Adult Mental Health - Systemic

Question 1

Rationale for family therapy + key references

Answer 1

Social network is good for MH
- Tang et al., 2022 - study of nearl 4k chinese adolescents reported that the association between negative life events and quality of life was mediated by social support

So working with those around the client who provide support = esp beneficial

Question 2

5 Cs of family therapy

Answer 2

Connectedness - between and within relationships
Circularity - how parts of the system influence one another
Curiosity - about multiple perspectives
Context - for how the problem developed and is maintained
Collaboration - between therapist and client / system

Question 3

Understanding of the problem and symptoms in family therapy and how this is changed

Answer 3

• Family therapy focuses on relational/interpersonal understanding rather than individual/intrapersonal understanding.
• ‘Symptoms” are considered to be problems in interactions.
• The mechanism of change is considered to be within the relationship (rather than within the individual).
  Compared to CBT, Family Therapy considers outside in problems, circular rather than linear causation, and a consideration of the wider context in how problems are developed and maintained.

Question 4

How did family therapy originate

Answer 4

Originated in 1950s: The ideas underpinning family therapy originated simultaneously in several different countries and disciplines during the 1950s. It was the prevailing psychodynamic model of the time.
Family system: Practice-based research observed the active impact of family life on the mental health of individuals. The focus was on how family patterns and interactions intensified symptoms in families.

Question 5

1st Generation / First Order Family Therapy + key references

Answer 5

2 forms:
Strategic Family Therapy (Haley, 1970): Took a problem-centred approach. Aimed to change patterns and to initiate behaviour change.
Structural Family Therapy (Minuchin, 1974): Was expert-led, focused on boundaries, held assumptions about ‘normal functioning’. Issues of power, race, gender, and culture were ignored. Critique focuses on too many assumptions about right and wrong way of being.

Question 6

The Milan Group

Answer 6

Milan Group (1980s): Focused on family’s belief systems (i.e., the meaning of behaviour). Developed a model for conducting family therapy (including the one-way mirror as a technique and the importance of the team as a resource). Focused on introducing multiple perspectives to allow for the identification of unhelpful explanations/beliefs (e.g., linear explanations), new meaning-making, and changes in unhelpful patterns of interaction.

Question 7

Post-Milan Ideas

Answer 7

Post-Milan ideas: Views the therapist as part of the system, not a neutral or expert observer, and a participant in the co-construction of meanings. Stories are heard and understood based on our own experiences and beliefs (John Burnham, 1992). Emergence of narrative and dialogical approaches, and a focus on reflexivity and knowing/uncertainty.

Question 8

Theoretical underpinnings of family therapy + references
(note not SC, thats another flashcard)

Answer 8

Systemic and family therapy (like other therapies) has changed and developed to recognise how ‘the family’ and ‘family life’ is influenced by the ideologies and discourse inherent across cultures and societies (Dallos & Draper, 2015).
Families translate these ideologies and discourses within their own ‘family culture’ to develop a set of shared premises, explanations, and expectations – in short, a family’s own ‘belief system’ (Dallos & Draper, 2015).
Family therapy is largely underpinned by social constructionism.

Question 9

What is social constructionism

Answer 9

Social constructionism is a theoretical perspective that emphasises the ways in which meaning, knowledge, and reality are created through social interactions and shared understanding rather than existing as objective truths. It challenges the idea of a fixed, universal reality and instead proposes that reality is co-constructed through language, culture, and relationships.

Question 10

Core concepts of social constructivism (4)

Answer 10

1. Language shapes our social reality: Language doesn’t just reflect reality, it creates it. Knowledge, ideas, and meaning is made through social interactions using language.
2. Relational process: Knowledge and meaning is a social agreement created by people through communication. Individuals co-create reality in dialogue with others.
3. Contextuality: Knowledge and truth are not absolute but are dependent on social, cultural, and historical contexts.
4. Multiplicity of truths: There is no single “truth”. Instead, there are multiple, equally valid interpretations or ways of viewing social reality.

Question 11

Implications of social constructionism for family/systemic therapy (intro + 5 points)

Answer 11

Social constructionism has had a profound influence on postmodern approaches to family and systemic therapy, shifting the focus from diagnosing and fixing problems to understanding and co-authoring new narratives.

Social constructionism invites therapists to become facilitators of new conversations, where families and individuals can explore alternative understandings of themselves and their relationships, often leading to more empowering and healing narratives.

1. Deemphasis on pathology:
   Instead of labelling individuals or families with diagnoses, therapists focus on understanding how problems are talked about and maintained through interaction.
   The problem is seen as the problem – not the person.
2. Collaborative dialogue:
   Therapy becomes a conversation where both therapist and client are partners in meaning-making.
   Therapists avoid the expert stance and instead adopt a “not-knowing” position, staying curious and open to clients’ perspectives.
3. Narrative and meaning-making:
   Techniques like Narrative Therapy (White and Epston) are grounded in social constructionism.
   Clients are invited to explore and re-author the stories they live by, focusing on preferred identities and untold strengths.
4. Cultural and social sensitivity:
   Therapists consider how cultural discourses (e.g., gender roles, societal expectations, racism, etc.) influence clients’ beliefs and experiences.
   This approach encourages empowerment by exposing and challenging oppressive narratives.
5. Focus on interaction over individuals:
   Systemic therapy influenced by social constructionism pays attention to patterns of communication and meaning within relationships rather than viewing problems as residing in individuals.

Question 12

Systems Theory + reference

Answer 12

Systems theory (Bateson, 1972): Family is viewed as a dynamic system with rules, roles, and structures. A person is a process of relationships, rather than a static entity. Changes in one part of the system affect the whole. No single “truth”. Embraces multiple viewpoints and seeks to understand different narratives.

Question 13

Social Graces + Intersectionality + references

Answer 13

Social graces (Burnham, 2012) and intersectionality (Crenshaw, 1989): Encourage therapists to reflect on visible/invisible aspects of identity and understand how multiple forms of oppression interact.

Question 15

Key features of systemic therapy practice (5)

Answer 15

1. Strengths-based approach – focuses on existing strengths, resilience, and capacity for change.
2. Context – Behaviour is understood within the context of family, culture, and relationships.
3. Focus on relationships, patterns, and interaction rather than internal pathology.
4. Circular causality – sees problems as part of reciprocal patterns
5. Reflexivity and therapist’s position – therapists reflect on their own role and influence on the system

Question 16

What is the idea behind the family life cycle

Answer 16

The Family Life Cycle considers the stages a family goes through over time, with each stage bringing unique developmental challenges, expansion, contraction, and realignment.
It’s believed that this developmental framework can help therapists to frame struggles as developmental challenges, rather than pathology, to normalise distress, and aid understanding of role renegotiation.
Central features of the family life cycle include developmental stages of families, family transitions, and horizontal and vertical stressors.

Question 17

Explain + reference the idea of stages in the family life cycle

Answer 17

Stages (Duval, Miller, & Hill, 1985):
A series of stages that families typically experience (marriage, child-rearing, launching children into adulthood, retirement.

Question 18

Explain + reference the idea of transitions in the family life cycle

Answer 18

Transitions (Duval, Miller, & Hill, 1985):
How transitions (e.g., birth of a child, death of a family member) can disrupt family equilibrium. Identifying and understanding these transitions key to the therapeutic work.

Question 19

Explain + reference the idea of horizontal and verticle stressors in the family life cycle

Answer 19

Horizontal and vertical stressors (Carter & McGoldrick, 1980, 1999):
Horizontal stressors focus on why a current issue is hard to manage. Focuses on challenges over time, often linked to the developmental life cycle of the family. Require adaptation to new roles, boundaries, or patterns.
Vertical stressors focus on what deeper patterns may be influencing responses. Focuses on transgenerational patterns, scripts, or beliefs. Move downward through the family tree (e.g., unresolved grief, cultural expectations).

Question 20

Clinical tools to explore the family life cycle

Answer 20

Timelines/Lifelines
What: A visual or written map of important events, relationships, and turning points in a person or family’s life.
How: Individually or with multiple family members, highlights how different people make meaning of shared or separate events.
Why: Can reveal intergenerational patterns, helps position the problem in a temporal/relational context.
Advantages: Externalises experiences, supports narrative and meaning-making, highlights patterns and transitions, enhances collaboration and reflection, flexible, visually engaging.
Disadvantages: Emotionally activating, time-consuming, depends on client memory/willingness.
Genograms:
What: A family diagram (like a family tree), but with added information – relationships, roles, mental/physical health, emotional cut-offs, alliances, migration, trauma, etc.
How: Can be interactive/co-created, uses in early assessment to identify key figures, patterns, and roles.
Why: Can identify and track vertical stressors, identifies repeating cycles of trauma, estrangement, or parenting patterns, enables conversations about social graces.
Advantages: Reveals intergenerational patterns, enhances family insight and reflection, flexible, engaging and collaborative.
Disadvantages: Can be culturally biased, emotionally risky without containment, accuracy depends on client knowledge, time-consuming.

Question 21

3 key critiques of the family life cycle

Answer 21

1. Heteronormativity and cultural bias: Original models (e.g., Duvall, Carter, & McGoldrick) assumes a Western, middle-class, nuclear family structure. Doesn’t accommodate alternative family compositions.
2. Over-emphasis on linear progression: The original mode conceptualises family development as a linear sequence of stages. In reality, families often revisit or skip stages.
3. Neglect of structural or societal factors: The model largely focuses on intra-family processes, which runs the risk of overlooking broader social, economic, cultural, and political considerations.

Question 22

Brief background on what is narrative therapy + named reference

Answer 22

• A postmodern, collaborative therapy focused on helping people re-author their lives by changing the dominant, problem-saturated stories they live by
• Founded by Michael White (Australian social worker) and David Epson (New Zealand therapist) in the 1980s
• Assumes that identities are shaped through storytelling
• Problems are seen as separate from people
• Grounded in social constructionism - reality is not fixed, but constructed through language, relationships, and culture

Question 23

Key characteristics of family therapy (6)

Answer 23

1. Externalising: Separating the person from the problem.
2. Deconstruction: Breaking down dominant, oppressive cultural narratives.
3. Re-authoring conversations: Helping clients construct alternative, preferred stories.
4. Thickening the plot: Exploring and expanding on positive, overlooked aspects of people’s stories (Unique Outcomes)
5. Collaborative and respectful stance: The therapist is a “curious listener” rather than an expert imposing change.
6. Focus on values and meaning: Therapy is about what is important to the client, not about diagnosis.

Question 24

philosophical underpinnings of narrative therapy

Answer 24

Reality negotiated in relationships (social constructionism)
We become who we are through relationships - through how others perceive us and interact with us and how we make meaning of the social interactions (Combs and Friedman, 1999)
Reality is constructed through language (Combs and Freedman, 1998)
Words shape our reality rather than being a reflection of our reality
Shared meaning (meaning is not created individually but between people) and Social Action (acting in certain ways reinforces certain stories) - Gergen (2001), Shotter (1993)
Critical Theory – societal structures create marginalisation. People’s problems are shaped by unfair systems. Whose voices are not being heard?

Question 25

position of the therapist in narrative therapy (6)

Answer 25

1. Non-expert position - people are experts in their lives and have abilities to help themselves 2. Not knowing position - allowing to be guided by client’s story 3. Collaboration with client as senior partner 4. Holding hope 5. Care, interest, respectful curiosity, openness, empathy 6. Therapeutic relationship: co-author or co-editor

Question 26

What is externalisation in narrative therapy

Answer 26

Separating the person from the problem through shift in use of language Naming the problem as being external Focus on the relationship between the person and the problem Can externalise everything: Feelings (guilt, anxiety), Behaviour (mischief, weepiness), interpersonal problems (self-hate), cultural/social practices (racism, parent-blaming, sexism), violence and sexual abuse

Question 27

what is the effecys of externalisation in narrative therapy

Answer 27

Effects of externalisation: Shuts down internal problem saturated descriptions Opens up pathways for action against the problem Decreases guilt, blame, pathology What made you vulnerable to [the problem] What effects does [the problem] have on your life and relationships? In what contexts does [the problem] take over?

Question 28

3 processes we use to deconstruct the problem in narrative therapy (i.e., types of discourses)

Answer 28

dominant discourses local discourses unique outcomes

Question 29

what are dominant discourses in narrative therapy

Answer 29

Dominant discourses (Foucault, 1972): widely held cultural, social or political ideas that define what is ‘normal’, ‘good’, or ‘successful’ or ‘acceptable’. ‘Shoulds and goods’ ‘E.g.: Real men don’t cry, a successful life means being rich and famous, good mothers always sacrifice everything for their children DDs oppress or limit individuals by defining rigid norms Often create problem-saturated narratives Therapist’s role: help clients identify, question, and deconstruct these dominant ideas. Support clients in finding alternative values and preferred ways of being

Question 30

what are local discourses in narrative therapy

Answer 30

Local Discourses: personal, family, cultural or community-based beliefs and values that may differ from dominant societal narratives. Often marginalized voices. E.g. ‘in our family, caring for elders is the highest achievement.’ ‘Our community believes that strength comes from collaboration, not competition.’ Offer resources for resistance against dominant, oppressive narratives Provide alternative storylines that can supper a client’s preferred identity - can liberate people Therapist’s role: Help client reconnect with or uncover empowering local discourses. Validate and amplify these alternative values and practices in therapy

Question 31

what are unique outcomes in narrative therapy

Answer 31

Unique Outcomes: Events or experiences that don’t fit the dominant, problem-saturation story - exceptions where the client acted differently or resisted the problem. Purpose: to highlight client agency, challenge limiting narrative, and build preferred stories (e.g. A person who sees themselves as "always failing" is helped to notice times they succeeded)

Question 32

Explain how you would do the technique of unique outcomes in narrative therapy

Answer 32

1. Landscaping of Action (exploring the event) focus on actions, behaviours and choices 2. Landscaping of Identity (exploring the meaning behind action) - What does this say about the client’s values and preferred identity - Link actions to who they are/who they want to be 3. Thickening the Plot (building a richer, alternative story) - Connecting UO into a broader narrative - Find other examples, highlight consistencies - Naming the preferred story (e.g. ‘The journey of Courage)

Question 33

What is the role of the therapist in unique outcomes (4)

Answer 33

1. Attentive listening to spot moments that contradict the problem narrative 2. Evocative questioning (how did you manage to do that despite the problem? ‘Have There been other times when you resisted the problem’) 3. Thickening the alternative story - help explore the meaning of the UO, thickening these moments into fuller, identity-affirming stories 4. Linking events: help the client connect multiple UO across time, building a coherent, powerful alternative narrative

Question 34

Some creative methods in narrative therapy

Answer 34

Letter writing - helps the client place their experience into a narrative story - Strengths and accomplishments, alternative story and UO or exceptions to the problem - Can be re-read over and over Certificates - referring to the comments made about the younger you - celebrating success in overcoming an alleged ‘character deficit’

Question 35

Strengths of narrative therapy (7)

Answer 35

1. Empowers clients by separating them from problems. 2. Respects and amplifies client voice and agency 3. Focuses on social, cultural and political influences on identity 4. Flexible, adaptable across different cultures and contexts 5. Helps build new, hopeful life stories through Unique outcomes 6. Non-pathologising - avoids medicalizing problems 7. Strong alignment with social justice values

Question 36

Weaknesses of narrative therapy (6)

Answer 36

1. May not suit all clients (some may prefer a more structured, directive approach) 2. Relies on verbal ability 3. Risk of being too abstract (may feel too theoretical or detached from immediate, practical problems for some) 4. Risk of cultural mismatch if dominant narratives are deeply valued 5. Requires high skill from the therapist - danger of imposing own interpretations, force stories, externalise in clumsy ways - invalidating 6. Criticism from evidence-based practice - limited large-scale quantitative research evidence compared to CBT

Question 37

Background to Reflecting teams - key people who developed the approach and what they did

Answer 37

Origin: Reflecting Teams (1985) developed by Tom Andersen while working as a psychiatrist and family therapist in Norway. Evolution: Emerged as a post-Milan innovation, shifting from expert-driven models to collaborative dialogue processes. Purpose: Developed as a response to “stuck systems” – families who needed new perspectives/ideas to unlock change. Bateson Introduced “news of difference” to move shift systems. Believed Problems will arise when they debate which picture of reality is right. There will always be different versions of the problem. Influenced by: Bateson: " Creates differences that makes a difference ", reality is co-constructed by observers. Highlighted the importance of sharing different versions of the same world. Distinction between different kinds of difference Too small – unnoticed. Appreciable – noticeable and manageable. Too great – potentially disruptive or disorganizing to the system. Maturana: Emphasis on multiversa (multiple perspectives/realities), and role of observer in creating meaning. Stated 3 ways to foster variety, change and observerhood in a relationship: Through love To become a foreigner (don’t understand their point of view ) Pull back into loneliness to come back as a “small foreigner” (ideas are a little foreign)

Question 38

Milan Team Contribution to reflecting teams

Answer 38

Introduced key systemic ideas: circular questioning, neutrality, and hypothesising. Focused on the families belief system i.e. meaning of behaviour. Believed problems arise out of unhelpful beliefs. Change happens by perturbing the system, and introducing multiple perspectives that allow for new meaning-making and therefore change in patterns of interaction. Teams encourage creativity and diverse perspectives Used one-way mirror, but didn’t share reflections with families directly. Andersen shifted this by making reflections transparent and dialogical. Focused on process, moving away from structural and strategic approached leaving space for transparent process of reflections.

Question 39

4 elements to Andersons approach to reflecting teams (note this is part of the Milan approach)

Answer 39

1. Way of Being in Relationship – Emphasis on presence and relational stance. 2. Appropriately Unusual Comments – Introducing new perspectives in a gentle, thought-provoking manner. 3. Inner and Outer Dialogues – Balancing internal reflection with external communication. 4. Ethics of Dialogical Relating – Ethical commitment to openness, respect, and co-creation in dialogue. Note: Dialogical conversation - It is easier to hear reflections that are embedded in a conversation(Anderson, 1992)i.e. “Where did that idea come from..”, “ How does that influence your thinking”

Question 40

What was the post-Milan and post-Modern influence on reflecting teams + references

Answer 40

Emphasis on curiosity (Cecchin, 1988), not-knowing stance, collaborative language systems (Anderson & Goolishian, 1988). Knowledge is constructed through conversation, not discovered. Therapist becomes part of the system (Not an expert), co-creating new meanings with families (Burnham, 2011). As soon as we join a system it changes, a new system is created Stories are heard and understood based on our own experiences and beliefs(John Burnham)

Question 41

Explain the Embedded and Embodied (Hardham 1996) - reflecting teams

Answer 41

Moving between ’outer’ and ‘inner’ experiences and conversations Inner dialogue: The therapist’s private, emotional, and intuitive thoughts. Outer dialogue: The spoken reflections shared with the team or family. Therapists negotiate what to share—balancing insight with respect and usefulness.

Question 42

Explain the intentional use of the self in reflecting teams

Answer 42

Therapist use of self is the way in which the therapist draws upon their own feelings, experiences or personality to enhance the therapeutic process. The therapist must be reflective and reflexive in their approach. Intentionality in the use of self Crucial element in building a strong therapeutic relationship. According to Rober (1999), it involves the therapist consciously navigating their inner experiences and professional role to foster healing conversations, drawing on intuition, imagination, and creativity. This includes openly sharing personal reflections as part of the dialogue.

Question 43

What does Peter Rober (1999) say on the reflective process in reflecting teams (3 elements)

Answer 43

Peter Rober (1999) describes the reflective process as an inner conversation involving three key elements: 1. Inspiration – Being open to intuition, emotions, and mental images to create space for unspoken thoughts. 2. Courage – Turning intuition into therapeutic action by sharing responses with the family. 3. Observation – Watching how clients respond to these interventions, helping open up new possibilities for change.

Question 44

How we think about the problem in reflecting teams

Answer 44

Problems are located within relationships rather than with the individual and they notice a circular cause rather than linear. Problems are due to feedback loops and multiple factors interacting in the loop rather than having a singular cause. The therapy looks at shifting the interactions can break the cycles by changing the contribution of the relationships and communication patterns.

Question 45

How does a reflecting team work

Answer 45

The lead therapist conducts the session and introduces the reflecting team, explaining they may share reflections later. During the session, the therapist invites the team to discuss their observations, speaking in the third person. The team shares reflections either in a separate room or within the therapy space, while the therapist stays with the family. The team discusses their reflections for 2–10 minutes, then the therapist invites the family to respond.

Question 46

Reflection rules as part of the reflecting team

Answer 46

Reflections must be positive, not blaming, starting with highlights. (“Change only occurs via positive discourse”-Milan All comments should be speculative and tentative (e.g., "I’m not sure…"). Reflections should only address what was discussed in the session. Mirror the family’s style of reflecting (speed, rhythm). Present both sides of a dilemma (a both/and position). Avoid hypothesizing before reflecting. Talk to each other, not directly to the client, allowing them to listen without responding immediately. Value and explore different ideas, focusing on themes from the session. Reflect on dilemmas to present alternative solutions. Be cautious with non-verbal communication and always aim to be helpful in the moment. Try to situate your comments (ie locate your expertise – is it from your experience as a therapist, as a woman etc) Remember that the function of the reflecting team is to be helpful to clients at that moment in time, rather than to try to get closest to ‘the truth’.

Question 47

Explain + reference puppet shows in reflecting teams

Answer 47

Puppet Shows (Brown, 2013) use puppets to engage younger children (may be bored or bemused) in reflecting team processes, portraying family members and therapists in role plays. The process includes 3 phases: 1) Role play the family's problem-saturated story, RT represent family members and as the family members, they try to guess at each members negative feelings. 2) Introduce hopeful ideas, and 3) Therapist asks the family to respond and explore any inaccuracies.

Question 48

Explain + reference reflecting role plays

Answer 48

Reflecting Role Plays (Brown 2013) – This approach is more suitable for adolescents and adults and can help to open up the room for reflection via messages of hope. It can be helpful in moments when the therapist and family all feel “stuck” and the conversation feels repetitive or the session comes to a therapeutic impasse.

Question 49

Benefits of a reflecting team

Answer 49

Provides live supervision, allowing the team to observe details the therapist may miss, such as non-verbal cues. Offers additional support to the therapist, especially when feeling “stuck.” Helps flatten hierarchy and challenges power dynamics by discussing the family in their presence in a respectful, non-jargonistic manner. Allows families to hear reflections directly, reducing suspicion and encouraging openness. It can provide a helpful and effective way of challenging a family without threatening the therapeutic relationship.

Question 50

Common pitfalls of the reflecting team

Answer 50

Teams may talk for too long, leaving little time for family responses. Members may become competitive or overly focused on their own expertise. Power dynamics and the family’s previous relationship need careful consideration.

Question 51

what is transgenerational family therapy

Answer 51

Transgenerational Therapy is a type of family therapy that focuses on how patterns, behaviours, beliefs, and emotional issues are passed down from one generation to the next. It explores how family history, including unresolved traumas, roles, and dynamics, influence current family functioning and individual behaviour.

Question 52

Bowen's 8 key concepts

Answer 52

1. Differentiation The capacity of an individual to function autonomously by making self-directed choices while remaining emotionally connected to a significant system. Simply, how a person functions in response to the level of their anxiety. The ability to separate thoughts and feelings. Fusion – the tendency for family members to share an emotional response as a result of poor interpersonal boundaries (eg., can’t separate own feelings). When an entire family is fused: undifferentiated family ego mass. 2. Triangles Family groupings of three as building blocks of the family. I.e., a two person relationship is easily wobbled during stress so a 3rd is drawn in. This third is not always a person, could be pub, working late, an affair… 3. Nuclear family emotional process A family’s coping mechanism of the means to deal with tension and instability 4. Family Projection process You find a partner with similar level of differentiation Parents transmit their lack of differentiation to their children Describes how children get caught up in the previous generations anxiety about relationships 5. Multigenerational transmission processes Patterns, themes and roles in a triangle are passed down from generation to generation from projection of parent to child. It is the “presence” of the past 6. Emotional cut off The process of separation, isolation and withdrawal from the importance of one’s parental family. Achieved through physical distance or emotional withdrawal. A person may appear differentiated but has unresolved difficulties separating their thoughts from feelings. 7. Sibling position Birth order influences the roles people take in the family which is reflected in later relationships 8. Emotional processes in society The same principles that apply to the emotional system in family can be applied to society. During periods of societal anxiety, society responds emotionally with sticking plaster legislation that increase the problems.

Question 53

Idea of scripts in transgenerational family therapy + reference

Answer 53

Scripts (Byng Hall) can be defined as the family’s shared expectations of how family roles are to be performed within various contexts. Replicative (e.g., repeat what your parents did when you parent) Corrective (e.g., did not like how your parents did it so you correct this when you parent) Improvised (e.g., abandoning the rules, roles and routines prescribed in the family script and exploring new possibilities, options and solutions).

Question 54

The role of therapist and goal of therapy in transgenerational family therapy

Answer 54

Therapist as stable third / mediator. Therapist must be able to separate thoughts from feelings and manage emotional reactivity. Therapist must have healthy separation from own family of origin. Not a problem solver The goal of therapy is to assist family members towards greater levels of differentiation, where there is less blaming, decreased reactivity and increased responsibility for self.

Question 55

Therapeutic techniques in transgenerational family therapy

Answer 55

Genograms – aiming for connection Process questions – “What did you notice, what is this like” De-triangulation - stepping out of an emotional triangle and reducing emotional reactivity between family members. Coaching Taking “I” position Displacement stories

Question 56

EDI critique of transgenerational family therapy

Answer 56

Lack of cultural context. Draws on a Western idea of differentiation, how does this apply to collectivistic cultures where interdependence is valued over independence. Power? You can’t fully address family stress without considering external forces like housing insecurity, racial trauma, immigration status, or systemic barriers to healthcare and education. Developed in heteronormative, patriarchal context with limited guidance how to work with families which are not “nuclear families”

Question 57

Eplain the idea of circularity

Answer 57

In a system, problems are being maintained through ongoing cycles of interaction within a system rather than stemming from a single cause or individual. e.g., child's behaviour influences parental response which in turn shapes the child's future actions creating a cycle core part of Milan systemic family therapy model

Question 58

Bateson's view of power

Answer 58

The "Myth" of power concept of power is not applicable to relationships as this would view people as objects and not subjects with their own agency and influence. Instead people are interconnected and influence each other in a circular (as opposed to linear) way the notion of power is unethical and toxic in its effect....

Question 59

Haley's view on power

Answer 59

The reality of existence of power Power is viewed as a crucial element in understanding and resolving family conflicts Therapy as a power struggle. Therapist directly intervenes to challenge existing power structures to help the family

Question 60

feminist critique of family therapy and reference

Answer 60

Goldner (1985) * Inadequacy of family systems metaphor - a therapist would be impartial to violence in a relationship?! * Gender as a fundamental category * Mother blaming - the "over involved mother" * blindness to political dimensions * failure to recognise / adress abuse, violence and control.

Question 61

explain gender sensitive approach in family therapy

Answer 61

Gender: a person's learned or cultural status as feminine or masculine as distinct from biological status therefore a question may be how do we perform maleness and femaleness

Question 62

explain gender blindness in family therapy

Answer 62

what was happening in family therapy * assuming that remaining in a marriage would be better for women * demonstrating less interest to a woman's career over a mans (note how this often happens today, praise when dad attends therapy) * perpetuating the belief that a child's problem is primarily the woman's responsibility

Question 63

reflect on some of the power the therapist may have

Answer 63

define the problem determine access explicit - use title implicit - your role even without your title setting rules determine treatment control resources (eg time) control information

Question 63

definitions of power

Answer 63

coercion, control, dominance the ability to act, to name, to influence, to comment, to have a choice to put yourself in a place of safety

Question 64

family therapy, what is power and references

Answer 64

Falicov (1995) a shared world view derived from simultaneous inclusion and exclusion (e.g., from contexts, occupations, religions, races..) Krause and Miller (1995) culture is both a blueprint for behaviour, thoughts, feelings handed down generative and a changing body of ideas open to change and interpretation

Question 65

idea of immersed with regards to culture

Answer 65

culture provides us with beliefs, values and expectations that tell us how to go on Staying in known shared culture gives a comfortable certainty to life cultural assumptions are difficult to see from inside a culture, we are immersed but don't notice it also cultural iceberg - there is a huge base underwater which we cannot see but know is present

Question 66

explain the ideas of power, priviledge and intersectionality

Answer 66

power - the influence to control situations, people or resources priviledge - unearned advantage people have simply because of aspects of their identity intersectionality - helps us understand that individuals experience power and priviledge differently based on the intersection of multiplease aspects of their identity

Question 67

self-reflexivity and reference

Answer 67

taking a position of observing one's own practice and using this act of observation to recalibrate how one acts in relation to others burnham 2010 go from unawareness to awareness to reflection to reflexivity