Final Flashcards
interventions aimed at helping he family change maladaptive interactions are called ______?
restructuring
strategic + structural
(strategic)
equifinality
can’t assume the cause of the symptom are the same
(strategic)
equipotentiality
can’t assume different techniques/theories will work for all clients
(strategic)
punctuation
ppl interpret language differently
(strategic)
traditional relationship based on differential in power that emphasizes differences between partners
complementary
maximize differences
greater stress = greater division of power
(strategic)
symmetrical relationship
based in equality
competitive & escalates to higher levels of aggression
partners mirror each others behaviors
strategic: techniques
paradoxical interventions
therapeutic double find
• variety of paradoxical techniques to change entreneched fam patterns – forces into no-lose situation = attempt new solutions & gain control over symptoms
• destructive form of paradoxical injunction: form of comm that must be obeyed & disobeyed to be obeyed
o 2 conditions must exist: a. close complimentary relationship & b, recipient can’t avoid responding to metacommunication
use of language to bring new meaning to a situation
reframing
strategic
directives
tasks aimed at breaking inappropriate sequences of beahvior
asked to continue/exaggerate Sx (remove resistance & challenges purpose of symptom) ex. ask family to fight everyday
prescribing the symptom
relabeling
change label attached to person/problem from neg to positive (alters meaning & invites new response)
paradoxical tasks
illogical intervention to maneuver family into abandoning dysfunctional behavior
types of paradoxical tasks
reframing relabeling prescribe Sx (pretend) Replace Sx (ordeal) directives (utilize resistance)
ask client to exhibit Sx
pretend/behavior prescription
replace Sx with more beneficial one
ordeals/Sx substitution
ask client to slow down not change
directives/utilize restistance
Tasks aimed at breaking inappropriate sequences of behaviors
directives
circular questioning
strategic
An interviewing technique, first formulated by Milan systemic therapists, aimed at eliciting differences in perception about events or relationships from different family members, particularly regarding points in the family life cycle when significant coalition shifts and adaptations occurred.
A type of dyadic transaction or communication pattern in which inequality and the maximization of differences exist (for example, dominant/submissive) and in which each participant’s response provokes or enhances a counter-response in the other in a continuing loop.
complementary
counterparadoxes
In systemic family therapy, placing the family in a therapeutic double bind in order to counter the members’ paradoxical interactions.
first-order changes
Temporary or superficial changes within a system that do not alter the basic organization of the system itself.
hypothesizing
As used by systemic therapists, the process by which a team of therapists forms suppositions, open to revision, regarding how and why a family’s problems have developed and persisted; to facilitate asking relevant questions and organizing incoming information, it occurs before meeting the family.
metacommunication
A message about a message, typically nonverbal (a smile, a shrug, a nod, a wink), offered simultaneously with a verbal message, structuring, qualifying, or adding meaning to that message.
neutrality
As used by systemic family therapists, a nonjudgmental and impartial position, eliciting all viewpoints, intended to enable the therapist to avoid being caught up in family “games” through coalitions or alliances.
A communication to obey a command that is internally inconsistent and contradictory, as in a double-bind message, forcing the receiver to disobey in order to obey.
paradoxical injunction
paradoxical interventions
A therapeutic technique whereby a therapist gives a client or family a directive he or she wants resisted; as a result of defying the directive, a change takes place.
rituals
Symbolic ceremonial prescriptions off ered by a therapist, intended to address family conflict over its covert rules, to be enacted by the family in order to provide clarity or insight into their roles and relationships.
relabeling
Verbal redefinition of an event in order to make dysfunctional behavior seem more reasonable and understandable, intended to provoke in others a more positive reaction to that behavior.
punctuation
The communication concept that each participant in a transaction believes whatever he or she says is caused by what the other says, in effect holding the other responsible for his or her reactions.
Paradoxical interventions based on play and fantasy, in which clients are directed to “pretend” to have a symptom; the paradox is that if they are pretending, the symptom may be reclassified as voluntary and unreal, and thus able to be altered.
pretend techniques
positive connotation
A reframing technique used primarily by systemic family therapists whereby positive motives are ascribed to family behavior patterns because these patterns help maintain family balance and cohesion; as a result, the family is helped to view each other’s motives more positively.
A paradoxical technique in which the client is directed to voluntarily engage in the symptomatic behavior; as a result, the client is put in the position of rebelling and abandoning the symptom or obeying, thereby admitting it is under voluntary control.
prescribing the symptom
second-order changes
Fundamental changes in a system’s organization, function, and frame of reference, leading to permanent change in its interactive patterns.
A type of dyadic transaction or communication pattern characterized by equality and the minimization of differences; each participant’s response provokes a similar response in the other, sometimes in a competitive fashion.
symmetrical
symmetrical escalation
A spiraling competitive effect in the communication between two people whose relationship is based on equality, so that vindictiveness leads to greater vindictiveness in return, viciousness to greater viciousness, and so forth.
systemic family therapy
A Milan-model therapeutic approach in which the family, as an evolving system, is viewed as continuing to use an old epistemology that no longer fits its current behavior patterns; the therapist indirectly introduces new information into the family system and encourages alternative epistemologies to develop.
therapeutic double bind
A general term that describes a variety of paradoxical techniques used to change entrenched family patterns.
exceptions
In solution-focused therapy, attention to the times when the problem did not occur, intended to help build problem-solving skills.
A postmodern procedure for gaining meaning by reexamining assumptions previously taken for granted, in the service of constructing new and unencumbered meanings.
deconstruction
constructivism
The belief that an individual’s knowledge of reality results from his or her subjective perceiving and subsequent constructing or inventing of the world, rather than resulting from how the world objectively exists.
relfecting teams
A process involving two-way mirrors in which team members observe a family and then discuss their thoughts and observations in front of the family and therapist. Later, the therapist and family discuss the team’s conversations about them.
externalizations
In the narrative approach, helping families view the problem or symptom as occurring outside of themselves, in an effort to mobilize them to fight to overcome it.
unique outcomes
In narrative therapy, those instances when the client did not experience the problem; such outcomes are intended to help contradict a client’s problem-saturated outlook.
therapeutic double bind is a form of paradoxical injunction & requires ____ 2 conditions?
(strategic)
close complementary relationship + recipeint of message can’t avoid responding to metacommunication
doomed to failure no matter what response is
strategists believe….all comm takes place on at least 2 levels:
- surface/content level (what is said) &
2. Metacommunication (qualifies what is said on first level – facial exp/tone)
strategists see Sx as a result of
faulty communication (transactional/behavioral) patterns & mishandling normal difficulties
problems arise from families missolutions in attempt to resolve problems – must give up faulty solutions
recursive feedback loops that maintain behaivor
strategists = people are resistant they are “stuck” in repetitive non-workable solutions to everyday transitions
pragmatic therapist directed approach to break familys repetitiev cycle
First-order change:
strategic
superficial behavioral change, short-lived, doesn’t change structure
(Ex. family agrees to end all arguing)
Second-order changes:
strategic
revise structure/function-change rules
ex. change families assumptions RE: problem
strategist:
all comm has content (report) and relationship (command)
= defines relationship
strategist:
therapist responsible for change through _____
directives:
tasks aimed at eliminating ineffective interational sequences
designed to gain control over Sx & force families to attempt different solutions
purpose of paradoxical approaches is?
interrupt families established but ineffective pattern of interaction by powerful indirect means
therapeutic double bind
variety of paradoxical techniques used to change entrenched family patterns
intended to force person into lose-lose (change by remaining the same)
prescribing the symptom
strategic
form of therapeutic double bind:
direct client to engage in symptom
relabeling
strategic
form of therapeutic double bind:
change meaning from negative to positive = different perception
language is used to alter the interpretation of what has occurred to invite possibilty of new response
the goal of therapeutic double bind (relabeling & prescribing the sx) ?
change the structure of family relationships & interactions
MRI: 3 types of misguided solutions
- actions is needed but not taken
- actions is taken when unnecessary
- actions is taken at wrong level
(strategic) in every transaction = struggle for control of the definition of the relationship
Sx in 1 partner = maladaptive control strategy
problems involve 2 or 3 people
strategic
focus on problematic family structures (hiearchy, boundaries)
+
dysfunctional behavioral sequences
(strategic)
bypass resistance through paradoxical directives
have client hold onto Sx and induce directions to induce change
stages of strategic:
brief social stage: observe family members
problem stage: why family is here
interactional stage: discuss problem
goal setting stage: determine problem wished to resolve
task setting stage: assignments/directives
paradoxical tasks (strategic) 1. Pretend
= behavior prescription – produce behavior even when not present - Ask client to exhibit their Sx
• if you can create Sx = you can get out of it - awareness/ownership
• (Ex. Pretend to be depressed throughout the week)
paradoxical tasks (strategic) 2. ordeals
= Sx substitution - replace Sx w/more beneficial Sx
• Client directed to engage in a mildly noxious activity that is also good for them each time Sx appears – (Ex. Trouble sleeping—clean the entire house
paradoxical tasks (strategic) directives
- utilize resistence – ask client to slow down, not change
o Tasks aimed at breaking inappropriate sequences of behaviors
o 2 forms:
♣ prescriptive (ask client to do something)
• ex. restrain from change & ordeal
♣ descriptive: (relabel w/positive meaning)
o (Ex. client suspicious of spouse affair – pretend to be a spy & find evidence that they’re not having an affair)
o goal = change behavior to change perception + intensify sessions by involving therapist + father info based off reactions
Strategic Theory
- communication theory, active, straightforward, use of directives/tasks change interactional patterns
- remove dysfunctional bhncr sequence by tracking fam interactional patterns + directive
- view problems by focus on: sequence of interactions & hierarchy of interactions – what maintains behaviors
- change oriented, Clients determine what the problem is
- focus on what gets communicated and how
- focus on hierarchies, triangles & transactions to see how presenting problem is maintained by faily
- help family re-examine belief systems (vs helping them change their interactive patterns)
- brief (10 sess-terminante when problems gone), structured sessions, pragmatic, non-historical,
- faulty comm & mishandling normal difficulties = dysfunction – focus on process of exchange (vs content)
- problems arise from families solutions in attempt to resolve problems – must give up faulty solutions
- all comm has content (report) and relationship (command) = defines relationship
Marital schism
(2 patterns of chronic marital conflict in schizo families: (schizo due to failure of both parents to be supportive & develop complementary roles) How disturbed families maladtively deal w/emotions & maintain relationships
• Parents preoccupied with own problems – undermine each others worth to children & compete for loyalty, affection, sympathy and support of children
• Parents don’t respect / value each other – fear that child will end up like spouse
• Common = Threats of separation/divorce & father is shunned
Marital Skew:
- 1 parent with serious psychological disturbance + other parent is weak/dependent
- weak parent accepts situation / denies realityl tells children its normal
- lead to further denial & distortions of reality by children
- common = male schizos from skewed family with dominant/emotionally disturbed mother
Pseudomutuality
- False appearance of a mutual, open & understanding relationship
- used to cover up conflict / conceal distance & lack of intimacy btwn members
- shared family defense mechanism to avoid separation from eachother + meaninglessness
- labels member Identified patient = allows myth by others that their normal
- family emphasis on togetherness & views personal identity as threat to family
- results in: no sense of self, lack in outside social interaction + family as priority
pseudohostility
: bickering = Inability to deal with intimacy + impairs realistic sense of relationships
First order cybernetics
- Family systems possess self-regulating ability. & Feedback processes can simultaneously occur at several systems levels with families.
- how systems are self-regulated & maintain stability – all changes understood as effort to keep constancy & all constancy kept through change
- Use of self-regulating feedback mechanism to resist change & maintain balance
- Analysis of feedback mechanisms = evidence of purpose & goal-directed behavior toward self regulation
Enabled family:
succeeds at balancing needs + operating on behalf of interest of members
• most therapists might start with a theoretical preference, but in practice eventually become eclectic
true
triadic, “I” positions
• bowen –
Building supportive partnerships within the family is a goal of
= psychoeducational therapy
Brief therapy =
strategic, social construct, CBT (NOT contemporary psychoanalytic)
Solution focused intervention =
posing miracle questions
Structuralist = combine action & insight
TRUE
White bypassed insight and action by focusing instead on cognitive change via finding new meanings
true
• Experiential therapist
= strive to be active, open & spontaneous
= try to help the family detach from a dominating story line
Narrative therapist
