Week 2: Traditional Approaches to Family Therapy Flashcards

1
Q

What is structuralism?

A

The foundational epistemology of all first order family therapy approaches

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2
Q

What is the structuralist way of looking at reality?

A

It is the way of looking at reality that has emerged from modernist positioning

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3
Q

What does structuralism assume?

A

It assumes that we can know reality directly as an objective observer external to that which we are observing.

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4
Q

What is “understanding” from a structuralism perspective?

A

To understand a thing we must understand the structure within which it is locted

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5
Q

What does structuralism focus on?

A

Focuses on the structure of what is under study, and attempts to differentiate dysfunctional, pathological or distorted structures from functional healthy or ordered structures

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6
Q

What implications does structuralism lead to?

A
  • development of ideas about ‘Normal Family Functioning’
  • The production of theories that facilitate the interpretation of people’s expressions (behaviour/transactions)
  • The construction of systems of analyses and systems of classification founded on these theories
  • The development of professional techniques of remediation
  • The power relations of expert knowledge
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7
Q

What did Murray Bowen say about multi-generaltional family therapy?

A

“You have inherited a lifetime of tribulation. Everybody has inherited it. Take it over, make the most of it and when you have decided you know the right way, do the best you can with it”

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8
Q

Who was Murray Bowed?

A

Bowen was a psychiatrist who did pioneering work with families of individuals diagnosed with schizophrenia.

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9
Q

What is Bowen Family systemic theories considered?

A

BFST is considered one of the most elegant approaches among systemic theories

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10
Q

What did Bowen focus on?

A

Focused on the analysis of the process of ‘differentiation’ drawing on his personal family experiences

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11
Q

what is multi-generaltional family therapy based on?

A

Therapy is based on facilitating understanding of multigenerational patterns and facilitating increased differentiation
It is not necessarily a therapeutic model as a way of thinking about relationships and family

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12
Q

what tools does multi-generaltional family therapy use?

A

Genograms

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13
Q

How are genograms used in multigenerational therapy?

A

For mapping at lease three generations of family to track replicating patters

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14
Q

What is the role of the therapist in multigenerational therapy?

A

The therapist acts as a coach and expert often working with an individual.

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15
Q

What does differentiation lead to?

A

Differentiation leads to the existential possibility of a ‘self’. This idea is based on the concept that opposing forces exist in any system along with togetherness; separateness; sameness and difference. This is understood as a fundamental process in nature and the way in which systems can evolve and change

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16
Q

What factors contribute to differentiation?

A
emotional separation
autonomous function
balance of togetherness-separation
validation of difference
adult to adult communication - I messages
Boundaries
emotional regulation
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17
Q

What is “responsibility for feelings” in differentiation?

A

Not being infected by the feelings of other family members

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18
Q

What did Bowen say the emotional system includes?

A

“the emotional system includes the force that biology defines as instinct, reproduction, the automatic activity controlled by the autonomic nervous system, subjective emotional and feeling states are the force that govern relationship systems… in broad terms, the emotional system governs the dance of life in all living things”

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19
Q

What did Bownen believe regarding anxiety contageon?

A

Bowen held the understanding that there is a chronic anxiety in all living systems that comes with the territory of being alive. This idea of anxiety is not worries or neurosis but rather something much more fundamental to the living systems and it was understood to be transmitted multi-generally

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20
Q

What does Bowne’s anxiety promote?

A

The anxiety or force was understood to be the primary promoter of all symptoms within a family, from schizophrenia through the health concerns and were seen to show up in the following places:

  • the marital relationship
  • The health of one of the partners (mental or physical_
  • or in the children
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21
Q

How did Bowen describe multigenerational transmission?

A

Bowen further understood that the force of anxiety was transmitted across generations. More specifically in terms of the presence of past emotional response both in their nature and degree

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22
Q

What does less differentiation of an individual lead to?

A

The less differentiated the individual form the system, the more likely that the emotional contagion would occur

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23
Q

What do the Bowen models of family focus on?

A

Bowen based family origin of work is often focused not only on any particular symptom or form in any one generation, but rather one the systemic emotional factors that are present within the history of the system

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24
Q

How did Bowen understand the triad or emotional triangle?

A

Bowen understood the triad or emotional triangle as the most stable form of relationship. He understood triangles to form as a function of the anxiety present within a two person system, where another member is drawn into the relationship to stabilise and reduce anxiety

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25
Q

What does Bowen’s emotional triangle lead to?

A

The emotional triable model is not necessarily pathological, however it does lead to alliances and skewed hierarchy and family structures

26
Q

How is the emotional triable relevant to therapists?

A

It is relevant to therapists as they will often become, in couple and family therapy, a part of an emotional triangle. Given this, the therapist must stay non-reactive and neutral, to ensure they do not become ‘triangulated’

27
Q

When did Structural family therapy emerge and who was the primary founder?

A

Emerged in the 70s with the primary founder Salvador Minuchin. It was one of the first therapies to view the whole family as the focus treatment

28
Q

Who was Salvador Minuchin?

A

A child psychiatrist concerned about the impact of families on children’s functioning

29
Q

How was structural family therapy developed?

A

Developed directly out o research and treatment projects that directly observed Families

30
Q

What does structural family therapy understand symptoms as?

A

Structural family therapy understands an individual symptom being a function of the family structure

31
Q

What is the therapist’s job in structural family therapy?

A

The therapist’s is to alter the family structure and the symptom will resolve

32
Q

How is ‘structure’ defined?

A

as patterns of relating

33
Q

How do families develop pathology according to the structural model?

A

families are seen to develop pathology as a result of not having structures that are able to process stressors or day to day operation. These stressors can be normative - i.e. part of the family life cycle or part of the wider social context or non-normative.

34
Q

What is a structural family assessment based on?

A

system & subsystems
boundaries
hierarchies
roles and rules

35
Q

What are subsystems in structural family assessment?

A

theoretically, the overall family structure is divided into subsystems. These are smaller systems that also have functions and sets of interactions with each having its own homeostasis and feedback mechanisms

36
Q

What are the family subsystems?

A

the parental subsystem
the sibling subsystem
the parent-partner subsystem

37
Q

what is the relation between the family subsystems?

A

They are all interdependent

38
Q

what are the boundaries in structural family assessment?

A

Boundaries are the barriers that separate a system or subsystem from its broader context

39
Q

Why must boundaries be flexible?

A

Boundaries must be flexible enough to allow for new ideas and processes to enter the system, but not permeable that the system no longer stays cohesive.

40
Q

How can boundaries be conceptualised?

A

Disengaged/Ridged Enmeshed/Diffused

41
Q

Why is hierarchy important in structural family assessment?

A

The hierarchical relationship between subsystems is given importance in this approach with each older generation having executive functioning over the younger generation. Decision making is seen to be the function of the higher subsystem

42
Q

What is detouring in structural family assessment?

A

Detouring is when a family member avoids dealing with someone in their subsystem, often the result of conflicts within this subsystem. i.e. communicating through the child

43
Q

What are cross generational coalitions in structural family assessment?

A

Cross generational coalitions is where members of two different generations join forces against another member of the family

44
Q

What are rules and roles in structural family assessment?

A

Within each level of the hierarchy is a set of roles and rules associated with each position. Rules govern the appropriate behaviours for each position.

45
Q

What happens when rules and roles are not followed in structural family assessment?

A

Failure to follow the rules results in a breakdown of the system or the emergence of symptoms

46
Q

What are appropriate rules and roles based on in structural family assessment??

A

Appropriate rules and roles are again based on a continuum between rigidity and flexibility, with flexible roles being necessary for creativity and responsiveness to change and stability to maintain cohesion.

47
Q

What is the primary role of the structural family therapist

A

The primary role of the structural family therapist is to join the family system and to alter the families organisation from within that system by providing different feedback between the family and its environment. The therapist takes an active, directive and expert position throughout the therapy.

48
Q

What idea is fundamental to structural family therapy?

A

Fundamental to structural family therapy is the idea that family structure is only observable in interaction and transaction between family members not in the content that is discussed

49
Q

What processes are involved in structural intervention?

A

joining
structural mapping
enactments
re-structuring (Role definitions, unbalancing & using space)

50
Q

What is involved in the joining process of a structural intervention?

A

This is where the therapist must join with the family in order to effect any change

51
Q

What is the goal of the joining process of a structural intervention?

A

The goal is to become a member of the family system

52
Q

What approach does the therapist take in the joining process of a structural intervention?

A

The therapist takes a neutral, non-judgemental stance and approaches the family with curiosity

53
Q

Which subsystem does the therapist join first in the joining process of a structural intervention?

A

the parental subsystem

54
Q

What does the joining process of a structural intervention achieve?

A

The leverage gained from joining is used to induce the desired change and accept the therapists’ directives

55
Q

What is a structural map?

A

A map that allows the therapist to develop hypotheses about areas within the family that function well and those that may be dysfunctional

56
Q

How do structural maps differ from genograms?

A

Differing from genograms, the family map does not try to describe the entire family structure. Rather, it focuses only on the family members present in the room

57
Q

What is the importance of the structural mapping process a structural intervention?

A

The map is fundamental to planning goals for intervention

58
Q

What is the enactment process of a structural intervention?

A

It is central technique in Structural Family Therapy, which involves directing the family to interact in a way that brings the family difficulty into the room

59
Q

what does the enactment process of a structural intervention demonstrate?

A

This demonstrates transactional sequences and allows for real time, in the moment modifications of interactions

60
Q

What might the therapist ask in the enactment process of a structural intervention?

A

‘could you demonstrate or give an example of how this argument would normally look right now?
‘Mum could you tell your daughter what your expectations of her are and why you think she needs to attend school?’

61
Q

What could the re-structuring process of a structural intervention include?

A

Establishing appropriate boundaries & intergenerational hierarchy
Supporting the executive hierarchy to decide of cleared shared expectations regarding children’s behaviour
Actively intervening when a child interrupts in a conversation between parents.
Actively intervening when a parent consistently speaks on behalf of a child
Working with space in the room, moving seating arrangements to reflect appropriate family structure and organisation.
Encouraging parental subsystem to allow the two teenage children to resolve their argument.
Supporting the partner subsystem to spend 5 minute discussing their response to their child before and decision are made.