Marriage and Family Exam

Bowenian Therapy: How dysfunction develops

Anxiety is the driving force, causing people to become emotionally reactive. Dysfunction also occurs when no adjustments are made to homeostasis, and the family becomes stuck in a structure that doesn't work.

Bowenian Therapy: Stance of the Therapist

Neutral, objective, and curious; acts as a coach/consultant, NOT interested in solving problems but supporting the person toward accepting behavior.

Bowenian Therapy: Goals of Therapy

Differentiation, Detriangulation, Lowering anxiety, Increasing self-focus, and seeing one’s role in the interpersonal process. (a)

Bowenian Therapy: Key Interventions

Genograms, process questions, relationship experiences, detriangulation, coaching, I-statements, and displacement stories. (a)

Structural Therapy: How dysfunction develops

Results from ineffective hierarchies, rigid and enmeshed boundaries, and a lack of clear hierarchy or executive functioning within the family.

Structural Therapy: Stance of the Therapist

ACTIVE and PROACTIVE; activates adaptive patterns (joins, accommodates, and restructures) and joins the family in a position of leadership.

Structural Therapy: Goals of Therapy

Creation of an effective hierarchy so the family can solve problems by altering its structure. For enmeshed families, this means differentiation and strengthening boundaries; for disengaged families, it means increasing contact and loosening boundaries. (a)

Structural Therapy: Key Interventions

Focus on structure, subsystems, and boundaries (rigid and enmeshed), hierarchy, accommodation, cross-generational coalition, ENACTMENTS (roleplays), structural mapping, Unbalancing

Strategic Therapy: How dysfunction develops

Cybernetic: Difficulties are turned into chronic problems by misguided solutions.

Strategic Therapy: Stance of the Therapist

Actively involved and responsible for failure or success; aims to outwit resistance, focusing on interaction and behavior rather than insight and reflection; proactive, direct, active, and engaged.

Strategic Therapy: Goals of Therapy

To interrupt negative cycles of behavior, create changes in interactions, incorporate problems with structure, and help people cope with problems and emotions.

Strategic Therapy: Key Interventions

Communication patterns and feedback loops (Report: content & Command: relational pattern context), Circular questioning, Metaphor, Prescribe the symptom, Restraining, Pretend technique, Positive connotation, Rituals, and Invariant prescription.

Experiential Therapy: How dysfunction develops

Due to a lack of tolerance for unruly emotions, fear of conflict, rigidity in rules and rituals, dishonest communication (blaming, placating, being irrelevant, being super reasonable), and low self-esteem leading to ineffective communication.

Experiential Therapy: Stance of the Therapist

Warm, supportive, caring, accepting, and genuine; the therapist becomes a family member, encouraging experience and expression, NOT solving problems; uses self and therapeutic alliance.

Experiential Therapy: Goals of Therapy

To create new experiences to break rigid expectations, roles, rules, and lack of awareness; move toward individuation; increase honest and intimate family relationships; and achieve breakthroughs (cut-off like).

Experiential Therapy: Key Interventions

identifying positive intentions; facilitating effective communication; therapeutic touch; Family sculpting; Family art therapy; family puppet interview; roleplaying; and empty chair technique.

Narrative Therapy: How dysfunction develops

The stories people take on construe their experience in unhelpful ways, leading to problem-saturated stories and clients being stuck in negative thinking or views of their problems.

Narrative Therapy: Stance of the Therapist

Collaborative; rejects categorizing or pathologizing; encourages education and correction of assumptions; does NOT assert interpretations; operates on good faith assumptions (people have good intentions, are influenced by discourse, are not their problems, can change their stories); client is the expert in their lives.

Narrative Therapy: Goals of Therapy

To deconstruct then reconstruct narratives, helping move away from totalizing views; involves three stages: 1) recasting problems (externalization), 2) finding exceptions to problems, and 3) recruiting support.

Narrative Therapy: Key Interventions

Externalization, personification, sparkling events, mapping influence, reauthoring, and various QUESTIONS (effects, relative influence, deconstruction, opening space, preference, story development, meaning, extension to future).

Solution-Focused Brief Therapy: How dysfunction develops

Doesn't focus on problem development but rather on 'problem talk' where clients are stuck in negative thinking or views of their problems.

Solution-Focused Brief Therapy: Stance of the Therapist

Believes the client is the expert in their lives; more about perceptions than feelings; mindful of the POTT for frame of reference; identifies three kinds of clients: Visitor, Complaintant, and Customer.

Solution-Focused Brief Therapy: Goals of Therapy

To resolve the presenting complaint as quickly as possible; shift language from problem talk to solution talk; encourage positive talk to cause positive actions, behaviors, and cognitions; explore what works; and establish well-focused, manageable, achievable goals defined in the client’s frame of reference, based on exceptions.

Solution-Focused Brief Therapy: Key Interventions

Key Questions: exception questions, coping questions, scaling questions, compliments, and the miracle question.

Solution-Focused Brief Therapy: Three kinds of clients

Visitor, Complaintant, and Customer.

Bowenian Therapy: How dysfunction develops

Anxiety is the driving force, causing people to become emotionally reactive. Dysfunction also occurs when no adjustments are made to homeostasis, and the family becomes stuck in a structure that doesn't work.

Bowenian Therapy: Stance of the Therapist

Neutral, objective, and curious; acts as a coach/consultant, NOT interested in solving problems but supporting the person toward accepting behavior.

Bowenian Therapy: Goals of Therapy

Differentiation, Detriangulation, Lowering anxiety, Increasing self-focus, and seeing one’s role in the interpersonal process.

Bowenian Therapy: Key Interventions

Genograms, process questions, relationship experiences, detriangulation, coaching, I-statements, and displacement stories.

Structural Therapy: How dysfunction develops

Results from ineffective hierarchies, rigid and enmeshed boundaries, and a lack of clear hierarchy or executive functioning within the family.

Structural Therapy: Stance of the Therapist

ACTIVE and PROACTIVE; activates adaptive patterns (joins, accommodates, and restructures) and joins the family in a position of leadership.

Structural Therapy: Goals of Therapy

Creation of an effective hierarchy so the family can solve problems by altering its structure. For enmeshed families, this means differentiation and strengthening boundaries; for disengaged families, it means increasing contact and loosening boundaries.

Structural Therapy: Key Interventions

Focus on structure, subsystems, and boundaries (rigid and enmeshed), hierarchy, accommodation, cross-generational coalition, ENACTMENTS (roleplays), structural mapping, Unbalancing, and 'stroke and a kick'.

Strategic Therapy: How dysfunction develops

Cybernetic: Difficulties are turned into chronic problems by misguided solutions.

Strategic Therapy: Stance of the Therapist

Actively involved and responsible for failure or success; aims to outwit resistance, focusing on interaction and behavior rather than insight and reflection; proactive, direct, active, and engaged.

Strategic Therapy: Goals of Therapy

To interrupt negative cycles of behavior, create changes in interactions, incorporate problems with structure, and help people cope with problems and emotions.

Strategic Therapy: Key Interventions

Communication patterns and feedback loops (Report: content & Command: relational pattern context), Circular questioning, Metaphor, Prescribe the symptom, Restraining, Pretend technique, Positive connotation, Rituals, and Invariant prescription.

Experiential Therapy: How dysfunction develops

Due to a lack of tolerance for unruly emotions, fear of conflict, rigidity in rules and rituals, dishonest communication (blaming, placating, being irrelevant, being super reasonable), and low self-esteem leading to ineffective communication.

Experiential Therapy: Stance of the Therapist

Warm, supportive, caring, accepting, and genuine; the therapist becomes a family member, encouraging experience and expression, NOT solving problems; uses self and therapeutic alliance.

Experiential Therapy: Goals of Therapy

To create new experiences to break rigid expectations, roles, rules, and lack of awareness; move toward individuation; increase honest and intimate family relationships; and achieve breakthroughs (cut-off like).

Experiential Therapy: Key Interventions

No techniques, only people; identifying positive intentions; facilitating effective communication; therapeutic touch; Family sculpting; Family art therapy; family puppet interview; roleplaying; and empty chair technique.

Narrative Therapy: How dysfunction develops

The stories people take on construe their experience in unhelpful ways, leading to problem-saturated stories and clients being stuck in negative thinking or views of their problems.

Narrative Therapy: Stance of the Therapist

Collaborative; rejects categorizing or pathologizing; encourages education and correction of assumptions; does NOT assert interpretations; operates on good faith assumptions (people have good intentions, are influenced by discourse, are not their problems, can change their stories); client is the expert in their lives.

Narrative Therapy: Goals of Therapy

To deconstruct then reconstruct narratives, helping move away from totalizing views; involves three stages: 1) recasting problems (externalization), 2) finding exceptions to problems, and 3) recruiting support.

Narrative Therapy: Key Interventions

Externalization, personification, sparkling events, mapping influence, reauthoring, and various QUESTIONS (effects, relative influence, deconstruction, opening space, preference, story development, meaning, extension to future).

Solution-Focused Brief Therapy: How dysfunction develops

Doesn't focus on problem development but rather on 'problem talk' where clients are stuck in negative thinking or views of their problems.

Solution-Focused Brief Therapy: Stance of the Therapist

Believes the client is the expert in their lives; more about perceptions than feelings; mindful of the POTT for frame of reference; identifies three kinds of clients: Visitor, Complaintant, and Customer.

Solution-Focused Brief Therapy: Goals of Therapy

To resolve the presenting complaint as quickly as possible; shift language from problem talk to solution talk; encourage positive talk to cause positive actions, behaviors, and cognitions; explore what works; and establish well-focused, manageable, achievable goals defined in the client’s frame of reference, based on exceptions.

Solution-Focused Brief Therapy: Key Interventions

Key Questions: exception questions, coping questions, scaling questions, compliments, and the miracle question.

Solution-Focused Brief Therapy: Three kinds of clients

Visitor, Complaintant, and Customer.

Bowenian Therapy: Two life forces

Individuality and Togetherness.

Who is considered the first family therapist?

John Bell.

Bowenian Theory: Central premise

Differentiation of self.

Emotional Triangles

Displaces anxiety onto a third person brought into conflicts or relationships.

Whitaker's view on theory and interventions

Anti-theory, emphasizing no theories or interventions, only people.

Satir's three goals of family therapy

1. Support each member in communicating openly and honestly on what they see, hear, feel and think about self and others in the presence of others. 2. Encourage decisions to be made by exploration and negotiation rather than power, respecting each person’s uniqueness. 3. Differentness should be acknowledged and used for growth.

Structural Therapy: Three constructs

Structure, Subsystems, and Boundaries.

Structural Therapy: Evaluation and results

Simple, inclusive of cultures, practical; can be a bit harsh ('stroke and a kick'); supports clinicians with a framework to look beyond content and look at structure.

Aponte's concept of the 'Person of the Therapist'

We must first understand ourselves and our pressing issues and themes to mitigate biases and reactivity in the therapeutic setting.