Ch. 7 Process of Family Therapy Flashcards
Lambert’s 4 common “curative” factors
extratherapeutic factors (accounts for 40% of change) the therapeutic relationship (accounts for 30% of change) expectations, hope, and placebo (accounts for 15% of change) model and techniques (accounts for 15% of change)
In family therapy, the client is …
the family relationship
Two primary components of family therapy are …
content and process.
redirection
technique in which the therapist asks the couple or family to attend to the process of their relationship instead of its content.
5 errors of overemphasis in family therapy
focusing on details (collecting content and neglecting process)
trying to make everyone happy
Focusing too much on verbal expression Coming to an early or too easy resolution
focusing on one member of a family
5 errors of underemphasis in family therapy
Neglecting establishing structure,
Conveying too little empathy
Not engaging each family member in the therapeutic process
Not letting the family work on its problem and thus win the battle for initiative
Not attending adequately to nonverbal family dynamics
7 tasks of initial family sessions
1 build rapport.
2 Inquire about members’ perceptions of the family.
3 Observe family patterns.
4 Assess what needs to be done.
5 Engender hope for change and overcome resistance.
6 Make a return appointment and give assignments.
7 Record impressions of family session immediately
10 tasks associated with the middle phase of family therapy
1 Involve peripheral family members.
2 connect family members.
3 Establish contracts and promote quid pro quo relations.
4 Emphasize some change within the family system.
5 Reinforce family members for trying new behaviors.
6 Stay active as a therapist.
7 Link family with appropriate outside systems. 8 Focus on process.
9 Interject humor when appropriate.
10 Look for evidence of change in the family
four steps of termination process
orientation
summarization
discussing long-term goals
follow-up
battle for initiative
the struggle to get a family to become motivated to make needed changes.
battle for structure
the struggle to establish the parameters under which family therapy is conducted
clinical notes
the written impressions of a couple or family taken down soon after a session is over, including progress toward a treatment plan.
coalition
an alliance between specific family members against a third member.
distancing
the isolated separateness of family members from each other, either physically or psychologically.
enhancers for family therapists
these include
an increased ability to solve one’s family problems,
an acceptance of one’s part in contributing to family dysfunctions,
a deeper appreciation of one’s family, and
a greater ability and desire to communicate effectively.
enmeshment
loss of autonomy due to overinvolvement of family members with each other, either physically or psychologically.
family dance
the verbal and nonverbal ways in which a family displays its personality.
follow-up
an appointed time with the family several weeks or months after formal treatment has ended. The family is again reinforced by the therapist in regard to competencies and ability to maintain or continue change.
frame
a perception or opinion that organizes one’s interactions.
homework
tasks clients are given to do outside of therapy session. Marital and family therapies noted for giving home-work assignments are behavioral, cognitive–behavioral, psychodynamic, systemic, structural, and postmodern approaches.
joining
the process of “coupling” that occurs between the therapist and the family, leading to the development of the therapeutic system. A therapist meets, greets, and forms a bond with family members during the first session in a rapid but relaxed and authentic way and makes the family comfortable through social exchange with each member.
major stressors for a family therapist
these include
increased depression from listening to a client family’s problem,
less time for one’s family because of work demands,
unrealistic expectations of one’s family, and psychological distancing from one’s family because of professional status.
paradox
a form of treatment in which therapists give families permission to do what they were going to do anyway, thereby lowering family resistance to therapy and increasing the likelihood of change.
patterns of communication
the ways in which family members relate to one another—for example, through double messages, withholding of information, or overgen-eralization.
power
the ability to get something done. In families, power is related to both authority (the decision maker) and responsibility (the one who carries out the decision).
reorient
an Adlerian process that focuses on helping families change what they are doing
roles
prescribed and repetitive behaviors involving a set of reciprocal activities with other family members or significant others; behaviors family members expect from each other and themselves.
rules
implicit or explicit guidelines that determine behaviors of family members.
scapegoat
a member that the family designates as the cause of its difficulties
SOLER
an acronym, each letter of which stands for the way professional skills may be shown. S stands for facing the couple or family squarely, either in a metaphorical or literal manner. The O is a reminder to adopt an open posture that is nondefensive. L indicates that the therapist should lean forward toward the client family to show interest. E represents appropriate eye contact. R stands for relaxation.
structuring behavior
a general term in family therapy for describing the activity of a therapist in teaching and directing.
subsystems
smaller units of the system as a whole, usu-ally composed of members in a family who because of age or function are logically grouped together, such as parents. They exist to carry out various family tasks.
supportive behavior
a general term in family therapy for describing the giving of warmth and care by a therapist.
typical day
an Adlerian technique of having a family explore the processes and interactions they go through daily in order to understand themselves better.
