View of Maladaptive Behavior
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
Haley's Strategic Family Therapy: Therapy Goals
Alleviate symptoms by altering transactions and hierarchical organization Behavior change results in changes in perception and emotions
57
Haley's Strategic Family Therapy: Four Stages of Therapy
Social stage Problem stage Interaction stage Goal-setting stage "Haley wants some water, turn on the SPIGot"
58
Haley's Strategic Family Therapy: Therapy Techniques
Therapist has and active, "take-charge" role Therapist issues directives/assignments to be performed outside of therapy Directive can be straightforward or paradoxical
59
Haley's Strategic Family Therapy: Paradoxical Interventions
Alters behavior of family by: Helping them see symptom in an alternative way Using their resistance in a constructive way
60
Haley's Strategic Family Therapy: Five Paradoxical Interventions
Ordeals Restraining Positioning Reframing Prescribing the Symptom
61
Haley's Strategic Family Therapy: Ordeals
Unpleasant tasks that client must perform whenever a symptom occurs
62
Haley's Strategic Family Therapy: Restraining
Encouraging the family not to change
63
Haley's Strategic Family Therapy: Positioning
Exaggerating the severity of a symptom
64
Haley's Strategic Family Therapy: Reframing
Relabeling a symptom to give it a more positive meaning
65
Haley's Strategic Family Therapy: Prescribing the Symptom
Instructing a family member to deliberately engage in the symptom
66
Milan Systemic Family Therapy: Origins
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
Milan Systemic Family Therapy: View of Maladaptive Behavior
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
Milan Systemic Family Therapy: Therapy Goals
Elucidate choices and assist family members in exercising their prerogative of choosing
69
Milan Systemic Family Therapy: Therapeutic Team
One or two members meet with family during sessions Remaining team members observe sessions behind a one-way mirror
70
Milan Systemic Family Therapy: Strategy Conference
When one observer calls a therapist out of the session to share observations and make suggestions
71
Milan Systemic Family Therapy: Four Therapy Techniques
Hypothesizing Neutrality Paradox Circular Questions
72
Milan Systemic Family Therapy: Paradoxical Strategies
Used to provide family members with helpful information (Not to elicit resistance) Counter paradox = therapeutic double bind Positive Connotation = reframing
73
Milan Systemic Family Therapy: Circular Questions
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
Behavioral Family Therapy: Overview
Operant conditioning Social learning theory Social exchange theory
75
Behavioral Family Therapy: subtypes
Behavioral marital therapy Parent training Conjoint sex therapy
76
Behavioral Family Therapy: View of Maladaptive Behavior
All behavior is learned and maintained by its antecedents and consequences
77
Behavioral Family Therapy: Therapy Goal
Alter environmental factors that are maintaining problematic behaviors
78
Behavioral Family Therapy: Therapy Techniques
Focus on observable behaviors Ongoing treatment formulation / target identification Contingent reinforcement
79
Behavioral Marital Therapy: Stuart (1969) Operant Interpersonal Therapy
Contingency contracts used to increase positive reinforcements exchanged by partners
80
Object Relations Family Therapy: View of Maladaptive Behavior
Unresolved intrapsychic conflicts in the family-of-origin are replicated in current relationships
81
Object Relations Family Therapy: Projective Identification
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
Object Relations Family Therapy: Primary Therapy Goal
Resolve each family member's attachment to family introjects
83
Object Relations Family Therapy: Therapy Techniques
Interpretation of transferences, resistances, and other factors in order to foster insight Recognition and addressing of Multiple Transferences
84
Object Relations Family Therapy: Multiple Transferences
Transferences of : One family member to another Each member to the therapist Family as a whole to the therapist
85
Double-Bind Communication Example
"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
Double-Bind Communication: Mnemonic
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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