family therapies Flashcards
What theory forms the roots of most approaches to family therapy?
General systems theory and cybernetic theory
What does general systems theory predict about systems?
All systems consist of interacting components, are governed by the same general rules, and have homeostatic mechanisms
What are homeostatic mechanisms?
Mechanisms that help systems maintain a state of stability and equilibrium
What is the focus of cybernetic theory?
Mechanisms that regulate a system’s functioning
What distinguishes negative feedback loops from positive feedback loops?
Negative feedback loops resist change; positive feedback loops amplify change
Who were the early contributors to the application of general systems theory in family therapy?
Bateson and his colleagues at the Mental Research Institute
What problematic behavior is linked to double-bind communication?
The development of schizophrenia
What occurs in double-bind communication?
A person receives two contradictory messages and is not allowed to comment on the contradiction
What are symmetrical interactions?
Interactions that reflect equality and elicit similar behavior from the other person
What can happen to symmetrical interactions over time?
They can escalate in intensity and become a ‘one-upmanship game’
What do complementary interactions reflect?
Inequality in behavior, where one person assumes a dominant role and the other a subordinate role
What occurs when interactions between family members are exclusively symmetrical or complementary?
Problems occur in families
What recent philosophical movement has influenced family therapy?
Postmodernism
What does postmodernism challenge regarding general systems theory?
The premise that there are universal laws governing systems that can be discovered scientifically
What perspective do recent approaches to family therapy generally adopt?
Constructivist or social constructionist perspective
How do recent approaches view the process of family therapy?
As a shared process where the therapist collaborates with the family
Fill in the blank: Bateson distinguished between symmetrical and _______ interactions.
complementary
What is Bowen’s extended family systems therapy also known as?
Intergenerational and transgenerational family therapy
What does differentiation refer to in Bowen’s therapy?
A person’s ability to distinguish between their own feelings and thoughts
What happens when a family dyad experiences tension according to Bowen?
They may recruit a third family member to form an emotional triangle
Fill in the blank: The family projection process refers to the parents’ projection of their emotional immaturity onto their _______.
Children
What is the multigenerational transmission process?
Transmission of emotional immaturity from one generation to the next
What is the primary goal of Bowenian therapy?
To increase each family member’s differentiation
In Bowenian therapy, what is a genogram used for?
To depict family relationships and important life events for at least three generations
What does Minuchin’s structural family therapy assume about family member symptoms?
They are related to problems in the family’s structure
What are subsystems in structural family therapy?
Smaller units of the entire family system responsible for specific tasks
What type of boundary leads to enmeshed relationships?
Overly diffuse boundaries
What is a stable coalition in structural family therapy?
An inflexible alliance between one parent and a child against the other parent
True or False: An unstable coalition occurs when each parent demands that the child side with them.
True
What is the primary focus of structural family therapy?
Promoting behavior change rather than insight
What are the three overlapping phases of structural family therapy?
Joining, evaluating, and intervening
What technique involves adopting the family’s communication style in joining?
Mimesis
What does reframing involve in structural family therapy?
Relabeling a problematic behavior to view it constructively
What is unbalancing in the context of structural family therapy?
Altering hierarchical relationships by aligning with a family member
Fill in the blank: Boundary making is used to alter the degree of _______ between family members.
Proximity
What does enactment involve in structural family therapy?
Asking family members to role-play a problematic interaction
What is the primary assumption of Haley’s strategic family therapy?
Struggles for power and control in relationships are core features of family functioning.
How is a symptom viewed in strategic family therapy?
A symptom is a strategy that is adaptive to a current social situation for controlling a relationship when all other strategies have failed.
What often leads to maladaptive family functioning according to strategic family therapy?
Unclear or inappropriate hierarchies within a family.
What is the primary goal of strategic family therapy?
To alter family interactions that are maintaining its symptoms.
What role does the therapist assume in strategic family therapy?
An active role using a variety of strategies aimed at changing behavior.
What are the four stages of the initial session in strategic family therapy?
- Social stage
- Problem stage
- Interactional stage
- Goal-setting stage
What occurs during the social stage of the initial session?
The therapist welcomes the family and observes the family’s interactions.
What happens in the problem stage of the initial session?
The therapist elicits each family member’s view of the family problem and its causes.
What is the focus of the interactional stage in the initial session?
Family members discuss their different views of the family’s problem while the therapist observes their interactions.
What is the aim of the goal-setting stage in the initial session?
To help family members agree on a definition of the family’s problem and set concrete therapy goals.
What are straightforward directives in strategic family therapy?
Instructions to engage in specific behaviors that will change how family members interact.
What are paradoxical directives in strategic family therapy?
Strategies that help family members realize they have control over problematic behavior.
What does prescribing the symptom involve?
Instructing family members to engage in the problematic behavior, often in an exaggerated way.
What is the purpose of restraining in strategic family therapy?
Encouraging family members not to change or warning them not to change too quickly.
What is an ordeal in the context of strategic family therapy?
An unpleasant task that a family member is asked to perform whenever engaging in undesirable behavior.
What is the primary assumption of Milan systemic family therapy?
The family as a whole protects itself from change through homeostatic rules and patterns of communication.
What are family games in Milan systemic family therapy?
Patterns of communication that are rigid and involve power struggles between family members.
Who are leading contributors to systemic family therapy?
- Salvini-Palazzoli
- Boscolo
- Ceechin
- Prata
What is the primary goal of Milan systemic family therapy?
To alter the family rules and communication patterns that are maintaining problematic behavior.
What distinguishes Milan systemic family therapy from other family therapies?
Its use of a therapeutic team and five-part therapy sessions with gaps of four to six weeks between sessions.
What does hypothesizing involve in Milan systemic family therapy?
A continual interactive process of speculating and making assumptions about the family situation.
What does neutrality refer to in Milan systemic family therapy?
The therapist’s interest in the family’s situation and acceptance of each family member’s perception of the problem.
What is circular questioning?
Asking each family member the same question to identify differences in perceptions about events and relationships.
What is positive connotation in Milan systemic family therapy?
A type of reframing that helps family members view a symptom as beneficial to the family’s cohesion and well-being.
What are family rituals in Milan systemic family therapy?
Activities carried out by family members between sessions to alter problematic family games.
Fill in the blank: In Milan systemic family therapy, problematic behaviors are often associated with __________.
[dirty games]
What is conjoint family therapy also known as?
The human validation process model
It was influenced by humanistic psychology and communication and experiential approaches to family therapy.
According to Satir, what causes family problems?
Problems arise when balance is maintained by unrealistic expectations, inappropriate rules and roles, and dysfunctional communication.
What are the four dysfunctional communication styles identified by Satir?
- Placating
- Blaming
- Computing
- Distracting
What characterizes the congruent communication style?
Congruence between verbal and nonverbal messages, directness and authenticity, and emotional engagement with others.
What is the primary goal of conjoint family therapy?
Enhance the growth potential of family members by increasing their self-esteem, strengthening problem-solving skills, and helping them communicate congruently.
What is considered the most important therapeutic tool in conjoint family therapy?
The therapist’s ‘use of the self’.
What roles do therapists take in conjoint family therapy?
- Facilitator
- Mediator
- Advocate
- Educator
- Role model
What is family sculpting in conjoint family therapy?
Having each family member position others to depict their view of family relationships.
What is the purpose of family reconstruction in conjoint family therapy?
To role-play three generations of the family to explore unresolved family issues and events.
What do practitioners of narrative family therapy believe about a person’s problems?
Problems arise from oppressive stories which dominate the person’s life.
What is the primary goal of narrative family therapy?
Replace problem-saturated stories with alternative stories that support more satisfying and preferred outcomes.
What are the general stages of narrative family therapy?
- Meeting family members
- Listening
- Separating family members from their problems
- Enacting preferred narratives
- Solidifying
What is externalizing in narrative family therapy?
Separating family members from their problems to view them as external.
What techniques are used in narrative family therapy?
- Externalizing questions
- Opening space questions
- Therapeutic letters
- Therapeutic certificates
- Definitional ceremonies
What is emotionally focused therapy (EFT) originally developed for?
As a treatment for couples.
What are the contraindications for EFT?
- Partners have different agendas for their relationship
- Emotional vulnerability is not safe
- Untreated substance use disorder
What are the assumptions of emotionally focused therapy?
- Emotions are essential to attachment behaviors
- Attachment needs are healthy but can lead to problems in insecurities
- Relationship distress is maintained by interaction patterns and emotional experiences
What is the primary goal of EFT?
Expand and restructure emotional experiences to develop new interactional patterns.
What are the three stages of emotionally focused therapy?
- Assessment and cycle de-escalation
- Changing interactional positions and creating new bonding events
- Consolidation and integration
What is EMDR and how has it been integrated into couples therapy?
Eye movement desensitization and reprocessing; integrated into EFT for couples affected by trauma.
What did Knox (2015) find regarding couples who received combined EFT and EMDR?
They experienced the greatest improvement in marital satisfaction and attachment security.
What is Functional Family Therapy (FFT)?
An evidence-based treatment for at-risk adolescents and their families that incorporates elements of structural, strategic, and behavioral family therapy.
What is the primary goal of Functional Family Therapy?
To replace problematic behaviors with nonproblematic behaviors that fulfill the same relationship functions.
How many sessions does Functional Family Therapy typically involve?
8 to 30 sessions over a 3- to 6-month period.
What are the three stages of Functional Family Therapy?
- Engagement and motivation stage
- Behavior change stage
- Generalization stage
What is emphasized during the engagement and motivation stage of FFT?
Forming a therapeutic alliance and reducing feelings of hopelessness.
What techniques are used in the engagement and motivation stage of FFT?
- Joining
- Reframing
What happens during the behavior change stage of FFT?
Immediate and long-term behavioral goals are identified and an individualized treatment plan is implemented.
What techniques are utilized in the behavior change stage of FFT?
- Training in parenting
- Communication
- Problem-solving
- Coping skills
What is the focus during the generalization stage of FFT?
Linking family members to community resources and helping them apply acquired skills to new problems.
What is Multisystemic Therapy (MST)?
An evidence-based treatment originally developed for adolescent offenders at risk for out-of-home placement and adapted for other serious clinical problems.
What model is Multisystemic Therapy based on?
Bronfenbrenner’s ecological model.
What are the nine treatment principles of MST?
- Finding the fit between identified problems and their broader systemic context
- Focusing on positives and strengths
- Increasing responsibility
- Being present-focused, action-oriented, and well-defined
- Targeting behavior sequences
- Using developmentally appropriate interventions
- Encouraging continuous effort
- Stressing evaluation and accountability
- Promoting generalization
Where is Multisystemic Therapy provided?
In the family’s home and community settings.
What is a key factor that MST targets in therapy?
Factors driving problem behaviors.
What does the MST Do-Loop refer to?
An analytic process that structures the development, implementation, and evaluation of the treatment plan.
What does research indicate about the effectiveness of MST?
Effectiveness is reduced when treatment fidelity is low.
What components are included in the quality assurance system for MST?
- Initial and booster training of therapists
- Ongoing supervision and consultation
- Evaluation measures for therapist adherence
- Program implementation review every 6 months
What are the formative stages of group therapy according to Yalom and Leszcz?
- Initial orientation and dependency
- Conflict, dominance, and rebellion
- Development of cohesiveness
What characterizes the initial orientation stage of group therapy?
Group members clarify the nature and purpose of the group and depend on the leader for structure.
What occurs during the conflict, dominance, and rebellion stage?
Members compete for power and control and may become critical of each other.
What is the hallmark of the development of cohesiveness stage?
Conflict decreases and trust among members increases.
What are the therapeutic factors described by Yalom and Leszcz?
- Group cohesiveness
- Instillation of hope
- Universality
- Altruism
- Imparting information
- Development of socializing techniques
- Corrective recapitulation of the primary family group
- Interpersonal learning
- Imitative behavior
- Catharsis
- Existential factors
Which therapeutic factor is considered the analogue of the therapeutic alliance in individual therapy?
Group cohesiveness.
True or False: Cohesiveness is viewed as a precondition for other therapeutic factors.
True.
