Constructivist Models: Narrative, Collaborative Language-Based Systems, Multicultural Family Therapy Flashcards
Modernism vs. Postmodernism
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
Postmodern Views
“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
Social Constructionism
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
5 Main Constructivist Models
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)
Inventive Questioning
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
Reflexive Questions
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
Feminist Family Therapy
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
Collaborative Language Systems
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
Assumptions
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
Normal development and dysfunction in Social Constructionism means…
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”
Goals of Social Constructionism
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
Solution Focused Therapy
(SFT)
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
Normal development and dysfunction in SFT means…
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
Stance of the SFT therapist
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
SFT Assumptions
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
SFT Treatment Goals
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
SFT Levels of commitment to change
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
SFT - The Death of Resistance
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
Assumptions of Narrative Therapy
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
Founders of Narrative Therapy
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
Normal development and dysfunction in Narrative Therapy is…
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
Narrative Therapy goals of treatment
Deconstruct problem-saturated stories and dominant cultural
discourses
Co-author new, more helpful stories
Narrative Questions
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?”
Narrative Therapy - Externalizing and Personifying
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”
Deconstructing and Mapping
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?”
Unique Outcomes and Sparkling Moments
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?”
Reconstructing and reinforcing a new narrative
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
