Week 4 Discussion


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  chose a family either from a popular movie, television series, book, etc. – and discuss the family from each family therapy approach.  Students are expected to elaborate on the character and highlight material obtained in chapter 15.   

Chapter 15 Summary LectureThe defining historical events in the family counseling field occurred in the 1950s when a number of researchers who were working independently began to look at schizophrenia as an area where family influences might be connected to the development of psychotic symptoms. Those efforts of Bateson’s Palo Alto, California, group, Lidz’s project at Yale, and Bowen and Wynn at the Institute of Mental Health led to research discoveries of the therapeutic value of seeing family members together.The principal difference between family and individual counseling is that family counseling focuses on the family and its members’ interactions and relations. Often, individual counseling tends to separate individuals and their problems from the family setting. Family counseling or family therapy, by contrast, almost always involves interventions to alter the way an entire family system operates. The family counseling and therapy label covers a wide variety of arrangements for the participants: It may be individual, couples, parent and child, or the entire family, including all who live in the home. Family therapists use a circular causality diagnosis that considers roles each person plays in the problem situation.The family is defined by an organizational structure that is characterized by degrees of cohesiveness, love, loyalty, and purpose as well as high levels of shared values, interests, activities, and attention to the needs of its members. Families may be considered a system, organized wholes or units made up of several interdependent and interacting parts. Each member has a significant influence on all other members. For positive change in an identified client, therefore, family members have to change the way they interact.  Family therapists work with the present relationships rather than the past. They are interested in the balance families maintain between bipolar extremes that characterize dysfunctional families. Core Concepts critical to understanding family therapy theories are these: centripetal and centrifugal, cybernetics, family, dyad, marital dyad, nuclear family, holon, family boundaries, family homeostasis, family projection process, family system, family therapist, family therapy, feedback loop, triangulationGoldenberg and Goldenberg  included some other fundamental concepts which are family roles, naratives and assumptions, pseudomutuality and pseudohostility, mystification, and scapegoating.Family therapists may use a variety of approaches in counseling but would all agree on these principles:People are products of their interactions and family relationships must be taken into account.Problem behavior in a person comes from the context of relationships. Interventions to help the person are most effective when the faulty interaction patterns are changed.Individual symptoms are maintained by the current family system transactions.Conjoint sessions, with the family as the treatment unit and the focus on family interaction, are more effective in producing change than trying to uncover intrapsychic problems in individual sessions.Assessing family subsystems and boundaries within the family and between the family and the external world provides clues about the family organization and susceptibility to change.Traditional diagnostic labels based on individual psychopathology do not provide an understanding of family dysfunctions but rather tend to pathologize people.The goals of family therapy are to change maladaptive or dysfunctional family patterns and/or to help people build alternative views about themselves to find new possibilities for the futureMurray Bowen, a family therapist, focused on how family members could maintain a healthy balance between being enmeshed (overly involved in each other’s lives) and being disengaged (too much detachment from each other). Self-differentiation was Bowen’s principal goal of family therapy. He focused on four ways of helping families develop individual identities for each member while maintaining a sense of closeness and togetherness with their families. Spousal relationships, de-triangulation, emotional systems, and differentiation are emphasized. Bowen paid attention to the spousal relationship and the definition and clarification of the couple’s relationship. He also considered the de-triangulation of self from the family emotional system.  Triangulation refers to the practice of two family members bringing a third family member into conflicts.Understanding family emotional systems and how they work is central to Bowen’s theory and he often assumed the role of educator in teaching people about family emotional systems. The nuclear emotional process refers to how the family system operates in a crisis. The family projection process refers to how parents pass good and bad things on to their children. The multigenerational transmission process refers to how a family passes its good and baggage between generations. In teaching clients about family systems and the intergenerational transmission process, Bowen used genograms and questions to move to intellectual levels. The genogram is a generational map of the family that describes who makes up the family, how they got to be family, when members arrived, what they did, what they valued and when they left the family. Finally Bowen would model differentiation to his clients by using “I” statements and taking ownership of his own thoughts, feelings, and behaviors. Self-differentiation was Bowen’s principal goal of family therapyStructural family therapy also assumes that the individual should be treated within the context of the family system. The overall goal of structural family therapists is to alter the family structure to empower the family to move toward functional ways of conducting or transacting family business and communications. Functional families are characterized by each member’s success in finding the healthy balance between belonging to a family and maintaining a separate identity. One way to find the balance between family and individual identity is to define and clarify the boundaries that exist between the subsystems. A family may have several subsystems such as a spouse, sibling, and parent-child subsystem. Each subsystem contains its own subject matter that is private and should remain within that subsystem. Boundaries between subsystems range from rigid to diffuse.  Diffuse boundaries can lead to over-enmeshment. Rigid boundaries allow too little interaction between family members, which may result in disengagement. Families who understand and respect differences between healthy and unhealthy subsystem boundaries and rules function successfully. Families who do not understand and respect these differences find themselves in a dysfunctional state of conflict. Salvador Minuchin is considered the founder of structural family therapy as it is practiced today.  Most of what he learned was by observation and in collaboration with colleagues at a school for delinquent boys. He has been praised for rescuing family therapy from intellectuality and mystery.  His pragmatic approach contributed both to understanding how families function and to productive interventions for correcting malfunctions in the family system. His style was to get the family to talk briefly until he identified a central theme of concern and the leading and supporting roles in the theme. Next he examined boundaries or family rules that define the participants, the areas of responsibility, the decision making and privacy rules. The idea is to change the immediate context of the family situation and thereby change the family members’ positions. His approach was both active and directive. He would shift the family focus from the identified client to the therapist to allow the identified client to rejoin the family. When treatment is complete, the therapist moves outside the family structure and leaves the family intact and connected without the loss of individual family member identities.Milton Erickson, Jay Haley, and Cloe Madanes are leaders of strategic family therapy. This type of family therapy is based on the assumption that family member behavior is ongoing and repetitive and can be understood only in the family context. Strategic refers to the development of a specific strategy, planned in advance by the therapist, to resolve the presenting problem as quickly and efficiently as possible. This brief therapy may be characterized by the highly active therapist who gives specific directives for behavior change that are carried out as homework assignments. Paradoxical interventions are often used to harness the strong resistance clients have to change and to taking directives. Clients may be asked to intensify the problem as one way of using paradox.  Another way is for the therapists to take a “one-down” position, encouraging the client not to do too much too soon. Counselors must differentiate between first-order and second-order changes.   First-order change occurs when the symptom is temporarily removed, only to reappear later because the family system has not been changed. Second-order change occurs when symptom and system are repaired and the need for the symptom does not reappear.Communication approaches to family therapy include John Gottman’s behavioral family therapy and Virginia Satir’s conjoint family therapy. Family therapists following a communications approach to family therapy hold the view that accurate communication is the key to solving family problems. An open and honest manner of communicating rather than using phony or manipulative roles characterizes good problem-solving families. Gottman built his approach on matching intent and impact of communication. He used a behavioral interviewing method to teach people about what they are doing that is not working and to help them correct the situation by learning how to get the impact they want from their communication. His stages include 1) exploration, 2) identification of goals, 3) perceptions of issues, 4) selection of one issue for discussion, 5) an analysis of interactions, 6) negotiation of a contract.Virginia Satir considered herself a detective who helps children figure out their parents. She thought 90% of what happens in a family is hidden. The family’s needs, motives, and communication patterns are included in this 90%. She believed that whatever people are doing represents the best they are aware of and the best they can do. She considered people geared to surviving, growing, and developing close relationships with others. Self-esteem plays a prominent role in Satir’s system. She viewed mature people as being in touch with their feelings, communicating clearly and effectively, and accepting differences in others as a chance to learn.  She believed the four components in a family situation that are subject to change are the members’ feelings of self-worth, the family’s communication abilities, the system, and the rules of the family.  The three keys to Satir’s system are to increase the self-esteem of all family member, help family members better understand their encounters and use experiential learning to improve interactions.Communication is the most important factor in Satir’s system and determines the kinds of relationships people have with one another and how people adjust. She discussed response patterns to which people resort as a reaction to anxiety. These universal response roles are the placater, the blamer, the computer, the distractor, and the leveler. Leveling helps people develop healthy personalities; all the others hide real feelings for fear of rejection. Satir divided families into two types: nurturing and troubled.  Each type had varying degrees. Her main objective for her clients was recognition of their type and then change from type or degree. The counseling method of conjoint family therapy involves communication, interaction, and general information for the entire family. She used several techniques to reach her goals of establishing proper environments and assisting family members in clarifying what they want or hope for themselves and for the family. Her method is designed to help family members discover what patterns of communication do not work and how to understand and express their feelings in an open, level manner. Simulated family games, systems games, and communication games are some of the methods she developed to deal with family behavior. The counselor’s role in this model is of a facilitator who gives total commitment and attention to the process and the interactions. The counselor intervenes to assist leveling and taking responsibility for one’s own actions and feelings. Play therapy with families has the advantage of helping children communicate their story to the therapist. Dynamic family play therapy engages family members in creative activity by using natural play. The counselor’s goal is to help the family develop and increase spontaneity. Filial therapy is a play therapy method based on the principles of child-centered therapy. The goals of filial therapy are to reduce the child’s problem behaviors, to help parents gain the skills of child-centered therapist to use as the parents relate to their children and to improve the parent-child relationship. Strategic family play therapy is a form of counseling in which all family members and the counselor play. Theraplay is a treatment method modeled after the healthy parent-child interaction in which parents are involved first as observers and then as co-therapists.All the schools of the various family therapies agree that families have interdependent parts in which one malfunction will affect all the other parts. Maintaining balance in ways that are healthy for all members is a common goal of the therapies. Counselors may help in determining safe ways to approach change. Finally, these approaches borrow from other approaches to counseling.    Chapter 15 Summary

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