Family Therapy Theories Flashcards
(58 cards)
1
Q
BOWENIAN/SYSTEMS Family Therapy
Theorists
A
- Murray Bowen
- Michael Kerr
- Monica McGoldrick
- Edwin H. Friedman
2
Q
BOWENIAN/SYSTEMS Family Therapy
Premises
A
- Theory and Therapy are one in the same
- There is chronic anxiety in living
- More highly differentiated persons recover emotional equilibrium faster following stress
- 8 Basic Concepts
- Differentiation of self
- Nuclear Family emotional
process - Multigenerational
transmission process - Family projection
- Triangles
- Cutoffs
- Sibling position
- Emotional process in
society
3
Q
BOWENIAN/SYSTEMS Family Therapy
Techniques
A
- Genograms
- Going Home Again
- Detriangulation
- Person-to-Person relationships (dyads)
- Differentiation of self
- Asking questions
4
Q
BOWENIAN/SYSTEMS Family Therapy
Role of Therapist
A
- Teacher, coach, and/or expert
- Lead cognitively, not emotionally
- Study (cognitive) cues to understanding
- Family members talk through the therapist
-The therapist has a calm presence, has differentiation from his/her family of origin, and is objective and neutral
5
Q
BOWENIAN/SYSTEMS Family Therapy
Process and Outcome
A
- Successful treatment will yield family members who understand intergenerational patterns and gain insight into historical events
- New focus on changing intergenerational influences currently operating in the family
- Changes are facilitated with improved differentiation
- Clarify fusion and unconscious patterns
- Chief focus of change unit is on individual or couple; whole family may not be seen together
6
Q
BOWENIAN/SYSTEMS Family Therapy
Unique Aspects
A
- Focuses on history, patterns, and correction of those patterns
- Systemic in focus
- Considered the most comprehensive theory of family therapy applied to individual counseling
- Has been criticized for being too male-oriented or politically conservative
- Can be costly and/or time-consuming
7
Q
EXPERIENTIAL Family Therapy
Theorists
A
- Carl Whitaker
- Virginia Satir
8
Q
EXPERIENTIAL Family Therapy
Premises
A
- Family members are not aware of their own emotions, or family members suppress their own emotions
- Emotionlessness is symptom representation
- Emphasize sensitivity and expression of feelings
- Action, here-and-now approach to accessing feelings
- Humanistic and phenomenological
- Attachment theory is important to this family therapy
9
Q
EXPERIENTIAL Family Therapy
Techniques
A
- Whitaker: redefine symptoms as efforts for growth, model fantasy alternatives for real-life stress, augment despair of family member, etc. (few)
- Satir: structured techniques such as “I” messages, sculpting, etc.
- Other: play therapy, family drawing, puppet interviews, etc.
10
Q
EXPERIENTIAL Family Therapy
Role of Therapist
A
- Active participant (a whole person) – not teacher/director
- User of absurd techniques
- Facilitator and resource person
- Assist family members in discovering their individuality
- Promoter for change
- Stimulator of experiences
11
Q
EXPERIENTIAL Family Therapy
Process and Outcome
A
- Family members become more aware of their feelings
- Family members are more capable of autonomy and real intimacy
- Whitaker: 3 phases of therapy are engagement, involvement, and disentanglement
- Satir: 3 phases of intervention are make contact, chaos, and integration
- Counselor wins the battle for structure, client wins the battle for initiative
12
Q
EXPERIENTIAL Family Therapy
Unique Aspects
A
- Emphasizes training programs set up to help others
- Emphasis on research, Satir’s and Guerney’s research specifically
- Treatment length varies, but can be short-term (direct)
- Too dependent on charismatic counselors
- Focus on the present, not past
- Promote individual growth and interpersonal change, not family growth
- Emphasis on feelings
13
Q
SOLUTION-FOCUSED Family Therapy
Theorists
A
- Steve deShazer
- Insoo Kim Berg
14
Q
SOLUTION-FOCUSED Family Therapy
Premises
A
- Social constructionism; knowledge is time and culture bound
- Dysfunctional families get stuck in dealing with problems, relying on patterns that do not work
- Identifying a problem is key/treating the problem
- Not so much focus on family history
- Small amounts of change are necessary
- If it’s not broken, don’t fix it.
- Do more of what works.
- Do not do more of what does not work.
15
Q
SOLUTION-FOCUSED Family Therapy
Techniques
A
- Co-create a problem
- Miracle question, hypothetical solution
- Exceptions
- Scaling
- Second-order (qualitative change)
- Compliment
- Clue
- Skeleton Keys
- deShazer’s 5 interventions
16
Q
SOLUTION-FOCUSED Family Therapy
Role of Therapist
A
- Deal with families as either visitors, complainants, or customers
- Respect, rapport, challenge them to find exceptions to complaints
- Co-create problems, compliment
- Facilitator of change
- Effective with language/pre-suppositional questions
- Mapper of solutions together with family
17
Q
SOLUTION-FOCUSED Family Therapy
Process and Outcome
A
- Seek solutions
- Tap inner resources
- Emphasizes expectation that change will occur
- Presupposes families as cooperative
- Change is inevitable
- Future-oriented
- Optimism-oriented
18
Q
SOLUTION-FOCUSED Family Therapy
Unique Aspects
A
- Family’s own theory is the best theory to follow
- Define problems and needed change precisely and clearly
- Focus is on change, not understanding the family’s history
- Do something different, imagine a future, imagine when symptoms do not occur
- Keep focus small
19
Q
NARRATIVE Family Therapy
Theorists
A
- Michael White
- David Epston
20
Q
NARRATIVE Family Therapy
Premise
A
- Non-systemic approach that is post-modernistic and socially constructivistic
- Drawn heavily from literature, anthropology, and critical theory
- Empower client-families to develop their own unique and alternative stories about themselves, hoping they can come up with novel options and strategies for living
- Externalization of the problem (difficulties are externalized)
- Lived experiences become narratives
- Task is to co-construct an alternative storyline
21
Q
NARRATIVE Family Therapy
Techniques
A
- More process-oriented
- Externalization of the problem
- Influence of the problem on the person
- Raising dilemmas
- Predicting setbacks
- Celebrations and certificates
- Using exceptions questions and significance questions
- Letters
22
Q
NARRATIVE Family Therapy
Role of Therapist
A
- Collaborator
- Non-expert
- Influential but de-centered
- Symptoms are not seen as a function for families, but problems are seen as oppressive
- Co-author or editorial assistant
23
Q
NARRATIVE Family Therapy
Process and Outcomes
A
- Families are taught to value experiences and stories
- Consists of three phases: deconstructing the dominant cultural narrative, externalizing the problem, and re-authoring the story
24
Q
NARRATIVE Family Therapy
Uniques Aspects
A
- Based on post-modern, social constructionist points of view
- Most intellectual of all of the family therapies, along with SFT
- Focus on exceptions to the problem, rather than the actual problem
- Expecting setbacks/predicting obstacles
- Letters being sent to families about progress
25
COGNITIVE BEHAVIORAL Family Therapy
Theorists
- Watson
- Pavlov
- Skinner
- Wolpe
- Bandera
- Patterson
26
COGNITIVE BEHAVIORAL Family Therapy
Premises
Irrational beliefs maintain maladaptive behaviors so the goal is to create new thought patterns
27
COGNITIVE BEHAVIORAL Family Therapy
Techniques
- Positive reinforcement
- Extinction
- Modeling
- Role playing
- Thought stopping
28
COGNITIVE BEHAVIORAL Family Therapy
Role of Therapist
- Expert
- Teacher
- Coach
- Designer
29
COGNITIVE BEHAVIORAL Family Therapy
Process and Outcomes
Change the cognitions which will lead to an increase of positive behaviors and a decrease of negative behaviors which will lower anxiety
30
COGNITIVE BEHAVIORAL Family Therapy
Unique Aspects
- Well researched and supported by empirical data
- Short term therapy
- Rejects medical model
31
EMOTIONALLY FOCUSED Therapy
Theorists
- Sue Johnson
- Les Greenberg
- Based on John Bowlby’s Attachment theory
32
EMOTIONALLY FOCUSED Therapy
Premises
- Secure attachment is related to: higher self-esteem, internal locus of control, extroversion, and openness to experience.
- EFT strives to develop more secure attachment styles in couples through the use of emotions as a “positive force for change.”
- Emotion is the music of the attachment dance.
33
EMOTIONALLY FOCUSED Therapy
Techniques
- Focus on disclosure of emotions.
- Therapist probes and asks partners to acknowledge immediate feelings.
- Explore perceptions that underlie emotional responses.
- Express and release emotions.
- Develop empathy and attachment.
- Psychodrama, Empty Chair technique
- Develop new cycles of safe emotional connection and go to deeper feelings
34
EMOTIONALLY FOCUSED Therapy
Role of Therapist
- Provide a safe environment for the release of positive and negative emotions.
- Encourage emotional expression, protect the couple as individuals and partners.
35
EMOTIONALLY FOCUSED Therapy
Process and Outcome
Three stage Interaction process with nine steps.
Stage 1 - Cycle De-escalation (steps 1-4)
Stage 2 Restructuring interactional positions (steps 5-7)
Stage 3 Consolidation/Integration (Steps 8,9)
36
EMOTIONALLY FOCUSED Therapy
Unique Aspects
- Strong empirical base.
- Process-research oriented and focuses on key elements of change.
- In sync with Gottman’s research on the importance of positive and negative interaction ratios.
- Appropriate to use with couples from all backgrounds.
37
STRUCTURAL Family Therapy
Theorists
Salvador Minuchin is the founder of the theory.
38
STRUCTURAL Family Therapy
Premises
- Every family has a family structure.
- Developmental or situational events increase family stress, rigidity, chaos, and dysfunctionality throwing the family into crisis.
- A person’s symptoms are best understood as rooted in the context of family transaction patterns. The family is seen as the client.
- Subsystems are formed when family members join together to form various functions.
- Boundaries are the physical and psychological factors that separate people from one another and organize them.
39
STRUCTURAL Family Therapy
Techniques
- Techniques are designed to address dysfunctional sets. Dysfunctional sets are the family reactions, developed in response to stress, that are repeated without modification whenever there is family conflict.
- The techniques are divided into those “that are primarily used in the formation of a therapeutic system.”
- They are aimed at provoking disequilibrium and change.
Joining-the therapist adjusts to the communication style and perceptions of the family members. The family is joined through tracking, mimesis, confirmation, and accommodation.
Disequilibrium Techniques-reframing, punctuation, unbalancing, enactment, working with spontaneous interaction, boundary making, intensity, restructuring, shaping competence, diagnosing, and adding cognitive constructions.
40
STRUCTURAL Family Therapy
Role of Therapist
- The therapist is both an observer and an expert who is active, like a theater director, in making interventions to modify and change the underlying structure of the family.
- In the first phase of treatment, the therapist joins the family and takes a leadership position.
- In phase two the therapist mentally maps out the family’s underlying structure. In the last phase the therapist helps the clients transform the family structure.
41
STRUCTURAL Family Therapy
Process and Outcomes
- The process is gradual but steady.
- When it is successful, the approach results in symptom resolution and structural changes.
- Family members are given homework in addition to what is done in therapy.
42
STRUCTURAL Family Therapy
Unique Aspects
- It is versatile.
- It emphasis on terminology and ease of application.
- It helped make family therapy as a whole acceptable to medicine in general and psychiatry in particular.
- It emphasizes symptom removal and reorganization of the family.
- Its pragmatic and problem solving.
43
BEHAVIORAL Family Therapy
Theorists
- The initial work was conducted by Gerald Patterson and John Reid.
- Neil Jacobson, John Gottman also was major theorist in this type of therapy.
44
BEHAVIORAL Family Therapy
Premises
- Behavior is maintained by its consequences and will continue unless more rewarding consequences result from new behaviors.
- Maladaptive behaviors, and not underlying causes, should be targets of change.
- Not everyone in the family has to be treated in order for change to occur.
- Does not have an emphasis on the importance of “family rules and patterned communication processes, and as well as a functional approach to outcome”
- Stresses the rewards and costs of relationships in family life according to a behavioral economy.
45
BEHAVIORAL Family Therapy
Techniques
- Focuses on parent training, interpersonal family functioning, treatment of sexual dysfunctions, and working with the family as the whole.
- Bring out behavioral changes by modifying the antecedents or consequences of an action
- Modify the consequences
- Emphasis on eliminating undesirable behavior and acceleration of positive behavior
- Teaching social skills
- Promoting competence and fostering and understanding of the dynamics of behavior
46
BEHAVIORAL Family Therapy
Role of Therapist
- Therapist is the teacher, collaborator, coach, and an expert
- Modeling is an excellent technique and give corrective feedback
- Use of the Anatomy of Intervention Model that delineates five phases in therapy-introduction, assessment, motivation, behavior change and termination
47
BEHAVIORAL Family Therapy
Process and Outcomes
- Family members learn to modify, change, or increase/decrease certain behaviors and or thought.
- Increase skills in specific areas such as parenting, interpersonal functioning, and sexual behaviors
- Family member will be able to modify their behaviors without the therapist
48
BEHAVIORAL Family Therapy
Unique Aspects
- Utilizes learning theory and research
- Continued evolution on familial skills to focusing on the family as a system
- Teaching new social skills
- Treatment is short term
- The theory rejects the medical model of abnormal behavior
49
PSYCHODYNAMIC Family Therapy
Theorists
- Ackerman, Boszmornenyi
- Nagy, Framo
- A “good enough mother”
- A catalyst stirring up interaction in family
50
PSYCHODYNAMIC Family Therapy
Premises
- Interlocking pathology,
- Object relations theory
“the past is active in the present”
- Change is hard work and takes lots of time.
51
PSYCHODYNAMIC Family Therapy
Techniques
- Transference
- Dream and daydream analysis
- Confrontation
- Focusing on strengths
52
PSYCHODYNAMIC Family Therapy
Role of Therapist
- Differentiation from other family members.
| - Opting for crisis resolution if differentiation not possible.
53
PSYCHODYNAMIC Family Therapy
Process and Outcome
- More linear than some approaches; focuses on cause and effect.
- Requires heavy time and financial commitment, above average intellectual ability, and lacks empirical research.
54
STRATEGIC Family Therapy
Theorists
- M. Erickson
- J. Haley
- Cloe Madanes.
55
STRATEGIC Family Therapy
Premises
- Emphasizes short-term therapy/ 10 sessions
- Evaluates what has been tried, and different solutions are tried.
- Nonverbal msgs, prescribing the symptoms.
56
STRATEGIC Family Therapy
Techniques
Reframing, directives, paradox, ordeals – helping client give up behaviors that are difficult to maintain, pretend, positioning – acceptance/exaggeration of fam members statements
57
STRATEGIC Family Therapy
Role of Therapist
- Helped to resolve and remove agreed-on problem
- defining problem clearly, investigating prev solutions, defining concrete change, implementing strategy
- emphasis on process, not content.
58
STRATEGIC Family Therapy
Process and Outcomes
- Flexible for variety of fams; Possibility of change at indiv, dyad, systemic levels.
- Focus is only on one problem; seen as too mechanical
- requires exp therapist; number of sessions could limit process.
