Week 3 - Traditional Approaches to Family Therapy 2 Flashcards
What did Rabkin say about strategic psychotherapy?
“Where I asked to explain strategic psychotherapy standing on one leg… I would answer ‘patients attempt to master their problems with a strategy which because it is unsuccessful, the therapist changes. All the rest is commentary’”
What will change lead to according to Erikson?
Change will lead to insight far more often than insight will lead change
What did Erikson believe about the person and psychotherapy?
‘Each person is an individual. Hence psychotherapy should be formulated to meet the uniqueness of the individual’s needs, rather than tailoring the person to fir the Procrustean bed of the hypothetical theory of human behaviour’
Who contributed mostly to Strategic Family Therapy?
Milton Erikson
What did Jay Haley and Cloe Madanes combine to produce strategic problem-solving family therapy?
The brief therapy model of Mental Research Institute
The structural therapy of Minuchin
The Cybernetic theories of Gregory Bateson
The communication theory of Don Jacson
What did Haley and Madanes’ product of strategic problem-solving family therapy evolve into?
Evolved into a family systems approach
What concept do Strategic family therapists use?
Strategic therapists used the concept of feedback loops and made it central to their model
What is the theory of problem formation according to the MRI group?
Families experience difficulties throughout their development. Whether the difficulty becomes a problem or not depends on how the family responds. The family may attempt to solve the problem through various means. If the problem persists, they tend to do more of the same attempted solution. This escalates the problem, at which point the family will try “more of the same solution” and a cycle is created
When does the theory of problem patter proposed by the MRI group develop?
They develop when families mishandle a normative lifecycle transition
What are the characteristics of normal families?
Flexible enough to modify solutions that do not work.
Flexible enough to adjust to development.
The choice of attempted solution is dependent on the rules that govern the system
What are the types of solutions often undertaken by families?
Terrible simplifications
Utopian syndrome
Paradox
Terrible simplification solution
Action necessary but none is taken
Utopian Syndrome solution
Action taken when none is necessary
Paradox solution
Action taken but at the wrong logical level (be spontaneous)
What is negative feedback?
Negative feedback are those patterns of interactions that maintain stability or consistency while minimising change. These types of cybernetic loops maintain homeostasis or morphistasis
What is positive feedback?
Positive feedbacks are patterns of interaction that facilitate change or movement toward either growth, change or dissolution known as Morphogenesis
What are the complementary and symmetrical patterns?
Pursuer/Distancer Criticise/Defend Control/Resist Logical one/Emotional one Over functioning/under functioning Helpless one/Rescuer
What are the types of change?
First order change
second order change
First order change
change that occurs within the rules of the system.
“this might look like the presenting problem moving between children in the family… i.e. parents who are detouring through a different child”
Second order change
Change of the structures and rules of the system.
“Detouring stops as parents choose to work on their relationship dissolving the problematic cross-generational hierarchy”
What is an example of the vulnerability cycle?
Shiela’s vulnerability leads to her feeling unprotected and overburdened. Her survival strategy leads to her acting critical, angry, over responsive.
As a result Dave’s Vulnerability is feeling inadequate and abandoned and his survival strategy is acting defensive and withdrawn.
This leads to sheila’s v and SS which cycles back to dave’s
What is the dis-junctive attributions cycle?
-> behaviour reinforces -> perceived view of self [disjunctive attribution] Preferred view of self -> behaviour reinforces -> perceived view of self [disjunctive attribution] Preferred view of self ->
What is meta-communication?
Communication about communication. It is attending to command aspect of the conversation
What are the command aspects of the conversation?
Non-verbal cues to interpret verbal messages - typically to comment on the relationship
What are the forms of meta communications?
Voice tone, gestures, eye glances or smirks
What may meta communications reinforce?
Verbal messages (congruent)
What may meta communications satirize?
the verbal message openly (openly contradict)
What may meta communications create?
a Double-Bind
What is a double-bind?
a contradiction of meta-communications that can’t be directly commented on
What is an example of a double bind?
A father demands that his son engage in a nightly discussion at the dinner table, when the child attempts to participate, the father is irritated that his dinner has been interrupted. The father is then critical of his son’s lack of subsequent conversation. The son is caught in a double bind, as both his silence and attempts to talk are punished… as such he develops over time a disordered form of communication and behaviours that appear as psychiatric in nature.
What is the role of the therapist in the role of problem resolution?
The therapist is an active and directive throughout the process
What is the process of problem resolution?
Introduce small yet meaningful alterations to family patterns of behaviour and meaning (the viewing & the doing) - perturbations
What does problem resolution allow?
Allows the family to naturally re-organise.
What are interventions in problem resolution?
Interventions are used to interrupt (not fix) behavioural sequences.
What are the types of intervention?
Persuasion & influence is fundamental
Metaphors - unconscious bias
Directiveness - homework
Reframing perception of problematic behaviour
Restraining
Positive connotations
pattern interventions
Paradoxical interventions / prescribing the patterns
ordeals
What is the restraining type of intervention?
Go slow, there are costs and reasons not to change so quickly
What are the positive connotations type of intervention
No one can change when the system has a negative connotation of the,
What is the process of the MRI/Strategic interview?
- Engage in family assessment/social stage
- Identify and define the solvable problem
- Identify attempted solutions
- Descrive desired behavioural/observable change
- Develop plan and deliver the intervention
What is a solvable problem in MRI/strategic interview?
Observable, behavioural and relational sequence/pattern, not interested in history
How should the tactic of change be delivered to clients in strategic interviews?
In the client’s language
What is the target of the change in strategic interviews?
The attempted solution
What are Haley’s stages of a typical strategic therapy interview?
- Social stage
- Problem stage
- Interaction stange
- goal setting
- selecting and making interventions
- Evaluation of results and homework
What is involved in Haley’s social stage of a typical strategic therapy interview?
Build rapport and assess content
What is involved in Haley’s problem stage of a typical strategic therapy interview?
Get a clear statement of concern and behavioural sequences
What is involved in Haley’s interaction stage of a typical strategic therapy interview?
Family interacts
What is involved in Haley’s goal setting stage of a typical strategic therapy interview?
Define therapy goal in concise, observable, behavioural terms
What is fundamental to the strategic approach to family therapy?
The idea that if family beliefs could be changed, then interactional patterns could change alsp
What often drives interaction sequences in strategic approaches to therapy?
It is from family beliefs about self, family and others that often drive interactional sequences, hence if we can change the meaning then we can change an individual reaction and respond, leading to a behavioural deviation
How are behaviours often framed in strategic family therapy?
Often behaviours were famed in ways as to ‘positively’ connote them as keeping the family together or as serving a useful function
What is systemic reframinig
Reframing is an alternative yet equally plausible explanation of the same facts
What is to be considered in systemic reframing?
Consider symptoms in the relational system; i.e. how it maintains homeostasis.
What is expected of the clients in systemic reframing?
clients are not expected to adopted reframes, but rather its ‘new of differences’?
What is the assumption underlying family assessment?
Family Assessment is aligned with the structural/modernist assumption that we can, as an ‘outside observer’ accurately assess dysfunction within a family system and this will guide the appropriate intervention to facilitate change
What opportunities can be provided with family assessment processes?
Assessment processes are important opportunities for building therapeutic alliance with all family members. The assessment process itself can be therapeutic depeding on how it is facilitated
What are the three primary tools of family assessment?
Timelines, Ecomaps and Genograms
What did Weingarten say about the modernist approaches to family therapy?
‘within family therapy, a modernist approach entails the observation of persons in order to compare their thoughts feelings and behaviours against pre-existing, normative criteria. The Modernist therapist then uses explanations, advice and planned interventions as a means to bring persons responses in line with these criteria’
