Constructivist Models: Narrative, Collaborative Language-Based Systems, Multicultural Family Therapy

Question 1

Modernism vs. Postmodernism

Answer 1

Prior to 1980s: Modernism
 Absolute Truths/Universals; families operate according to implicit
laws of interaction
 Interest in cognitive sciences
 Therapist was a technical expert who could diagnose and repair
family systems
1980s: Postmodernism
 Reality is socially constructed; meaning emerges from interactions
between people
 Interest in semiotics, hermeneutics, narrative, and linguistics
 Science is a product of one’s perspective, as well as of dominant
discourses in culture

Question 2

Postmodern Views

Answer 2

 “Where a society says, ‘that’s just the way it is,’ there is mythology” –
Joseph Campbell
 Constructivism: the idea that “human experience is fundamentally
ambiguous.”
 Meanings are assigned – e.g. “chair,” “love”
 Challenges essentialism (things are the way they are because that’s
natural) and authoritarianism
 Social constructionism: taking constructivism one step further,
looking at the cultural influences on how we construct reality
 All beliefs have origins, even those assumed to be laws of nature –
e.g. “killing people is wrong”
 New constructions may lead to new ways of being
 Neither therapist nor client has a corner on the truth – their
identities influence their truths

Question 3

Social Constructionism

Answer 3

Lynn Hoffman
 The observer cannot be separated from the thing being observed,
so it is not possible to be completely objective
 The “self” is socially constructed
 No standards for normal development
 Emotions are not an internal state, but are determined by context
 Product of language or discourse
 Communication has no underlying, consensual meaning, but is
subjective
 Therapists participate in the construction of reality for our clients
and are not experts
- Focus attention to language and meaning
- Therapy and outcome is jointly constructed
 Reject the systemic view of families
- No inherent patterns of communication

Question 4

5 Main Constructivist Models

Answer 4

 Inventive Questioning (Tomm)
 Reflecting Team (T. Anderson)
 Collaborative Language Systems (Anderson and Goolishan)
 Solution-Focused Therapy (de Shazer and Berg)
 Narrative Therapy (White and Epston)

Question 5

Inventive Questioning

Answer 5

Karl Tomm
 Psychiatrist in Calgary, Canada
 Principal translator for Milan model in North America
Influenced by Milan group
 Hypothesizing
 Circularity
 Neutrality
Strategizing
 Construct questions not to just gather info but to induce change in
system as well
 Reflexive Questions

Question 6

Reflexive Questions

Answer 6

 Future-oriented questions
- To stimulate new options for the future
 Observer-perspective questions
- To stimulate self-observations
 Unexpected counterchange questions
- To alter the context in which the problem behavior is viewed
- To open up choices not yet considered
 Embedded suggestion questions
- To allow the therapist to point to new possibilities
 Normative-comparison questions
- Normalize circumstance by comparing to other people in similar
circumstances
 Distinction-clarifying questions
- To separate the components of a problem
 Questions introducing hypotheses
- To offer tentative hypotheses about the meaning of the problem
 Process-interrupting questions
- To create sudden shift in the therapeutic session

Question 7

Feminist Family Therapy

Answer 7

 Challenge traditional family roles by questioning gender roles and
their stereotyping and how these have affected the family
 No separate model
 Motivated by active concern with justice and desire to contribute to
overcoming of women’s subordinations
 Focus on gender norms as “embedded in language, culture, and
experience, and [are] thus subtly communicated and internalize
from the moment of birth”
 Pathology of female experience
 Faults other models for favoring masculine values and assuming
equal-power and control
 Therapy should be egalitarian
 May use unbalancing to align with females when power differential
is present in session

Question 8

Collaborative Language Systems

Answer 8

 Harlene Anderson and Harry Goolishan (1960s)
 Multiple Impact Therapy
 Influenced by post-Milan group that challenged cybernetic
approaches
 Houston-Galveston Institute
- Training center for family therapy
 Other contributors: Lynne Hoffman, Tom Anderson, Ken Gergen,
Sheila McNamee, John Shotter

Question 9

Assumptions

Answer 9

 Person’s reality/knowledge is socially constructed and maintained
through dialogue, which emerges as a narrative reality
 Each session is unique and therapist has no preconceived notion of
how things should be
- “Not knowing” position: non-expert position
- Helps clients to become experts in own lives
- Takes state of “being informed” by the client
 Transparency on part of therapist
- Role = co-explorer, offers perspectives, not an answer or solution
 Frequency, duration, and termination of sessions are determined
and negotiated on a session-by-session basis with input from all
members of the family and therapy team

Question 10

Normal development and dysfunction in Social Constructionism means…

Answer 10

 Meaning is created through language and social discourse
 Problems and solutions are also socially constructed
- Not fixed, concrete entities
- Something that someone is worried about and wants to change
 Problems develop a “problem-determined system”
- Made up of people who wish to talk about the problem (e.g. family
members, teachers, members of agencies, etc)
- Therapist is not separate from the problem system
 “Problems are stories that people have agreed to tell themselves”

Question 11

Goals of Social Constructionism

Answer 11

 Dissolution of the problem system as a result of “evolution of new
meaning through the narratives and stories created in the
therapeutic conversation and dialogue”
- Once problem is “dissolved”, so are the systems around which it
was organized
 Client-therapist conversation
- Collaborative
- Mutual search and exploration through dialogue in which
meanings are continually evolving
- Linguistic process of co-creating stories

Question 12

Solution Focused Therapy
(SFT)

Answer 12

 Steve de Shazer and Insoo Berg
 Brief Family Therapy Center (Milwaukee, WI)
 Late 1970s
 MRI Influence (de Shazer)
 Dedicated to brief treatment
 Adhere to minimal intervention
 Do not emphasize underlying pathology or family history
 Focus attention away from problems and help identify and repeat
behaviors that have previously been helpful
 Solutions develop by emphasizing previous successes while
deemphasizing the problem

Question 13

Normal development and dysfunction in SFT means…

Answer 13

 No “normative’ model
 No single “right way” to live and act
 Thus, no need to analyze conceptual ideas of patterns, structures
 Difficulties exist when people engage in problem-focused thinking
rather than their own competencies to solve problems

Question 14

Stance of the SFT therapist

Answer 14

 Work collaboratively with clients to negotiate achievable goals
 Believe that clients have the ability to solve their own problems with
only slight shifts in how they behave or view problems
 Ability to convey hope and understanding through use of solution
focused language
 Can be helpful to first validate previous difficulties and experience
of the problem
 Highlight exceptions to the problems and design interventions to
amplify non-problematic patterns

Question 15

SFT Assumptions

Answer 15

 Small changes in ways families view themselves and abilities to
solve problems will result in significant improvement in ability to
reach goals
 No need to attend to hypothetical underlying causes

Question 16

SFT Treatment Goals

Answer 16

 Shift talking about problems to talking about solutions
 Identify resources
 Build on successful past solutions and problems
 When clients can begin to focus on exceptions and engage in non
problematic behavior, over time, exceptions become the norm

Question 17

SFT Levels of commitment to change

Answer 17

 Visitor
- No specific problem
- No commitment to participating productively in treatment
 Complainant
- Brings specific problem
- Currently unwilling to focus on solution
 Customer
- Brings problem and willingness to work toward its resolution
- Therapist gives compliments
- Leans on relationship to move therapy forward
- Gives compliments AND an assignment, asking client to observe
for exceptions
- Can progress beyond solutions focused language, compliments,
and assignments to amplify behaviors in moving client toward
goals

Question 18

SFT - The Death of Resistance

Answer 18

 Your ideas of resistance might be pre-construed
- Self- or Person-of-the-Therapist is a helpful construct here
 In SFT, “resistance” does not exist
- Either clients are using their natural protective mechanisms or
realistic desire to be cautious and go slowly, or the therapist has
not yet found an intervention that fits the client’s solution

Question 19

Assumptions of Narrative Therapy

Answer 19

 No absolute reality
- Reality is constantly being constructed (including during therapy)
 “Self” is not a stable entity but rather a “constitutionalist self”,
continuously deconstructed and reconstructed through interactions
- Sense of self derives from dominant narrative
 People are not their problems
- Avoids diagnosing and labels
- Problems are external to a person and exert an influence on him
or her
 View problems within social context
 Therapy is designed to collapse the historic, emotional response of
family members to the subjugated story
- Techniques are designed to generate neutrality
 Goal of therapy: create a new narrative that emphasizes their
preferred way of relating to themselves in the larger culture

Question 20

Founders of Narrative Therapy

Answer 20

Michael White (Australia)
 Influenced by cybernetics’ information processing & effects of
cognitions on behavior
 Society’s discourses (large scale narratives) maintain distribution of
power
 Influenced by Bruner’s “The Narrative Construction of Reality”
(cognitive psychology)
David Epston (New Zealand)
 Focused on individual narratives that people construct
 Developed line of questions to draw out people’s stories
 Recognized need for client support system
- Leagues (linking clients with similar problems)
- Letter-writing

Question 21

Normal development and dysfunction in Narrative Therapy is…

Answer 21

 No specific notions about normal development
 Avoid categorization and labeling of problems with diagnoses
 Awareness of larger societal pressures and discourses and their
influences
 Narrative stories exert powerful influence over lives of clients
- Some are more helpful than others
- People are not viewed as dysfunctional, but rather under the
influence of “problem saturated stories”
- Stories affect what they notice and how they understand
experiences
- Tend to select data that supports stories and ignore data that does
not
 Problems also exist because of negative social, political, and cultural
influences that affect narratives
- Internalization of dominant cultural norm

Question 22

Narrative Therapy goals of treatment

Answer 22

 Deconstruct problem-saturated stories and dominant cultural
discourses
 Co-author new, more helpful stories

Question 23

Narrative Questions

Answer 23

 Deconstruction Questions: externalizing the problem
- “What does Depression try to tell you to do?”
 Opening Space Questions: uncovering unique outcomes
- “Has there been a time that Guilt did not take control over your
life, even when you might have expected it to?”
 Preference Questions: ascertaining if the unique outcome is
preferred
- “Do you think this way of reacting was better or worse?”
 Story Development Questions: broadening the story from the
unique outcomes
- “Who will notice your new way of handling these situations?”
 Meaning Questions: developing a more positive view of self
- “What does this new reaction say to you?”
 Questions to Extend the Story into the Future: reinforcing the
positive changes
- “What will your life be like now that Fear does not have the upper
hand?”

Question 24

Narrative Therapy - Externalizing and Personifying

Answer 24

 First goal: identify and externalize (separate the person from) the
problem
 Once identified, the problem is personified
- Portrayed as an unwelcome invader that tries to dominate the
family members’ lives
- Unites the family against the common enemy of “the problem”

Question 25

Deconstructing and Mapping

Answer 25

Ask questions to draw out the effect that the problem has on clients’ lives
 Thin description: “Dad is depressed”
 Questions:
- “How does Depression convince Dad to stay in bed rather than
going to work?”
- “How often is Mom able to fight Depression’s wish to curtail their
social interactions?”
- “What do you think that Depression has in store for your lives?”
 Externalized, thick description: “Dad is a person who at times is
overcome by the family’s common enemy, Depression”

Explore the influence of socio-cultural norms, which can be internalized as problems
 “How did you come to believe that in order to be a strong man, you had to hide your emotions?”

Question 26

Unique Outcomes and Sparkling Moments

Answer 26

 Though clients initially hold to the dominant narrative, many
alternative subjugated stories exist
- Obscured by dominant story
- Some are helpful, some are not
 Help clients construct a new, more helpful story that includes
unstoried competencies
- “landscape of action” questions: gather info about times that family
was able to resist effects of problem
- Unique outcomes; sparkling moments
 “Can you remember a time that Depression threatened to create a
distance in your relationship, but didn’t?”

Question 27

Reconstructing and reinforcing a new narrative

Answer 27

 Therapist helps client to broaden and strengthen view of self by
including the past and the future
- “Who in your past would not be surprised to learn that you were
able to resist the forces of Depression on those occasions?”
- “What do you think your marriage will look like now that you don’t
let Depression make your decisions?”
 Landscape of meaning questions: Helps clients to consider a new,
more heroic view of self
- “What does it say about you as a person that you were able to
fend off Depression last week?”
 Therapeutic letters: Therapist documents client’s competencies in
overcoming the problem and acknowledges the sparkling events
 Leagues: Groups of people coming together who are working on
similar problems to provide support for the construction and
maintenance of new narratives