Family therapy Flashcards
Types of family therapy
general systems cybernetics double-bind communication communication/interaction family therapy extended family systems therapy structural family therapy strategic family therapy object relations family therapy
General systems theory
system is maintained by mutual iterations of its components
actions of interacting components are best understood by studying in context
open system
continuously receives input from and discharges output to the environment and is more adaptable to change
homeostasis
tendency for family to act in ways to maintain the family equilibrium or status quo; if one problem improves, likely to appear elsewhere in family
Cybernetics
negative/positive feedback loops
negative feedback loop
reduces deviation and helps system maintain status quo
positive feedback loop
amplifies deviation or change and disrupts the system; can promote appropriate change in dysfunctional family system
Grandfather of family therapy
nathan ackerman
traditional view of individual therapy
Lockean, Western, scientific cause and effect
Systems view of therapy
Kantian; reciprocal view of causality
double-bind communication
conflicting injunctions; one expressed verbally and one nonverbally
Communication/interaction family therapy assumptions
people are always communicating
communication has report (info) and command (relationship) function
interactions are symmetrical or complementary
symmetrical communication
equality between communicators but may escalate to competitive
complementary communication
inequality, maximizes difference between communicators - dominant/submissive
communication/interaction family therapy view of maladaptive behavior
circular model of causality, symptoms are both cause and effect; dysfunction includes blaming, criticizing, mind reading, and overgeneralizing
Communication/interaction family therapy goals and techniques
alter interactional patterns using direct and paradoxical strategies such as prescribing the symptom and reframing
Extended family systems therapy premise
extends system theory beyond nuclear to extended family
Differentiation of self
refers to ability to separate intellectual and emotional functioning; lower differentiation become fused with emotions that dominate family
undifferentiated family ego mass
family whose members are highly fused; choose mates of similar differentiation
emotional triangle
in two-person system with instability, third is recruited to stabilize or reduce stress; lower level of differentiation in family, greater probability of emotional triangle
family projection process
parental conflicts and emotional immaturity are transmitted to kids who have a lower level of differentiation; often involves oldest child or one born during time of stress; this child is perceived as special;
extended family systems view of maladaptive bx
multigenerational transmission process progressively lower levels of differentiation
extended family system goal
increase differentiation
extended family therapy techniques
therapeutic triangle with couple, remaining objective and neutral, reduce fusion; work with more differentiated individual, other will come along
Genogram
depicts relationships between family members, dates of significant life events
Extended family therapy strategies
talk to therapist rather than each other in calm, factual manner; send clients home to family of origin
Structural family therapy - boundaries
overly rigid = disengaged from each other
too diffuse = permeable, family members are enmeshed
rigid triads
chronic boundary problems:
- detouring - parents focus on a child by overprotecting or blaming the child “scapegoating” for family problems
- stable coalition: parent and child form cross-generational coalition and gang up against other parent
- triangulation: aka unstable coalition; each parent demands that the child side with him/her against other parent
structural therapy view of maladaptive bx
result of an inflexible family structure
psychosomatic families
when illness threatens life of child, often a high degree of enmeshment limits individual autonomy with low tolerance for conflict and overprotectiveness
structural family therapy goals
restructure family; actions precede understanding, emphasize chaining bx vs foster insight
Joining
join family in a position of leadership
tracking
identifying and using family values, life themes, and sig life events in conversation
mimesis
adopting family’s affective and communication style
evaluating family structure
evaluate structure, transactional patterns, power hierarchies, and boundaries; may construct family structural map
restructuring family
deliberately unbalance (stress) the family’s homeostasis
enactment
role-play relationship patterns so they can be identified and altered
reframing
relabeling behaviors so they can be viewed in a more positive way
Strategic family therapy influences
Jay Haley - communication/interaction and structural school of family therapy
Milton Erickson - hypnotic technique to increase ability to manipulate client and control course of therapy; paradoxical directives - use client’s resistance to change behavior
Strategic family therapy view of maladaptive bx
role of communication and how it is used to exert control; symptom is an interpersonal phenomenon
Strategic family therapy goals
alter family transactions and organization, particularly hierarchies and generational boundaries
Strategic family therapy 4 stages
social stage, problem stage, interaction stage, goal-setting
Strategic family - approach of therapist
active, take-charge; issue directives
Paradoxical intervention
by resisting the directive, family member ends up abandoning dysfunctional behavior
ordeals
unpleasant tasks the client must perform whenever a symptom occurs
restraining
encouraging family not to change
positioning
exaggerating the severity of symptom
prescribing the symptom
deliberately engage in symptom
Milan systemic family therapy view of maladaptive bx
circular patterns of action and reaction; patterns so fixed that members are no longer to act creatively or make choices about their lives
milan therapy goal
help family members see their choices and assist in exercising choice
milan therapy techniques
therapeutic team: 1-2 members meet and others observe; observers may call therapist out for strategy conference
neutrality
therapist remains an ally of the entire family
milan use of paradox
use counter paradox (therapist double-bind) positie connotation (reframing) -- used not to elicit resistance but to provide info so family can derive solutions
circular questions
used to help recognize differences and similarities in perceptions eg. who was more upset, mom or dad
behavioral family therapy principles
operant conditioning, social exchange and social learning theory
behavioral family therapy maladaptive bx
learned and maintained by antecedents and consequences
bx family therapy techniques
focus on observable bus; ongoing assessment; emphasis on increasing/decreasing bxs through contingent reinforcement; improving communication and problem-solving
functional family therapy
uses cbt strategies
object relations family therapy view of maladaptive bx
result of intrapsychic and interpersonal factors
projective identification
family member projects old introjects onto another family member and reacts as if
object relations family therapy techniques
interpret transferences, resistances to foster insight
multiple transferences
between family members, to therapist, family as whole
