Family Systems theory

Question 1

Who conceptualised the Multigenerational Family Therapy and what is it known for?

Answer 1

Murray Bowen
- creator of the family genogram
- shows emotional connections between family members

Question 2

4 of them

What are the key concepts in Multigenerational Family Therapy?

Answer 2

1. Triangles
2. Differentiation of self
3. Nuclear family emotional process
4. Family projection process

Question 3

Bowen’s MFT

What does Bowen’s approach premises on?

Answer 3

His approach premises on a predictable pattern of interpersonal relationships connecting the functioning of family members across generations

Question 4

Bowen’s MFT

What is the concept of triangles about?

Answer 4

Identifying triangles help us notice certain patterns of interaction
Coping mechanisms involve interaction patterns which transmit through generations

Question 5

Bowen’s MFT

What do social workers need to be aware about triangles? And what should social workers do about it?

Answer 5

Triangulation can easily happen between family members and the counsellor when there is tension; hence, Bowen stressed the need for counsellors to be aware of their own family-of-origin

Question 6

Bowen’s MFT

What is differentiation of self? How does good differentiation look like?

Answer 6

a very distinct separation between intellect and emotion and independence of the self from others
a well-differentiated person can
* set healthy boundaries between their and others’ emotions
* manage their anxiety
* able to accept responsibility for their actions and feelings
* have overall better functioning

Question 7

Bowen’s MFT

What does poor differentiation of self look like?

Answer 7

Emotional reactivity
“I feel like he shouldn’t have done that to me.”
“If my mum is not ok, I am not ok. I need to save her.”

Question 8

Who conceptualised Structural Family Therapy?

Answer 8

Salvador Minuchin

Question 9

What did Minuchin premise his approach on?

Answer 9

• thrust of the issue lies in the systems and dynamics rather than the individual
• every family structure has a family hierarchy, boundaries, roles, issues of power and implicit rules

Question 10

What is the key concept in Structural Family Therapy?

Answer 10

Patterns of interaction

Question 11

Minuchin’s SFT

What questions do we ask to examine patterns of interaction?

Answer 11

• Who is in charge?
• Where is the power?
• Who is left out?
• Who is allied with who?
• What are the rules of interaction? (unwritten family rules)
• What types of interactions: Chaotic? Enmeshed? (loose boundaries because client is so open they allow the person come in any time) Disengaged? (rigid boundaries because client is not open to receiving and giving energy) Balanced?

Question 12

Minuchin’s SFT

What are the goals of Structural Family Therapy?

Answer 12

1. reduce symptoms of dysfunction
2. change patterns of interaction
3. bring about structural change within the system by modifying family rules and developing more appropriate boundaries

Question 13

Minuchin’s SFT

What is the therapeutic process like for Structural Family Therapy?

Answer 13

• invite the family to re-enact a conflict scene
• “what if i’m gonna give you permission to not be involved with this conflict? give you freedom to participate as a parent“
• invite the family to re-enact in a different way (e.g. change the seating positions, make sure the client speaks with the other member instead of the therapist)
• after the acting, “how is this different from the first scene?”

Question 14

Who developed Systemic Family Therapy?

Answer 14

Milan Group

Question 15

What are the key concepts in Systemic Family Therapy?

Answer 15

• Circular questioning
• Co-therapy with a reflecting team behind a one-way mirror

Question 16

What are the four types of questioning in Family Systems Theory?

Answer 16

1. lineal: for cause-and-effect understanding
2. circular: for tracking interaction patterns
3. strategic: to influence in a specific manner (interventive interviewing)
4. reflexive: Facilitative and generative (interventive interviewing)

Question 17

What kind of intent do lineal and circular questions have?

Answer 17

Orienting intent - to find out more about the client

Question 18

What kind of intent do strategic and reflexive questions have?

Answer 18

Influencing intent - to influence and facilitate change in client

Question 19

What are lineal questions? What is the intent and effect of it?

Answer 19

• Clarify sequence of events over time
• intent: investigative, to generate cause-and-effect understanding for interviewer
• effect: conservative

Question 20

What are examples of lineal questions?

Answer 20

• what is happening? (problem definition question)
• can you tell me more?
• when did this problem start?
• what makes you think there is a problem between you two? (problem explanation question)

Question 21

What is circular questioning? What is the intent and effect of it?

Answer 21

• clarify the here and now relationships
• intent: exploratory. explore the context and track interaction patterns
• effect: liberating

Question 22

What are examples of circular questioning?

Answer 22

• When he said this, what is your response? (Behavioural effect question)
• did any member agree or disagree with you on this?
• how is your husband’s perception of your son’s bed-wetting different from yours? (Difference question)

Question 23

What are strategic questions? What is the intent and effect of it?

Answer 23

• Questions to influence the client or family ‘correctively’
• intent: corrective - influence client in a particular manner by helping them think deeper about the consequences, the kind of outcome they really want and how stuck they are
• effect: constraining

Question 24

What are some examples of strategic questions?

Answer 24

• What do you think will happen if you continue to engage him when he is already so enraged?
• I wonder if you continue to do this, what is going to happen to your relationship with your son? (leading/confrontation question)

Question 25

What is reflexive questioning? What is the intent and effect of it?

Answer 25

intent: facilitative.
* surface underlying assumptions and question them
* to trigger the client to become the observer of their own behaviour and mobilise their awareness to modify the behaviour
* to facilitate self-healing in individual/family by activating reflexivity among meanings within pre-existing belief systems

effect: generative

Question 26

What are the 7 types of reflexive questions?

Answer 26

1. future-oriented
2. observer-perspective
3. unexpected context change
4. embedded questions
5. normative comparison
6. distinctive-clarifying
7. process-interruption

Question 27

What is the intent of future-oriented questions? What are examples?

Answer 27

intent: to unstuck clients who are stuck in the past/present
Examples:
1. What would you like to be in five years’ time?
2. What would it be like in 10 years time if you continue fighting?
3. How would that affect your relationship with [person]?
4. What is your greatest fear if your parents continue stopping you from seeing your friends?

Question 28

What is the intent of observer-perspective questions? What are examples?

Answer 28

intent: to help client view the situation as an observer; see things from more perspectives and be opened to new possibilities
Examples:
* When was the last time when you had a good time with your family?
* Imagine you’re your friend, how would you see this differently?
* Supposing there was an important reason for you to continue in this uncomfortable way of communication what could it be?

Question 29

What is the intent of normative-comparison questions? What are examples?

Answer 29

intent: to help clients orient themselves towards healthier patterns by focusing on differences and highlighting similarities with sociocultural and developmental norms
Example: What do you observe your peers doing at this stage of life, which is different from what you are doing now? Do you think you are more open to disagreements than most families, or less?

Question 30

What is the intent of distinction-clarifying questions? What are examples?

Answer 30

intent: to clarify confusion in meanings and beliefs by making distinctions - find out exactly what the client feels
Examples:
* What tears do you think this is- sad or angry tears (or something else)?
* Do you think he sees your frequent phone calls as more caring for him or more controlling him?
* From the scale of 1-10, where do you think you are in wanting to leave the marriage?

Question 31

What is the intent of embedded-suggestion questions? What are examples?

Answer 31

• Intent: when family members need a little nudge with more specificity
• I wonder what could this situation go if you spoke more calmly with one another?
• How do you think your relationship would improve if you share your thoughts honestly with one another?

Question 32

What are the intentions of process-interruption questions?

Answer 32

intent:
* to enhance client’s awareness of interaction patterns so that clients make more conscious choices of their participation
* anchored in the here-and-now
* dealing with the process there and then

Question 33

What is an example of process-interruption questions?

Answer 33

Whenever two of you quarrel, does your daughter intervene by crying and screaming as she does now?
(specify “when you two quarrel”, not “when you are at home” to show impact of interaction pattern)

Question 34

What shall a counsellor do/ask when a client is silent/unwilling to share?

Answer 34

• acknowledge their presence
• “Jacob has been listening quietly. I wonder what he is thinking and I’ll be happy when he is ready to share”