Theories Flashcards
First order change
System does not change, even if behavior does….
I.e. husband and wife who are fighting, stop talking to each other so no more fighting, but original problem or cause of conflict remains
Black box
No idea what internal process or cause of external behavior is, but can see still observe outcome
White box
Able to see process/cause of external behaviors
Double bind
A situation where one cannot effectively comment on it since one is receiving a conflicting message simultaneously and it would be dangerous or impossible to disengage the message
Double bind is treated via
Paradox
Functional Analysis
CB(F)T
Systemic Practice of defining the role of the symptom in the system
Operant conditioning
When you reward positive behavior towards ultimate goal
(Shaping behavior),
Ideally, you reward positive behavior immediately
REBT
A,B,C,D. etc
Confronting irrational beliefs in session
DBT
Evidence based treatment for Borderline
Finding balance or synthesis between 2 polar opposites
DBT
- Transition client’s away from black and white thinking
- Integrative theory
- DBT group for one year also
Solution focused therapy
Always looking for everything to be stated in positive terms
Solution focus therapy
Assess strengths
Solution focused therapy
Looking for exceptions
Solution focused therapy
Times when problem was expected to happen but it didn’t
Solution focused therapy
Assess solution,in positive behavioral terms, i.e. miracle question/Magic wand
Solution focused
Scaling questions
Solution focused therapy
Do one thing differently
Small changes in small steps
Solution focused therapy
Formula first session task:
What you DON’T want to change
Narrative therapy
Looking to enact preferred identities
Narrative therapy
Separate person from problem (narrative)
Who are you when you’re not in this problem?
Narrative therapy
Once you separate client from problem, start having them enact PREFERRED narrative
Narrative therapy
Relative influence question:
When you are mapping the influence of the person, vs the problem, or vice versa
Interrupt pattern and allow client to “self organize”
Strategic Therapy
Minimum amount of disruption to effect change, get them out of ruts with smallest change possible
Strategic Therapy
Morphogenesis
How a (family) system can react and change from new information WITHOUT losing stability
Morphostasis
A system’s (family) ability to react to new information change and to still remain stable
Cybernetic Process
Constant tension between morphogenesis and morphostasis to maintain homeostasis
First order change
Roles shift, but no actual change
Second order change
When a system changes its homeostasis due to “positive” feedback
Communication: Report and Command
Report (content)
Command (relationship)
Report: Literal content of the communication
Command:Relationship Metacommunication, how to interpret communication
Holon
An entity or organism unto itself (like a family)
Symbolic Experiential Theory
Carl Whitaker
Therapy of the Absurd
Carl Whitaker
Symbolic Experiential Theory
2 Battles
Battle for structure
Battle for initiative
This battle should only be won by therapist
Battle for structure
Symbolic Experiential Theory
This battle should only be won by client
Battle for initiative
Symbolic Experiential Theory
Absurdity for specific purpose:
To perturb the system in a compassionate/caring way
Symbolic Experiential Theory
Therapist always conveys caring, no matter how brutal the truth
Use of Co-Therapists: good cop/ bad cop
Symbolic Experiential Theory
Therapist focuses on Emotional Systems
(Not just behavior and interactions)
Symbolic Experiential Theory
Carl Whitaker
Satir Family Therapy
5 Communication stances when threatened
- Congruent (the Positive One)
Satir Family Therapy
5 Communication stances when threatened
- Placator- most common for therapy
Satir Family Therapy
5 Communication stances when threatened
- Blamer: Must learn empathy
Satir Family Therapy
5 Communication stances when threatened
- Super Reasonable: Spock
Satir Family Therapy
5 Communication stances when threatened
- Irrelevant: Distracts/class clown
Satir’s Family Therapy Stances all acknowledge:
3 realities:
Self
Other
Context
Satir’s 6 Stage Model of Change
(First 3)
- Status Quo
- Foreign elements
- Chaos
Satir’s 6 Stage Model of Change
(Last 3)
- Integration of new Responsibilities
- Practice
- New Status quo
Family Life Chronology
Satir Family Therapy
Surviving Triad
Child and two parents
Satir Family Therapy
Iceberg
Tip of iceberg represents problem/symptoms
Bottom is emotions driving it
Satir Family Therapy
Sculpting
Position each person to metaphorically represent their roles
one member of the family at a time is asked to physically arrange the family members in relationship to one another.
Satir Family Therapy
Represents both Systemic and Individual therapy
Satir Family Therapy
Model is intended to be a brief solution to a specific problem
Strategic Therapy, and why it’s called Strategic
Jay Haley and MRI
How to fix problems as quick as possible
Strategic Therapy
Therapist viewed as an authority/teacher
Strategic Therapy
Circular Causality
Series of causes and effects leading back to original cause of problems and either alters or confirms it, leading to new sequence/feedback loop
Strategic Therapy,
First Order Change
Change occurs but only impacts symptom relief, not family roles
Second Order Change
Creates Lasting Change, NOT just symptom relief
Problem: Symptom is an attempt to address/solve problem
Strategic Therapy
Goal is to relieve symptom of family
Goal: Relieve Symptom of Family
Strategic Therapy
Strategic Family Therapy Goals
To address negative behaviors of poor hierarchy and boundaries in family
Therapist Role:
Strategic Family Therapy
Works in collaboration with Family
Directive:
Task assigned by therapist to address family problem
Strategic Family Therapy Goals
- Social stage
Therapist observes
Strategic Family Therapy Goals
- Problem Stage
Problem defined
Strategic Family Therapy Goals
- Interaction stage
Combines first and second steps
Strategic Family Therapy Goals
- Goal setting
Sign contact to address fix goals
Strategic Family Therapy Goals
Paradoxical Intervention
Counter intuitive or opposite prescribed
Strategic Family Therapy Goals
Paradoxical Intervention
Goal: Symptom Relief
i.e. “Argue at 7pm”
Strategic Family Therapy Goals
Ordeals:
Pair unpleasant tasks w/ symptoms
I.e. “When you get anxious, scrub bathroom”
Strategic Family Therapy Goals
Restraining:
Strategic Family Therapy Goals
“Do not change!” (Almost sarcastically)
Strategic Family Therapy Goals
Positioning:
Strategic Family Therapy Goals
Exaggerating severity of symptom
Strategic Family Therapy Goals
Strategic Directives:
Get people out of rut with smallest changes possible
Systemic Therapist
Interrupts negative interactions, often with ridiculousness,
i.e. “Wear hats whenever you argue”
Systemic Therapy
Interrupts system and allows it to reorganize in manner without priblems
5 stages of Strategic Family Therapy
- Social Stage
5 stages of Strategic Family Therapy
- Problem Stage
5 stages of Strategic Family Therapy
- Interaction Stage
5 stages of Strategic Family Therapy
- Goal setting stage
5 stages of Strategic Family Therapy
- Task setting stage
Strategic Family Therapy
Initial appointment:
Invite all members of household, even if it’s only individual therapy
Strategic Positioning by Therapist
Role of therapist shifts
Strategic Positioning by therapist
What response most likely to cause change?
Strategic Positioning by Therapist
Most commonly used:
Social courtesy and one down position
Strategic Therapy
5 ways to think of problems
- Involuntary vs voluntary
5 basic ways to think of problem
- Helplessness vs Power
Strategic Family Therapy
5 basic ways to think of problem
- Helplessness vs Power
Strategic Family Therapy
5 basic ways to think of problem
- Metaphorical vs Literal
Strategic Family Therapy
5 basic ways to think of problems
- Hierarchy vs Equality
Strategic Family Therapy
5 basic ways to think of problems
- Hostility vs love
Strategic Family Therapy
Emphasize increasing family’s ability to love
Strategic Family Therapy
Strategic Goals
How to get family to redefine Homeostasis to cause it to reset
Strategic Family Therapy
Interventions
Straight forward directives: Therapist has more power/authority
Strategic Family Therapy
Interventions
Indirect directives: less power with clients
Strategic Family Therapy
Interventions
Paradoxical Symptom:
Therapist reframes meaning and context of symptom so client can no longer use it
Strategic Family Therapy
Allows client to reorganize according to cultural beliefs, no actual notion of “normal”
Strategic Family Therapy
Indirect directives
- Metaphorical taskes
Strategic Family Therapy
Indirect directives
- Pretend techniques: “Fake it till ya make it!”
Paradoxical Symptom
Reframe symptom in context of client meaning so client can no longer use it
Metaphorical Task
Indirect Directive
Strategic Therapy
Pretend Techniques (fake it till you make it)
Indirect directives
Strategic Therapy
Ordeal Therapy:
When client feels helpless, assign an “illogical” task, and also before “A” first do “B”
Strategic Therapy
Allows clients to Reorganize according to culture
Strategic Family Therapy
Existential Therapy
Daseinanalysis
Feels more like psychodynamic, how is client engaging and interacting with environment
Existential Therapy
Logotherapy
Developed by Victor Frankl
Existential
Life has no meaning, we must find it (except for Frankl)
Existential
Freedom and Responsibility
Major focus
Existential
Even with consequences we are free to choose
Existential
Therapist:
Where is it client does NOT feel free?
Existential
Death anxiety:
Instinctual and plays major role in terms of death, anxiety, denial, etc
Existential
How is fear of death related to presenting problem?
Existential
Work on client’s accepting their death, death of others, which leads to more responsibilities and better choices
Existential
Purpose of neurosis/symptom:
Purpose of neurosis/symptom:
To preserve our sense of self in outside world, symptom gives clue where person is not taking responsibility for self/behavior
Existential
Goals:
Long term goal:
To live a long and authentic life
Existential
Interventions
Subtle, identifying issues, reflecting, addressing and resolving
Existential
Acknowledging existential isolation
We come in, journey, and die alone in life. We must learn to live with it…define and affirm self to achieve true sense of freedom