Family Therapy (CAU Quals)

What is Bowen's Theory?

Family Systems Theory

Bowen's 8 forces that shape family functioning

1. Differentiation of self

2. Triangles

3. Nuclear family emotional system

4. Family projection process

5. Emotional cutoff

6. Multigenerational transmission process

7. Sibling position

8. Societal regression

Fromm-Reichmann's term?

Schizophrenogenic mother

= very cold, domineering

Bateson's term?

Double-bind

= lose-lose situation

(i.e. mother gives a guilt trip for going to a party because she will be "lonely")

Michuchin's boundaries

Permeable (- - -)

= members can cross subsystems, healthy

Enmeshed (. . .)

= blurred boundaries, overinvolvement

Disengaged (----)

= rigid, isolated boundaries

Techniques used in Minuchin's theory

Joining

= entering a family by engaging its seperate members/subsystems

Accomodating

= therapist attempts to make personal adjustments in adapting to the family style (to build therapeutic alliance)

Mimesis

= copy or mimic a family's communication and bx patterns to gain acceptance by family members

Cybernetics

"everything is a controlled system"

- The study of methods of feedback control within a system, especially the flow of information through feedback loops.

Epistemology

* The study of the origin, nature, and methods of knowledge (as well as the limits).

* A framework for describing and conceptualizing what is being observed and experienced.

Identified Patient (IP)

"problem person, originator of therapy"

- The family member with the presenting symptom who initially seeks treatment.

Family Life Cycles

(Betty Carter and Monica McGoldrick)

- Series of stages/events that mark a family's life, developing them over time.

Gender-sensitive Family Therapy

- Examines the impact of gender socialization.

- Aims to empower clients to make sexist-free role choices.

Feminist Family Therapy

(Rachel Hare-Mustin)

- Egalitarian, nonsexist intervention addressing family gender roles, patriarchal attitudes, and social/economic inequalities in male-female relationships

General System Theory

"Heirarchy in the family"

- Unity and organizational heirarchy of interactional parts in context (i.e. family)

Systems Theory

"Family viewed as parts making up a whole"

- Generic term encompassing General Systems Theory AND Cybernetics.

- The view of interacting units making up a whole

Don Jackson

* Pioneer of Family Therapy, MRI

Don Jackson -

Marital Quid Pro Quo

* How married couple arranges/agrees to define themselves/eachother in the marital relationship.

Don Jackson -

Redundancy Principle

* Repetitive bx sequences that continue to happen in the family.

Don Jackson -

Metarules

* A family's unstated rules/norms

Don Jackson -

Homeostasis

*Returning to the norm (as a family)

Don Jackson -

Metacommunication

"message about the message"

Nonverbals that add meaning to the message

Don Jackosn -

Symmetical Relationships

*Dyadic communication pattern where (EQUALITY) both responses to minimizing differences are similar

Don Jackson -

Complementary Relationships

*Dyadic communication pattern where (INEQUALITY) differences counterrespond and complement eachother in solving issues

Don Jackson -

Paradoxical Injunction

*Forcing to disobey in order to obey (double-bind message)

2 forms of therapeutic Double-Bind

1. Prescribing the Symptom =

Client directed to voluntarily engage in symptomatic behavior, realizing voluntary control of bx

2. Relabeling =

Reframing bx.

Human Validation Process Model

(Virginia Satir)

*8 Aspects of Self =

physical, intellectual, emotional, sensual, interactional, contextual, nutritional, spiritual

Virginia Satir -

5 Communication patterns

*4 BAD Communication patterns =

placate, blamer, super-reasonable, irrelevant

*1 GOOD Communication patterns =

congruent communication

Virginia Satir -

Family Reconstruction

*Family members are guided back through the stages of their lives in order to discover dysfunctional patterns from the past.

Theodore Lidz -

Marital Schism VS. Marital Skew

Marital Schism

= Disturbed marital situation characterized by disharmony, self-preoccupation, undermining spouse, threats of divorce

Marital Skew

= Disturbed marital situation where one partner dominates to an extreme degree

Murray Bowen

- Family Systems Theory

- Genograms (genetic family tree)

Undifferentiated Family Ego Mass

(Bowen)

- Emotional "stucktogetherness"

- Fail to become individuals because family is too fused.

Pseudomutuality

(Lyman Wynne)

*Family pretends like everything is fine (surface appearance), but it's total BS

Pseudohostility

(Lyman Wynne)

*Family avoids tenderness and deeper feelings by bickering and turmoil to maintain the relationship

Rubber Fence

(Lyman Wynne)

*Family shifting boundary to protect themselves from outside contact.

Psychodrama

(Jacob Moreno)

*"Role Play" in family group therapy to achieve catharsis/resolve conflicts

Complementarity

(Nathan Ackerman)

*The degree of harmony in the meshing of family roles.

Detriangulation

(James Framo)

*The process of breaking up the triangles/alliances

Contextual Therapy

(Ivan Boszormenyi-Nagy)

*In therapy, looking at the context, circumstances of an experience or event

Invisible Loyalty

(Ivan Boszormenyi-Nagy)

*In therapy, a child's unconscious commitment to help the parents (i.e. as a scapegoat)

Carl Whitaker

- CO-THERAPY = 2 ppl leading group to model nonverbals, etc.

- Symbolic-Experiental Family Therapy

Gestalt Family Therapy

(Walter Kempler)

- Focus on the "Here & Now" to heighten self-awareness and increase self-direction

Emotionally Focused Couple Therapy

(Susan Johnson & Les Greenberg)

- Similar to client-centered therapy

Salvador Minuchin

- Structural Family Therapy

- Discussed family subsystems

- Boundaries

Structural Family Therapy

(Salvador Minuchin)

*Directed at changing/realigning the family structure/organization.

Clarify subsystem boundaries.

Minuchin's highlighted points...

*Alignments

= clusters of alliances/splits between subgroups

*Power

= influence, control over outcome

*Triangulation

= each parent demands a child ally to allign them against partner

*Coalitions

= secret alliances against others in family

Family Mapping

(Salvador Minuchin - Structural Family Tx)

*Graphing out the family structure/boundaries/alliances

*NOT the same as genogram, focuses on dysfunctions.

Boundary Making

(Salvador Minuchin - Structural Family Tx)

*Realigning boundaries within a family by changing the psychological proximity (close/far) b/w family subsystems.

Unbalancing

(Salvador Minuchin - Structural Family Tx)

*Altering the heirarchal relationship by supporting one member and upsetting family homeostasis.

Tracking

(Salvador Minuchin - Structural Family Tx)

*Therapist deliberately attends to symbols, language, values of the family,

using them to influence the transactional patterns.

Enacting

(Salvador Minuchin - Structural Family Tx)

*Role-playing.

Reframing

(Salvador Minuchin - Structural Family Tx)

*Relabeling behaviors in a more positive way.

*Invites new responses to behavior.

Strategic Family Therapy

(Jay Haley)

*Therapist develops a specific plan of strategy/design interventions for solving the problem.

Prescriptive VS. Directive

*Prescriptive = "You could do this"

*Directive = "You need to do this

Paradoxical Interventions

(Jay Haley - Strategic Family Tx)

*Therapist gives a client/family a directive expecting them to resist it.

By resisting the directive, a change takes place.

Milan-Systemic Family Therapy

(Mara Selvini-Palazzoli)

*Milan -model approach. Family viewed as an evolving system that is living in an old epistemology.

*Invariant Prescription = single, unchanging directive for parents with symptomatic children.

Counterparadoxes

(Mara Selvini-Palazzoli)

...

Positive Connotations

(Mara Selvini-Palazzoli)

...

Family Rituals

(Mara Selvini-Palazzoli)

...

Milan-Systemic Family Therapy's

Intervention Strategies

*Hypothesizing

= therapists come up with hypotheses of why things are happening to develop discussion

*Neutrality

= Therapist takes a neutral perspective

*Circular Questioning

= Interviewing technique that elicits differences in perception of events by family members

Behavioral Couples Therapy

(Robert Liberman)

*Training couples in communication skills, positive reinforcement, problem-solving skills, etc.

Operant Interpersonal Therapy

(Richard Stuart)

*Marital therapy approach that uses CBT framework and positive rewards.

Integrative Couples Therapy

(Neil Jacobson)

*Behaviorally based technique, emphasizes emotional acceptance of behavior in a partner who isn't open to change.

Behavioral Parent Training

*Pioneered by Gerald Patterson

Constructivism

*Belief that an individual's knowledge of reality results from his subjective perceiving and constructing of the world.

Deconstruction

*Gaining meaning by reexamining assumptions previously taken for granted, and constructing new meanings.

Functional Family Therapy

(James Alexander)

* Based on systems theory, cognitive theory, & behaviorism.

* Clients are helped to understand the interpersonal payoff of certain behaviors as a way of substituting with new ways of achieving same result.

Solution-Focused Brief Therapy

(Steve de Shazer)

* Concerned with change, NOT why bx is happening.

* Ask the Miracle Question

* Talk about Exceptions (when bx didn't occur)

* Scaling Questions (quanitifying perception)

Narrative Therapy

(Michael White)

* Therapist and family co-construct new stories about their lives that encourage the possibilities of new experiences

* Clients EXTERNALIZE the problem

Medical Family Therapy

(George Engel)

* Psychoeducational family therapy involving collaboration with health physicians.

* For families with health problems.