Family Based Therapy Deck 2

Question 1

What is Circularity in terms of families?

Answer 1

Patterns of behavior develop within systems, which are repetitive, circular in nature, constantly evolving and which affect all family members.

Question 2

Regarding connections and patterns the therapist should?

Answer 2

Consider the connections between circular patterns of behaviors and the connections between the beliefs and behaviors within the system.

Question 3

What is the importance of Narratives and Language?

Answer 3

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.

Question 4

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?

Answer 4

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.

Question 5

What is social constructionism?

Answer 5

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.

Question 6

Goals during initial session are?

Answer 6

1. Outline Therapy boundaries and structure
2. Engage and involve all family members
3. Gather and clarify information
4. Establish goals and objectives of therapy

Question 7

Goals during middle sessions are?

Answer 7

1. Develop and monitor engagement
2. Gather information and focus discussion
3. Identity and explore Beliefs
4. Work towards change at the level of beliefs and behaviors
5. Return to objectives and goals of therapy

Question 8

Goals during ending sessions are?

Answer 8

1. Gather information and focus discussion
2. Continue to work towards change at the level of behaviors and beliefs
3. Develop family understanding about behaviors and beliefs
4. Secure collaborative decision re: ending
5. Review the process of therapy

Question 9

Examples of various types of circular questions

Answer 9

1. About another’s state/behaviors/beliefs
2. Offering alternative perspectives
3. About relationships
   - Direct
   - Indirect
4. Circular definitions
5. About possible futures
6. Ranking

Question 10

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?

Answer 10

Another’s state/behaviors/ beliefs

Question 11

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 ….?

Answer 11

Offering alternative perspectives

Question 12

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?

Answer 12

About relationships

• Direct
• Indirect

Question 13

When you and John raise your voices and Jill starts crying what does John do then?

This is a circular question that provides a ….?

Answer 13

Circular Definition

Question 14

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?

Answer 14

Possible futures

Question 15

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?

Answer 15

Ranking/scaling

Question 16

Statements from the therapist are used for primarily 3 reasons, these are?

Answer 16

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

Question 17

The book Families in Perpetual Crisis by Kagan and Schlosberg, trauma is perpetuated by:

Answer 17

Fear of Abandonment 
Secrets
Acting out
Rejection/Blaming 
Emptiness 
Escalation
Control
Anger
Distancing or isolation

Question 18

As therapist we engage with the family through…

Answer 18

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

Question 19

Four Conflicting agendas between the family goals and therapeutic goals

Answer 19

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

Question 20

3 areas to consider regarding strengthen Family Resilience

Answer 20

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 Resourse

Question 21

Intervention Skills for Family

Answer 21

Rituals 
Enactments 
Circular Questions
Triad
Reframe/Metaphor

Question 22

FBMH Service Components

Answer 22

In-home/Community
Intensive
Comprehensive
Coordinated
Team Delivered

Question 23

FBMH Principles

Answer 23

Child centered and family focused
Strength/competency based
Collaborative 
Eco-systemic 
Structural
Trauma informed
Culturally competent

Question 24

Structural Family Therapy is based on the following beliefs:

Answer 24

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.

Question 25

Structural Family Therapy is:

Answer 25

Present Focused
Goal Directed
Action Oriented
Competence Based

Question 26

Mission verse Method means:

Answer 26

To Honor the mission, while challenging the Method

Question 27

Therapeutic Process of the Eco-Systemic Structural Model

Answer 27

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 treatment

Question 28

Semi-Structured First Interview Session

Answer 28

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:

Question 29

Assessing Suicide Lethality

Answer 29

Ideation
Plan
Motivation
Intent

Question 30

Adaptive functioning is determined by:

Answer 30

The “fit” of a family’s structure to the demands made upon it from within and beyond the system.

Question 31

The contextual Assessment focuses on the following areas:

Answer 31

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)

Question 32

Family Life Cycles

Answer 32

Couples before Children
Child Bearing Years
Child Rearing Years
Families with Teenagers
Launching: child leaves home
Beyond parenting
Retirement

Question 33

Assessment Tools

Answer 33

Genogram
Structural Map
Time Line
Eco Map
Semi-structured First Treatment Session or semi-structured first interview

Question 34

What are the stages of the Logical Model

Answer 34

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