Family therapy M.A. Fourth Semester - PowerPoint Presentation

1. Family therapyM.A. Fourth SemesterPsycho-diagnostics and therapeutics Dhananjay KumarProfessorDepartment of PsychologyD. D. U. Gorakhpur University,Gorakhpur

2. HISTORYfamily therapy came to be known from the studies of psychopathology & communication in the families of schizophrenia patients by a group namely Palo Alto Group.In the early years of 1950s in Palo Alto, California, this group began their studies of communication patterns in such families. anthropologist Gregory Bateson was the leader of that group. Two concepts were emerged having the central role in the pathologies in the family members-1. The double bind 2. Family homeostasis

3. Indications And Contraindications Of Family Therapy

4. MODELS OF FAMILY THERAPYVarious models of family therapy are:Human Validation Process Model of Family TherapyStructural Family TherapyStrategic Family TherapyMultigenerational Family TherapyExperiential Family TherapyPsychodynamic Family TherapyBehavioral & Cognitive- behavioral Family therapyNarrative Family TherapySolution- focused Family Therapy

5. Human Validation Process Model Salvador Minuchiun, Jay Heley, and Virginia Satir is considered to be the pioneers of couple & family therapy.Satir’s Human validation process model, is also known as communication theory & change process model. according to Satir a primary survival triad exists that includes parents and the child, child’s sense of well-being & self- esteem as the result of this traid.Low self-esteem sometimes lead individuals to adopt one of four unhealthy universal communication pattern:The placater, appeasing people so that others won’t get angry on him or her.The blamer, who always blame others to diffuse the hurt getting from different situations.The computer, who play cool, calm & in a gestalt to deal with the world as there is nothing that will hurt him or her, The distractor, who make things irrelevant at least for him, in an effort to treat threats as if they do not exist( Satir, 1972). She also believed that children who generally, experiences healthy parenting will grow into a person who are congruent and can communicate clearly with others.Satir popularize the use of family sculpting in an effort to bring forth blocked and expressed emotions.She advocated that a family therapist should be caring & respectful, she also acknowledge the ability of the family to heal, and encourage family to change & be spontaneous.

6. Conti…… in this model Therapist takes several role e. g., facilitator, a resource person, an observer, a detective, and a modal for effective communication.” Satir described certain conditions for individuals taking participation in therapy to have mature relationships , but they have to adopted these behaviors: he/ she should have take responsibility for oneself & have a strong sense of self. people have to make decisions based on accurate perceptions of self, others, and the social context. he/ she will be able to make wise choices for which one takes full responsibility. they must be in touch with one’s feelings. people have to be clear in their communication. they will be able to accept others for who they are.see difference in others as an opportunity to learn, not as threat.

7. Structural Family Therapystructural school, was made famous by Salvador Minuchin.Minuchin (1974) believes that all families have interactional and transactional rules maintained by the kinds of practices in the family.He further states that at various time all families experience stress, and handled variedly by each family with the available existing rules, boundaries & structure and hierarchy in the family.structural family therapist join with the family, Map the family, and Provide interventions for restructuring the family to bring the pre settled change in families.Joining: Change in the family begins to occur when therapist ‘ join’ the family.It is acceptance of the counselor by the family & when he wins the confidence of familyIt can be done in several ways: through empathy, being friendly, or sharing common stories with family.It allows the counselor to understand the family rules, boundaries, structure & hierarchy and stress.

8. Conti……Mapping: It can be done formally or informally.It is an examination of how family communicates, who is in charge and what are the rules in family to maintain homeostasis.Understanding structure & hierarchy in family.Mapping is first step of restructuring. Restructuring: After the counselor has joined the family & mapped its structure , the process of restructuring starts.It involves developing new boundaries and changing structure & hierarchy, to enable family deal with stress and function in a healthier manner.The family therapy is deliberate and purposeful.

9. Strategic Family Therapy Jay Haley ( 1973,1976), Cloe Madanes and the Milan Group, have known to be most associated with the strategic approach This is based on how individuals communicate with one another and how communication sequences can be changed to help people to feel better. It also emphasize how power is dispersed in the family.Power of strategic therapist: if a man can order someone to behave in a certain way it is a form of power, but he also has power if he can provoke someone to behave in a certain way. (Haley,1986).Haley’s stages of his first interview are:The social stage: in this stage, the therapist invites the whole family & asks them to introduce himself/ herself. In this process therapist observe the quality of interaction among family members & overall mood of the family. At this stage, the therapist does not share his/ her observation with the family. The problem stage: after that each family member is asked to tell his/her perceptions of problem. Interactions among family members are carefully observed, but therapist does not share interpretations about the problem.The interaction stage: in the next stage therapist invite the family to interact during the session in the same manner in which they might at home. Goal- setting stage: finally, the family is asked to be very clear about what they would like to change in collaboration with therapist.

10. MULTIGENERATIONAL FAMILY THERAPYThis model of family therapy focus on how behavioral patterns & personality traits from prior generations transferred to new members of families.Therefore, therapist encourage to bring in parents, grandparents, cousins, uncles, and aunts in the therapeutic process. Families are believed to be a relational systems in which loyalties, and entitlements passed down from generation to generation.Murray Bowen, believed that previous generations could dramatically affect one’s ability to develop a healthy ego.In his opinion the ultimate goal of couples & family therapy is to differentiation of self.Differentiation of self include, differentiation of self from others & the differentiation of one’s emotional processes from one’s intellectual processes.Bowen used genogram of the families to know details of a family functioning over a number of generations.

11. Conti……Genogram includes , date of birth & death, names, major relationships, breakup and divorces. Genogram is a best method to know how families evolve over time & to identify current issues in the families.From the perspective of Bowen, therapists should be detached, helping their clients to understand family dynamics and systems.

12. Experiential Family TherapyBased on the assumptions of humanistic & existential psychology. Therapy starts with positive view of human nature. It believes that individuals as well as family has a natural growth tendency, that relies on the relationship between the therapist and the individuals to bring change.Carl Whitaker is known as experiential family therapist.Whitaker suggested that initially, the family is defensive and closed to the therapist.When the therapist join the family and come closure, the family begins to accept him/her as a genuine person and starts to open up.Whitaker believes that counselor should:Respect each family member’s self- actualizing process.Create an atmosphere of oneness and nondefensiveness.Assist families in resolving the pain& anger that bring them to therapy.Establish an “ I- Thou” relationship with the families. openness, the ability to dialogue and to express feelings works. .

13. Psychodynamic Family TherapyThe present approach attempts to merge the concepts from systematic thinking with psychodynamic theory.Nathan Ackerman(1958, 1966) and Robin Skynner ( 1981) are known as psychodynamic family therapist.In this system, therapist focuses on how effective parents assist their children to overcome their complexes effectively through different developmental stages. Therapist believed that unresolved issues of the developmental stages can be reflected in the families in unconscious way.Therapy major goal is to free family members from their unconscious constraints so that they’ll be able to interact with one another as healthy individuals.

14. Behavioral and Cognitive-Behavioral TherapyBehavioral family therapy does not focus on intrapsychic processes, or the unconscious. It is rather oriented towards symptom relief. This approach is highly structured & focus on specific behaviors and techniques.The family behavior therapist has a wide range of techniques from operant / classical conditioning, social- learning theory or modeling like individual behavior therapy.Cognitive- behavioral family therapist stressed that interfering into cognitions can also affect family members and should be addressed in treatment.Common elements of behavioral & cognitive- behavioral therapy: building a working relationship. basic learning theory principles can be applied to structure a systems.structuring therapy as brief and time limited.focusing on specific behaviors or cognitions that will be taken into consideration in treatment.setting clear, realistic, concrete and measurable goals. intervention through Teaching & coaching to understand the relationships among events in the lives, behaviors, cognitions & consequences.

15. Narrative Family Therapy founders of narrative therapy were Michael White and David Epston.Michael White said that The person or family is not the problem; the problem is the problem. development in social constructionism, post- modernism and Narrative reasoning incorporated in this approachthe core belief is that there are no absolute truths , and to understand the stories that people& families tell, deconstruct the meaning of that stories construed by the family members.GOAL- To recreate how the family comes to understand itself.It share some similarities to solution- focused therapy, it is also optimistic, proactive, future- oriented approach.Followings are the list of specific act for therapists practicing this approach: they must show interest in family & develop a strong collaborative relationship.understand family’s history through the stories it tells & analyze the problem.manifest non- judgmental attitude to understand the issues in the family & help the family redefine the problem.help the family to externalize the problem.

16. CONTI…..search for expectations to the problem.help the family to re- define their understanding of themselves by focusing on their strengths and their possibilities for the future.reinforce existing strengths of the family and new found narratives through behaviors acknowledging the changes the family has made.The final goal of narrative family therapy is to develop new understandings of how their history had defined who they are, & how they interacted. Help them to become aware about their own unique, new ways of being in the world.

17. Solution-focused Family TherapyIt was originated by Insoo Kim Berg, Steve de Shazer, Bill O’ Hanlon in association with some other contributors.It is a pragmatic & future- oriented approach.This approach focuses on solutions, not problems, and discussion of the past is very limited.Creation of a problem free language is associated with new behaviors, develop solutions, and moves towards creating a new reality.In this therapy, therapists help to examine alternatives ways of viewing themselves and focus solely on finding solutions to their problems based on their strengths.Therapist want to see only those family members who want to work on their own solutions.Assumptions: Change in every aspect of life is a constant and inevitable phenomenon. Client is capable to know and interpret his or her experience. Clients come to therapist with his unique resources and strength..

18. Conti……If therapy works, do more of it; if it’s not working, try something different Simple Small steps can lead to desirable changes.We will not found always a logical relationship between the solution & the problem.No problem repeated itself all the time.The future can be both created & negotiable. Solution- focused therapy can be viewed through a series of six stages:Pre- session changeForming collaborative relationshipDescribing the problemEstablishing preferred outcomesProblem to solution focusReaching preferred outcomesEnding therapy

19. EFFICACY OF COUPLES AND FAMILY THERAPYSummarizing some of the major findings, research suggests the following:Couples & family therapy seems to be effective as individual therapyThe ability of the therapists to build a relationship with the family is one of the key factors in successful outcomes.Rates of deterioration in couples& family therapy are about the same as those in individual therapy.Couples therapy is better than each partner’s seeing a clinician separately.Brief therapy is as effective as open- ended therapy.When fathers are in therapy with the family, treatment outcomes improve.Co- therapy does not seem to be effective than one therapist seeing the family.When an individual in a couple or family has been diagnosed as having a severe psychological problem, successful outcomes are less likely.Interaction styles of a family & family demographics are not related to outcomes in treatment.

20. Consulted booksGoldenberg, H.(1982). Contemporary Clinical Psychology, Brooks/Cole pub. Co.Korchin, j. (1979). Modern Clinical Psychology. New York: Harper CollinsNeukrug, Ed. (2011). Counseling Theory and Practice, Brooks/Cole CENGAGE Learning