PSYC2140 - Week 9

Clinical Psychology Intervention in Couples and Families


Family & Couples Therapy

Definitions

Family Therapy: A form of psychotherapy that focuses on improving:

  • Interfamilial relationships.

  • Behavioral patterns of the family unit as a whole.

  • Patterns among individual family members.

  • Dynamics among groupings or “subsystems” within a family. (APA, n.d.)

Couples Therapy: Defined as therapy wherein both partners in a committed relationship are treated concurrently by the same therapist(s). (APA, n.d.)

Foundational Concepts in Family & Couples Therapy

Origins

  • Developed around the 1940s.

  • Influenced by a multitude of fields including:
      - Psychoanalysis.
      - Cybernetics.
      - Anthropology.
      - Linguistics.
      - Communication Theory.
      - Philosophy. (Lee & Singh, 2020)

Systemic Approaches

  • A paradigm shift in understanding psychological problems and their origins.

  • Emphasizes that the whole is greater than the sum of its parts.

  • Problems are increasingly perceived as by-products of a dysfunctional family environment, rather than solely issues residing within the individual. (Pomerantz, 2023)

Key Components of Systemic Therapy Approaches

  1. Circular Causality
       - Distinguishes between linear and circular causality.
       - Linear causality: A common perspective in individual therapy; considered unidirectional where past events dictate present behavior.
       - Circular causality: Characterizes a systemic approach which is bidirectional and continuous; past and present events reciprocally influence each other.
       
       - Visual Representation:
          - Linear: A → B (Past events influence the present)
          - Circular: A ↔ B (Events influence each other)

  2. Functionalism
       - Describes mental life and behavior as active adaptations to environmental challenges and opportunities (APA, n.d.).
       - Psychological symptoms serve a functional (i.e., adaptive) role in the family’s environment. (Pomerantz, 2023)
       - Example: When a parent expresses anger, their adolescent may exhibit sadness or low mood; the parent then softens, thus decreasing their own anger.

  3. Homeostasis
       - Refers to systems regulating themselves by returning to usual levels deemed optimal or familiar (Pomerantz, 2023).

Application of Concepts

Example Case of Jacob and Stephanie

  • Jacob, an 8-year-old, is experiencing anxiety manifested through sleeping issues and physical complaints before school.

  • Stephanie, his mother, also reports her own anxiety and the family dynamics involve parental arguments in Jacob's presence.

  • Linear Causality Perspective: Jacob’s anxiety is viewed as a direct result of the arguments and parental stress.

  • Circular Causality Perspective: The anxiety influences and is influenced by the family dynamic, showcasing the reciprocal nature of problems.

  • Functionalism Perspective: Jacob’s anxiety serves a purpose in the family structure—potentially masking or mediating the intensity of parental conflict.

  • Homeostasis Perspective: Jacob's anxiety might maintain homeostasis by preventing further escalation of disturbances in the family's social environment.

Individual vs. Systemic Approaches

  • Discussion Questions (One Minute Paper):
      - What strengths does a systemic approach possess?
      - What potential limitations exist?

Recap of Session

  • Family and couples therapy uses systemic approaches to view problems within the entire environment, emphasizing family and couples dynamics.

  • Core concepts include circular causality, functionalism, and homeostasis.

  • While systemic approaches have notable strengths, there are also weaknesses that must be considered.

Practical Aspects of Therapy with Couples and Families

Range of Approaches and Features

  • There exists a wide array of theoretical perspectives, intensities, and formats within the field of therapy.

  • Across these approaches, a systemic focus tends to concentrate on:
      1. Relationships between individuals.
      2. Understanding the cultural makeup of the families or couples.
      3. Identifying strengths and resources within the family unit. (Lee & Singh, 2020)

Common Features of Systemic Therapies

  • Emphasis is placed on relationships between individuals rather than solely on internal experiences.

  • Examples of therapies that embody these principles include:
      - Attachment-Based Family Therapy by Dr. Guy Diamond: Focuses on family relationships rather than individuals.
      - Emotionally Focused Therapy for Gay Couples by Dr. Sue Johnson: Integrates culture and personal narratives into therapeutic practice.
      - Solution-Focused Couples Therapy by Dr. Insoo Kim Berg: Encourages couples to recognize and utilize their strengths and options.

Genograms

Definition and Usage of Genograms

  • A genogram is an illustration that details the biological and social connections among family members.

  • It serves several purposes:
      - Develops a shared understanding between therapists and clients.
      - Tracks family patterns over time.
      - Generates hypotheses regarding family dynamics.
      - Identifies treatment possibilities.

Understanding Genogram Components

  • Basic Structure: Each individual represented by one “shape.”

  • Generational Hierarchy: Older generations are depicted at the top, with younger generations at the bottom.

  • Relationships: Connections, such as marriages and parenthoods, are shown with lines.

  • Life Events: Details of significant events—such as deaths, divorces, and marriages—are indicated, often with dates when known.

  • Behavioral Indicators: Notable patterns of interaction and any physical or psychological concerns are annotated as needed.

Practical Application of Genograms in Therapy

  • Discussion prompts:

  • How might genograms aid clients and therapists in understanding family dynamics?

Summary

  • Family and couples therapies employ a systemic approach that is fundamentally relationship-focused.

  • Genograms provide valuable insights into family contexts, assisting therapists in tailoring their interventions and fostering a common understanding with clients.