Systems Therapies Flashcards
4 Types of Systems Therapies
1) Bowen
2) Satir Communications
3) Strategic
4) Structural
Bowen Family Therapy
Theory of Change
- Change occurs by understanding MULTIGENERATIONAL dynamics and increasing DIFFERENTIATION
- Only concerned with past 3 GENERATIONS
- Issues transmitted through family
Bowen Family Therapy
Therapist’s Role
- COACH / educator
- Supervisor
- Investigator
- Neutral
- Doesn’t take sides
- Deal with conflicts directly
Bowen Family Therapy
Treatment Goals
- Reduce anxiety and emotional turmoil in family system
- Self DIFFERENTIATION within the context of family
- Decrease emotional fusion
- Reduce emotional reactivity
- Improve COMMUNICATION skills
- Decrease recurrence of dysfunctional patterns
- Facilitate DETRIANGULATION
Bowen Family Therapy
Phases of Treatment
Beginning
- Create a GENOGRAM of MULTIGENERATIONAL emotion connections
- Assess individual’s levels of DIFFERENTIATION and TRIANGULATION
- Identify dysfunctional patterns that have been passed along through the GENERATIONS
Bowen Family Therapy
Phases of Treatment
Middle
- Teach and model DIFFERENTIATION through communication skill building
- DETRIANGULATION
- Encourage reunification from CUTOFF family member
- Teach the family how to take responsibility for their feelings and thoughts
Bowen Family Therapy
Phases of Treatment
End
REVIEW new skills and knowledge gained in therapy
Bowen Family Therapy
Key Concept: Triangles
- Three person relationship
- Considered the building block of larger emotional systems
Bowen Family Therapy
Key Concept: Differentiation of Self
- Individuals vary in their susceptibility to a “group think”
- Groups vary in the amount of pressure they exert for conformity
- These differences between individuals and groups reflect differences in people’s levels of differentiation of self
Bowen Family Therapy
Key Concept: Nuclear Family Emotional System
- Four basic relationship patterns that govern where problems develop in families
- Marital Conflict
- Dysfunction in one spouse
- Impairment in one or more children
- Emotional distance
Bowen Family Therapy
Key Concept: Family Projection Process
- The primary way parents transmit their emotional problems to a child
- Can impair the functioning of one or more children and increase their vulnerability to clinical symptoms
Bowen Family Therapy
Key Concept: Multigenerational Transmission Process
- Small differences in the levels of differentiation between parents and their offspring lead over many generations to marked differences in differentiation among the members of the MULTIGENERATIONAL family
Bowen Family Therapy
Key Concept: Emotional Cutoff
- People managing unresolved emotional issues with parents, siblings and other family members by reducing or totally cutting off emotional contact with them
Satir Communications Therapy
Theory of Change
- Change happens through self-awareness and improved COMMUNICATION
- AKA Communications Family Therapy
A Humanistic Approach
Satir Communications Therapy
Therapist’s Role
- Active Facilitator
- RESOURCE DETECTIVE
- Genuine and warm
- Honest and direct
- Looking for different strengths and untapped resources
Satir Communications Therapy
Key Concept: Family Life Chronology
- Gathering HISTORY as far back as possible
- Includes: ideology, values, rules, disruptions, moves and major events
- How EVENTS impact the family
- How past EVENTS and unresolved issues are carried out presently
Satir Communications Therapy
Key Concept: Family Sculpting
- Put people in to a spatial metaphor
- A physical representation of family characterization
Strategic Therapy
Theory of Change
- Change occurs through action-oriented directives and paradoxical interventions
- Relate to the PROBLEM in a different way
- No longer powerless to the PROBLEM
Strategic Therapy
Therapist’s Role
- Therapist delivers directives that facilitate change, particularly around patterns of communication
- Focuses on solving PROBLEM / eliminating symptoms
- Designs a specific approach for each person’s presenting PROBLEM
Strategic Therapy
Treatment Goals
- Solve the presenting PROBLEMS
- Change dysfunctional patterns of interaction
Strategic Therapy
Phases of Treatment
Beginning
- Define the PROBLEM
- Determine how the client understands the PROBLEM
- Assess family’s destructive patterns of relating and communicating the continue PROBLEM
- State goals
- What behaviors need to change and what would be the signs of change
Strategic Therapy
Phases of Treatment
Middle
- Review attempted solutions
- Assign ordeals
- PRESCRIBE the PROBLEM
- Relabel behavior
- Instruct the client to respond to the PROBLEM in a new way
Strategic Therapy
Phases of Treatment
End
- Plan for maintenance of new behavior
- Plan for future challenges
- Emphasize positive changes made
Strategic Therapy
Intervention: Paradoxical Directives
- Maneuvers that are in apparent contradiction to the goals of therapy, but are designed to achieve goals
- Help avoid confrontation with therapist’s instructions
- Undermines resistance by keeping client in charge
Strategic Therapy
Intervention: Positioning
- Therapist takes a more EXAGGERATED and EXTREME view of the problem and family is obligated to rebel
- Leads family to seeing ways in which they competency
Strategic Therapy
Intervention: Prescribing the Symptom
- Therapist encourages or instructs the client to engage in or practice the symptom
Strategic Therapy
Intervention: Restraining
- Therapist will discourage change or changing too quickly in an effort to elicit the desire to change from client
Strategic Therapy
Intervention: Ordeals
- Particular type of symptom prescription in which clients are encouraged to carry out harmless, but unpleasant tasks whenever symptoms occur
- Having to get up and clean the basement every time client can’t sleep
Structural Family Therapy (MINUCHIN)
Theory of Change
Change occurs through restructuring the family’s organization
Structural Family Therapy
Functional Family
4 Traits
- Clear generational HIERARCHY
- Parental COALITION
- Clear spouse SUBSYSTEMS
- Clear BOUNDARIES
Structural Family Therapy
Therapist’s Role
- Active and involved (be a part of the family)
- Helps the family understand how family structure (relationships and hierarchies) can be changed, the impact of rituals and rules, and how new patterns of interaction can be integrated into the family
Structural Family Therapy
Treatment Goals
- Restructure family system to allow for symptom relief and constructive problem solving
- Change dysfunctional transactional patterns and create new ways of relating
- Help create FLEXIBLE BOUNDARIES
Structural Family Therapy
Phases of Therapy
Beginning
- JOIN with family
- Accommodate and challenge rules of family system
- Assessment / Mapping of hierarchy, alignments and boundaries
- REFRAMING of problem to include whole system
Structural Family Therapy
Phases of Therapy
Middle
- Highlight and modify interactions
- Utilize ENACTMENTS of issues to challenge participants and unbalance system
Structural Family Therapy
Phases of Therapy
End
- Review progress made
- Reinforce structural change
- Provide tools for future
Structural Family Therapy
Key Concept: Coalition
Alignment where 2 or more family members join together to form a bond against another family member
Structural Family Therapy
Key Concept: Disengaged Boundaries
- Family members are ISOLATED from each other
- Can lead to alcohol and other drug use
- Result of rigid boundaries
Structural Family Therapy
Key Concept: Enmeshed Boundaries
- Family members are OVERLY DEPENDENT and too closely involved and reactive to other family members
- Can lead to incest
Structural Family Therapy
Interventions: Joining
- Therapist’s first task
- BLENDING in with the family
- Adapting the family’s affect, style and language
Structural Family Therapy
Interventions: Tracking
- Paying close attention to family members and how they relate to one another during an ENACTMENT or spontaneous behavioral sequence
- Noticing boundaries, coalitions, roles, rules, etc.
Structural Family Therapy
Interventions: Mimesis
Tracking family communication style and using it
Structural Family Therapy
Interventions: Unbalancing
- Supporting someone who is in a one-down position, thus changing hierarchical position
Structural Family Therapy
Interventions: Enactment
- Actualization of transactional patterns under the control of the therapist
- It allows the therapist to observe how family members mutually regulate their behaviors
- To determine the place of the problem behavior within the sequence of transactions
- Replaying issues in the room
