Chapter 18 Flashcards
Canadian rate of marriage (. per 1000 ppl)Average age of marriage for canadiansize of avg family?
4.4 per 1000ppl married30 years is average age of marriage2.5 is avg size for family
divorce rate for first marriage? additional marriages?
40% for first marriage10% each additional marriage
types of families
nuclear: husband wife childrenmultigenerational: 3 gens (kids parents gparents)single-parentremarried (prev. married partner w/ children)dual-career family: what it sounds likechildless: omg!aging: heads of household 65+gay/lesbian: w/ or w/o kidsmulticultural family
3 events that has had an impact on the family since WWII
-sharp rise in divorce rate, has since leveld at 40%-changing role of women, more working outside the home-expanding lifespan
systems theory
“a generic term for conceptualizing a group of related elements (people) that interact as a whole entity (family or group).
TEXT 3 basic assumptions of systems theory counselling that distinguish it
- causality is interpersonal2. psychosocial systems best understood as repeated patterns of interpersonal interaction3. symptomatic behaviors must… be understood from an interactional viewpoint
circular causality
ongoing circular feedback loopsevents related thru series of interacting feedback loops(vs. normal linear causality)
largest oldest professional association in states for accredited marriage & family counsellors
American Association for Marriage and Family Therapy6 schools in canadareq. minimum of master’s degree for accreditation
approx __% of all problems brought to counsellors are related to marriage and family issues
50% of all issues!
facts about family therapy efficacy
-at least as effective as individual therapy, lead to greater durability of change–some forms of family counselling more effective at some problems than individual approaches -presence of both parents, ESP. noncompliant fathers, greatly improves chances for success-when family counselling not offered to couples systematically, intervention can be NEGATIVE/worse-high client satisfaction, 97% rating services as good to excellent
family lifecycle! 9 stages
- Unattached adult: Accepting parent-offspring separation2. Newly married: Commitment to the marriage3. Childbearing: Accepting new members4. Preschool-age child: Accepting the new personality5. School-age child: Allowing child to establish relationships outside the family6. Teenage child: Increasing flexibility of family boundaries7. Launching center: Accepting exits from and entries into the family8. Middle-age adult: Letting go of children and facing each other9. Retirement: Accepting retirement and old age
family circumplex model, what measures?
family adaptability (ability to be flexible and change).b to t: rigid, structured, flexible, chaoticfamily cohesion (emotional bonding).l to r: disengaged, separated, connected, enmeshed-middle is most healthy
Triangulation
“a dysfunctional pattern of involving a third party to cope with a strained relationship”Involving a kid… A parent might not get along with partner, so gets closer to kidOr calls mom to deal with a conflict with partner, instead of addressing the conflict with the person in question
Enmeshment
refers to “family environments in which members are overly dependent on each other or are undifferentiated”
TEXT differences between group therapy and family therapy
-family members are NOT equal in status and power like in group therapy-families may perpetuate myths, groups more objective-more emotional baggage
TEXT questions to ask when initially working with a family
-outward appearance of family?-repetitive nonproductive sequences noticeable?-basic feeling state of family, who carries it?-what individual roles reinforce family resistance, what are most prevalent family defenses?-how are family members differentiated from each other? what are the subgroup boundaries?-what part of life cycle is family experiencing, what are it’s problem solving methods?
TEXT rules for couples counselling
-see both members FROM BEGINNING.if one member tries to change w/o other’s knowledge, conflict can ensue-treating one spouse alone for two sessions can increase other’s resistance to counselling and anxiety.best to see individually once equally at beginning, or half session each
TEXT identified patient
an individual who is seen as the cause of trouble within the family structure–whom family members use as their ticket of entry
structure (or FAMILY RULES)
implicit and explicit rules that govern interactions within the system (family) and subsystems
equifinality
many ways to reach outcomes, and every family has different starting points!-focus on interactional family patterns rather than conditions or events (e.g. a tragedy can make families stronger OR weaker)
non-summativity
family is greater than the sum of its parts (look at the interaction patterns over individual actions)
morphogenesis
.ability of family to modify its functioning to meet changing demands of internal and external factors.usually requires SECOND ORDER CHANGE over FIRST ORDER CHANGE .prof said just “first order and second order changes…”
homeostasis
.steady equilibrium that a family balances to, can be GOOD or BAD
TEXT redundancy principle
part of “family rules,” most families operate on a small set of predictable rules
TEXT communication
all behavior seen as communicative, interpersonal messages have two functions: content (factual info) and relationship (how msg is understood).WHAT of a msg conveyed by how it is delivered
genogram
graph of generations of family, almost like a family tree.outlines behaviors and rls between family members, health problems, heritage, occupation…-helps understand person-to-person rls
premises upon family/marriage/couple therapists operate
- counsellor is psychologically healthy and understand their own families well, and not in conflict2. equal in treatment to all family members, no favoritism3. counsellor wins battle for structure (their paramaters), family wins battle for initiative (their motivation to make changes)4. counsellors should have some life experience
pre-session planning and initial sessions
pre.get basic demographic info and issue, know what getting intoinitial.working alliance huge, getting a good start w/ first sessions pivotal to success.gain ‘frames,’ or perspective on how each individual views a presenting problem.look for ‘couple or family dance’ the way they typically interact on a verbal/nonverbal level.function mostly as observer
TEXT 3 techniques for creating working alliance in therapy w/ family
maintenance: counsellor affirms/supports a couple’s or member’s positiontracking: counsellor tracks sequence of events thru clarifying qsmimesis: counsellor adopts a couple/family’s style or tempo, serious or jovial depending
TEXT circular questioning
asking the same question to each family member, highlighting differences and dynamics.if ask how daughter responds when verbally attacked by wife, ask how EACH MEMBER of family responds when verbally attacked by wife
Second order change
SECOND ORDER CHANGE (ability to make entirely new response, changes to actual rules within system) .this is what is most hoped for in systems counselling, but harder!
First order change
FIRST ORDER CHANGE (doing more of same things worked previously, change within that system, easier).often superficial changes
TEXT middle phase of marriage/couple/family counselling
-make needed changes if at all-new behaviors, take chances-unsure systems make first-order changes first, usually superficial, set curfew back an hour-counsellor links family with appropriate outside agencies if needed (AA)-look for even subtle changes from beginning of treatment (even seating arrangement in session)-push for greater change if needed-give homework (setting aside time for convo) or psychoeducational assignments (reading book or video) to complete TOGETHER!!!! bonding
TEXT termination
-summarize and CELEBRATE work accomplished-create long-term goals-predicting and accounting for SETBACKS-follow-up, conveys care and lets couples/families know there is an invitation to come back if they need one
Murray Bowen?
-founder of Bowen Systems Theory-believed there is chronic anxiety in all life.hi anxiety = few problems in family.lo anxiety = chronic dysfunction-previous generations can pass down dysfunction!-focus on cognitive processes
differentiation (bowen)
-distinguishing one’s thoughts from emotions and oneself from others-focus of bowen’s systems theory, creating a healthy self-concept, not get overstressed when a rl experiences difficulty
according to bowen, if great deal friction exists in marriage, less mature partners will display… what and what?
fusion (undifferentiated emotional togetherness, like enmeshment)cutoff (physical or psychological avoidance).when stressed, these people also tend to triangulate
TEXT bowen systems therapy: techniques
-genogram-get client to ask questions of family members, of significant events, promotes person to person rls at dyadic level (content-based questions)-detriangulation
TEXT bowen systems theory: strengths/limitations
strengths.focus on multigenerational family history and patterns therein.genogram, originated in this approach.cognitive emphasis, differentiation and detriangulationlimitations.extensive and complex, too much investment req’d.the severely dysfunctional benefit most
salvador minuchin.summarize his theory
.founder of structural family counselling.every family has a structure, the informal way it is organized and interacts.counsellor works to modify underlying structure, changing interactional patterns and establishing clear boundaries.action emphasized over insight
TEXT structural family counselling: coalitions & cross-generational alliances
coalitions: alliances between specific members against a third membercross-generational alliances (alliances between family members of two diff generations)ALL TO BE AVOIDED
structural family counselling: punctuation
punctuation: highlighting or emphasizing an interaction between two people”i noticed when u talked bout last night, partner looked w/ disapproval LOLZ”
structural family counselling: unbalancing
Unbalancing.opu do something to unbalance the homeostasis in the system.maybe you empower someone with little power in the system/relationship, watch how those dynamics shift change and adjust
structural family counselling: enactment
Enactment: ask people to reenact fights in front of you… Lol-demonstrate problematic behavior in session, counsellor can challenge existing patterns/rules as they happen
structural family counselling: intensity, restructuring, boundary making, adding congitive constructions
intensity: hi emotional reactivity, to family?restructuring: what it sounds like (disobeying family rules/norms)adding cognitive constructions: giving advice or suggestions to the system
structural family counselling: strengths/limitations
strengths-versatile for all families, culturally sensitive-efficacy, pragmatic, clear in definition and termslimitations-not complex enough, may be sexist, too present-focused-counsellor has too much power-hard to distinguish from strategic family counselling
strategic brief counselling: basics
-several branches-limited sessions (t working-if behaviors modified, SPILLOVER EFFECT, other individuals will make changes as well
strategic brief counselling: 4 dimensions of family life
focus on….family rules: overt/covert family rules used to govern themselves.family homeostasis: tendency to remain in same patterns unless challenged.quid pro quo: family members treat others they way they are treated.circular causality: idea that events are interconnected, factors behind behavior are multiple
strategic brief counselling: techniques
relabelling: this behavior is not rude, it’s assertiveparadoxing: opposite of what one wants?prescribing the symptom: fight at least 3 times this week (shows have control over symptoms)pretend: homework wouldn’t do otherwiseordeals: suffer, sacrifices make long-term improvements enhanced
strategic brief counselling: strengths/limitations
-strengths.therapists work in teams.pragmatic, flexible.creative and innovative.one problem at a time.can be used in other settings (like schools)limitations..overlap w/ other theories.weird people leading.maybe doesn’t encourage independence
emotion-focused couples and family therapy (EFCFT): basics
-sue johnson & les greenberg-relationships at core of human experience-grounded in attachment theory and emotion focused-“emotion is the music of the interactional dance. change the music, change the dance”-unmask primary emotions, anger is secondary emotion, usually masks invalidation, abandonment, sadness, whatever
emotion-focused couples and family therapy (EFCFT): 5 stage framework
I. validate and establish working allianceII. de-escalate negative cycle that has developedIII. access underlying feelingsIV. restructure negative communicationsV. consolidate and integrate the changes
emotion-focused couples and family therapy (EFCFT): techinques
-reflection of emotion-tracking and reflecting interactional patterns-validating each person’s experience-evocative questions-heightening-interpreting-reframing-enactments
emotion-focused couples and family therapy (EFCFT): strengths/limitations
strengths.empirically supported, validated.versatile, applied to many problems and populations.interventions/strategies are clearlimitations.efficacy evidence comes from founder lol.some evidence done on less distressed families.not good with violence.some cultures that don’t like emotion expression might hate it
effectiveness/limitations of marriage/couple/family counselling in general
strengths-appropriate for children psychological (schizo, depression, anxiety) and behavioral (substance abuse, delinquency) problems-some promise for video-conferencing!-b/t 40-50% of couples attain complete recovery!limitations-does not work for every disorder (esp. autism, ADHD)-no uniform theory-no support for including children-longitudinal follow-ups show limited recovery and rl decline sometimesfuture-push for evidence-based therapies
