Ch. 7 Process of Family Therapy

Question 1

Lambert’s 4 common “curative” factors

Answer 1

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)

Question 2

In family therapy, the client is …

Answer 2

the family relationship

Question 3

Two primary components of family therapy are …

Answer 3

content and process.

Question 4

redirection

Answer 4

technique in which the therapist asks the couple or family to attend to the process of their relationship instead of its content.

Question 5

5 errors of overemphasis in family therapy

Answer 5

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

Question 6

5 errors of underemphasis in family therapy

Answer 6

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

Question 7

7 tasks of initial family sessions

Answer 7

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

Question 8

10 tasks associated with the middle phase of family therapy

Answer 8

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

Question 9

four steps of termination process

Answer 9

orientation
summarization
discussing long-term goals
follow-up

Question 10

battle for initiative

Answer 10

the struggle to get a family to become motivated to make needed changes.

Question 11

battle for structure

Answer 11

the struggle to establish the parameters under which family therapy is conducted

Question 12

clinical notes

Answer 12

the written impressions of a couple or family taken down soon after a session is over, including progress toward a treatment plan.

Question 13

coalition

Answer 13

an alliance between specific family members against a third member.

Question 14

distancing

Answer 14

the isolated separateness of family members from each other, either physically or psychologically.

Question 15

enhancers for family therapists

Answer 15

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.

Question 16

enmeshment

Answer 16

loss of autonomy due to overinvolvement of family members with each other, either physically or psychologically.

Question 17

family dance

Answer 17

the verbal and nonverbal ways in which a family displays its personality.

Question 18

follow-up

Answer 18

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.

Question 19

frame

Answer 19

a perception or opinion that organizes one’s interactions.

Question 20

homework

Answer 20

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.

Question 21

joining

Answer 21

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.

Question 22

major stressors for a family therapist

Answer 22

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.

Question 23

paradox

Answer 23

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.

Question 24

patterns of communication

Answer 24

the ways in which family members relate to one another—for example, through double messages, withholding of information, or overgen-eralization.

Question 25

power

Answer 25

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).

Question 26

reorient

Answer 26

an Adlerian process that focuses on helping families change what they are doing

Question 27

roles

Answer 27

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.

Question 28

rules

Answer 28

implicit or explicit guidelines that determine behaviors of family members.

Question 29

scapegoat

Answer 29

a member that the family designates as the cause of its difficulties

Question 30

SOLER

Answer 30

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.

Question 31

structuring behavior

Answer 31

a general term in family therapy for describing the activity of a therapist in teaching and directing.

Question 32

subsystems

Answer 32

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.

Question 33

supportive behavior

Answer 33

a general term in family therapy for describing the giving of warmth and care by a therapist.

Question 34

typical day

Answer 34

an Adlerian technique of having a family explore the processes and interactions they go through daily in order to understand themselves better.