marriage and family counseling

when did marriage and family specialization become the most popular academic track?

1980s

American Association for Marriage and Family Therapy

• AAMFT

• is a professional organization founded in 1942 that represents marriage and family therapists

• sets standards for education, training, and ethical practices in the field.

• feels that marriage and family counseling is a profession

ACA division of marriage and family therapy

• international association of marriage and family counselors (IAMFC)

• asserts that marriage and family counseling is a speciality you acquire after generic counseling knowledge and experience

Nathan Ackerman

• wrote “The family as a social and emotional unit”

• referred to as the grandfather of family therapy and founder of psychoanalytic family therapy

• used psychodynamic principles (dream work, life history, transference, linear causality, or cause-and-effect model)

linear causality

• cause effect model

• psychoanalytic family theory that stresses that one thing causes another

object relations

• another person that the child wants to bond with to meet their needs

• intrapsychic conflicts from one’s family of origin continues to affect the individual’s relationship with their own spouse and children

james framo

• analytic object relations psychologist

• family of origin therapy

• suggested that object relations gets in the way of people changing because they have parental introjects

introjection

• occurs when you incorporate a parent’s attitude as your own

• imprints or memories from the past are generally based on unresolved relationships with a parent

splitting

• related to object relations family therapy

• occurs when a young child turns an object into either all good or all bad and then internalizes the perception

• if not resolved, as an adult, they will view people as all bad or all good

don jackson

• founded the mental research institute (MRI) created to study and teach family therapy

• temed up with jay haley and Ackerman to create the first journal for family therapy Family Process

• known for his contributions to the communications approach and systemic therapy

virginia satir

• Conjoint Family Therapy

• therapist joins with the family to improve family function

• delineated four patterns of dysfunctional communication that exits when family members experience stress

  • placater

  • blamer

  • detractor

  • analyzer

• experiential family counselor

placater

• family member who tries to please everybody in the family

• people pleaser

blamer

family member who insists that everything is everybody else’s fault

analyzer

super reasonable family member who is emotionally detached, calm, cool and prone to intellectualization

detractor

family member who is totally removed and talks about things that are totally irrelevant

collaborative therapy

a therapeutic approach that emphasizes working together between family members and the therapist to address issues and improve relationships, fostering cooperation and mutual support.

concurrent family therapy

one counselor sees everybody individual

network family therapy

people from the outside (neighbors, colleagues, friends) are brought into therapy sessions

multiple family/couples therapy approach

model resembles group therapy and treatment audience is made up of several couples or families

identified patient

• IP

• person who is asked to seek therapy

• goal is to change relationships in the family (family itself is IP_

IP for insurance and managed care organizations in family/couples

• for billing purposes an individual will need to be chosen and diagnosed

• must be clearly explained to family or couple and needs to know which person has been picked

murray bowen

• observed a client that was functioning appropriately while in the hospital but would be discharged and function poorly at home due to familial dynamics

according to the theories of family therapy

• when relationship between family members changes, symptoms go away

• concept emphasizes that resolving interpersonal issues and improving communication within the family can alleviate psychological symptoms by addressing the root cause rather than just the individual symptoms.

homeostasis

• family will interact in ways that keep things in balance, equilibrium or status quo

• resistance to change

double blind hypothesis

• stipulates that “family members are sometimes placed in a no-win, damned if you do, damned if you don’t position,”

• person who is double bind receives two mutually exclusive messages from the same person and thus cannot really respond appropriately

• repeated messages may lead to schizophrenic behavior according to this theory

equifinality

• implies that similar outcomes can occur in the family from different origins

• suggest that the family can achieve similar goals in vastly different ways

equipotentiality

refers to the fact that the same processes can produce markedly different results

genetic fallacy

focusing on the past too much when you are performing marriage and family therapy

feedback

process that the family uses to adjust itself

negative feedback

• occurs when the family goes back to the way its always been in the past

• remains and keeps the status quo

positive feedback

occurs when a family is forced to change, so it cannot return to its previous state

circular causality

• what most forms of family therapy rely on to understand and address interactions

• deals with feedback loops

• asserts that you impact other members in a family but their behavior also comes back in a circle to impact you

behavioral family therapy

• use interventions based on operant conditioning

• positive reinforcement

• might include behavior modification techniques to help change maladaptive family dynamics.

  • sensate focus = sex problem

• focuses on changing behavioral patterns within family interactions by using reinforcement strategies to encourage desirable behavior

cognitive behavioral family therapist

• foucs on thinking processes such as irrational thinking, rational thinking, or cognitive distortion

• relies on REBT or cognitive reframing

quid pro quo contract

• used to get two people to engage in comparable function

• also used to discuss issues of sexual discrimination

gerald patterson

• often considered the trailblazer in terms of applying behavioral theories to families

• 1960s: teaching parents to use reinforcement, modeling, and timeout with their children

richard b. stuart

• another major pioneer in behavioral family therapy

• became convinced that good families and marriages thrived on this something for something

family systems theory

• a theoretical framework that views the family as a complex system of interconnected relationships, emphasizing how these interactions influence individual behavior and family dynamics.

murray bowen

• extended family systems theory approach

• major proponent and pioneer of systems theory

• focused on insight

• had family members speak directly to him rather than to each other to ward off arguments

• goal to teach an individual to remain themselves within the family system

• believed birth order is important

differentiation

• notion of being yourself

• within a family system while maintaining emotional connections with others.

family projection process

• describes how parents may project their own emotional problems onto their children, affecting the children's development and behavior

• differentiation level is similar to our parents

de-triangulate

• process of breaking the triangle between family members to reduce conflict and improve communication.

going home again technique

individual in treatment literally returns home to their family of origin to better understand their family

multigenerational transmission

• transgenerational therapy

• undesirable behavior patterns can be transmitted from one generation to the next

genograms

• visual representation of family relationships and patterns over generations, used in therapy to identify dynamics and issues.

bowen was also considered a ___ in family therapy

• critic, he believed it was not focused enough on theory and lack of clarity on theory was causing chaos in the field

action oriented approach

• structural family therapy

• Salvador Minuchin/Harry Aponte

• focused more on the parent-child relationship

• a therapeutic model focusing on changing the family's structure and interactions to improve relationships and resolve issues.

• Families of the Slums 1960

• spokesman for family therapy

two basic problems noted by minuchin with families

1. family memvers are enmeshed, choatic and very closely interconnection

2. family members are disengaged, unrelated and isolated

marital spousal subsystem

• subset or multi-bodied organism

• governs husband-wife interactions and dynamics within the family unit.

• crucial role in shaping the overall family system and influencing parenting processes

parental subsystem

• subset or multi-bodied organism

• governs parental interaction and dynamics with children

• plays a key role in influencing children's development and overall family functioning.

sibling subsystem

• subset or multi-bodied organism

• governs interactions and dynamics among siblings

• influences sibling relationships and overall family dynamic

minuchin’s views on boundaries

• believe that the job of the therapist was to loosen or establish boundaries between the members of the family

healthy families

• clear boundaries firm but flexible

dysfunctional families

• rigid or diffuse boundaries

  • cause people to disengage

diffused boundaries

• everyone is in everybody’s else business even when it isnt necessary

• parent who is consumed with parenting their child

  • child will have trouble leaving home and becoming their own person

generation gap

• according to minuchin this is a good thing between kids and parents

• parents should be seen as the top of the hierarchy in the family not as an equal or friend

steps in a structural family session

1. initial session: joining & building rapport

2. assessing subsystems and family organization

3. evaluating and modifying boundaries

4. active interventions and restructuring techniques

joining

• therapist attempts to be on the same wavelength as clients

• helper meets and greets everyone in the family and has a social exchange with every member

• uses tracking to help

tracking

• using a lot of person centered techniques such as reflecting, attending and relying on open ended questions

• use metaphors to reveal patterns of family communication

mimesis

• mimicking

• therapist might join the family by imitating certain body postures or nonverbal behaviors of a given family member thus aligning themselves with that person

reframing

• used to change the perception that a client has about themselves

• redefine or relabel the problem

intensity

• used in structural family therapy

• “putting pressure on the family.”

• achieved when you repeat a message again and again or you change the distance between family members

• can also occur if counselor encourages family interaction to go beyond the time that discussion would normally occur

jay haley

• MRI approach/problem solving model

• 1973

• often uses paradox

caveats of MRI approach/problem solving model

1. should always see the entire family

2. use a second therapist or team of therapist behind a one-way mirror as consultants

3. assume first session must be successful to perform successful therapy

4. during first session try to engage every family member

5. redefine problem as that of the family not IP; let family discuss the problem

6. give a directive at the end of the session

paradox

• therapist instructs the client or family to engage in, exaggerate or refrain from changing the very symptom or problematic behavior they are seeking to resolve

• rather than fighting the unwanted pattern, a directive that is counterintituvie is prescribeto encourage awareness and promote change

exception question

• avoids problem talk and foucses on what is already working in family or relationship

• goal is to uncover times when issues were handled differently, revealing existing strengths, resources and potential solutions

miracle question

• a technique where clients are asked to envision how their life would be different if a miracle occurred and their problems were solved overnight.

• helps to clarify goals and desired outcomes in therapy

modality possibility therapy

• does not promote catharsis, abreaction or ventilation

• focuses on changing behaviors through various therapeutic techniques and interventions

• approach emphasizes practical solutions over emotional release.

Milan model

• originally relied on co-therapists who were observed by members of a treatment team

• sessions = 1x month and 10 sessions, and used a one-way mirror

• seeks to understand family dynamics by focusing on patterns and interactions rather than individual issues

• employs circular questioning and emphasizes the systemic nature of problems

• critics: not warm and were impersonal

peggy papp

• social worker who brough team directly into therapy session room (chorus)

• team may even disagree with the therapist and interact with the therapists as well as the family

consultation

• act of working with individuals or groups who are working with clients

• joint problem solving venture (collaboration or collaborative effort)

• training workshop

mental health consultation

• based on crisis intervention by gerald caplan

• sometimes called the psychodynamic model

• asserted that consultation can be focused on the client, on consultee’s own dilemma, actual program or adminsitrative duties

• must not be plagued via lapses of objectivity

edgar schein

• doctor-patient model

• consultant is brought in to diagnose the problem and doctor prescribes something to fix it

• diagnosis is a good thing as something or someone in organization is sick

• expertise model

expertise model

• consultee knows what is wrong and consultant is hired to come in and fix it or rectify the problem

• Schein

process consultation model

• Schein

• seven steps used to enhance decision making and interaction in an organization

content consultations

• focus on the actual communication process

behavioral consultation

• uses behavior modification or aba strategies and social learning theory

• change the environment

• approach is popular with teachers