module 8;systemic approaches Flashcards
explain the benefits of systemic approaches
Helps to relieve individual suffering by improving family understanding/communications/connections, heal rifts, have difficult conversations,accept differences, challenge beliefs.
Systemic approaches are used when the desired outcome is a change between or among members of the system.
describe the history of systemic thinking and practices and how it continues to evolve
The Systemic Approach places individual problems as existing within systems (usually family but there are other systems).
PHASES;
1. First Order Cybernetic phase;1950’s-19’70’s. System knowledge and the view that the whole is bigger than the parts, and the parts influence and interact with each other. Objective descriptions of family functioning.Modernity.
2. Second Order Cybernetic Phase;1970’s-1980’s. There is not just one objective view, but multiple perspectives to be considered. Post -modern.
3. Third Order Cybernetic phase;1980’s-2000. Social Contructivism. Considers impact of language, gender roles, culture.
SCHOOLS OF FAMILY THERAPY;
1.Structural Family Therapy (Minuchkin);Often uses in-therapy enactments. Focuses on rules (explicit/implicit), boundaries (rigid/diffuse/clear), disengagement/enmeshment, subsets/triangles/hierarchies/coalitions.
2.Intergenerational (Bowen);focusses on family mapping and genograms.Identify recurring patterns of communication. Also helps identify coalitions/triangles.
3. Strategic Interventions (Hayley);Designed as brief. 10 sessions. Much homework. Is intervention-ie counsellor decides more. less insightful. Often uses paradoxes. Focuses on problem assessment.
4.Milan School;Focuses on multiple perspectives. Uses circular questioning and usually 2 therapists (commonly a man and a woman)
5.Narrative Approaches (White & Epstein):empower clients to develop personal narratives. Also much awareness of cultural/social expectations and how these influence family functioning. This approach is part of the Third Phase approach.
outline how core systems models can be used to produce therapeutic change
CORE SYSTEMIC CONCEPTS;
1.Collective versus individual.
2.Connected in circular ways. Consequence is often described as linear (A leads to B). But in family systems in is usually A leads to B which causes more A, and keeps cycling/spiralling. Plus, there are often many more members interacting together, not just A and B.
3.Coherence: structure, hierarchy, rules.The term systemic rule is a euphemism for interactions between individual members that are so predictable that one might think a rule exists to govern the behavior. For example, the manner in which the father reenters the family system each evening (no one is to disturb him until he has had time to answer his email or drink a beer), or the manner in which a particular child is disciplined (only the mother may discipline Sal).
In families, for example, siblings have different rules with each other than they have with either parent. Parents have one set of rules as parents; another set as a married couple.
Each individual operates within a complex network of systems within systems.
4.Communication: patterns of interaction; content and process.
5.Context.
6.Closed and open system.-an open system allows information to flow in from outside, whereas as a closed system does not. Generally, elements of both are required for a healthy system.
Because dysfunctional systems experience greater vulnerability, the systemic tendency is to become more rigid and resistant to change. Thus, the dysfunctional family finds change to be more difficult to accomplish than the family with more flexible boundaries. This can be particularly problematic when the dysfunctional system involves a cultural dimension in which family identity and solidarity are emphasized (e.g., the Italian American family), thus possibly magnifying the intensity of the problem.
7.Change and stability, cycles.
Usually a system is in homeostasis, thus if 1 change occurs, another might occur to counter it (especially so in a closed system).
POINTS AGAINST SYSTEMIC THERAPY;
1. Considered inappropriate in situations of domestic violence.
2. Usually rooted in traditional eurocentric views of family , somewhat patriarchal and not adequately embracing of complex step relations etc.
describe some specific strategies that can be used within systemic approaches
SOME STRATEGIES IN SYSTEM FAMILY THERAPY;
1.Reframing, Positive Connotation
2.Joining
3.Family Sculpture
4.Restructuring
5. Prescribing the Symptom (paradoxical)
SYSTEMIC SKILLS AND INTERVENTIONS;
1. Joining-process by which counsellor connects with each member of the family and establishing neutrality across the system. All members heard equally.
2.Structuring-Establishing ground rules within which the family functions while in counseling. Stop bullying or escalating arguements. May need to specify that certain fraught topics can only be brought up in counselling etc.
3.Circular Questioning;A method of gaining information by asking one member of a family to predict what another member’s answer would be to a given question. important to get info regarding think, behaviour and emotion. Get different members to describe same scenarios etc. often provides insight into the circular causality of the problem.
4.Generating and Observing Interactions;
A method of choreographing interactions among family members in order to study the system and each member’s contributions to the system. systems usually have a spokesperson. Important to get all views and responses/interpretations.May need to stop during re-enactments and get each person’s thoughts etc.
5.Assessing Family Structure;
Based on the results of observing interactions and so forth, determining the extent to which coalitions, triangulation, and scapegoating are operating within the family. May need to alter seating to change dynamics, Be aware of coalitions and triangles-some are protective and helpful and others are negative.
Family genograms can also be used to arrive at these conclusions.
6.Assessing Family Functions
Using data collected to determine the various functions within the family, including how roles operate, how emotions are expressed, and how power is wielded. Most families have motivation to improve their system. Even poorly functioning systems do some things right sometimes.
7.Increasing Awareness;
an intervention to increase communication within a family, an intervention to assist individuals to understand the internal process by which they filter their reactions to others in the family.
8.Shared Meaning;
Teaching the process of active listening between and among family members.
9.Role-Play;
Asking the clients to engage in a typical conversation around a challenging issue for the purpose of deconstructing their communication patterns.
10.Negotiation and Conflict Management;
For known issues of contention, counselors teach how to negotiate with another that leads to resolution rather than continued discontent.
11.Altering Hierarchy and Boundary Making;
An intervention aimed at interrupting habitual and dysfunctional sequences and patterns so that the family must create new and healthier patterns.
12.Enactment;
This intervention encourages family members to play out a chronic dysfunctional sequence so the counselor can then intervene with suggestions for improvement.
13.Prescribing the Symptom;
A second-order intervention that places family in a double-bind by prescribing that they do that over which they have claimed to have no control. In addition, prescribing the symptom can help reestablish a functional hierarchy.
explain genograms and their uses in mapping systemic relations and interactions
Genograms are a family tree diagram, including details such as relationship (abusive/harmonious/indifferent etc), mental illness, substance abuse, education, disowned/ignored by family, how client views member, etc. Can become very complex. Helpful to highlight patterns in generations and demonstrate coalitions etc.
outline how genograms can be used in professional practice.
Can help show who are good/bad role models, which extended family member’s opinion counts, who is scapegoats etc etc. Patterns across generations can be seen.
GEMS
1.it is important that systems work for individuals, not vice versa.
2. Coalition=2 people in a system having an alliance, usually against a third person.May be subtle or obvious. May be useful or harmful.
3.Triangulation= pulling in a third person, when a dyad (2 people)is under stress. Often seen with divorce where each parent tries to form a coalition with child, against other parent. Sign of dysfunction.
4.Scapegoating=variation on triangulation. One member of the family is blamed for all the family’s woes. The scapegoat (or Identified Patient) is often the reason for the family seeking counselling.
Scapegoating or triangulation often indicates boundaries need to be re-set, and sometimes need second order intervention.
5. Very important to reframe issues as not an individual problem, but how individuals interact.eg is not “dad is abrasive”, nor”son is disrespectful” but might be more like “the frequency of father and son explosive arguments”
6. As per individual counselling, family needs to agree on what the problem is, and what the goals of counselling are.
7. Externalization is sometimes a helpful re-frame. The problem is re-defined as external to the family
8. Sometimes need communication skills training.Effective communications rules are fairly simple. They include (a) speaking in the first person singular, (b) speaking for self (i.e., limiting your communication to your own experience), and (c) speaking directly to the person for whom the communication is intended.
9. An underresponsible communication style may hide behind suggestions of what others think, as opposed to definately voicing what you think, or may be where a comment is said to a third person, but really intended for the 2nd person. Such communications are to be discouraged.
10. The Awareness Wheel is a useful tool anywhere where someone is feeling misunderstood. Helps to sort out exactly what thoughts/feeling are present, and not just what is assumed. Process is for any little situation to clearly define the stages one experiences; Senses, Thinking, Feeling, Intending, Doing.
11. Shared Meaning Exercise helps communication. Say a simple phrase, partner repeats in own fashion, and checks back with speaker that they have the correct meaning.For persons who have a lot of history and do not communicate well, it may take more than a couple of rounds for the decoder to get it right. Although seemingly quite simple, shared meaning can stimulate systemic changes by challenging communication assumptions that often lead to miscommunication. Once persons in a relationship are communicating more accurately and feeling heard by the other, positive feelings can infiltrate other layers of their relationship.
12. Family Meeting Activity;structure of gripe time, agenda building, and problem solving.
13. Sometimes have parentification of a child(child has more power than parent), or flat hierarchy (child has equal power with parent). This is not desirable. Need to ascertain if parents able to become responsible, such that boundaries can be re-defined.
