W6

Question 1

The shift to the family as a locus of pathology

Answer 1

If serious problems cannot be
explained by a prevailing paradigm, efforts are made to expand or replace the
existing system.

This sort of scientific revolution and perspective shift occurred in the mid-1950s as
some clinicians were dissatisfied with slow progress when working with individual patients, or
frustrated when change in the patients was undermined by other family members.

They began to look at the family as the locus of pathology. Breaking away from the Traditional Focus on
individual Personality Characteristics and Behavior Patterns, they adopted a new perspective - a
family frame of reference - that provided a new way of conceptualizing human problems (especially the initial development of symptoms and their alleviation)

Question 2

Organization and Wholeness in Systemic Therapy

Answer 2

Systems are composed of units that stand in some
consistent relationship to one another. Thus, we can infer that they are organized
around those relationships.

Units or elements, once combined, produce an entity (a
whole) that is greater than the sum of its parts.

Question 3

Circular Causality

Answer 3

Family therapists prefer to think in terms of circular causality:
reciprocal actions which occur within a relationship network by means of interacting loops.

Any cause can be considered an effect of a previous cause, and becomes in tum the cause of a later event.

There is no use in figuring out how it started – we prefer to focus on interrupting the circle.

Question 4

Feedback Loops

Answer 4

Families use feedback mechanisms to either maintain balance or instigate
change.

Negative feedback has a weakening effect (restoring equilibrium) whereas
positive feedback leads to further change by accelerating the deviation.

Question 5

Familial Subsystems

Answer 5

Families are comprised of several coexisting subsystems in which members group
together to carry out certain family functions or processes.

Each family member is likely
to belong to several subsystems at the same time (i.e., siblings, parents, daughters, etc.,)

Question 6

System Boundaries

Answer 6

Boundaries are invisible lines that separate a system, a subsystem, or an individual from its outside surroundings.

They serve protect the system’s integrity - distinguishing
between those considered insiders and those viewed as outsiders.

Question 7

The Living Systems Perspective in the Present Day

Answer 7

Contemporary systems theorists rely on a living systems perspective (not mechanistic models) to
understand families.

Adopting systemic “habits of the mind” allows the family therapist to think using systemic concepts when working with families - in order to socially construct an understanding of that
family’s dynamics.

Question 8

The Influence of Gender and Culture on Family Dynamics

Answer 8

Family therapists today examine how gender, culture, and ethnicity shape the perspectives and behavior patterns of family members. Men and women develop distinct behavioral expectations due to early indoctrination into gender-role behavior in their families, leading to different socialization experiences and different life outcomes.

Changes in work roles and family roles over the past 30 years have necessitated new male-female interactions and family adaptations (Barnett & Hyde, 2001).

Gender, cultural background, ethnicity, sexual identity. and socioeconomic status are intertwined, with each influencing and being influenced by the others. For instance, what it means to be male or female is shaped by factors like socioeconomic status, race, and ethnicity (Kliman. 2015).

Therapists must be cautious
not to reinforce stereotypical sexist and patriarchal attitudes or class differences. In the present day, there is greater focus on power, status, and position differences within families and society (Sue & Sue. 2016).

Understanding the
cultural context (race. ethnicity. social class. religion. sexual identity) and family organization
(stepfamily. single-parent family. LGBT couples. etc.) is essential in order to comprehensively assess family functioning. A multicultural framework acknowledges that attitudes and behavior patterns
are often deeply rooted in a family’s cultural background! (Sue & Sue. 2016).

Developing culturally sensitive therapy requires
therapists to move beyond the typical white, middle-class outlook and recognize that not all ethnic groups embrace values like self-sufficiency. independence. and individual development Therapists must understand how ethnic values influence child-rearing practices, intergenerational relationships.
and family boundaries (Prochaska & Norcross. 2014).

Culturally competent family therapists will be aware of
their own cultural filters, and avoid misdiagnosing or mislabeling unfamiliar family patterns as
abnormal! They should also avoid Overlooking or Minimizing deviant behavior by attributing it
solely to cultural differences (Madsen, 2007).

Question 9

Systemic Therapy and Other Therapeutic Systems

Answer 9

Object relations family therapists search for unconscious relationship seeking from the past as the primary determinant of adult personality formation, whereas most family therapists deal with current interpersonal issues to improve overall family functioning.

Adlerian psychotherapy’s efforts to establish a child-guidance movement, as well as Adler’s
concern with improving parenting practices, reflect his interest beyond the individual to
family functioning. However, the individual focus of his therapeutic efforts fails to change
the dysfunctional family relationships that underlie individual problems (as achieved in systemic therapy)

Client-centered therapy’s humanistic outlook was particularly appealing to
experiential family therapists such as Satir and Whitaker, who believed families were stunted in their growth and would find
solutions if provided with a growth-facilitating therapeutic experience. Experiential family therapists are usually more directive than Rogerians, however, and in some cases they act as teachers to help families open up their communication processes.

Existential psychotherapies are phenomenological in nature, emphasizing the here and now. Considered by most family therapists
to be too concerned with the organized wholeness of the single person, this viewpoint has found a home with Kempler; who argued that people define themselves and their relationships with one another through their current choices and decisions and what they choose to become in
the future rather than through their reflections on the past.

Behavior therapists traditionally take a more linear view of causality in family interactions than systems theory advocates. A child’s tantrums, for example,
are viewed by behaviorists as maintained and reinforced by parental responses. Systems
theorists contrastingly view the tantrum as an interaction, including an exchange of feedback information, within a family system. Most behaviorists now acknowledge that cognitive factors (attitudes, thoughts, beliefs, expectations) influence behavior, and cognitive-behavior therapy has become a part of mainstream psychotherapy. However, rational emotive behavior therapy’s view that problems stem from maladaptive thought processes
seems too individually focused for most family therapists.

Question 10

Three Key Precursory Theorists for Systemic Therapy

Answer 10

Sigmund Freud: Began early efforts to uncover and mitigate symptomatic behavior in
neurotic individuals. Freud acknowledged the impact of fantasy and family conflict on the individual, but he did avoid
involving the family in treatment

Alfred Adler: Emphasized the relevance of the family context for understanding neurotic behavior. Specifically, he highlighted the
importance of family constellation on personality formation (e.g., birth order, sibling rivalry)

Harry Stack Sullivan: Argued that people were the product of their
“relatively enduring patterns of recurrent interpersonal situations.” Hence, emphasized the role the family plays in interpersonal relations, particularly
in one’s formative years, and its enduring impact on current relationships (recurring interactive patterns)

Question 11

General Systems Theory

Answer 11

Developed by von Bertalanffy and others.

A theoretical model which embraced all living
systems, and challenged the reductionist view in science at the time (that phenomena can be broken down into linear cause and effect reactions)

General systems theory posits that Interrelations
between parts assumes a far greater significance. A recognition of this is seen in family systems
concepts like circular causality

Question 12

Group Therapy (Family Therapy)

Answer 12

John Bell developed family group therapy.; applying social psychological theories to the
family as a naturally occurring group.

Family therapists involve entire families in therapy, believing that kinship groups provide more real
situations which can incite powerful and lasting system changes.

Question 13

Early Research on Schizophrenia and its Relationship with Family Therapy

Answer 13

Researchers began in the 1950s to study schizophrenia as a disorder where family influences might relate to psychotic symptoms. Early efforts focused on linear views of causes, but later expanded into a broader systems point of view. These efforts laid a foundation for systemic analysis of family functioning.

Current views on schizophrenia emphasize genetic predispositions which can be exacerbated by environmental
stressors.

> Bateson and colleagues identified double-bind communication patterns within families which lead
to confusion and withdrawal in children. Double-bind situations exist when an individual, usually a child, habitually receives simultaneous contradictory messages from the
same important person, typically a parent, and is forbidden to comment on
the contradiction (no matter how you react you will have made some sort of mistake - lose-lose - naturally produces conflict). Bateson also explored communication process and the importance of context in assigning meaning to information (“differences that make a difference”)

> Lidz and colleagues hypothesized that schizophrenics
did not receive the nurturing they needed necessary as children, leading to autonomy conflicts in adulthood. The marital discord often responsible for this was marital skew; extreme domination by one emotionally disturbed partner that is
accepted by the other - implying to the children that the situation is normal. In the marital schism scenario, parents undermine their spouses, threats of divorce are common, and each parent fights for the loyalty and affection of the children.

> Bowen studied symbiotic mother-child bonds which had been hypothesized to lead to schizophrenia - observing
emotional intensity and reciprocal functioning in families (family emotional system)

> Wynne studied blurred, ambiguous, and
confused communication patterns In families with schizophrenic members - describing
pseudomutualilty as a false sense of family closeness.

Question 14

The Early Contributions of Ackerman

Answer 14

Nathan Ackerman argued for family sessions to untangle interlocking pathologies; endorsing the systems view that problems of any one family member cannot be understood apart from others.

Ackerman’s work demonstrated the applicability of family therapy to less disturbed patients and contributed to the founding of the
journal “Family Process”.

Question 15

Minuchin and Delinquent Families

Answer 15

Salvador Minuchin led a project at the Wiltwyck School for Boys; developing brief, action-oriented therapeutic procedures to help reorganize unstable family structures for delinquent youngsters from poor, fatherless homes.

Question 16

Current Trends in Family Therapy

Answer 16

Eclecticism and Integration: Due to the recognition that no single technique fits all clients
or situations. there is a trend toward eclecticism and integration of therapeutic
approaches.

Multisystemic Evidence-Based Approaches: Therapists are using research-based approaches; borrowing from each other’s theories to treat a variety of behavioral and emotional problems in adolescents and families.

Question 17

Family Therapies for Delinquency and Recidivism

Answer 17

Sexton’s Functional Family Therapy: Aimed at treating delinquency and reducing recidivism, this approach offers systems-based, cost-effective programs.

Henggeler and Schaeffer’s Multisystemic Therapy: Also aimed at treating delinquency
and reducing recidivism. This approach has garnered considerable research support.

Question 18

Eight Theoretical Viewpoints and Approaches to Family Therapy

Answer 18

O.N.E S.S.S C.T

1. Object Relations Family Therapy
2. Experiential Family Therapy
3. Transgenerational Family Therapy
4. Structural Family Therapy
5. Strategic Family Therapy
6. Cognitive-Behavior Family Therapy
7. Social Constructionist Family Therapy
8. Narrative Therapy

Question 19

Object Relations Family Therapy (+ Personality Perspective)

Answer 19

The need for satisfying relationships with others is viewed as a fundamental motive of life.

This approach focuses on how introjects (memories of loss or
unfulfillment from childhood) affect current relationship - with the aim of helping family members gain insight into their own internalized objects from the past.

[PERSPECTIVE ON PERSONALITY] = (Hughes and Scharff)
> Emphasizes the role played by attachment needs and unresolved conflicts from childhood.
Believes that people seek emotional bonding based on early experiences.
> Investigates “object loss” and its impact on adult relationships. If one’s relational needs are unmet
by parents or other caregivers, then the child will internalize both the characteristics of
the lost object and the accompanying anger and resentment over the loss. The resulting
unresolved unconscious conflict develops into frustration and self-defeating habits in
the adult, who continues unconsciously and unsuccessfully to choose intimate partners
to repair early deprivation.
> Addresses unconscious conflicts leading to self-defeating habits

Question 20

Experiential Family Therapy

Answer 20

Believes troubled families need growth experiences derived from
intimate interpersonal experiences ,with therapists.

Focuses on being real or authentic to help family members learn to be more honest and expressive of their feelings and needs.

Question 21

Transgenerational family therapy

Answer 21

Argues that family members are tied in thinking, feeling, and behavior to the family system; leading to individual problems arising and being maintained by
relationship connections.

Emphasizes the importance of differentiating the self from the family to resist being overwhelmed by emotional reactivity.

Question 22

Structural Family Therapy

Answer 22

Focuses on how families are organized and what rules govern members’ transactions.

Challenges rigid and repetitive transactions within a family to help unfreeze them; and allow family reorganization.

Question 23

Strategic Family Therapy

Answer 23

Involves designing novel strategies by the therapist to eliminate undesired behavior.

Uses indirect tasks and paradoxical interventions to force clients to abandon symptoms and change undesired family interactive patterns.

Question 24

Cognitive-Behavior Family Therapy (+ Personality Perspective)

Answer 24

Expands the behavioral perspective by including a cognitive viewpoint.

Helps clients overcome dysfunctional beliefs. attitudes. or expectations and replace self-defeating thoughts with more positive self statements.

[PERSPECTIVE ON PERSONALITY] =
- People develop personality traits based on learned cognitions.
- Identifies negative or rigid cognitions contributing to maladaptive behavior.
- Aims to modify maladaptive cognitions through intervention.

Question 25

Social Constructionist Family Therapy

Answer 25

Challenges systems thinking and contends that each perception is mediated through language and socially determined through relationships.

Requires collaboration between therapist and family members to examine belief systems and construct new options.

Question 26

Narrative Therapy:

Answer 26

Argues that our sense of reality is organized and maintained through stories.

Helps families reduce the power of problem-saturated stories and reclaim their lives by substituting previously subjugated stories with successful ones.

Question 27

Family Life Cycle Perspective On Personality

Answer 27

This developmental outlook notes that certain
predictable marker events or phases (marriage, birth of a first child, children leaving home, and so on) occur in all families, regardless of structure, composition, or cultural background, compelling each family to deal with these events.

Because there is an ever-changing family context in which individual members grow up, there are many chances for maladaptive responses.

Situational family crises and key transition points represent periods of vulnerability. Symptoms in family members
are especially likely to appear during these critical periods of change as the family struggles to reorganize while negotiating the transition.

Both continuity and change characterize the progression of family systems throughout the life cycle.

Question 28

Family Rules

Answer 28

Organized patterns regulating family interactions.

These governs expectations for and behaviors of family members. They can be verbalized, or may be understood without being explicitly stated.

Such rules regulate and stabilize family systems.

Question 29

Family Narratives and Assumptions

Answer 29

Beliefs and stories which shape a family’s identity.

They influence daily family functioning and interactions, and can be derived from historical experiences and passed down through generations.

Narratives and assumptions can impact perceptions of events and situations encountered by the family.

Question 30

Pseudomutuality vs. Pseudohostility

Answer 30

Pseudomutuality: Rather than encourage a balance between separateness and togetherness, such families fear expressions of
individuality as a threat to the family as a whole. By presenting a facade of togetherness,
they maintain unity—at the expense of not allowing disagreements or expressions of affection. This prevents them to avoid dealing with any underlying conflict; while also preventing them from experiencing deeper intimacy.

Pseudohostility: Apparent quarreling or bickering between family members is in reality a way of maintaining
a connection without becoming either deeply affectionate or deeply hostile to one another. A distorted way of communicating (maintaining unity at the expense of deeper intimacy)

Question 31

Mystification

Answer 31

Parental distortion of a child’s experience to avoid conflict (i.e., denying what the child believes to be occurring - “you are tired, go to bed”.). [or just distortion of another’s experience in general]

This can lead to the child questioning their own perception of reality. It hinders conflict resolution (by clouding the meaning of the conflict) and communication within the family.

Question 32

Scapegoating

Answer 32

Blames one individual for family problems to avoid addressing deeper issues (i.e., redirecting parental conflict toward a child - making it unnecessary for the family to look at the impaired father–mother relationship, which would be far more threatening to
the family)

Scapegoated individuals often play an active role in maintaining the dynamic (become so entrenched in their role as the “bad child” that they can’t act otherwise).

Because the family retains a vested
interest in maintaining the scapegoated person in that role, changes in family interactive patterns must occur before scapegoating
will cease. Otherwise, the scapegoated person, usually symptomatic, will continue to
carry the pathology for the family.

Question 33

Basic Premises of Family Therapy

Answer 33

People are products of their social connections, and attempts to help them must
take family relationships into account.

Symptomatic or problematic behavior in an individual arises within a context of relationships, and interventions to help that person are most effective when those faulty interactive patterns are altered.

Individual symptoms are maintained externally in current family system transactions.

Conjoint sessions, in which the couple or family is the therapeutic unit and the
focus is on interpersonal interaction, are more effective in producing change
than attempts to uncover intrapsychic problems in individuals via individual
sessions.

Assessing family subsystems and the permeability of boundaries within the family
and between the family and the outside world offers important clues regarding family organization and susceptibility to change.

Traditional psychiatric diagnostic labels based on individual psychopathology often fail to provide an understanding of family dysfunctions and tend to pathologize individuals.

The goals of family therapy are to change maladaptive or dysfunctional family interactive patterns or help clients construct alternative views about themselves that offer new options and possibilities for the future

Question 34

Systems Thinking in Family Therapy

Answer 34

Focuses on circular causality rather than linear causality.

Emphasizes interpersonal patterns and redundant maladaptive patterns.

Views interrelationships as central - explaining behavior through interactions.

Shifts explanations from Individual Traits to Interactions among family member.

Question 35

Monadic Models and Interrelationships

Answer 35

When interrelationships are emphasized over individual needs
and drives, explanations shift from a monadic model (based on the characteristics of a
single person) to a dyadic model (based on a two-person interaction) or a triadic model
(based on interactions among three or more persons)

Question 36

Modalities of Family Therapy

Answer 36

Individual symptoms are maintained externally in current family system transactions. Therefore, conjoint sessions are more effective than individual sessions in producing change.

Assessing family subsystems and boundaries offers important clues regarding family organization! Note that traditional psychiatric diagnostic labels often fail to provide an understanding of family
dysfunctions.

Question 37

First-Order vs. Second-Order Changes

Answer 37

First-order changes are changes within the system that do not alter the organization of
the system itself (superficial individual changes that will allow the system to return to its former tenuous balance)

Second-order changes are fundamental changes in a system’s organization and function. They require a change in the way the family organizes itself, and hence they provide a fresh revised context in which new patterns of behavior can emerge.
 

Question 38

The Process of Family Therapy

Answer 38

[Contact - Session - Engaging - Assessing - History - Change]

1. The Initial Contact Family therapy typically begins when a family member or group
   acknowledges a problem and seeks outside help. The therapist uses this initial contact to
   form tentative hypotheses about the family’s dynamics and assess the willingness of
   family members to participate in therapy.
2. The Initial Session: In the first session the therapist encourages as many family members
   as possible to attend. Observing their interactions and seating arrangements provides
   insights into family alliances and coalitions. Each member’s perspective on the problem is
   heard, and past attempts to solve it are discussed. The therapist aims to redefine the
   problem as a family issue and explores whether the family wishes to continue therapy.
3. Engaging the Family: The therapist works to build a working alliance with the family;
   adapting to their communication styles and creating a safe space for members to express their concerns.
4. Assessing Family Functioning: Various assessment techniques are used to understand
   the family’s dynamics: including formal assessments and informal observations. The
   therapist aims to understand the underlying patterns that contribute to the family’s issues and identify the most effective interventions.
5. History Taking: Different approaches to family therapy emphasize different aspects of
   the family’s history. Some therapists focus on understanding attachment patterns from
   childhood. while others prioritize current family organization and dynamics.
6. Facilitating Change: Therapists use a variety of techniques to help families change
   dysfunctional patterns. These include reframing, therapeutic double-binds, enactment,
   family sculpting, circular questioning, cognitive restructuring, the miracle question. and externalization (personifying symptoms as external burdens)

Question 39

Therapeutic Double-Binds

Answer 39

Directing family members to continue to manifest their presenting symptoms (i.e., quarreling husbands and wives are instructed to indulge in and even exaggerate their fighting). This suggests that the symptom, which they have claimed is “involuntary” and thus out of their control, can be done voluntarily.

Such paradoxical interventions are designed to evoke one of two reactions: If the patient complies,
this is an admission that the symptomatology is under voluntary control, not involuntary as claimed, and thus can be stopped. On the other hand, if the directive to continue the symptom is resisted, then the symptom will be given up.

OR

Intentionally displaying symptoms to show that you actually can manage them when they arise naturally (i.e., consciously spending a day in bed to see how one could better manage a day in bed when it is “forced” upon you)

Question 40

Family Sculpting

Answer 40

Family members each take a turn
at being a “director”—that is, placing other members in a physical arrangement in
space. The result often reveals how the director perceives his or her place in the family, as well as that person’s perception of what is being done to whom, by whom,
and in what manner. Individual perceptions of family boundaries, alliances, roles,
and subsystems are typically revealed, even if the director cannot or will not verbalize such perceptions.

The resulting graphic picture of individual views of family
life provides active, nonverbal depictions for other members to grasp. Because of its
non-intellectualized way of putting feelings into action, family sculpting is especially
suited to the experiential approach of Satir.

Question 41

Circular Questioning

Answer 41

Focuses attention on family connections rather than individual
symptomatology. Each question posed to the family by the therapist addresses differences in different members’ perceptions about the same events or relationships (highlighting differing percpetions)

By asking several members the same question regarding their attitudes toward those
situations, the therapist is able to probe more deeply without being confrontational or interrogating the participants in the relationship, allowing the family to examine
the origin of the underlying conflict.

Advocates of this technique believe questioning is a therapeutic process that allows the family to untangle family problems by changing the ways members view their shared difficulties.

Question 42

Miracle Question

Answer 42

[de Shazer] - In this solution-focused technique, clients are
asked to consider what would occur if a miracle took place and, on awakening in the morning, they found the problem they brought to therapy solved.

Each family member is encouraged to speculate on how things would be different, how each
would change his or her behavior, and what each would notice in the others. In this
way, goals are identified! And, potential solutions are revealed.

Question 43

Mechanisms of Change in Family Therapy

Answer 43

[Structural, Behavioural, Experiential, Cognitive = B.E.C.S]

1. Structural Change: Therapists assess the family’s organizational structure and
   transactional patterns to identify and challenge rigid. repetitive patterns. By modifying
   unworkable patterns families can adopt new rules and achieve realignments, clearer
   boundaries, and more flexible interactions.
2. Behavioral Change: Therapists help families achieve desired behavioral changes.
   Strategic therapists focus on the family’s presenting problems and devise strategies for
   alleviating them. Systemic therapists may assign tasks or rituals that challenge outdated
   family rules; leading to behavioral change through emotional experiences.
3. Experiential Change: Therapists such as Satir, Whitaker, and Kempler emphasize growth producing transactions and open communication. They act as models for families;
   encouraging them to explore and disclose their feelings. This approach helps families
   establish new and more honest relationships while maintaining healthy separation and
   autonomy.
4. Cognitive Change: Psychodynamically oriented therapists focus on providing insight and understanding. They address intergenerational issues; helping clients understand how
   relationship patterns are passed down through generations. By gaining awareness of
   their family history and unresolved issues, clients can examine and correct old patterns
   of behavior.

Overall, family therapists take an active, problem-solving approach; to therapy, focusing on
changing current dysfunctional patterns within the family to promote healthier interactions and
relationships.

Question 44

Applying Family Therapy

Answer 44

Therapists who use a family frame of reference consider client relationships
even when working with single individuals.- to understand the context of problematic
behavior. They may involve family members in counseling sessions to provide insights
into relationship difficulties within the family system.

Family therapists often deal with parent-child conflicts,
particularly during transitions like adolescence. They help families adapt to changes and
modify outdated rules to account for changing conditions.

Family therapists practice couples therapy to address communication patterns, sexual incompatibilities, commitment issues, conflicts over money or children, and other
interpersonal difficulties that can escalate dissatisfaction and jeopardize relationships.

Family therapy focuses on changing dysfunctional aspects of the family system. Therapists may see the entire family together or work with various dyads
or subsystems. They must actively engage in the family’s interpersonal processes to
bring about change.

Indications and Contraindications: Family therapy is valuable for resolving relationship
difficulties; especially those involving contributions from all family members. However, it
may be contraindicated in cases where key family members are unavailable or refuse to
attend therapy (or its too late, too difficult, or dominated by a destructive member)

Family therapy can be brief or extended, depending on the nature
of the problem and family resistance to change. It tends to be relatively short-term
compared to individual therapy!

Family therapy is practiced by psychiatrists, psychologists,
social workers, marriage and family counselors, and pastoral counselors in various
settings; including outpatient offices, school counselor settings, and inpatient hospital
wards.

Family therapy typically involves initial sessions with the entire
family to assess transactional patterns. Therapists then help redefine presenting
problems as relationship issues to be addressed within the family context. The final stage
focuses on teaching families effective coping skills and ways to resolve relationship
issues.

Question 45

Process vs. Outcome Research

Answer 45

Therapeutic research efforts typically are directed
at process research (what actually occurs during the course of therapy that leads to a
desired outcome) and outcome research (what specific therapeutic approaches work
best with which specific problems).

Question 46

Family Therapy and Multiculturalism

Answer 46

Family Therapists Should:

Understand Changing Demographics and Cultural Values.

Be Aware of Personal Biases and Prejudices.

Be Willing to Refer or Collaborate to Ensure the Best Care for Diverse Clients (cultural relevance)

Distinguish between idiosyncratic behavior and culturally determined thinking (recognize cultural differences)

Understand the Layers of Cultural Influence through The Progression From the family unit to the family of origin, to the multicultural family genogram, and finally to a global perspective.

Utilize White’s Narrative Model (provides a philosophical foundation for
multicultural counseling. It emphasizes the importance of not imposing dominant culture
imperatives, and incorporating diverse cultural voices in therapy. By adopting this approach,
therapists can help clients explore their unique narratives and develop a deeper understanding of
their cultural identities. This process can lead to greater self-awareness and empowerment for
clients from diverse backgrounds)

Question 47

The Importance of Social Connection for Humans

Answer 47

Children with stable, happy parents => strongest protective factors against mental, physical, educational, and peer-related problems.

Harvard Study of Adult Development: 1939 till present (one of the longest longitudinal studies). Its main finding underscores the importance of relationships; People who are more connected to family, friends, community are happier, physically healthier, and live longer life than those less well connected.

Question 48

Cybernetics

Answer 48

Scientific discipline that focuses on information processing and control systems – its development being influenced by World War II [self-directing anti-aircraft guns]

Such machines are self-regulating and operate on feedback. Its processes are not linear, but circular (continuous circular causality) – e.g., central heating system.

Question 49

Families as Systems seeking Homeostasis

Answer 49

Homeostasis: A dynamic state of balance/equilibrium in the family.

Families = Systems seeking stability through the principle of feedback.

Symptomatic behaviour can therefore be considered not merely an individual matter, but an attempt to stabilize the family.

Question 50

The Family as an Autopoietic System

Answer 50

Autopoietic system in a therapy context refers to the fact that the family has healing knowledge in itself, it doesn’t need to be provided from an outside source, the resources just need to be uncovered by the therapist.

Question 51

Boundaries; and Enmeshed and Disengaged Families

Answer 51

Boundaries are invisible lines that separate the system, subsystem, individual & outside. They protect the system’s integrity, and distinguish between insiders and outsiders.

In an Enmeshed family, the boundaries between family members diffuse and the boundaries with the external world become rigid. It is difficult to engage with an enmeshed family as a therapist (as their boundary towards the world is rigid). Their roles fuse.

In a Disengaged Family, the boundaries between family members are rigid and the boundaries with the external world diffuse. A disengaged family has minimal interaction with one another but is open to others entering the unit.

Question 52

Quote - The Goal of Family Therapy

Answer 52

“The goal of family therapy is not healing or problem-solving. The family therapist aims to promote connections within the family. The family therapist understands that connection heals and protects against suffering in the future.”

Question 53

Wampold and Imel’s Characteristics of a Positive Therapeutic Relationship

Answer 53

o Collaboration between therapist and client.
o Empathy of therapist.
o Acceptance of the client.
o Authenticity from the therapist.

Question 54

Genogram

Answer 54

A tool that outlines mostly 3 family generations (visually like a family tree with a little more info). It enables you to visualize patterns, medical histories, mental health problems. It can reveal family issues that need to be addressed. It contains information, including: - demographic info: name, gender, date of birth, date of death - education, occupation, major life events, and chronic illnesses - types and styles of family relationships. - disorders like alcoholism, depression, diabetes.

Question 55

Defining Systemic Psychotherapy

Answer 55

Systemic therapy is based on the idea that mental health issues never
exist in isolation, but there is always an influence from and to the social
environment. System therapists examine and address mental problems
in their relational, social, and cultural context—the system to which
people belong. For this reason, significant others such as partners,
children, or family members are directly or indirectly involved in
therapy within systemic therapy. Systemic therapy can vary from
individual therapy to couples therapy, family therapy, or couples and
family group therapy.

Question 56

Take-Home Foci of Systemic Therapy

Answer 56

1. Context = the environment in which things are
   happening
2. Individuals, families, couples
3. Interactions between people
4. Positive resources and growth
5. Past, here and now, and future are important
6. Collaboration