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PSY 520 MFT > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Family systems theory

A
  1. Examines context in which individuals live

2. Context shapes meaning in lives of individuals

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2
Q

Reductionism

A
  1. theory that reduces complex data to simple terms
  2. When broken into parts > insight into how things work > understand reality
  3. Mechanistic > machine parts> everything is reducible
  4. Does it apply to complex systems? No, cannot understand complexity this way
    E. Cannot study families by looking at individual members > study members in relation to one another
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3
Q

General systems theory

A
  1. Focus on relationship and interaction between objects in system
  2. Focus on unrelated events as interrelated parts of larger system
  3. Bertalanffy
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4
Q

Cybernetics

A
  1. Humans (and machines) attempt to control disorganization in systems through feedback that influences future performance
  2. Cybernetics + general systems theory = systems theory
  3. Wiener
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5
Q

Paradigm

A
  1. Schema of how we understand the world

2. Paradigm shift: from individual orientated therapy > family therapy

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6
Q

System is an organized whole, objects within interdependent

  1. What are systems?
  2. What is a family system?
  3. what is a suprasystem?
  4. how does context alter meaning?
  5. What is interdependence?
A
  1. Systems: set of elements in interaction
    A. family members + attributions of family members (goals, attitudes, and relationships)
  2. Family system: attributes of family members and relationship between members
    A. nuclear family, extended family, family of choice, family of origin
  3. Suprasystem: larger system impacting families
    A. culture, religion, community, govt., economic, education
  4. Context alters meaning: why can’t dad stop smoking?
    A. Raised w/ parents who smoked
    B. Smoking for 40 years
    C. Smoking legal in banks, restaurants
  5. Interdependence: change in one family members creates change in other members: dad quits smoking?
    A. Mom more happy to physically touch dad
    B. Children have happier/healthier dad
    C. Dad has more self confidence
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7
Q

Whole greater than sum of parts

1. What is nonsummativity?

A
  1. Nonsummativity: assertion a system is its own entity, greater than sum of its parts
    A. Each family member one part
    B. Interaction of family members another part
    C. Relationship of members is more than contributions of ind. members
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8
Q

Patterns in systems are circular rather than linear

  1. What is feedback?
  2. What is feedback loop?
  3. What is morphostasis?
  4. What is equilibrium?
  5. What is morphogenesis?
  6. What is linear causality?
  7. What is circular causality
A
  1. Feedback: input of each member leads to complex output
    A. Malfunction of one member caused by failure of family system
  2. Feedback loop: individuals influence one another’s actions
    A. Positive loop: change occurred and accepted by system, status quo not maintained
    Ex. Dad decides to go back to school. He is expected to be available at the same rate as before going to school, but he cannot be. Family agrees to set boundaries of availability, has ‘unavailable study time’
    B. Negative loop: family adjusts to change, maintaining status quo, stabilizes system
    Ex. Dad decides to go back to school. Dad expected to be available as before going to school.
  3. Morphostasis: systems tendency toward stability
  4. Equilibrium: state of order
  5. Morphogenesis: systems mechanism for growth, creativity, change
  6. Linear: A causes B (thinking only ‘one’ person)
    A. dad is controlling > controlling behavior is interaction of son’s careless behavior
  7. Circular: A’s behavior outcome on B’s behavior and vic versa
    A. Dad’s controlling behavior because son is risk taking behavior > son is risk taking behavior because dad is controlling > dad doesn’t want anything bad to happen to son > son trying to exercise creative independent behavior.
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9
Q

Life cycle of family

A
  1. Individual independence
  2. Marriage coupling
  3. Couple with infant
  4. Couple w/ school age
  5. Couple w/ adolescent
  6. Launching adult children
  7. Empty nest
  8. Aging
  9. How is homeostasis achieved through the life span?
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10
Q

Brofenbrenners ecological ‘ring’ model

A
  1. Inner: individual
  2. Second ring: Microsystem, nuclear family, mom, dad, brother, gma, friends
  3. Third ring: exosystem, extended family, neighbors, media, school, work
  4. Fourth ring: macrosystem, cultural groups, religion, laws, history, race and ethnicity
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11
Q

Positive connotation

A
  1. The alteration of what a behavior is being perceived to be
  2. Ex. Father/ controlling, son/ careless >
  3. Father cares about son’s safety, son trying to take risks and learn how to be successful
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12
Q

Complex systems composed of subsystems

  1. Subsystems?
  2. Parental subsystem?
  3. Spousal subsystem?
  4. Sibling?
  5. Personal?
A
  1. Subsystems: within family, smaller self contained but interrelated systems
  2. Parental: rules, boundaries, goals
  3. Spousal: marriage rules, boundaries
  4. Sibling: brother, sister, half brother rules
  5. Personal: biological, cognitive, emotional components that make an individual and impact other systems and vice versa
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13
Q

Systems have homeostatic mechanisms that maintain stability of their patterns

  1. Homeostasis?
  2. Family rules?
  3. Overt rules?
  4. Covert rules?
  5. Roles?
  6. Boundaries?
  7. Permeability?
  8. Diffuse boundaries?
  9. Rigid boundaries?
A
  1. Homeostasis: desire to maintain stability or status quo
  2. Family rules: agreements that organize family interactions
  3. Overt: “our family goes to church every Sunday”
  4. Covert: implied, not stated, “never challenge your mother”
  5. Roles: individual patterns reinforced by expectations of family, by gender, talent, age, “black sheep,” “clown”
  6. Boundaries: data flowing from one system to another, who is a part of system, who is not, separation of subsystems, or identity of families
  7. Permeability: degree to which data flows from one system to another
  8. Diffuse boundaries: difficult to distinguish boundaries, or lack of, child as parent because he/she is the oldest or has substance abuse neglectful parent
  9. Rigid boundaries: family members separate, difficult to tell members are a part of family
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14
Q

Evolution and change inherent in open system

  1. Closed?
  2. Open?
  3. Adaptability?
  4. Equinfinality?
  5. Equipotentuality?
  6. Entropy?
  7. Negentropy?
  8. Digital communication?
  9. Analogic communication?
  10. Process?
  11. Content?
  12. Double message?
A
  1. Closed: no interchange with environment, ex. Machines > clock needs hand to wind it
  2. Open: exchange matter, energy, information w/ environment ex. Plants > give oxygen and environment gives moisture, heat, food. Families are open > child prejudice > parent teaches acceptance > child shares w/ other children
  3. Adaptability: ability to adjust patterns to changing conditions Ex. Crisis
  4. Equinfinality: ability of family to achieve similar goals, but’s in different ways, various routes
  5. Equipotentiality: the same cause produces different results > no single causes or effects in systems theory
  6. Entropy: maximum disorder, totally open or totally closed
  7. Negentropy: balanced order, some info open, some closed
  8. Digital communication: verbal, spoken, content of communication
  9. Analogic comm: nonverbal + context (tone, gesture, facial exp.) tells about interpersonal relationships
  10. Process: deciphering communication and what it means in family relationships
  11. Content: what is said (not as important as how said)
  12. Double message: “you look nice today,” person rolling eyes
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15
Q

LMFT

A
  1. Focus on Relationship context / individuals > relational context
  2. Rx as encompassing environment
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16
Q

LPCC

A
  1. Broader, improving mental health
  2. Requires more licensing hours
  3. Acceptable in more states as opposed to LMFT in CA
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17
Q

LCSW

A
  1. Special knowledge of social resources
  2. Social adjustments
  3. Hospitals, community, govt
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18
Q

Group dynamics

A
  1. Lewin’s research on group dynamics introduces concepts such as roles, norms, group cohesion
  2. Bell: family as group, facilitate communication w/ family members
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19
Q

Group vs. family

A
  1. Group: support in group only, not carried outside group
    - culture, roles emerge in group
    - disclosure processed
  2. Family: has past, present, future
    - disclosure rules > not allowed >affects and gets carried into family
    - members bring rules, norms, culture into group >challenge them?
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20
Q

Early marriage counseling

A
  1. 1920’s
  2. Marriage counseling > marriage + family counseling
  3. Greater emphasis on providing support, info w/troubled couples
  4. Provided by doctors, lawyers, clergy, professors
  5. Family therapy challenges autonomous self > systems based relational self
  6. Narrative self movement: the story of me in the environment
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21
Q

Sociological theory
Symbolic?
Structural?

A
  1. Early model of family therapy informed by 2 theories
    - symbolic interaction: meaning established with symbols from world and people around them
    - structural functionism: role of family to rear child to fit society
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22
Q

Ecological theories

A
  1. Provided a conceptual framework for understanding impact of the transactions between family and broad environment
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23
Q

Murray Bowen

A
  1. Families as open and natural systems
  2. Members enter and exit over time
  3. Boundaries altered
  4. Intergenerational, reciprocal, repetitive
  5. What is created in relationship, can be fixed in relationship
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24
Q

First generation therapist focus

A
  1. Alto, Bowen, Minuchin, Milan group
  2. Influenced by systems theory
  3. Therapist as observer
  4. Theories can guide, uncover, manipulate interaction > solve problems
  5. Assumptions based on middle class/ working class
  6. Ignores sociopolitical context w/in families
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25
Q

Marital schism?
Marital skew?
Lidz Theory w/ schizophrenia

A
  1. Schism: failure to create compatible relationship because partners are preoccupied by ind. conflicts
  2. Skew: parents competition for loyalty, affection, sympathy and support of children
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26
Q

Second generation therapy focus

A
  1. Critique of systems based approaches > too mechanistic
  2. Concern about gender bias, social status, ethnic minority
  3. Influenced by feminist, multicultural movement, social constructivist
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27
Q

Third generation therapy focus

A
  1. 21st century movement > evidence based family therapy
  2. Increased focus on effectiveness: define & measure, standardization
  3. Concerns? Is clinical judgement and research evidence cohesive and predictive
  4. Ex. CBT : behavior in nice order
  5. Gottman love lab: strongest work w/couples 4 horseman(stonewalling, contempt, name calling, defensiveness)
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28
Q

Gender, culture, spirituality, sexual orientation

A
  1. Driven by feminist critique
  2. Spiritual rituals improve health & healing
  3. Negative consequences when individuals develop intimate relationships based on power differentials, or hold harmful religious beliefs regarding homosexuality
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29
Q

Metaframeworks

A
  1. An umbrella perspective taking into account contextual issue like, culture, gender, etc., that covers all of the other theories of marriage and family therapy
  2. Promotes competence and protection from biases
  3. Bring these issues into therapy directly
  4. Closed umbrella: encourages stereotyping, continues discrimination
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30
Q

Gender

A
  1. Psychological, social, cultural features and characteristics that have become strongly associated w/ biological categories of male and female
  2. Evidence for gender on a continuum
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31
Q

Transgender vs. transsexual

A
  1. Individuals whose gender identity is different from the gender socially assigned to them based on biological sex
  2. Individuals who do not identify w/ sex they were born with and change their sex through use of medical intervention
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32
Q

Feminism critique of couple and family therapy

A
  1. Adherence to circular causality: does systems theory inhibit development of gender equity in family therapy? YES, failure to account for power imbalances w/in relationships
  2. Traditional roles generally give one partner all the power
    - domestic violence more likely to be female victim assaults because men have more physical power
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33
Q

Therapeutic neutrality
Critique?
2 issues?

A
  1. Therapist attempt to remain neutral so as not to impose their ideals of family functioning on others
  2. Criticism: can support the status quo by silent support, not speaking up or taking a stand to imbalanced gender equity
  3. Feminism: equality of men and women
    - not giving attention to gender issues in therapy results in less effective therapy
    - power imbalances w/in relationships linked to lack of intimacy and engagement for both partners
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34
Q

Assessing gender through assessment

A
  1. To gauge extent of gender issues, therapists might examine the following questions:
    - what ways do presenting problems reflect gender power issues?
    - how does each partner define equality, and do partners agree or disagree w/each other?
    - does relationship empower both partners?
    - is communication in relationship equally shared?
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35
Q

Genogram

Sociogram

A
  1. Draft of intergenerational family patterns used to explore individual roles, culture, power
  2. Sociogram:
    - circles with names inside > represents different members
    - size of circle > represents strength and importance
    - lines between circles > solid = strong, dashed = weak, different colors if negative link
    - arrows: direction of relationship, if reciprocal, or only one way
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36
Q

Gender intervention

A
  1. Therapists view themselves as mediators between clients and larger society
  2. Having explicit conversations about gender inequities
  3. Support awareness
  4. Validate individual experiences
  5. Question status quo
  6. Clarify new roles
  7. Examine social traps
  8. Discuss social support
  9. Empower women: more assertive, attention to self care, attention to personal time
  10. Empower men: more vulnerable, more emotionally expressive, attend relationship maintenance
  11. Use universal statements about gender, “it is painful when family members experience limitations”
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37
Q

Critical consciousness

A
  1. Guidelines that help therapists raise issues of power and privilege for discussion and analysis
  2. Ex. Finances:
    - are you employed? Work outside home? Money do you earn? How resources allocated?
  3. Help couple identify power imbalances outside relationship (decrease defensiveness), then apply knowledge to their relationship patterns and consequences
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38
Q 
Sexual orientation and couple, family therapy
Three prominent issues:
-Minority stress
-coming out
-relational ambiguity
A
  1. Prominent issue: LGBT clients vulnerable to marginalization and discrimination (from people & social institutions)
    - Minority stress: anti gay attitudes, societal oppression & internalized homophobia (not necessarily similar across LGBT community members)
    - Homosexuality decriminalized by U.S Supreme Court in 2003!
  2. Coming out: unique, and continuous stressors throughout life
    - multiple levels: family, society
    - clients may act out, suicidial ideation, family conflict
  3. Relational ambiguity: lack of social and legal ceremony (marriage), approval of other (family, society), formal termination (divorce)
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39
Q

Assessment sexual orientation

A
  1. Therapists should seek to understand level of societal anti gay prejudice
  2. Remain curious about coming out minority stress:
    past, present, future
  3. Build sociogram (concentric circles: couple, family & friends, community)
  4. LGBT affirmative therapy:celebrant of constructive LGBT relationships, acknowledge legitimacy, worthiness of equal support
40
Q

Intervention sexual orientation

A
  1. LGBT not ethical for reparative therapy: homosexuality not a disorder that requires treatment
  2. Coming out to famiily: sustaining the self, respecting different agendas, hope and remembering love
  3. Parents of gay children: loss of heterosexual paradigm, grief and loss perspective
  4. Create power and control wheel
  5. LGBT starting family, and other transitional times in life: creating life cycle rituals (naming ceremony for child)
41
Q

Multicultural perspective

A
  1. Knowledge, practice, and awareness of the internal and external contextual variables that compose our humanness including systems and subsystems of family, identity, group affiliation, sex, gender, political background, religious affiliation, education, entertainment, disability, ses, race, ethnicity, occupation, etc.
  2. US most culturally diverse nation in history: guide on how to behave, think, feel
  3. Need to be aware of prejudice and discrimination on all levels of society
42
Q

Culture and couples and family therapy

A
  1. Distinguish between families that have universal patterns from patterns of other particular families who are culture specific
    - awareness of generalizations
    - knowledge of variety of cultural groups
  2. Racial sensitivity: recognition of ways race and racism shape reality, using oneself to challenge attitudes, behaviors that create/reinforce racial injustices
43
Q

Assessment of culture

A
  1. If culture different, careful not to misinterpret culturally based behavior
  2. If culture similar, careful not to assume more similarity than exists (you might believe you understand client more than you do)
  3. Careful when using assessment materials, do they have different meanings in different cultures?
44
Q

Intervention on culture

A
  1. Make culture central metaphor for therapy: native Americans & harmony with nature
  2. Validate and strengthen cultural identity: individually, in family, and in community subsystems
  3. Reduce polarization within families: older and younger generations at different levels of acculturation
  4. Maintain collaborative relationship
45
Q

Spirituality and couple and family therapy

A
  1. Many couples seeking deeper meaning and connection, not just a reduction of symptoms
  2. Spiritual beliefs and practices are key ingredients in healthy functioning
46
Q

Assessment spirituality

A
  1. Identify affiliation with religion/ transcendent values
  2. Identify religious/ spiritual sources of stress
  3. Assess degree of fit between therapist and client regarding belief systems (make differences explicit)
47
Q

Intervention on spirituality

A
  1. Maintain collaborative relationship
  2. Be aware of own personal values and beliefs
  3. Use spiritual/religion as a resource in therapy (prayer, meditation, rituals)
  4. Exploration on nonreligious rituals to incorporate
  5. Encouragement of social justice services to others
47
Q

4 types of acculturation Berry

A
  1. Assimilation: culture of origin not important > wants to identify with new (US) culture
  2. Separation: culture of origin of high value > do not want to learn about new US culture
  3. Marginalization: not identifying with culture of heritage, or with new US culture
    Integration: maintain cultural heritage and learn about new US culture
49
Q

Transitional gender positions continuum

A
  1. Traditional
  2. Gender aware
  3. Polarized
  4. In transition
  5. Balanced
50
Q

Structural family therapy

A
  1. Views families and emotional distress from an organizational perspective: individuals problems not a personal pathology, but a flaw in family’s organizational design
  2. Enables individuals in families to alter organization of family relations and solve problems themselves
  3. Minuchin: action orientated approach, focus on context
  4. Active and directive
  5. Began as a mode of treating low income African American
    / Latino families concerned w/ adolescent violence, substance abuse, illegal activities > quick, large change
  6. May be most effective for childhood/adolescent issues, substance abuse, delinquency, psychosomatic problems
51
Q

Minuchin: alliance

A
  1. Which family members are in alliance?
  2. Interest in present centered issues
    - who has power over whom
    - how much personal space exists for family members to assume responsibility for actions
    - which family members in conflict
    - flexibility for family members to change roles in new situations
52
Q

Structural: Halon

A
  1. Subsystem that is both a system in its own right, and a subsystem of a larger system
  2. Individual > nuclear family > extended family > community = both a whole and a part
  3. Individual personality formed by being a member of numerous subsystems
53
Q

Structural: Enmeshed boundaries

A
  1. Little autonomy between individuals and other subsystems
    Ex. Therapist pressing wrist of diabetic girl, one parent can “feel it,” the other sad because she can’t.
    -psychosomatic diabetes: cases of diabetes that need consistent hospitalization even though insulin tx - flare ups thought to be psychological and/or family issues
    Ex. Parent/infant: appropriate because babies cannot care for themselves
54
Q

Structural: Disengaged boundaries

A
  1. Successfully enclose a subsystem but are impenetrable to outside info
    Ex. Closed off from community, outside services, families believe parents promote autonomy in their children
    Ex. Inappropriate: parents have no idea where teenager spends time when away from home, who friends are, school
55
Q

Structural: Hierarchy

A
  1. Boundary distinguishing leadership subsystems
    from rest of family
  2. Structural ft believes an individual or group must assume leadership role for a family to successfully resolve a task
    Ex. Parent-child hierarchy: parents responsible for child rearing issues
  3. Families must often rearrange structure and hierarchy often to meet specific demands
    Ex. Mother cooking dinner, older sibling caring for younger sibling, single mother caring for two children, children more chores during divorce
56
Q 
Structural: 
Coalition
Triangle
Cross generational coalition
Detouring
A
  1. Coalition: When two + family members join forces against one or more of the others
  2. Triangle: specific coalition in which two family members join forces against someone else
  3. Cross generational coalition: two family members from different generations ally against a third member
  4. Detouring: Parents shift focus to one child every time problem arises between them
57
Q

Goals of structural family therapy
Joining
Accommodation

A
  1. Problems are maintained by dysfunctional family structure > help family develop new structure
  2. Problem resolution is a byproduct of change, as new appropriate structures lead to effective problem solving
  3. Process orientated model > alter family transactions rather than solving problems > family collectively realizes goals
  4. Therapist does not focus on family content> ask questions about how family attempts to resolve problems/ observe family in action > diagram family map of dysfunctional structure
  5. Joining: therapists let clients know they understand and are working to help
  6. Accommodation: ability of therapist to adapt his/her behavior to fit a specific family
  7. Strengthen parental hierarchy
  8. Create clear flexible boundaries
  9. Separate subsystems > spousal from parental
58
Q

Structural diagnosis

Restructuring

A
  1. Process by which therapist identifies dysfunctional family structure that maintains an individual’s symptoms
  2. Several sessions of questioning & observation to understand structural makeup
  3. Diagnosis 2 parts: 1. Dysfunctional pattern 2. Hypothesized alternative structure to resolve problem
  4. Restructuring: helping family find appropriate structure for solving problems
  5. Therapist is:
    - observer
    - describes
    - director
    - expert
    - educator
    - interpreter
    - reframer
  6. Therapist techniques:
    - enhancing strengths
    - task assignments: homework
    - boundary making: new subsystems
59
Q

Structural: Enactment

A
  1. Family members engaging in their problematic behaviors in the therapy room
  2. People may provide inaccurate accounts of their behavior
  3. Structural ft might have family members talk among themselves about how to solve a problem > therapist can observe problematic structure as it unfolds
60
Q

Structural: Unbalancing

A
  1. Technique of therapist to temporarily side w/ specific individual or family member to induce change
    Ex. Therapist sits next to less powerful spouse to help him/her assert needs and encourage continuation of talking
    Ex. “Because you are the parents, I will support your rules”
  2. Therapist must be strongly joined with all members of family
  3. Therapist must return sides to support other opposed member
61
Q

Strategic family therapy
How is problem seen?
Pathology?

A
  1. Two schools of focus: MRI approach (Mental research institute), and Washington school
  2. Strong influence on evidence based tx
  3. Active and directive: remain outside family system, avoid challenging family’s defenses
  4. Do not stress expression of feelings
  5. Develop hypothesis about how problem is maintained, takes leadership role for solving problem
  6. Problem is not pathological, symptoms are the unfortunate behaviors of the social setting
  7. Pathology > receptive sequence of narrow range interactions
62
Q

Strategic: MRI

A
  1. Interactive view of problems : behavior that happens between people rather than within them
  2. Focus on communication, interaction within family, and the social context of interaction in the present moment
  3. Therapists pay close attention to what is said and done to try to resolve problems
  4. Vicious cycles: problems result from applying solution that does not work and continuing to do more of the same despite undesirable results
  5. Tx: new alternative behavior, and stopping the performance of attempted solution
  6. Client position: strongly held beliefs, values, and priorities that determine how clients behave: frame interventions the way client will most likely accept
  7. Problems not random, but reflect dysfunctional systems, resulting from family life cycle transitions
  8. Do not label (diagnosis) behavioral disorders: obstacle to resolution
  9. Only fairly minor changes often enough to initiate positive changes
  10. Like to see only members who most motivated to see change happen rather than routinelyseeing all members
63
Q

Strategic: Washington school

A
  1. Problems: PUSH (emphasis on solutions rather than causes)
  2. Protection: symptoms serving as a protective function
  3. Unit: focus on triangle, a third person between two others
    - ex. Adolescent substance abuse to draw parents attention away from their conflict with each other
  4. Sequence of interaction: describes problem, and points to solution
    - ex. Negative sequences replaced with positive ones
  5. Hierarchy: people w/ history and future together organize a way of behaving with one another, they form power ladder: each has a place someone above, someone below
    - ex. Incongruent hierarchy: child (repetitive misbehavior) who is in charge of parents. Reestablish hierarchy necessary
  6. Symptoms as metaphors: presenting problems metaphors for actual problems
  7. Problems not random, but reflect dysfunctional systems, resulting from family life cycle transitions
  8. Do not label (diagnosis) behavioral disorders: obstacle to resolution
  9. Identified persons communication changes only if family system also changes (confused hierarchy?)
  10. Likes to work w/ all individuals involved in problem, if client a child, then whole family
64
Q

Strategic therapy: goals

A
  1. Negotiate presenting problem that can be defined in clear, solvable behavioral terms > goal for therapy to check outcome of therapeutic success
  2. Brief therapy: behavior change rather than feelings & insight, tend to occur
  3. Change can happen w/o understanding
  4. Change happens by behaving differently (first order), not by expression of feelings (second order)
  5. Change happens by refining the problem: one of life’s many problems
65
Q

Strategic therapy: techniques

A
  1. Collection of: info. about prob., goals for change, interaction that maintain problem
  2. Strategy for change: give family one or more directives or tasks with intent to change interactional sequence
  3. Assign new directive, assess family response to directive, plan new therapeutic change depending on response
  4. Change strategy if directive does not produce intended result
66
Q

Strategic therapy: therapeutic alliance

A
  1. Important for creating cooperative atmosphere, but not a specific goal of strategic therapy
  2. Therapist to be viewed as being helpful and on side of client
  3. Use empathy, highlight clients strengths rather than liabilities
  4. Stress the ability of client to take charge of their own problems
67
Q

Strategic therapy: reframing

A
  1. Changing the meaning of the problem or reframing situation
  2. How clients view a problem may keep them stuck
  3. When new meaning given, development if new action can happen
68
Q

Strategic therapy: explicit directive, implicit directive, compliant based directive

A
  1. Explicit: telling a client to stop
    -straightforward: therapist hopes client will do
    Ex. Compliant based directive: advice, explanation, information the family lacks, suggestions to promote communication, coaching, establish rules, redistribute jobs among family members: given to all members
    - circular questioning:
  2. indirect: therapist hopes client will not do
    -Ex. Paradoxical directive: illogical interventions that appear contradictory to goals of therapy, yet are designed to achieve goals of therapy
    -Ex. Prescribing the symptom: family told to continue having the problem
    -restrain change: discourage change, slow down patient
    -symbolic act: entire family carries out specific series of actions
    -pretending: client pretends to have symptom or problem, giving client more control over symptom
  3. Implicit: turning away and changing the subject
69
Q

Strategic therapy: diversity issues

A
  1. Cultural influences not relevant: cultural exploration prolongs tx
  2. Strategic under fire by feminists
  3. Research indicates strategic therapy equally applicable to African, Hispanic, and white Americans
70
Q

Experiential Approaches

A
  1. Originated from humanistic movement
  2. Philosophy of growth
  3. Emphasis on expression of feeling/ meaning
  4. Therapist sharing of personal feelings/ thoughts in session
  5. Action orientated
  6. Communication skills
  7. Physical + emotional = wholeness
  8. Responsibility for self
70
Q

Satir Humanistic-Experiential Approach

A
  1. Dysfunctional behavior result of deficit of growth
  2. Growth natural process of all humans
  3. Humans have resources w/in themselves
  4. Subjective is reality, not objective
  5. Symptoms are privy to be paid to keep balance > low self esteem
  6. Self esteem directionally linked to communication
    - low self esteem = dysfunctional communication patterns
  7. Wheel hub: body, brain, emotions, senses, interactions, nutrition, context, soul = self
  8. Pathology = absence of growth
  9. Symptoms = blockage of growth = low self esteem
71
Q

Satir: 4 communication styles

A
  1. Placater: please at all costs, acts weak, always agrees, apologizes
  2. Blamer: blame others for own mistakes, dominates, self-righteous
  3. Super reasonable: emotionally detached and controlled, rigid thinking
  4. Irrelevant: distracted, noncommittal to process
71
Q

Satir: Dysfunctional communication

A
  1. Poor communication is indirect, unclear, vague, dishonest, incomplete
  2. Low nurturing, low self esteem, poor communication
  3. Vulnerable in times of stress, cannot adapt
  4. Dysfunction family homeostasis is a “closed system”
  5. Rules and roles are fixed, rigid, arbitrary, inconstant
73
Q

Whitaker Symbolic Experiential Approach

A
  1. Reciprocity of therapist and family: therapist must grow and learn of own issues
  2. Distrust of cognitions: therapist active and physical contact used
  3. Unconsciousness fertile ground for growth
  4. Family roles flexible: kids as parents vice versa
  5. Cotherapy: 2 therapists at same time
  6. Goal of therapy to trigger anxiety > trigger change > motivation and desperation to change
  7. Health never ending process: ability to adapt and change, flexibility key
74
Q

Satir techniques

A
  1. Family sculpting: demonstration through body position > representing relationships
  2. Metaphor: idea that represents interactional pattern > nurturance = sun warming flower
  3. Humor
  4. Touch: ask permission, use sparingly, ethically
  5. Communication stance: sculpt new physical stance > representative
  6. I statement: own feelings, communicate with “I” clearly, eye contact
  7. Family reconstruction: one member ‘star’ to recreate scenes and role play
75
Q

Whitaker: therapist role

A
  1. Battle for structure:
    - therapist assumes control over structure of family
    - therapist decides who attends sessions, and when
  2. Battle for initiative:
    - therapist defines structure, then family next to take initiative
    - family creative forces unfold in new space
  3. nontheory: theory hinders client creativity
  4. emotional experience: therapist and family effectively engage together
  5. Depathologizing human experience: experience of being stuck first step toward change
  6. No preplanned technique: spontaneous connection w/ family = change, preplanning not necessary/ hindering
  7. Use of self by therapist: therapist draws from personal experience and affective reasoning
  8. Use of cotherapy: one active, one observer, teaching tool
76
Q

Whitaker techniques

A
  1. Redefining symptoms as attempts to get unstuck
  2. Modeling: alternatives to real life stress
    - therapist on floor w/ toys > child joins, parents join
  3. Separate interpersonal and intrapersonal stress:
    - girl > pressure to be grown up (intrapersonal) parents unable to control behavior (interpersonal)
  4. Practical intervention: invitation parents to play with child
  5. Augment despair: increase family anxiety, add to despair
  6. Affective confrontation: confronting denial, invalidated affect
  7. Treat children as children: generational boundaries clear
77
Q

Johnson’s Emotionally Focused Couple Therapy

A
  1. Brief and empirically validated
  2. Change dysfunctional patterns by modifying inner experience of partners
  3. Builds on attachment theory: access and responsiveness of attachment figure = achievement of security
  4. Primary emotions: core feelings, genuine and authentic, open
  5. Secondary reactive emotions: defenses of vulnerable primary emotions
    - ex. Husband express anger, mask for fear and hurt of wife home late
78
Q

EFT: primary emotions

Secondary emotions

A
  1. Authentic, genuine expression of core emotions
  2. Secondary: defensive emotions of our real vulnerable ones.
    - occurs from lack of attachment, partner doesn’t feel safe in expressing core emotions
80
Q

EFT: Attachment model

A
  1. Secure (child): distress when mother leaves, greet when return > secure (adult) comfortable in relationships, can seek support
  2. Avoidant: do not seek when mother returns, focus on environment > dismiss: greater autonomy, cut off emotionally from partner
  3. Ambivalent/ resistant: very upset w/o mother, explore very little > preoccupied: fears rejection, strong desire to remain close
81
Q

Johnson’s Emotion focused tx manual

A
  1. No specific intervention/ tech.
  2. Focus on core emotions > pertinent conflict issue in detail
  3. Identify negative interaction cycle > pursue- distance, blame-withdrawal
  4. Access unacknowledged feelings: primary emotions
  5. Reframe problems
  6. Identify w/ disowned needs > integrate into relationships
  7. Promote acceptance of partners need
  8. Facilitate expression, connect
  9. New solutions
  10. consolidate New positions
82
Q

CBT

A
  1. CBT assumes dysfunctional behaviors learned, and can be reduced or replaced w/ constructive behaviors > new learning
  2. Overt interactions among family members and internal experiences of each member
  3. Utilizes EFT
  4. Utilizes dialectal behavioral therapy: venting negative emotions
  5. Child problems > therapist may intervene in parental conflict
83
Q

CBT: systematic desensitization

A
  1. Tx for phobias based on learning principles
  2. Phobia is classically conditioned response to non dangerous
  3. Pair anxiety stimulus with relaxation, assertiveness
  4. Done in steps, or hierarchy
  5. Progressive
  6. Deconditioned: low anxiety to stimulus
84
Q

Mutual influences

Shape

A
  1. A process in couple or family interaction in which each person’s behavior simultaneously affects and is affected by others behavior
  2. Two members shape each other’s behavior by providing consequences for specific responses > reinforce, ignore, punishment
85
Q

Cognitive therapies

A
  1. Focus on overt actions
  2. Internal thought processes can influence individuals emotional and behavioral responses
  3. Inappropriate thought process: cognitive distortions
86
Q

Functional family therapy

A
  1. Systems + behavioral
  2. Interactions among family members
  3. Identify sequence of behavior among family members > modify problem patterns
  4. Identify interpersonal context : how you influence and are influenced
  5. Behavior intentionally designed to produce particular consequences
  6. Strong empirical support
87
Q

Negative reciprocity

A
  1. A person who receives a negative from a partner reciprocates with a negative action towards the partner
88
Q

Demand/ withdrawal

A
  1. Ne person pursuing the other, while the other person withdrawals
89
Q

Coercive family systems

A
  1. Aggressive children who grow up w/ parents who use criticism, threats, punishment of control
  2. Negative reciprocity
  3. When little attention or reinforcement for positive behavior, and attention for negative actions (verbal, physical aggression), attention strengthens negative behavior.
  4. Stronger negative reinforcement when attention to negative actions are intermittent (occurring unpredictably)
90
Q

Negative tracking

A
  1. Tendency to notice another’s negative behavior and overlook positive behaviors.
91
Q

Cognitive factors in relationships
Automatic thoughts
Schemas

A
  1. Cognitive Therapies based on premise that a persons emotional and behavioral responses to life events depend on persons thoughts about those events
  2. Automatic thoughts: spontaneous thoughts running through one’s mind, plausible at the time, even if distorted
  3. Schemas: long standing beliefs that individuals have about characteristics of people, objects, relationships > gender roles
92
Q

Rational emotive behavior therapy

A
  1. Increased focus on behaviors
  2. When ind. holds unrealistic beliefs about people and life experiences, he/she likely to be upset and behave negatively when realities of life fall short of standards
93
Q

CBT: Emotional reasoning

A
  1. Relying on emotion cues as signs of some truth
  2. Ex. “I am depressed because I don’t feel I can do anything”
    - therapist helps person understand not to trust emotional or physical cue
    - possible to engage in activities even when feeling ‘I can’t do anything’
  3. Ex. Panic attack > rapid heart rate, sweat, short of breath
    - therapist teaches individual that symptoms are uncomfortable, not dangerous
  4. Ex. Anger management
    - therapist teaches self soothing > muscle relaxation, walking, warm shower, non- aggressive self talk, time- outs
94
Q

CBT: aversive control strategies

Cascades

A
  1. Threats and punishment
  2. Attempts to try to change each other’s behavior
  3. Typically backfires > escalates negative behavior or demand/ withdrawal pattern
  4. Cascades: behavior sequences in which attacking, defensive, withdrawal behavior that increases distress and increase dissolution of relationship
95
Q

CBT: situational conditions

A
  1. Attributing behaviors to traits rather than situation
  2. Ex. Attributing distracted, active, disobedient behavior to ADHD instead of considering the ways the environment may be eliciting and reinforcing undesirable behavior
    - problem may have developed through learning experiences
    - careful observation of child in variety of situations
96
Q

CBT: techniques

A
  1. Cognitive restructuring: modification of problematic emotional responses, and changes in behavior
    - increase positive interactions
    - decrease negative interactions
    - develop effective communication, problem solving skills
  2. Emotional regulation: controlling strength of individuals emotions
    - relaxation techniques
    - homework assignments
  3. Cognitive assessment
    - family interviews/questionnaires to assess perceptions, attributions, expectancies, assumptions, standards
    - here and now probing
    - catching cognitions vs asking to recall
    - reduce selective perception: daily written log hw, how many times did this behavior occur?
    - modify bias attributions: when biased perception expressed > ask for other possible explanation of behavior
    - hw: keep track of whether your predictions of behavior came true
  4. Behavioral
    - contracts: formal agreement that each person will enact particular behaviors
    - parental contracts: may not work in collectivistic cultures > children expected to act in best interest of family > reframe child as too immature to act on well being of family
    - behavior chart: behaviors to be monitored
    - communication skill training: expressive and listening > therapist coaches reflective listening, eye contact, avoid interrupting/advice giving
97
Q

CBT: Multiculturalism

A
  1. Focus on cultural sensitivity of intervention > are they consistent with client beliefs, values, traditions
    - Ex. Client from traditional gender roles > parents using behavior contracts vs. a democratic approach like a negotiation strategy
    - Ex. Collectivistic culture > might not welcome individual needs and desires over communal goals
  2. Therapist understands own culture, and aware of own biases
  3. Therapist immerses, seeks knowledge about other cultures

PSY 520 MFT (3 decks)

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