Family Therapies Terms

Family Therapies

Extended Family Systems Therapy
What theories form the foundation of most family therapy approaches?	General systems theory and cybernetic theory.
What does general systems theory predict about systems?	All systems consist of interacting components, are governed by the same general rules, and have homeostatic mechanisms to maintain stability and equilibrium.
What is the focus of cybernetic theory?	It examines mechanisms that regulate a system’s functioning, distinguishing between negative feedback loops (resist change, maintain status quo) and positive feedback loops (amplify change, disrupt status quo).
What are negative feedback loops?	resist change, maintain status quo
What are positive feedback loops?	amplify change, disrupt status quo
Who were early contributors to communication theory in family therapy?	Bateson and his colleagues at the Mental Research Institute.
What is double-bind communication?	when a person receives two contradictory messages from a family member and cannot comment on the contradiction.
What disorder is double-blind communication linked to?	Schizophrenia
What are symmetrical interactions?	interactions that reflect equality, where one person’s behavior elicits a similar type of behavior from the other person.
What problems can arise from symmetrical interactions?	can escalate into a "one-upmanship game."
What are complementary interactions?	Interactions that reflect inequality, where one person’s behavior complements the other’s behavior (e.g., one assumes a dominant role, the other a subordinate role).
What problems occur with complementary interactions?	when family members’ interactions are exclusively symmetrical or exclusively complementary.
How has postmodernism influenced recent approaches to family therapy?	challenges general systems theory’s premise of universal laws. It adopts a constructivist or social constructionist perspective, assuming multiple viewpoints and realities.
How do postmodern approaches view the role of the family therapist	see therapy as a shared process where the therapist collaborates with the family to identify alternative ways of interpreting and resolving problems.
What is another name for Bowen's extended family systems therapy?	Intergenerational and transgenerational family therapy.
What does "differentiation" refer to in Bowen's therapy?	A person's ability to separate their own feelings and thoughts (intrapersonal) and distinguish their emotional functioning from others' (interpersonal)
What happens when someone has a low level of differentiation?	They become "emotionally fused" with other family members
What is an emotional triangle?	A three-person system that forms when a family dyad recruits a third person to alleviate tension and increase stability.
When is an emotional triangle more likely to form?	When the levels of differentiation in family members are low.
What is the family projection process?	Parents project their emotional immaturity onto their children, resulting in lower differentiation in the children.
What is the multigenerational transmission process?	The transmission of emotional immaturity and lower differentiation from one generation to the next, leading to severe symptoms in a child over time.
Who does a Bowenian therapist usually see in therapy?	Either two family members (often the parents) or the individual family member most capable of increasing differentiation.
What is the primary goal of Bowenian therapy?	To increase each family member’s level of differentiation.
What tool is used during assessment in Bowenian therapy?	A genogram that maps family relationships and patterns for at least three generations.
What role does the therapist assume in Bowenian therapy?	A coach who stays neutral and avoids becoming involved in the family's emotional processes.
How do Bowenian therapists reduce emotional reactivity?	They have family members talk directly to the therapist rather than to each other.
Structural Family Therapy
What is the assumption of Minuchin’s structural family therapy?	A family member’s symptoms are related to problems in the family’s structure.
What are subsystems in structural family therapy?	Smaller units within the family system responsible for specific tasks, such as the parental subsystem.
What are boundaries in structural family therapy?	Implicit and explicit rules that determine the level of contact family members have with each other
What happens when boundaries are overly diffuse?	They lead to enmeshed relationships.
What happens when boundaries are overly rigid?	They lead to disengaged relationships.
What are clear boundaries?	Boundaries that allow close relationships while maintaining individual identities.
What is a stable coalition?	An inflexible alliance between one parent and a child against the other parent.
What is an unstable coalition (triangulation)?	When each parent demands the child side with them against the other
What is a detouring-attack coalition?	When parents blame the child to avoid their own conflict.
What is a detouring-support coalition?	When parents avoid conflict by overprotecting the child.
What are the primary goals of structural family therapy?	To alleviate symptoms and change the family structure by altering coalitions and creating clear boundaries.
What is the focus of structural family therapy?	Promoting behavior change rather than insight.
What are the three phases of structural family therapy?	Joining, evaluating, and intervening.
What is joining in structural family therapy?	Establishing a therapeutic alliance with the family.
What are the three techniques of joining?	Mimesis (adopting the family’s style), tracking (adopting content of communications), and maintenance (providing support).
What is a family map used for in structural family therapy?	To depict the family’s subsystems, boundaries, and structure.
What is reframing in structural family therapy?	Relabeling a problematic behavior to view it in a more constructive way.
What is unbalancing in structural family therapy?	Aligning with a family member to change hierarchical relationships.
What is boundary making?	Altering the proximity between family members.
What is enactment in structural family therapy?	Role-playing problematic interactions to encourage alternative behaviors.
Strategic Family Therapy
What is the core feature of family functioning in Haley’s strategic family therapy?	Struggles for power and control in relationships.
What is a symptom in strategic family therapy?	A strategy for controlling a relationship when all other strategies have failed.
What is the primary assumption about power and control in strategic family therapy?	Power and control are determined by hierarchies within the family.
What is the primary goal of strategic family therapy?	To alter family interactions that maintain symptoms.
What is the focus of strategic family therapy?	Changing behavior rather than instilling insight.
What are the four stages of the initial session in strategic family therapy?	Social stage, problem stage, interactional stage, and goal-setting stage.
What happens during the social stage of the initial session in strategic family therapy?	The therapist welcomes the family and observes interactions.
What happens during the problem stage of the initial session in strategic family therapy?	The therapist elicits each family member’s view of the problem and its causes.
What happens during the interactional stage of the initial session in strategic family therapy?	Family members discuss the problem, and the therapist observes interactions.
What happens during the goal-setting stage of the initial session in strategic family therapy?	The therapist helps the family define the problem and set concrete goals.
What types of directives does the therapist use in strategic family therapy?	Straightforward and paradoxical directives
What are straightforward directives?	Instructions to engage in specific behaviors to change family interactions.
What are paradoxical directives?	Instructions that help family members realize they have control over problematic behavior.
What is prescribing the symptom in strategic family therapy?	Instructing family members to engage in problematic behavior, often exaggerated.
What is restraining in strategic family therapy?	Encouraging family members not to change or warning them not to change too quickly.
What is an ordeal in strategic family therapy?	A task a family member must perform whenever engaging in undesirable behavior.
Milan Systemic Family Therapy
What is the primary assumption of Milan systemic family therapy?	The family protects itself from change through homeostatic rules and patterns of communication.
What are "family games" in Milan systemic family therapy?	Patterns of communication that involve power struggles and can become rigid, leading to problematic behavior.
What is the primary goal of Milan systemic family therapy?	To alter the family rules and communication patterns that maintain problematic behavior
What is the distinguishing feature of Milan systemic family therapy compared to other therapies?	The use of a therapeutic team and five-part therapy sessions (pre-session, session, intersession, intervention, and post-session)
How long are the gaps between therapy sessions in Milan systemic family therapy?	Four to six weeks.
What is "hypothesizing" in Milan systemic family therapy?	A continual interactive process of speculating and making assumptions about the family situation.
What is the role of neutrality in Milan systemic family therapy?	The therapist remains interested in the family’s situation and accepts each family member’s perception of the problem.
What is "circular questioning" in Milan systemic family therapy?	Asking each family member the same question to identify differences in perceptions about events and relationships.
What is "positive connotation" in Milan systemic family therapy?	A reframing technique that helps the family view a symptom as beneficial, maintaining cohesion and well-being.
What are family rituals in Milan systemic family therapy?	Activities carried out by family members between sessions to alter problematic family games.
Conjoint Family Therapy
What is the main cause of family problems according to conjoint family therapy?	Family problems arise when balance is maintained by unrealistic expectations, inappropriate rules and roles, and dysfunctional communication.
What are the four dysfunctional communication styles identified in conjoint family therapy?	Placating, blaming, computing, and distracting.
What is the "placating" communication style in conjoint family therapy?	Agreeing with or capitulating to others due to fear, dependency, and a desire to be loved and accepted
What is the "blaming" communication style in conjoint family therapy?	Accusing, judging, and bullying others to avoid responsibility and hide feelings of vulnerability.
What is the "computing" communication style in conjoint family therapy?	Taking an overly intellectual and rational approach to avoid emotional engagement with others
What is the "distracting" communication style in conjoint family therapy?	Changing the subject or making inappropriate jokes to distract attention and avoid conflict
What is the "congruent" (or leveling) communication style in conjoint family therapy?	A functional style characterized by congruence between verbal and nonverbal messages, directness, authenticity, and emotional engagement.
What is the primary goal of Conjoint Family Therapy?	To enhance family members’ growth potential by increasing self-esteem, strengthening problem-solving skills, and improving congruent communication.
What is "family sculpting" in Conjoint Family Therapy?	A technique where each family member positions others to depict their view of family relationships
What is "family reconstruction" in Conjoint Family Therapy?	A type of psychodrama that involves role-playing three generations of the family to explore unresolved issues and events.
Narrative Family Therapy
Who are the leading contributors to narrative family therapy?	White and Epston.
What is the core belief of practitioners of narrative family therapy regarding problems?	Problems are seen as arising from and being maintained by oppressive stories that dominate a person’s life. The problem is external, not internal to the person.
What is the primary goal of narrative family therapy?	To replace problem-saturated stories with alternative stories that lead to more satisfying and preferred outcomes.
What are "sparkling moments" in narrative family therapy?	Unique outcomes or experiences that are not consistent with problem-saturated stories.
What are the general stages in narrative family therapy?	1. Meeting family members. 2. Listening. 3. Separating family members from their problems. 4. Enacting preferred narratives. 5. Solidifying alternative stories.
How does narrative family therapy separate problems from family members?	By externalizing the problems, viewing them as something outside of the person.
What is the role of the therapist in narrative family therapy?	The therapist acts as a collaborator, using questions and techniques to help family members identify and construct alternative, healthier stories.
What is an example of an "externalizing question" in narrative family therapy?	"What does your anger tell you to do?"
iWhat is an example of an "opening space question" in narrative family therapy?	“Can you think of times when conflicts didn’t control your life?"
What are some interventions used in narrative family therapy?	Therapeutic letters, therapeutic certificates, and definitional ceremonies.
What are therapeutic letters in narrative family therapy?	Letters written by the therapist to reinforce emerging alternative stories.
What are therapeutic certificates in narrative family therapy?	Certificates given to family members at the end of therapy to acknowledge their accomplishments.
What are definitional ceremonies in narrative family therapy?	Ceremonies where family members have the opportunity to tell others how they overcame their problems and celebrate the changes they’ve made
Emotionally Focused Therapy (EFT)
What is Emotionally Focused Therapy (EFT)?	brief, evidence-based treatment integrating attachment theory, humanistic-experiential approaches, and systems theory.
What was EFT originally developed for?	couples but applied to families and individuals.
What is the primary goal of EFT?	To expand and restructure the emotional experiences partners have with each other, develop new interactional patterns, and experience attachment security.
What are the core assumptions of EFT?	1. Emotions are essential for organizing attachment behaviors and self-experience in relationships. 2. Attachment needs are healthy and adaptive, but problems arise from insecurities. 3. Relationship distress is maintained by interaction patterns and dominant emotional experiences.
What is the 1st assumption of EFT?	Emotions are needed for organizing attachment behaviors and self-experience in relationships.
What is the 2nd assumption of EFT?	Attachment needs are healthy and adaptive, but problems arise from insecurities.
What is the 3rd assumption of EFT?	Relationship distress is maintained by interaction patterns and dominant emotional experiences.
When is EFT contraindicated in couples therapy?	Untreated substance use disorder, partners have different agendas for going to therapy, and when emotional vulnerability is not safe
What are the three stages of EFT therapy?	1. Assessment and cycle de-escalation. 2. Changing interactional positions and creating new bonding events. 3. Consolidation and integration.
How is EFT related to Eye Movement Desensitization and Reprocessing (EMDR)?	combined EFT and EMDR leads to greater marital satisfaction and attachment security.
What did Knox (2015) find regarding the effectiveness of EFT combined with EMDR?	Couples who received combined EFT and EMDR experienced the greatest improvement in marital satisfaction and attachment security, compared to those who received only EFT or EMDR.
Functional Family Therapy
What is Functional Family Therapy (FFT)?	An evidence-based treatment for at-risk adolescents and their families, particularly those with conduct disorder or substance use disorder, incorporating elements of structural, strategic, and behavioral family therapy.
What is the primary goal of FFT?	replace problematic behaviors with non problematic behaviors that serve the same relationship functions, interpersonal relationships, and relational hierarchies
How many sessions does FFT typically involve?	8 to 30 sessions over a 3- to 6-month period.
What are the three stages of FFT?	1. Engagement and Motivation 2. Behavior Change 3. Generalization
What happens during the engagement and motivation stage of FFT?	Emphasis is placed on forming a therapeutic alliance, reducing negativity, increasing positive expectations, and developing a family-focused understanding of the problem.
What happens during the behavior change stage of FFT?	identifying immediate and long-term behavioral goals and implementing an individualized treatment plan
Techniques in FFT during behavior change stage	training in parenting, communication, problem-solving, and coping skills.
What happens during the generalization stage of FFT?	linking family members to community resources, helping them apply acquired skills to new problems, and identifying ways to avoid relapse.
What techniques are used during the engagement and motivation stage of FFT?	Joining and reframing.
Who benefits most from FFT?	At-risk adolescents, particularly those with conduct disorders and/or substance use disorders, and their families.
Multisystemic Therapy
What is Multisystemic Therapy (MST)?	focuses on addressing factors in the family, school, and social environments that contribute to the adolescent's problems.
What population was Multisystemic Therapy (MST) created for?	adolescents with serious problems like substance abuse, mental health issues, or conduct problems.
What is the main idea behind Multisystemic Therapy (MST)?	individuals are affected by multiple systems, such as family, peers, and the community. It aims to improve the interaction between these systems to address the problems the adolescent is facing.
How many treatment principles are there in MST?	nine
What is the goal of Multisystemic Therapy (MST)?	address the factors in the adolescent’s life that are driving their problem behaviors, such as family issues, peer influence, and school struggles.
Where is MST typically provided?	in the adolescent’s home and community, where the problems are happening.
What types of therapy are used in MST?	strategies from strategic and structural family therapy, behavior therapy, and cognitive-behavior therapy.
Who provides MST?	delivered by a team of professionals, such as a caseworker, family therapist, and substance abuse counselor
What is the importance of treatment fidelity in MST?	most effective when it is implemented as designed. Treatment fidelity is monitored to ensure the therapy is delivered correctly.
Group Therapy
What are the three formative stages of group therapy according to Yalom and Leszcz (2005)?	1) Initial orientation, hesitant participation, search for meaning, and dependency stage. 2) Conflict, dominance, and rebellion stage. 3) Development of cohesiveness stage.
What happens in the initial orientation stage of group therapy?	Group members focus on clarifying the nature and purpose of the group.
What happens in the hesitant participation stage of group therapy?	Group members are unsure about participating and often depend on the leader for structure and answers.
What happens in the search for meaning stage of group therapy?	Members search for meaning in their experiences and the purpose of the group.
What happens in the dependency stage of group therapy?	Group members depend on the leader for support, structure, and guidance.
What happens in the conflict, dominance, and rebellion stage of group therapy?	Members compete for power and control and attempt to establish a pecking order.
What happens in the conflict stage of group therapy?	Members may become critical or hostile toward each other and the therapist.
What happens in the dominance stage of group therapy?	Members try to establish themselves as leaders and assert control over the group.
What happens in the rebellion stage of group therapy?	Some members may rebel against the therapist or other group members.
What happens in the development of the cohesiveness stage of group therapy?	Trust increases between members, and conflict decreases as they begin to open up.
What signifies the development of cohesiveness in a group?	Members start revealing the real reasons they are in therapy and show concern for each other’s absence.
What marks the beginning of a mature group in therapy?	The group becomes cohesive and can effectively address the concerns and problems of its members.
What are the 11 therapeutic factors in group therapy according to Yalom and Leszcz (2005)?	1) Group cohesiveness 2) Instillation of hope 3) Universality 4) Altruism 5) Imparting information 6) Development of socializing techniques 7) Corrective recapitulation of the primary family group 8) Interpersonal learning 9) Imitative behavior 10) Catharsis 11) Existential factors
Which therapeutic factor is considered the analogue of the therapeutic alliance in individual therapy?	Group cohesiveness.
What is group cohesiveness a precondition for in group therapy?	The other therapeutic factors.
What has been most consistently found to be a strong predictor of positive group therapy outcomes?	Group cohesiveness.