Family Based Therapy Deck 2 Flashcards
What is Circularity in terms of families?
Patterns of behavior develop within systems, which are repetitive, circular in nature, constantly evolving and which affect all family members.
Regarding connections and patterns the therapist should?
Consider the connections between circular patterns of behaviors and the connections between the beliefs and behaviors within the system.
What is the importance of Narratives and Language?
Behaviors and beliefs firm the basis of stories and narratives, which are constructed by, around and between individuals and the system itself. The language that is used to describe the narratives and the interactions between individuals constructs the reality of their everyday lives.
Construction is the idea that people form autonomous meaning systems and will interpret and make sense of information from their frame of reference. This means?
Understanding is constrained and affected by this meaning system, and thus an assumption should not be made regarding the meaning given the information offered or contributed to others.
What is social constructionism?
The idea that meaning is created in social interactions that take place between people and thus is context dependent, constantly changing, taking precedence over the concept of single external reality.
Goals during initial session are?
- Outline Therapy boundaries and structure
- Engage and involve all family members
- Gather and clarify information
- Establish goals and objectives of therapy
Goals during middle sessions are?
- Develop and monitor engagement
- Gather information and focus discussion
- Identity and explore Beliefs
- Work towards change at the level of beliefs and behaviors
- Return to objectives and goals of therapy
Goals during ending sessions are?
- Gather information and focus discussion
- Continue to work towards change at the level of behaviors and beliefs
- Develop family understanding about behaviors and beliefs
- Secure collaborative decision re: ending
- Review the process of therapy
Examples of various types of circular questions
- About another’s state/behaviors/beliefs
- Offering alternative perspectives
- About relationships
- Direct
- Indirect - Circular definitions
- About possible futures
- Ranking
What do you think John is feeling?
What do you think John is feeling when he yells at you?
What ideas do you think John might have about that?
Are all examples of circular questions addressing what?
Another’s state/behaviors/ beliefs
What does John think of your school performance?
If I ask a teacher what would they say about it?
These are example of circular questions about ….?
Offering alternative perspectives
Do the girls dislike each other?
How do the children react when they see you arguing?
These are example about what type of circular questioning?
About relationships
- Direct
- Indirect
When you and John raise your voices and Jill starts crying what does John do then?
This is a circular question that provides a ….?
Circular Definition
What will you think in five years time?
Miracle Question: imagine you woke up tomorrow morning and all the difficulties you were experiencing currently had disappeared, how would things be different? What effect would that have on your relationship with (x)?
This type of circular question talks about what?
Possible futures
Who is most to get upset when father is away, and who next is most upset?
On a scale of 1 to 10, how close do you think James and Sue feel when they argue is an example of a circular question employing?
Ranking/scaling
Statements from the therapist are used for primarily 3 reasons, these are?
To clarify and acknowledge a communication from the family.
To comment on the position or emotional state of a family member.
To introduce therapist/team ideas, directly or by reflecting on the family dynamics
The book Families in Perpetual Crisis by Kagan and Schlosberg, trauma is perpetuated by:
Fear of Abandonment Secrets Acting out Rejection/Blaming Emptiness Escalation Control Anger Distancing or isolation
As therapist we engage with the family through…
Learning their story
Dealing with Barriers
Evaluating strengths and Competency
Helping through transitions while supporting change
Dealing with home re-entry and crisis management
Team meetings
Promoting Effective Parenting
Four Conflicting agendas between the family goals and therapeutic goals
Failure/No Hope vs. change is possible
Loyalty to family rules vs. promoting alternative patterns
Avoiding painful topics vs. exposing serious issues and/or secrets
Looking to others for control vs. empowering and skill building
3 areas to consider regarding strengthen Family Resilience
Belief System
Making meaning out of adversity
Focusing on a positive outlook
Transcendence and Spirituality
Communication Process
Clarity
Permitting healthy expression of emotion
Utilizing Collaborative Problem Solving
Organizational Patterns
Exploring flexibility
Exploring Connectedness
Exploring social and economical ResourseIntervention Skills for Family
Rituals Enactments Circular Questions Triad Reframe/Metaphor
FBMH Service Components
In-home/Community Intensive Comprehensive Coordinated Team Delivered
FBMH Principles
Child centered and family focused Strength/competency based Collaborative Eco-systemic Structural Trauma informed Culturally competent
Structural Family Therapy is based on the following beliefs:
Issues are viewed systemically verses by individual pathology
Every family is unique
Competency: focus on family strengths
Hierarchy: Who is in charge?
Boundaries: who operates with or against whom?
Roles and Rules: Who is responsible for what? And when?
Relationships: close, distant, cut off, etc.
Structural Family Therapy is:
Present Focused
Goal Directed
Action Oriented
Competence Based
Mission verse Method means:
To Honor the mission, while challenging the Method
Therapeutic Process of the Eco-Systemic Structural Model
1. Stages of Treatment
Biopsycosocial developmental focus
Strength based competency
2. Assessment and Treatment Tools
Contextual assessment
Time line, eco map, genogram, structural map
3. Intervention
Inclusionary and. Collaborative
Utilized throughout course of treatmentSemi-Structured First Interview Session
Social Stage:
Follow the Hierarchy
Assess Social interaction
Spontaneous enactment
Problem/Change stage:
family identifies problems and goals for change and desired outcome.
Interaction Stage:
Begin contextual assessment and observing relational dynamics.
Diagnostic enactment
Have them talk about the pattern between two people.
Summarize stage:
Assessing Suicide Lethality
Ideation
Plan
Motivation
Intent
Adaptive functioning is determined by:
The “fit” of a family’s structure to the demands made upon it from within and beyond the system.
The contextual Assessment focuses on the following areas:
Structure/Organization (genogram) Developmental (individual/family Biology Patterns of Interactions (structural maps) Meaning and Language Unresolved trauma/loss Social constructs Larger System issues (eco map)
Family Life Cycles
Couples before Children Child Bearing Years Child Rearing Years Families with Teenagers Launching: child leaves home Beyond parenting Retirement
Assessment Tools
Genogram Structural Map Time Line Eco Map Semi-structured First Treatment Session or semi-structured first interview
What are the stages of the Logical Model
Stage 1: create a therapeutic alliance/system
Stage Two: stabilize the child and family
Stage 3: assess patterns
Stage 4: establish a relational focus
Stage 5: facilitate functional family relationship (restructuring)
Stage 6: solidify changes and prepare for discharge
