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CPCE/NCE Prep > Counseling and Helping Relationships (6/6) > Flashcards

Counseling and Helping Relationships (6/6) Flashcards

Family Counseling

1
Q

Paradigm shift of going into family counseling

A

rather than individual perspective (of individual therapy), must shift into looking at problem definition and problem resolution from a systems perspective

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2
Q

Reciprocal determinism

A

every member can influence and be influenced by every other member in a continuous process

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3
Q

Linear causality

A

one event causes another in a unidirectional fashion such as found in a stimulus-reponse sitation
simple, straightforward language (context) may explain what is occurring

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4
Q

Circular causality

A

there are forces moving in many directions at the same time so the influences and results impact each other resulting in a complex array of outcomes
the explanation of what is occurring in this situation focuses on the process

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5
Q

Differences between individual and family counseling theories

Locus of pathology

A

family counseling views the locus of pathology not within the individual but within the social context of the individual, ordinarily the family

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6
Q

Differences between individual and family counseling theories

Focus of treatment interventions

A

The focus of treatment of the family counselor is on the family rather than the individual even though a particular individual may be the identified client or patient

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7
Q

Differences between individual and family counseling theories

Unit of treatment

A

because the locus of pathology is the family, the unit of treatment in family counseling is the family not the individual

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8
Q

Differences between individual and family counseling theories

Duration of treatment

A

individual psychotherapy is often focused on problems of a long-standing nature, and thus long term counseling is indicated
- family counseling attempts to provide brief counseling to resolve current family problems
- the duration of family counseling may be shorter than individual therapy

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9
Q

Life cycle of a family warning

A

don’t reduce family development into discrete, identifiable, common stages
the cycles and stages of family development within a particular class or culture are dynamic

For many families, the cycle may look like this:

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10
Q

Life cycle of a family
Leaving Home: Emerging Young Adults

A

single young adults
accepting emotional and financial responsibility for self

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11
Q

Life cycle of a family
Joining of Families Through Marriage/Union

A

commitment to new system

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12
Q

Life cycle of a family
Families with Young Children

A

accepting new members into the system

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13
Q

Life cycle of a family
Families with Adolescents

A

increasing flexibility of family boundaries to permit children’s independence and grandparents’ frailties

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14
Q

Life cycle of a family
Launching Children and Moving on at Midlife

A

accepting a multitude of exits from and entries into family system

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15
Q

Life cycle of a family
Families in Late Middle Age

A

accepting the shifting generational roles

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16
Q

Life cycle of a family
Families nearing the end of life

A

accepting the realities of limitations and death and completion of one cycle of life

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17
Q

Aternative families

A

number of alternative families is growing and rate of growth of these alternative family styles in the US may be greatest among those with Eurocentric backgrounds

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18
Q

Alternative families
Single-parent families

A

comprise about one-fourth of all families with children

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19
Q

Alternative families
Remarried families

A

because of the high divorce rate and subsequent remarriages
- result in complex relationships within stepfamilies

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20
Q

Alternative families
LGBT families

A

may or may not have children
not immune from complex multigenerational family dynamics, need to sort through the roles and rules which will arise

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21
Q

Ludwig von Bertalanffy

General systems theory

A

the organization and interrelations of the parts are important
Not linear thinking (A causes B) but circular (A may cause B, but B also causes A)

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22
Q

Psychodynamic theory of family counseling

Nathan Ackerman

A

principle proponent
- theory came out of psychoanalytic background
- in a new marriage, the couple brings psychological heritage and resemblances from families of origin
- may bring introjects (imprints or memories) from parents or others
- family unit seeks homeostasis and an individual family member’s symptomatic or pathological behavior disturbs the homeostasis

  • believed in an interactive style of therapy, moving into the family’s living space, stirring things up, acting as a catalyst for change
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23
Q

Psychodynamic theory of family counseling

James Framo

A
  • believed that the social context of a person’s life helped shaped behavior
  • conflict stemming from one’s family of origin continued to be acted out in current relationships in one’s family
  • believed that humans in childhood are object seeking (i.e., hoping to establish satisfying object relationships, especially with parents. if child is rejected, this frustration is retained as an introject which will appear later)
  • begins therapy with entire family, but often concludes by doing conjoint (couple) therapy followed by couples group therapy and then family of origin (intergenerational) conferences
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24
Q

Experiential Family Counseling

Carl Whitaker

May refer to his approach as experiential symbolic family therapy

A
  • does family counseling from an experiential perspective - experiences, not education, changes family
  • less reliant on theory
  • becomes highly involved in therapeutic process
  • actively joins the family paying close attention to what he himself was experiencing in therapy
  • would then use awareness to press for changes in the family
  • therapy process is most important and the encounter in therapy is designed to challenge the old ways of thinking and behaving, on the way to new growth
  • used symbolism to help explain many experiences, which are often outside of awareness/consciousness
  • psychotherapy of the absurd
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25
Q

Experiential Family Therapy

Virginia Satir

A
  • humans and families have the resources within themselves to flourish, grow, develop
  • self-concept is important
  • poor communication (discrepancies) within the family is often blocking members of healthy functioning so Satir would serve as a teacher and trainer
  • believed that family members would adopt one of five different styles of communication
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26
Q

Experiential Family Therapy

Satir’s five styles of communication

A
  • placater
  • blamer
  • super-reasonable
  • irrelevant
  • congruent communicator
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27
Q

Experiential Family Therapy

Satir’s counseling approach

A
  • process oriented
  • therapeutic style is also experiential
  • believed in interacting closely with the family and stressed the need for intimacy in family relationships
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28
Q

Family Systems Theory

Murray Bowen

A
  • created systems theory of family counseling
  • well developed theory
  • emphasized the family as an emotional unit in the formation of dysfunctional behavior in a family member
  • believed family history included more than one generation of family was central to therapy (transgenerational)
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29
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Differentiation of self

1

A

the degree to which individuals can distinguish between their intellectual (thinking) and their feeling processes
- if there is fusion between these two processes, individuals are likely to experience involuntary emotional reactions and become dysfunctional

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30
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Triangles

2

A

individuals have a need for closeness and individuation. To the extent two individuals (e.g., husband and wife) are fused, they may bring in a third person (e.g., child) to resolve such two-person stress
- this is the basic building block of family’s system
- the greater the fusion in the family, the greater the triangulating that will occur

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31
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Nuclear family emotional system

3

A

marital partners choose mates with equal levels of differentiation
- two undifferentiated partners will probably become highly fused and produce family with similiar characteristics (will be unstable)

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32
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Family projection process

4

A

the fused, unstable marital partners will focus on one of the children (typically most infantile)

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33
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Emotional cutoff

5

A

children involved in projection process may try to escape the fusion by moving away geographically, or isolating psychologically
- this cutoff is only a deception

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34
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Multigenerational transmission process

6

A

the poor differentiated child of poorly differentiated parents will select a similarly poorly differentiated child to marry
- could repeat itself through several generations with the ‘weak links’ marrying other weak links

Big emphasis on intergenerational considerations

(Ivan Boszormenyi-Nagy is also intergenerational)

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35
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Sibling position

7

A

roles tended to be associated with birth order
- if two individuals of same or different birth order marry, these individuals could complement each other or compete with each other

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36
Q

Family Systems Theory: Theoretical concepts identified by Bowen

Societal Regression

8

A

society is regressing because it does not differentiate between emotional and intellectual decision making

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37
Q

Bowen Family Systems Theory

Bowen’s session focus

A
  • begins with a comprehensive assessment process
  • develops a genogram for last 3 generations
  • tends to work only with the marital couple even if child has been identified (IP - identified patient) as having the family problem
  • goal is to maximize each partner’s self-differentiation
  • style is to remain neutral and detriangulated unlike experiential and humanistic family therapists
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38
Q

Structural Family Therapy

Who created Structural Family Therapy

A

Salvador Minuchin

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39
Q

Structural Family Therapy

Transactional Patterns

A
  • each family has an organization or structure characterized by the evolved rules (transactional patterns between members)
  • these rules dictate how, when, and with whom family members interact
  • rules may be generic (for all members) or idiosyncratic (individualized)
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40
Q

Structural Family Therapy

Family is composed of subsystems

A
  • are necessary to carry out family functions
  • may have boundaries/rules for membership
  • spousal, parental, sibling
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41
Q

Structural Family Therapy

Boundaries

A
  • may be permeable or diffuse
  • if boundaries are too diffuse, may lead to enmeshment
  • rigid boundaries lead to disengagement
  • either extreme is likely to create problems within the family
42
Q

Structural Family Therapy

Alignments

A

the way family members join together or oppose each other

43
Q

Structural Family Therapy

Power

A

who has authority and responsibility

44
Q

Structural Family Therapy

Coalitions

A

alliances between specific family members

45
Q

Structural Family Therapy

Structural map

A
  • diagrams current family structure in identifying where dysfunction may be present
  • shows boundaries, alliances, coalitions, conflicts
46
Q

Structural Family Therapy

Minuchin joins the family

A

as an active member
- may mimic (mimesis) some aspect of the family’s manner, style, etc., and encourages enactments of some dysfunctional interactions
- through reframing, he labels what occurs into a more positive or constructive perspective

47
Q

Structural Family Therapy

In therapy

A

challenge the transaction patterns in the family and hope to change, reorganize, restructure the family
- one goal might be clearer boundaries
- parental subsystem must be clearly defined with executive power and responsibility

48
Q

Strategic Family Therapy: Communication techniques

Therapeutic double bind

A

a paradoxical technique where the client is asked to continue some undesirable behavior or symptom when they expected to be told to stop it
- the client is caught in a bind and must give up the symptom or acknowledging control over it

49
Q

Strategic Family Therapy: Communication techniques

Prescribing the symptom

A

the paradox here is to refuse to continue the behavior and abandoning it or acknowledging control over it

50
Q

Strategic Family Therapy: Communication techniques

Relabeling

A

similar to reframing where the meaning of the situation is changed so that the situation is perceived differently

51
Q

Strategic Family Therapy

Main proponents

A

Jay Haley and Cloe Madanes

52
Q

Strategic Family Therapy

Concepts

A
  • power and control characterize relationships in families
  • symptoms are attempts at controlling a relationship
  • techniques are often direct suggestions/assignments (assignment of paradoxical tasks often occurs)
53
Q

Strategic Family Therapy

Paradoxical techniques

A

positioning: helper accepts client’s predicament and then exaggerates the condition (ex. saying ‘it is very possible that your depression is hopeless. it is possible you will never get over it’)
- paints even more negative picture of the situation for the client than restraining
restraining: therapist may warn family of negative consequences of change. Might tell them to take it very slow or expect a relapse. helps them overcome resistance by suggesting that it might be best if family does not change
pretending: family enacts a make-believe scenario of the problem. more gentle and less confrontational than traditional paradoxical interventions
prescribing the symptom: i think this is increasing the frequency of the dysfunctional symptom (if a couple fights once a day, the therapist says to fight twice a day)
reframing: redefine a situation in a positive context (make the situation or behavior seem acceptable to the client) to evoke a different emotional response

54
Q

Milan Systemic Family Therapy

Proponent

A

came from Milan, Italy, but was led by Mara Selvini-Palazzoli

55
Q

Milan Systemic Family Therapy

Concepts

A
  • the family is viewed as a system with connections between family members with a goal of keeping the system in balance
  • family is viewed as “playing a game” to maintain the system
  • therapists bring hypotheses to sessions to be checked out
  • usually a team of therapists are also observing, and they may provide suggestions/directives to be relayed to the family before it leaves
56
Q

Milan Systemic Family Therapy

Circular questioning

A

asking several family members the same question about the same relationships
- reveals connections and differences in meaning they ascribe to an event

57
Q

Milan Systemic Family Therapy

Rituals of the family

A
  • often used therapeutically
  • established family patterns might be changed suggesting new ways of doing things, which may alter beliefs and attitudes
  • by revealing family ‘games’ and through new info, Milan therapists want to change family rules/relationships
58
Q

Madanes and incongruous hierarchy

A

a malfunctioning hierarchy where the child is in control
(normal family hierarchy = mother controls child)

59
Q

Behavioral/Cognitive Approaches

can be used for

A
  • behavioral marital therapy
  • behavioral parent-skills training, functional family therapy
  • conjoint sex therapy
60
Q

Behavioral/Cognitive Approaches

Cognitive behavior therapy

A

emphasis on thoughts and actions, received increasing emphasis

61
Q

Behavioral/Cognitive Approaches

Robert Liberman

A

introduced operant conditioning and social learning principles to the solution of family problems

62
Q

Behavioral/Cognitive Approaches

Behavioral parent-skills training

A

focuses on child management
- time out
- designing contingency contracts

63
Q

Behavioral/Cognitive Approaches

Richard Stuart

A

Operant Interpersonal Therapy
- social exchange model that argues for the influence of ongoing behavioral exchanges on their long-term outcomes in relationships
- features marital skills training and behavioral contracting

64
Q

Behavioral/Cognitive Approaches

Functional Family Therapy

A

all behavior is viewed as adaptive, always serving a function
- therapy helps individuals learn new skills through education

65
Q

Behavioral/Cognitive Approaches

Conjoint Sex Therapy

A

practiced by Masters and Johnson
- any sexual inadequacy exists in a system the two partners represent

66
Q

Social Constructionist

Main ideas

A

do not believe we share a common reality
- we use language to share our experiences and perceptions and use language to communicate with others and construct a common reality

67
Q

Social Constructionist

Solution-focused therapy

A

Steve deShazer
- pays little attention to history of the problem or underlying causes
- therapist and client have ‘discussions’ about solutions they want to construct together
- goal: to get agreement on the reality under discussion since word and language meanings vary for different people and from different perspectives
- clients already know what they need to do to solve the problem but need help in constructing a new way to use the knowledge

68
Q

Social Constructionist

Solution-oriented therapy

A

William O’Hanlon
- the language used by clients and therapists is important because meanings and perceptions are embedded within
- counselor collaborates with clients, acknowledges them and suggests that the possibilities for solution and change already exist within them
- some of the focus of therapy is on what is working well (rather than what is not) and increasingly doing something different

69
Q

Narrative Family Therapy

Narratives

A

stories family members bring to therapy
may be negative and limiting perceptions of themselves and their lives

70
Q

Narrative Family Therapy

Deconstruction

A

process of examining a narrative, determining underlying assumptions, suggesting that there may be other meanings attached to the story
- provides family an opportunity to reauthor the story and the process empowers them
- therapist may assist in building a scaffold for a new story and assist in co-authoring

71
Q

Psychoeducational family therapy

Psychoeducation

A

assist a family with daily functioning in general, dealing with specific issues the family may be experiencing such as with an individual with medical problems
- psychoed may be beneficial in marriage preparation, martial enrichment, stepfamily blending

72
Q

Feminist issue and gender-sensitive family therapy

Concepts

A
  • must be recognition of social, cultural, political factors which influence treatment of men and women
  • roles for men and women within a society/culture/families are well established
  • in many cultures, patriarchal models dominate with attendant power differentials between genders
  • therapists are influenced by the same social/cultural factors and role stereotypes as anyone else
73
Q

Feminist issue and gender-sensitive family therapy

In session

A
  • therapist challenges traditional viewpoints of gender roles and must be sensitive to how these roles are being played out by family
  • there should be identification of strengths and needs of both men and women
  • family members must be empowered and enabled to move beyond traditional sex roles and be given choices like changing established sex roles and the expectations of those roles
74
Q

Genogram

A

a pictorial representation of the relationships within a family typically extending through three generations
- may identify emotional, communication, behavioral patterns within a family
- can also gather religion, occupations, ethnic origin

75
Q

Play Therapy

Play therapy

A

children are encouraged to express feelings, act out dreams/ambitions, direct own life
- helps children master anxieties, relieve tensions, cope with life’s problems, expend physical energy
- allows children to relieve frustrations and helps therapist analyze child’s conflicts
- children often feel less threatened and more at ease in showing feelings through play
- use variety of toys/art supply/equipment to make decisions and gives therapist opportunity to observe how children deal with conflict (approach-approach)

76
Q

Play Therapy

Virginia Axeline

A

Play Therapy and Dibs: In Search of Self
- believes the leader/therapist attends, recognizes feelings, helps child express self, help child implement new behaviors

77
Q

Issues families faced during COVID

A
  • responsibility and distribution of family/couple activites create a mental load
  • cooperation and flexibility are needed to create a workable schedule of home life activities
  • women may more often be expected to carry a larger role of home activities
  • forced schedule to be at home may allow for greater insight in home activities and how to renegotiate relationships
78
Q

General Definitions

Alignments

A

clusters of alliances between family members within the overall family group; affiliations and splits from one another, temporary or permanent, occur in pursuit of homeostasis

79
Q

General Definitions

Boundary

A

an abstract delineation between parts of a system or between systems, typically defined by implicit or explicit rules regarding who may participate and in what manner

80
Q

General Definitions

Closed system

A

a self-contained system with impermeable boundaries, operating without interactions outside the system, resistant to change and thus prone to increasing disorder

81
Q

General Definitions

Coalitions

A

covert alliances of affiliations, temporary or long-term, between certain family members against others in the family

82
Q

General Definitions

Conjoint

A

involving two or more family members seen together in a therapy session

83
Q

General Definitions

Cybernetic

A

the study of methods of feedback control within a system, especially the flow of info through feedback loops

84
Q

General Definitions

Enmeshment

A

a family organization in which boundaries between members are blurred and members are over concerned and overinvolved in each other’s lives, limiting individual autonomy

85
Q

General Definitions

Family sculpting

A

a physical arrangement of family members in a space, with placement of each person determined by an individual family member acting as ‘director;’ the resulting tableau represents that person’s symbolic view of family relationships

86
Q

General Definitions

Feminist family therapy

A

a form of collaborative, egalitarian, nonsexist intervention, applicable to both men and women, addressing family gender roles, patriarchal attitudes, social and economic inequalities in male-female relationships

87
Q

General Definitions

Genogram

A

a schematic diagram of a family’s relationship system in the form of a genetic tree and usually including at least three generations, used in particular by Bowen and his followers to trace recurring behavior patterns within the family

88
Q

General Definitions

Homeostasis

A

a dynamic state of balance or equilibrium in a system, or a tendency toward achieving and maintaining such a state in an effort to ensure a stable environment

89
Q

General Definitions

Identified patient (IP)

A

the family member with the presenting symptoms; the person who initially seeks treatment or for whom treatment is sought

90
Q

General Definitions

Joining

A

the therapeutic tactic of entering a family system by engaging its separate members and subsystems, gaining access in order to explore and ultimately to help modify dysfunctional aspects of that system

91
Q

General Definitions

Multiple family therapy

A

a form of therapy in which members of several families meet together as a group to work on individual as well as family problems

92
Q

General Definitions

Nuclear family

A

a family composed of a husband, wife, and their offspring, living together as a family unit

93
Q

General Definitions

Open system

A

a system with more or less permeable boundaries that permits interaction between the system’s component parts or subsystems and outside influences

94
Q

General Definitions

Permeability

A

the ease or flexibility with which members can cross subsystem boundaries within the family

95
Q

General Definitions

Strategic theories

A

a therapeutic approach in which the therapist develops a specific plan or strategy and designs interventions aimed at solving the presenting problem

96
Q

General Definitions

Structural approach

A

a therapeutic model directed at changing or realigning the family organization or structure in order to alter dysfunctional transactions and clarify subsystem boundaries

97
Q

General Definitions

System

A

a set of interacting units or component parts that together make up a whole arrangement or organization

98
Q

General Definitions

Triangulation

A

a process in which each parent demands that a child ally with them against the other parent during parental conflict

99
Q

Premack principle of law

A

a family member must complete a low probability behavior (LPB) before they could be allowed to engage in a high probabiltiy behavior/pleasant task (HPB)

100
Q

Watzlawick, Weakland, Fisch

First- vs. second- order change

A

first-order change: changes that are superficial (behavioral changes do occur but the organization or structure of the system do not change

second-order change: an actual change in the family structure that alters an undesirable behavioral pattern

101
Q

Oslon, Sprenkle, Russell

Circumplex family model

A

Cohesion: level of emotional bonding between family members
Adaptability: how rigid, structured, flexible the family is… balance between stability (morphostasis) and change (morphogenesis)

the key factor is that the family should have balance in its cohesion and adaptability

CPCE/NCE Prep (18 decks)

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