Tags: Family Therapy - Practical Guide – Manual – Theory – Summary - Course – counselling – counsellor

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Family Therapy – Wikipedia
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1 History and theoretical frameworks 2 Techniques 3 Publications 4 Licensing and degrees o 4.1 Values and ethics in family therapy 5 Founders and key influences 6 Summary of Family Therapy Theories & Techniques 7 Academic resources 8 Professional Organizations 9 See also 10 References 11 External links


Brief Strategic Family Therapy Strategic Family Therapy – Kimberly Gail Solution Focused Brief Therapy – Wikipedia
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1 Basic Principles 2 Questions 3 Resources 4 History of Solution Focused Brief Therapy 5 Solution-Focused counselling 6 Solution-Focused consulting 7 References

Brief (psycho-) Family Therapy – Wikipedia Extended Family Therapy or Bowenian Family Systems Therapy I - Wikipedia
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Introduction Differentiation of Self Triangles The Nuclear Family Emotional Processes The Family Projection Process The Multigenerational Transmission Process Sibling Position Emotional Cutoff Societal Emotional Processes Normal Family Development Family Disorders Goals of Therapy Techniques Family Therapy with One Person


Wikipedia Narrative Family Therapy II Definitions Basic Family Therapy Techniques • • • • • • Techniques for Information Gathering Joining Diagnosing Family System Strategies Intervention Techniques Communication Skill Building Techniques 56 62 66 68 70 72 75 76 78 83 84 86 87 88 89 89 90 95 96 97 97 100 103 153 164 167 Structure of a Family Therapy Session Stages and steps of Problem Centred Systems Therapy .Bowen’s Family Systems Therapy II • More about triangles Salvador Munichin’s Structural Family Therapy .Physician A guideline for family assessment Structure of Family Therapy Systemic Family Therapy Manual Basic Family Therapy Techniques in alphabetical order Summary of Family Therapy Theories and Techniques Family Therapy Survey 4 .Fam.I Salvador Munichin’s Structural Family Therapy .I Virginia Satir’s Humanistic Family Therapy Behavourial & Conjoint Family Therapy Milan Systemic Family Therapy or “Long Brief Therapy” Response Based Therapy – Wikipedia Narrative Family Therapy I .Can.

This involvement of families is commonly accomplished by their direct participation in the therapy session.1 Values and ethics in family therapy 5 Founders and key influences 6 Summary of Family Therapy Theories & Techniques 7 Academic resources 8 Professional Organizations 9 See also 10 References 11 External links 5 . As the field has evolved. including organizational dynamics and the study of greatness. Family therapy has been used effectively in the full range of human dilemmas. especially those of family systems theorists. It tends to view change in terms of the systems of interaction between family members. What the different schools of family therapy have in common is a belief that. The skills of the family therapist thus include the ability to influence conversations in a way that catalyzes the strengths. In the field's early years. It emphasizes family relationships as an important factor in psychological health. there is no category of relationship or psychological problem that has not been addressed with this approach. wisdom. the free encyclopedia Family therapy. and support of the wider system. The conceptual frameworks developed by family therapists.FAMILY THERAPY From Wikipedia. Contents • • • • • • • • • • • 1 History and theoretical frameworks 2 Techniques 3 Publications 4 Licensing and degrees o 4. regardless of the origin of the problem. the concept of the family is more commonly defined in terms of strongly supportive. also referred to as couple and family therapy and family systems therapy. many clinicians defined the family in a narrow. and regardless of whether the clients consider it an "individual" or "family" issue. traditional manner usually including parents and children. long-term roles and relationships between people who may or may not be related by blood or marriage. have been applied to a wide range of human behaviour. involving families in solutions is often beneficial. is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development.

History of Marital Therapy
Gurman, A. S. & Fraenkel, P. (2002). The history of couple therapy: A millennial review. Family Process, 41, 199-260. G&F point out that couples therapy (formerly marital therapy) has been largely neglected, even though family therapists do 1.52 times as much couple work as multigenerational family work. They also note this is not such a bad ratio, as 40% of people coming to therapy attribute their problems to relationship issues. G&F define Four Phases in the History Couples Therapy: Phase I - 1930 to 1963 Atheoretical • • • • 1929 to 1932 - Three marital clinics opened; they were service and education oriented, and saw mostly individuals The closest thing to theory was what was borrowed from psychoanalytic - interlocking neurosis 1931 the first marital therapy paper was published Theory was marginalized due to a lack of brilliant theorists, and a lack of distinction from individual analysis

Phase II - 1931 to 1966 Psychoanalytic Experimentation • • • • Therapists are seen as telling truth from distortion, rather than creating a truth Mostly individual sessions, but some conjoint; still treated like seeing two individual clients in the same room though Some started to downplay the role of the therapist Family was outshining couples work, and the couple techniques weren't innovative or particularly effective

Phase III - 1963 to 1985 Family Therapy Incorporates • Family therapy overpowers couples, even though a number of big name people really mostly saw couples o Jackson Coined concepts like quid pro quo, homeostasis, and double bind for conjoint therapy o Satir Coined naming roles members played, fostered self-esteem and actualization, and saw the therapist as a nurturing teacher o Bowen Multigenerational theory approach, with differentiation, triangulation, and projection processes, with the therapist as an anxiety-lowering coach - societal projection process was the forerunner of our modern awareness of cultural differences Copied from the web. o Haley Power and control (or love and connection) were key. Avoided insight, emotional catharsis, conscious power plays. Saw system as more, and more important, than the sum of the parts

Phase IV - 1986 to now Refining and Integrating • • 1986 was the publication of G&K book New Theories were tried and refined, like Behavioral Marital Therapy, Emotionally Focused Marital Therapy, and Insight-Oriented Marital Therapy. All four have received good empirical support. Couples therapy was used to treat depression, anxiety, and alcoholism. Efforts were focused on preventing couples problems with programs like PREP Feminism, Multiculturalism, and Post-Modernism impacted the field Eclectic integration, brief therapy, and sex therapy ideas were incorporated into our work Copied from the web.

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History and theoretical frameworks
Formal interventions with families to help individuals and families experiencing various kinds of problems have been a part of many cultures, probably throughout history. These interventions have sometimes involved formal procedures or rituals, and often included the extended family as well as non-kin members of the community (see for example Ho'oponopono). Following the emergence of specialization in various societies, these interventions were often conducted by particular members of a community – for example, a chief, priest, physician, and so on - usually as an ancillary function.[1] Family therapy as a distinct professional practice within Western cultures can be argued to have had its origins in the social work movements of the 19th century in England and the United States.[1] As a branch of psychotherapy, its roots can be traced somewhat later to the early 20th century with the emergence of the child guidance movement and marriage counselling.[2] The formal development of family therapy dates to the 1940s and early 1950s with the founding in 1942 of the American Association of Marriage Counsellors (the precursor of the AAMFT), and through the work of various independent clinicians and groups - in England (John Bowlby at the Tavistock Clinic), the US (John Bell, Nathan Ackerman, Christian Midelfort, Theodore Lidz, Lyman Wynne, Murray Bowen, Carl Whitaker, Virginia Satir), and Hungary (D.L.P. Liebermann) - who began seeing family members together for observation or therapy sessions.[1][3] There was initially a strong influence from psychoanalysis (most of the early founders of the field had psychoanalytic backgrounds) and social psychiatry, and later from learning theory and behaviour therapy and significantly, these clinicians began to articulate various theories about the nature and functioning of the family as an entity that was more than a mere aggregation of individuals.[2] The movement received an important boost in the mid-1950s through the work of anthropologist Gregory Bateson and colleagues – Jay Haley, Donald D. Jackson, John Weakland, William Fry, and later, Virginia Satir, Paul Watzlawick and others – at Palo Alto in the US, who introduced ideas from cybernetics and general systems theory into social psychology and psychotherapy, focusing in particular on the role of communication (see Bateson Project). This approach eschewed the traditional focus on individual psychology and historical factors – that involve so-called linear causation and content – and emphasized instead feedback and homeostatic mechanisms and “rules” in here-and-now interactions – so-called circular causation and process – that were thought to maintain or exacerbate problems, whatever the original cause(s).[4][5] (See also systems psychology and systemic therapy.) This group was also influenced significantly by the work of US psychiatrist, hypnotherapist, and brief therapist, Milton H. Erickson - especially his innovative use of strategies for change, such as paradoxical directives (see also Reverse psychology). The members of the Bateson Project (like the founders of a number of other schools of family therapy, including Carl Whitaker, Murray Bowen, and Ivan Böszörményi-Nagy) had a particular interest in the possible psychosocial causes and treatment of schizophrenia, especially in terms of the putative "meaning" and "function" of signs and symptoms within the family system. The research of psychiatrists and psychoanalysts Lyman Wynne and Theodore Lidz on communication deviance and roles (e.g., pseudo-mutuality, pseudo-hostility, schism and skew) in families of schizophrenics also became influential with systems-communications-oriented theorists and therapists.[2][6] A related theme, applying to dysfunction and psychopathology more generally, was that of the "identified patient" or "presenting problem" as a manifestation of or surrogate for the family's, or even society's, problems. (See also double bind; family nexus.) By the mid-1960s a number of distinct schools of family therapy had emerged. From those groups that were most strongly influenced by cybernetics and systems theory, there came MRI Brief Therapy, and slightly later, strategic therapy, Salvador Minuchin's Structural Family Therapy and the Milan systems model. Partly in reaction to some aspects of these systemic models, came the experiential approaches of Virginia Satir and Carl Whitaker, which downplayed theoretical constructs, and emphasized subjective experience and unexpressed feelings (including the subconscious), authentic communication, spontaneity, creativity, total therapist engagement, and often included the extended family. Concurrently and somewhat independently, there emerged the various intergenerational therapies of Murray Bowen, Ivan Böszörményi-Nagy, James Framo, and Norman Paul, which present different theories about the intergenerational transmission of health and dysfunction, but which all deal usually with at least three generations of a family (in person or conceptually), either directly in therapy sessions, or via "homework", "journeys home", etc. Psychodynamic family therapy - which, more than any other school of family therapy, deals directly with individual psychology and the unconscious in the context of current relationships - continued to develop


through a number of groups that were influenced by the ideas and methods of Nathan Ackerman, and also by the British School of Object Relations and John Bowlby’s work on attachment. Multiple-family group therapy, a precursor of psychoeducational family intervention, emerged, in part, as a pragmatic alternative form of intervention - especially as an adjunct to the treatment of serious mental disorders with a significant biological basis, such as schizophrenia - and represented something of a conceptual challenge to some of the "systemic" (and thus potentially "family-blaming") paradigms of pathogenesis that were implicit in many of the dominant models of family therapy. The late-1960s and early-1970s saw the development of network therapy (which bears some resemblance to traditional practices such as Ho'oponopono) by Ross Speck and Carolyn Attneave, and the emergence of behavioural marital therapy (renamed behavioural couples therapy in the 1990s; see also relationship counselling) and behavioural family therapy as models in their own right.[2] By the late-1970s the weight of clinical experience - especially in relation to the treatment of serious mental disorders - had led to some revision of a number of the original models and a moderation of some of the earlier stridency and theoretical purism. There were the beginnings of a general softening of the strict demarcations between schools, with moves toward rapprochement, integration, and eclecticism – although there was, nevertheless, some hardening of positions within some schools. These trends were reflected in and influenced by lively debates within the field and critiques from various sources, including feminism and post-modernism, that reflected in part the cultural and political tenor of the times, and which foreshadowed the emergence (in the 1980s and 1990s) of the various "post-systems" constructivist and social constructionist approaches. While there was still debate within the field about whether, or to what degree, the systemic-constructivist and medical-biological paradigms were necessarily antithetical to each other (see also Anti-psychiatry; Biopsychosocial model), there was a growing willingness and tendency on the part of family therapists to work in multi-modal clinical partnerships with other members of the helping and medical professions.[2][6][7] From the mid-1980s to the present the field has been marked by a diversity of approaches that partly reflect the original schools, but which also draw on other theories and methods from individual psychotherapy and elsewhere – these approaches and sources include: brief therapy, structural therapy, constructivist approaches (e.g., Milan systems, post-Milan/collaborative/conversational, reflective), solution-focused therapy, narrative therapy, a range of cognitive and behavioural approaches, psychodynamic and object relations approaches, attachment and Emotionally Focused Therapy, intergenerational approaches, network therapy, and multisystemic therapy (MST).[8][9][10][11][12][13][14][15] Multicultural, intercultural, and integrative approaches are being developed.[16][17][18][19][20][21] Many practitioners claim to be "eclectic," using techniques from several areas, depending upon their own inclinations and/or the needs of the client(s), and there is a growing movement toward a single “generic” family therapy that seeks to incorporate the best of the accumulated knowledge in the field and which can be adapted to many different contexts;[22] however, there are still a significant number of therapists who adhere more or less strictly to a particular, or limited number of, approach(es).[23] Ideas and methods from family therapy have been influential in psychotherapy generally: a survey of over 2,500 US therapists in 2006 revealed that of the ten most influential therapists of the previous quarter-century, three were prominent family therapists, and the marital and family systems model was the second most utilized model after cognitive behavioural therapy.[24] As we move through the 21st century, the internet is fostering the growth of online programs that make courses and programs in family therapy more widely accessible. Using mass media techniques to increase public understanding of issues in family therapy has added a new frontier for amplification in the future.


Therapy interventions usually focus on relationship patterns rather than on analyzing impulses of the unconscious mind or early childhood trauma of individuals as a Freudian therapist would do .although some schools of family therapy. family therapists are relational therapists: They are generally more interested in what goes on between individuals rather than within one or more individuals. a therapist may focus on analyzing specific previous instances of conflict. with the effect that for many families a focus on causation is of little or no clinical utility. or experiential family therapists—tend to be as interested in individuals as in the systems those individuals and their relationships constitute. Some families may perceive cause-effect analyses as attempts to allocate blame to one or more individuals.Techniques Family therapy uses a range of counselling and other techniques including: • • • • • • • • communication theory media and communications psychology psychoeducation psychotherapy relationship education systemic coaching systems theory reality therapy The number of sessions depends on the situation. Family Process. Journal of Family Therapy. for example psychodynamic and intergenerational. Depending on the conflicts at issue and the progress of therapy to date. The Psychotherapy Networker. Journal for the Study of Human Interaction and Family Therapy. A family therapist usually meets several members of the family at the same time. The International Journal of Narrative Therapy and Community Work. The Australian & New Zealand Journal of Family Therapy. as by pointing out patterns of interaction that the family might have not noticed. Specifically. although some family therapists—in particular those who identify as psychodynamic. intergenerational. do consider such individual and historical factors (thus embracing both linear and circular causation) and they may use instruments such as the genogram to help to elucidate the patterns of relationship across generations. The Australian Journal of Family Therapy. object relations. Journal of Systemic Therapies. or instead proceed directly to addressing the sources of conflict at a more abstract level. The distinctive feature of family therapy is its perspective and analytical framework rather than the number of people present at a therapy session. even though the therapist is now incorporated into the family system. This has the advantage of making differences between the ways family members perceive mutual relations as well as interaction patterns in the session apparent both for the therapist and the family. 9 . Family therapists tend to be more interested in the maintenance and/or solving of problems rather than in trying to identify a single cause. EFT. Publications Family therapy journals include: Journal of Marital and Family Therapy. as by reviewing a past incident and suggesting alternative ways family members might have responded to one another during it. but the average is 5-20 sessions. The Journal of Sex and Marital Therapy. These patterns frequently mirror habitual interaction patterns at home.

A master's degree is required to work as an MFT in some American states.[35] 10 . in the United States there is a specific degree and license as a Marriage and Family therapist. and work variously in private practice.[34] "functioning" versus "authenticity".[27][28][29] Specific issues that have emerged have included an increasing questioning of the longstanding notion of therapeutic neutrality. control. click here. License restrictions can vary considerably from state to state. Most commonly.[7] and questions about the degree of the therapist’s "pro-marriage/family" versus "pro-individual" commitment.[25] Marriage and family therapists in the United States and Canada often seek degrees from accredited Masters or Doctoral programs recognized by the Commission on Accreditation for Marriage and Family Therapy Education(COAMFTE). degree in marriage and family therapy.A. values. or counsellors who have done further training in family therapy. Requirements vary. or M. but in most states about 3000 hours of supervised work as an intern are needed to sit for a licensing exam.. and how prospective clients should best go about finding a therapist whose values and objectives are most consistent with their own. Today. psychotherapists. a division of the American Association of Marriage and Family Therapy. After graduation. prospective MFTs work as interns under the supervision of a licensed professional and are referred to as an MFTi. either a diploma or an M. MFTs will first earn a M. in clinical settings such as hospitals. Contact information about licensing boards in the United States are provided by the Association of Marital and Family Regulatory Boards.[30][31][32] a concern with questions of justice and self-determination. counsellors who specialized in this area were called Marriage.Sc. In the United Kingdom.[26] Values and ethics in family therapy Since issues of interpersonal conflict. there has been debate within the profession about the different values that are implicit in the various theoretical models of therapy and the role of the therapist’s own values in the therapeutic process.S. they are known as Marriage and Family Therapists (MFT). MFTs must be licensed by the state to practice. For accredited programs. and some are specifically qualified or licensed/registered in family therapy (licensing is not required in some jurisdictions and requirements vary from place to place). However. nurses. the AAMFT. or counselling organizations. and ethics are often more pronounced in relationship therapy than in individual therapy. family therapists are usually psychologists.Licensing and degrees Family therapy practitioners come from a range of professional backgrounds. family studies. Family and Child Counsellors. social not required to gain a license as an MFT or membership of the main professional body. psychology. or social work. power.[33] connectedness and independence. institutions. There have been concerns raised within the profession about the fact that specialist training in couples therapy – as distinct from family therapy in general . Only after completing their education and internship and passing the state licensing exam can a person call themselves a Marital and Family Therapist and work unsupervised. Prior to 1999 in California.

co-therapy) Michael White (narrative therapy) Lyman Wynne (Schizophrenia. experiential. systems theory) John Weakland (Brief therapy. brief therapy) Richard Fisch (brief therapy. Public understanding of issues through media) Cloe Madanes (strategic therapy) Salvador Minuchin (structural) Braulio Montalvo (structural)[citation needed] Virginia Satir (communications. Jackson (systems theory) Sue Johnson (Emotionally focused therapy. conjoint and co-therapy) Mara Selvini Palazzoli (Milan systems) Ross Speck (network therapy) Robin Skynner (Group Analysis) Paul Watzlawick (Brief therapy. communications) Lynn Hoffman (strategic. strategic therapy) James Framo (object relations theory. attachment theory) Bradford Keeney (cybernetics. experiential. intergenerational. strategic therapy. intergenerational) Edwin Friedman (Family process in religious congregations) Harry Goolishian (Postmodern Collaborative Therapy and Collaborative Language Systems) John Gottman (marriage) Robert-Jay Green (LGBT. post-systems. resource focused therapy) Walter Kempler (Gestalt psychology) Bernard Luskin (media psychology. systems theory) Carl Whitaker (Family systems.Founders and key influences Some key developers of family therapy are: • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • Alfred Adler (phenomenology) Nathan Ackerman (psychoanalytic) Tom Andersen (Reflecting practices and dialogues about dialogues) Harlene Anderson (Postmodern Collaborative Therapy and Collaborative Language Systems) Harry J Aponte (Person-of-the-Therapist) Gregory Bateson (1904–1980) (cybernetics. cross-cultural issues) Jay Haley (strategic therapy. collaborative) Don D. relational ethics) Murray Bowen (Systems theory. systems theory) Ivan Böszörményi-Nagy (Contextual therapy. pseudomutuality) Principal Leaders in the Field: • • • • • • Salvador Minuchin Jay Haley Murray Bowen Nathan Ackerman Virginia Satir Ivan Boszmormenyi-Nagy • • • • • • John Elderkin Bell Philip Guerin Don Jackson Carl Whitaker Betty Carter Michael White 11 . intergenerational) Steve de Shazer (solution focused therapy) James Dobson (Christian psychologist) Focus on the Family Milton H. strategic therapy. Erickson (hypnotherapy.

" isolated and seemingly unrelated. In 1962 Minuchin formed a productive professional relationship with Jay Haley." Haley conducted research at the Mental Research Institute in Palo Alto until he joined Salvador Minuchin at the Philadelphia Child Guidance Clinic in 1967." their members shadowing to steps they do not see. California. Accordingly. In 1981. on-line supervision. Jay Haley A brilliant strategist and devastating critic. At the Philadelphia Clinic. Families and Family Therapy (Minuchin. or "perverse triangles. Minuchin helped us understand that families are structured in "subsystems" with "boundaries. In 1976. Haley. Minuchin..C. Through the lens of structural family theory." chaotic and tightly interconnected.setting a standard against which other therapists still judge their best work. or bewilder families into changing -. which has become one of the major training institutes in the country. and the use of videotapes to learn and apply the techniques of structural family therapy. which eventually became the world's leading center for family therapy and training. bully. Haley moved to Washington D. and combined ideas from each of these innovative thinkers to form his own unique brand of family therapy.Gregory Bateson. and Salvador Minuchin. 1974) Minuchin taught family therapists to see what they were looking at. In 1953 Haley was studying for a master's degree in communication at Stanford University when Gregory Bateson invited him to work on the schizophrenia project. his immediate impact was due to his dazzling clinical artistry. At the Philadelphia Clinic. Minuchin established Family Studies. Inc. in New York. which became popular in the 1970's. Braulio Montalvo. Haley and Minuchin developed a training program for members of the local black community as paraprofessional family therapists in an effort to more effectively related to the urban blacks and Latinos in the surrounding community. seduce. Haley developed his therapeutic skills under the supervision of master hypnotist Milton Erickson from 1954 to 1960. Minuchin stepped down as director of the Phildelphia Clinic in 1975 to pursue his interest in treating families with psychosomatic illnesses and to continue writing some of the most influential books in the field of family therapy. This compelling man with the elegant Latin accent would provoke. intergenerationsl relationships. Haley thought that the healing aspect of the patient-therapist relationship involved getting patients to take responsibility for their actions and to take a stand in the therapeutic relationship. In 1965 Munuchin became the director of the Philadelphia Child Guidance Clinic. This work had an enormous impact in shaping the development of family therapy. and founded the Family Therapy Institute with Cloe Madanes. Haley retired in 1995 and currently lives in La Jolla. a process he called "therapeutic paradox.Salvador Minuchin Born and raised in Argentina. Salvador Minuchin began his career as a family therapist in the early 1960's when he discovered two patterns common to troubled families: some are "enmeshed. Haley was instumental in bridging the gap between strategic and structural approaches to family therapy by looking byond simple dyadic relationships and exploring his interest in the situation required -. In 1969. Haley developed a brief therapy model which focused on the context and possible function of the patient's symptoms and used directives to instruct patients to act in ways that were counterproductive to their maladaptive behavior. Haley met with patients and their families to observe the communicative style of schizophrenics in a natural environment. who was then in Palo Alto. When Minuchin first burst onto the scene. Where others saw only chaos and cruelty. He was also an active clinical member of the University of Pennsylvania's Department of Psychiatry. 12 . Milton Erickson. while others are "disengaged. Minuchin retired in 1996 and currently lives with his wife Patricia in Boston. and Bernice Rosman developed a highly successful family therapy training program that emphasized hands-on experience." Haley believed that a patient's symptoms arose out of an incongruence between manifest and covert levels of communication with others and served to give the patient a sense of control in their interpersonal relationships. Jay Haley was a dominating figure in developing the Palo Alto Group's communcations model and stategic family therapy. Haley pursued his interests in training and supervision in family therapy and was the director of family therapy research for ten years. Haley believed that it was far more important to get patients to actively do something about their problems rather than help them to understand why they had these problems. He studied under three of the most influential pioneers in the evolution of family therapy . previously puzzling interactions suddenly swam into focus. But even Minuchin's legendary dramatic flair didn't have the same galvanizing impact as his structural theory of families. In his classic text. a center committed to teaching family therapists.

Allyn & Bacon). He further broadened his attachment research to include fathers and developed the concept o triangulation as the central building block o relationship systems (Nichols & Schwartz. and desires to surface. Allyn & Bacon 1998). Allyn & Bacon). He opened the Family Institute in 1960. Ackerman joined the Menninger Clinic in Topeka. In 1938 Ackerman published The Unity of the Family and Family Diagnosis: An Approach to the Preschool Child. Betty Carter. Kansas. and became the chief psychiatrist of the Child Guidance Clinic in 1937. Bowen became the first director of the Family Division at the National Institute of Mental Health (NIMH). 4th ed. The core goal underlying the Bowenian model is differentiation of self. Ackerman proposed that underneath the apparent unity of families there existed a wealth of intrapsychic conflict that divided family members into factions (Nichols & Schwartz. 1998. Initially. Here he developed the concepts of anxious and functional attachment to describe interactional patterns in the mother-child relationship. Ackerman's training in the psychoanalytic model is evident in his contributions and theoretical approach to family therapy. Bowen's therapy is an outgrowth of psychoanalytic theory and offers the most comprehensive view of human behavior and problems of any approach to family therapy. Ackerman founded the first family therapy journal. In 1959. 1998. The Bowenian model also considers the thoughts and feelings of each family member as well as the larger contextual network of family relationships that shapes the lie of the family. but soon discovered that this approach fractionated families instead of bringing them together. However. 4th ed. 1998. Allyn & Bacon 1998). He used his strong will and provocative style of intervening to uncover the family's defenses and allow their feelings. In 1954. Nathan Ackerman Nathan Ackerman's astute ability to understand the overall organization of families enabled him to look beyond the behavioral interactions of families and into the hearts and minds of each family member. Murray Bowen's emphasis on theory and insight as opposed to action and technique distinguish his work from the more behaviorally oriented family therapists (Nichols & Schwartz. From 1946 to 1954. the oldest child of a large cohesive family. 4th ed. which is still the leading journal of ideas in the field today. Ackerman was committed to sharing his ideas and theoretical approach with other professionals in the field. 13 . Family Therapy: Concepts and Methods. As a result. In 1955 Ackerman organized the first discussion on family diagnosis at a meeting of the American Orthopsychiatric Association to facilitate communication in the developing field of family therapy. including Phil Guerin. Ackerman followed the child guidance clinic model of having a psychiatrist treat the child and a social worker see the mother (Nichols & Schwartz. especially the intense influence of family life. Michael Kerr. Family Therapy: Concepts and Methods. Bowen studied the symbiotic relationships of mothers and their schizophrenic children at the Menninger Clinic in Topeka. namely. Bowen pursued a career in psychiatry. Together with Don Jackson. which was later renamed the Ackerman Institute after his death in 1971. and gained international recognition for his leadership in the field of family therapy. He began studying schizophrenia and his strong background in psychoanalytic training led him to expand his studies from individual patients to the relationship patterns between mother and child. Tennessee. the ability to remain oneself in the face of group influences. Family Therapy: Concepts and Methods. Kansas. In his first year at NIMH. Bowen began a thirty-one year career at Georgetown University's Department of Psychiatry where he refined his model of family therapy and trained numerous students. Bowen grew up in Waverly. In 1957 Ackerman established the Family Mental Health Clinic in New York City and began teaching at Columbia University.Murray Bowen Among the pioneers of family therapy. Family Therapy: Concepts and Methods. and Monica McGoldrick. 4th ed. Bowen decided to treat the entire family as a unit. He died in October 1990 following a lengthy illness. 4th ed. Allyn & Bacon). Bowen provided separate therapists for each individual member of a family. within his first year of work at the clinic. and became one of the founders of family therapy. both of which inspired the family therapy movement. hopes. Family Process. After graduating from medical school and serving five years in the military. and suggested that family therapy be used as the primary form of treatment in child guidance clinics (Nichols & Schwartz. Ackerman became a strong advocate of including the entire family when treating a disturbance in one of its members. Family Therapy: Concepts and Methods.

4th ed. trust. Nagy was trained as a psychoanalyst and his work has encouraged many family therapists to incorporate psychoanalytic ideas with family therapy. She believed that caring and acceptance were key elements in helping people face their fears and open up their hearts to others (Nichols & Schwartz. Satir gave lectures and led workshops in experiential family therapy across the country. and mutual support are the key elements that underlie family relationships and hold families together. Nagy established the Eastern Pennsylvania Psychiatric Institute (EPPI) and served as codirector and cotherapist along with social worker Geraldine Spark. and Bell continued to stimulate communication among family members and to help solve family problems. Family Therapy: Concepts and Methods. was applying group psychotherapy techniques to treat individual families. Unfortunately. Nagy is perhaps best known for developing the contextual approach to family therapy. Satir's beliefs went against the more scientific approach to family therapy accepted at that time. and she shifted her efforts away from the field to travel and lecture. She began treating families in 1951 and established a training program for psychiatric residents at the Illinois State Psychiatric Institute in 1955. Bell's pioneering efforts in the field of family therapy are less well-known as compared to other family therapists. Family Therapy: Concepts and Methods. feelings. Satir served as the director of training at the Mental Research Institute in Palo Alto from 1959-66 and at the Esalen Institute in Big Sur beginning in 1966. In addition. 4th ed. A student of Virginia Satir and an accomplished scholar and clinician.Virginia Satir Virginia Satir is one of the key figures in the development of family therapy. Family Therapy: Concepts and Methods. She believed that a healthy family life involved an open and reciprocal sharing of affection. Allyn & Bacon). Allyn & Bacon 1998). contextual therapy accentuates the need for ethical principles to be an integral part of the therapeutic process. who began treating families in the early 1950's. John Elderkin Bell Perhaps one of the first family therapists was John Elderkin Bell. Bell decided to follow Bowlby's approach. and that symptoms develop when a lack of caring and liability result in a breakdown of trust in relationships (Nichols & Schwartz. Bell encouraged children's involvement by facilitating the expression of their thoughts and feelings. Bell did not publish his ideas until the 1960's. such as "the rescuer" or "the placator. 1973). In 1957. Satir made enormous contributions to family therapy in her clinical practice and training." that function to constrain relationships and interactions in families (Nichols & Schwartz. Satir died in 1988 after suffering from pancreatic cancer.both within the family and between the family and society -. and he did not establish family therapy clinics or training centers. Bell believed that the treatment of families should follow a series of three stages designed to encourage communication among family members and to solve family problems. loyalty. Unfortunately. which emphasizes the ethical dimension of family development. Bell's ingenious approach to family therapy involved developing a step-by-step. Bell's treatment approach was an outgrowth of group therapy and was aptly named family group therapy. 14 . 1998. Based on the psychodynamic model. easy-to-follow plan of attack to treat family problems in stages. Nagy has continued to develop his contextual approach to family therapy and remains associated with Hahnemann University in Pennsylvania. In 1951 Bell discovered that John Bowlby. Satir's genuine warmth and caring was evident in her natural inclination to incorporate feelings and compassion in the therapeutic relationship. In the parent-centered stage. a well-respected clinician. She was well-known for describing family roles. Satir's was the most powerful voice to wholeheartedly support the importance of love and nurturance as being the most important healing aspects of therapy. 4th ed. The family-centered stage was the final phase of treatment. The therapists' role is to help the family work through avoided emotional conflicts and to develop a sense of fairness among family members. and love.made major contributions to the field of family therapy since its inception in the 1950's (Nichols & Schwartz. parents responded to their children's concerns and often related difficulties they experienced with their children's behavior. In the first stage. Allyn & Bacon). and did not discover until many years later that Bowlby had only used this treatment approach with one family. Above all other therapists. 1998. Nagy believes that trust. Nagy was also an active researcher of schizophrenia and family therapy and coauthored Invisible loyalties: Reciprocity in intergenerational family therapy (Boszormenyi-Nagy & Spark. and relational ethics -. Family Therapy: Concepts and Methods. Allyn & Bacon 1998). 4th ed. the child-centered phase. Ivan Boszmormenyi-Nagy Ivan Boszmormenyi-Nagy's emphasis on loyalty. Since the closing of EPPI.

1987) and Working with relationship triangles: The one-two-three of psychotherapy (Guerin. which emphasize the multigenerational context of families. Whitaker's confrontive approach earned him the reputation as the most irreverent among family therapy's iconoclasts. Allyn & Bacon). and he developed the concept of family homeostasis to describe how families resist change and seek to maintain redundant patterns of behavior. rather than any fixed techniques. comfortable. Family Therapy: Concepts and Methods. Family Process. and defining specific patterns of relationships within families. Instead. 4th ed. 1998. Jackson strongly rejected the psychoanalytic concepts that formed the basis of his early training. and individual adults (Nichols & Schwartz. 1998. Paul Watzlawick and Bateson. Guerin has authored some of the most influential and valuable books and articles in the field of family therapy. he focused his interest on Bateson's analysis of communication and behavior. 4th ed. Guerin's family systems approach is designed to measure the severity of conflict and to identify specific areas in need of improvement. one of the most exceptional family therapy programs for training and practice in the nation (Nichols & Schwartz. 1998. Whitaker viewed the family as an integrated whole. New York. couples. By 1954. John Weakland. and quickly recognized the importance of treating the family unit instead of removing patients for individual treatment. In 1970 Guerin became the Director of Training of the Family Studies Section at Albert Einstein College of Medicine and Bronx State Hospital. 1998. and emphasized the importance of including extended family members. and felt that a lack of emotional closeness and sharing among family members resulted in the symptoms and interpersonal problems that led families to seek treatment. Jackson observed the mutual impact of schizophrenic patients and their families in the home environment. 1998. Whitaker liked a crowd in the room when he did therapy. Family Therapy: Concepts and Methods. Carl Whitaker Carl Whitaker's creative and spontaneous thinking formed the basis of a bold and inventive approach to family therapy. not as a collection of discrete individuals. Don Jackson The vibrant and creative talent of Don Jackson contributred to his success as a writer. His early work centered on the effects of patients' therapy on the entire family. Allyn & Bacon). 1996). 4th ed. In 1968.Philip Guerin A student of Murray Bowen. lantern-jawed man. especially the expressive and playful spontaneity of children. Guerin's highly articulated model outlines several therapeutic goals. Jackson also suggested that family members react to schizophrenic members' symptoms in ways that serve to stabilize the family's status quo and often result in inflexible ways of thinking and maintain the symptomatic behavior (Nichols & Schwartz. He believed that active and forceful personal involvement and caring of the therapist was the best way to bring about changes in families and promote flexibility among family members. a family therapy training center originally organized by Israel Zwerling and Marilyn Mendelsohn. Jules Riskin. 4th ed. Family Therapy: Concepts and Methods. Allyn & Bacon). He relied on his own personality and wisdom. By 1963. tragically Jackson died by his own hand at the age of 48. researcher. 4th ed. Jackson had developed a rudimentary family interactional therapy out of his pioneering work with the Palo Alto group and research on schizophrenia (Nichols & Schwartz. working to calm the emotional level of family members. Whitaker also pioneered the use of cotherapists as a means of maintaining objectivity while using his highly provocative techniques 15 . which shaped his most important contributions to the developing field of family therapy. In 1958. and that the therapist's role was to make the rules explicit and to reconstruct rigid which maintained family problems. Fay & Kautto. In addition to being a distinguished clinician. Jackson believed that family dysfunction was a result of a family's lack of rules for change. in treatment. He equated familial togetherness and cohesion with personal growth. Two of his best are: The Evaluation and treatment of marital conflict: A four-stage approach (Guerin. Family Therapy: Concepts and Methods. Philip Guerin's own innovative ideas led to his developing a sophisticated clinical approach to treating problems of children and adolescents. Fogarty. to stir things up in families and to help family members open up and be more fully themselves (Nichols & Schwartz. Jackson established the Mental Research Institute and worked with Virginia Satir. Guerin's pioneering efforts and exceptional leadership resulted in his establishing an extramural training program in Westchester in 1972 and founding the Center for Family Learning in New Rochelle. and cofounder of the leading journal in the field of family therapy. Allyn & Bacon). Allyn & Bacon). Jackson's model of the family involved several types of rules that defined the communication patterns and interactions among family members. Family Therapy: Concepts and Methods. Jay Haley. A 1943 graduate of Stanford University School of Medicine. A big.

and Marianne Walters. That's why people have the interesting habit of becoming the stories they tell about their experience. clients are encouraged to create audiences of support to witness and promote their progress in restoring their lives along preferred lines. Finally. where he focused on treating schizophrenics and their families. White's tenaciously positive attitude has undoubtably contributed to his enormous success as a therapist. 16 . Together with his wife. Currently. they shape it. South Australia. Family Therapy: Concepts and Methods. and emphasized the importance of historical antecedents of family problems and the multigenerational aspects of the life cycle that extended beyond the nuclear family. But he soon realized that he preferred people to machines and went into social work where he gravitated to family therapy. White's innovative thinking helped shape the basic tenets of narrative therapy. or narratives. Allyn & Bacon). White is well-known for his persistence in challenging clients' negative self-beliefs and for his relentless optimism in helping people to develop healthier interpretations of their life experiences. Carter further expanded on the family life cycle concept by considering the stages of divorce and remarriage (Nichols & Schwartz. which serve to intensify and speed up the communication process and help couples move out of rigid patterns of behavior. shape their self-concept and personal relationships. Individual clients of families are then encouraged to reconstruct their narratives to facilitate more adaptive views of themselves and more effective interpersonal interactions. White lives in Adelaide. began his professional life as a mechanical draftsman.S.W. 1998. 4th ed. such as letter writing. Whitaker left Emory to enter into private practice. Allyn & Bacon). Olga Silverstein. Family Therapy: Concepts and Methods. and has been an outspoken leader about the gender and ethnic inequalities that serve to keep women in inflexible family roles. Currently. a training and clinical facility that also publishes the Dulwich Newsletter. and served on the staff of the Family Studies Section at Albert Einstein College of Medicine and Bronx State Hospital with Phil Guerin and Monica McGoldrick. Family Therapy: Concepts and Methods. He also helped to develop some of the first major professional meetings of family therapists with colleagues such as John Warkentin. and became a professor of Psychiatry at the University of Wisconsin in 1965 until his retirement in 1982. 4th ed. Whitaker died in April 1995. Her work with couples focuses on helping her clients to understand their situation and to address unresolved family issues. 1998. White came to believe that stories don't mirror life. Thomas Malone. Carter left the Center for Family Learning to become the founding director of the Family Institute of Westchester in 1977. 1998. Betty Carter was instrumental in enriching and popularizing the concept of the family life cycle and its value in assessing families. In 1955. White works at the Dulwich Centre. By challenging fixed and pessimistic versions of events. John Rosen. White's leadership of the narrative movement in family therapy is based not only on his imaginative ideas but also on his inspriational persistence in seeing the best in people even when they've lost faith in themselves. Carter is an active clinician and specializes in marital therapy and therapy with remarried couples (Nichols & Schwartz. Allyn & Bacon). Carter entered the field of family therapy after being trained as a social worker. which White uses to explore his ideas with the field. and Jackson. therapists make room for fliexibility and which new and more optimistic stories can be envisioned. Carter incorporates tasks. Carter served as Codirector of the Women's Project in Family Therapy with Peggy Papp. Cheryl. 4th ed. Carter's interest in family therapy was stimulated by taking part in a family therapy field placement at the Ackerman Institute as part of her M. In developing the notion that people's lives are organized by their life narratives. Michael White Michael White. the guiding genius of narrative family theapy. therapists try to understand how clients' personal beliefs and perceptions. White became more interested in the ways people construct meaning in their lives than just with the ways they behaved. leaving a heartfelt void in the field of family therapy. In the narrative approach. Betty Carter An ardent and articulate feminist. Beginning in 1946. Following an initial attraction to the cybernetic thinking of Gregory Bateson. Whitaker served as Chairman of the Department of Psychiatry at Emory University. She quickly became an avid student of the Bowenian model. requirements at Hunter turn up the emotional temperature of families (Nichols & Schwartz. cultural and political framework of the family. which considers the broader historical. Narrative therapists break the grip of unhelpful stories by externalizing problmes. Bateson.

the therapist considers the therapy in terms of step-by-step change in the way from one type of abnormal organisation to another type before a more normal organisation is finally achieved. Conjoint Family Therapy (Satir. 7. 9. 1991) In this type of therapy. 10. 11. Colapinto. the therapist challenges “how things are done“ and begins restructuring the family by offering alternative. 5. Contextual Therapy (Boszormenyi-Nagy. more functional ways of behaving. 6. Therapy begins with the therapist “joining” with the family. 4. The therapist must attune himself or herself to the families value systems and existing hierarchies. 1974. Behavioural Family Therapy Bowen theory Brief Therapy: MRI Contextual Therapy Eriscksonian Family Therapy Focal Family Therapy Milan Systemic Therapy Family Psychoeducational Therapy Strategic Therapy Structural Therapy Symbolic-Experiential Therapy Some contemporary family therapies: Structural Family Therapy (Minuchin. For a strategic therapist two questions are basic: How is the symptom “helping” the family to maintain a balance or overcome a crisis? How can the symptom be replaced by a more effective solution of the problem? 17 . After “joining”. 1991) In the contextual approach the word “context“ indicates the dynamic connectedness of a person with her or his significant relationships. the long-term relational involvement as well as the person’s relatedness to his or her multigenerational roots.MODELS AND SCHOOLS Family therapists and counselors use a range of methods and over the years a number of models or schools of family therapy have developed. 1981) In this approach. He or she has the purpose to enhance the feeling of worth of individual family members. Therapists use all levels of communication to express the relational qualities present in the family to achieve change in family system. This approach uses many feeling and communication exercises and games. The therapist encourages family members to explore their own multilaterality. the structural therapist believes that change of behaviour is most important. 3. A well-known classification of these approaches is described by Gurman and Kniskern (1991): 1. for example family sculpture. Strategic Therapy (Madanes. 2. 1967) Conjoint family therapy works with personal experiences and helps experiencing the value of the individual within the family system. 8.

1996) The followers of the narrative approach consider that experience rooted in the life events is elaborated in the form of a story. ISSN: 1322-9400. in the course of which meanings attributed to the events can change or alternate. UK [3] Karnac Systemic Thinking and Practice Series Professional Organizations • • • • • • American Association for Marriage and Family Therapy American Family Therapy Academy European Family Therapy Association (EFTA) International Association of Marriage and Family Counsellors National Council on Family Relations The Ackerman Institute for the Family 18 . Narrative Therapy (Freedman.jgytf. in which maladaptive “solutions“ behaviours maintain the problem. The therapists consider that the way to eliminate the symptom which is present in the family is to change the rules and beliefs. Change is achieved in clarifying the ambiguity in relationships. ISSN: 1062-1024 (Print) 1573-2843 (Online).htm Academic resources • • • • • • • • • • • • • Family Process Journal of Child and Family Studies. Significance of any particular behaviour or event may be derived from its social context. eContent Management Pty Ltd [1] Journal of Family Therapy. but it represents comprehensively a way of orientation in therapeutic practice. Combs. ASIN: B00007M2W5. Alteration of these behaviours /or beliefs/ should interrupt the cycle and initiate the resolution of the problem. Univ of Calgary/Dept Sociology Journal of Family Studies. the “life story” of a family is connected with the internal and external culture of the family. AFT. In the therapy process. Problem formation and maintenance is seen as parts if vicious-circle process.Brief Therapy This name refers not only to the duration of the therapy. AFT (Association for family Therapy & Systemic Practice in the UK) [2] Context Magazine. Australian Institute of Family Studies Journal of Comparative Family The symptomatic behaviour is conceived as a part of the transactional patterns of the system.u-szeged. Milan Systemic Therapy (Boscolo et al. 1987) Basic assumption of Milan Systemic Therapy is that mind is social. http://www.dmrtk. Springer Journal of Marital and Family Therapy Journal of Family Psychology Family Relations Contemporary Family Therapy Australian & New Zealand Journal of Family Therapy Family Matters. Change is enabled by retelling the story. which gives to these events a meaning reflecting the systems of belief.

. ^ a b Barker. 2. M. & Becvar. ^ Attachment and Family Systems. Berkshire. M. Kniskern (Eds. New York: Open University Press. Basic family therapy. ^ Sprenkle.) (1998). ^ Guttman. Contemporary family therapy in the United States. 22. 7. ^ Booth. R. Recent Developments in Family Therapy: Integrative Models. & Schwoeri. S. Adelaide. 28 July 1962. 12. (2005). The history of couple therapy: a millennial review. (Ed. 18.B. M. 11.P. G.) (1998). & Schwartz. P. NJ: John Wiley and Sons. Family therapy: A systemic integration. Guilford Press: New York. (2006). Multisystemic therapy. Handbook of Family Therapy.J. M.: 2007. R. London.: Guilford Press.G. (Ed. Culture and System in Family Therapy. M. 7th ed. (2003). and Epistemology. 14. H. (2000). 21. 15. Cybernetics. 8. Case Studies in Couple and Family Therapy: Systemic and Cognitive Perspectives. 13.D. Boston: Pearson/Allyn & Bacon. J. Family Theory and Therapy. (2001). retrieved 29 Oct. ^ a b c Broderick. Handbook of Family Therapy. F. J. S. Families in Society: The Journal of Contemporary Human Services. R. ^ Van Buren. R. South Australia: Dulwich Centre Publications. Family therapy: concepts and methods. 2. ^ McGoldrick. ^ Lebow. Couple. 20. R. 16(1): 5-23(19) ^ Dattilio. 82(6): 623-30. Special Issue: Fall 2002 41(3) ^ Denborough. American Journal of Family Therapy. & Garcia-Preto. Gurman & D. S. (2002). Classification. Vol. Hoboken. and Trends. 16.A. (2006). Gurman & D. March/April (retrieved 7 Oct 2010) 19 . Psychotherapy Networker. Wiley-Blackwell. L. M. H. Practice. (2006). 7th ed. & Schrader. Saturday Evening Post. 17.C. 24.H. 3.P. C. (1991). Family Process. (2003). In Sholevar. Maidenhead. ^ Gurman.P. 5th edition. 5. D. ^ The Top 10: The Most Influential Therapists of the Past Quarter-Century.J. 28(4): 329-346. DC: American Psychiatric Publishing Inc. Journal of Family Therapy. 19. 2009 ^ McGoldrick. Vol. The History of Professional Marriage and Family Therapy. 7th ed.S. 3rd Ed. 10. ^ a b Nichols.S. New York: BrunnerRoutledge. I-B. J. G. (2008). & Fraenkel.). & Cottone. 41(2): 199-260(62) ^ Couple therapy Harvard Mental Health Letter 03/01/2007. Kniskern (Eds. Measurement. NY: Brunner/Mazel ^ a b c d e Sholevar. 9. Culture. ^ Nichols. Giordano. (2007). 4. (1991). Textbook of Family and Couples Therapy: Clinical Applications. Handbook of clinical family therapy.R. & Schwartz. & Silverman.See also • • • • • • • • • Alternative dispute resolution CAMFT Child abuse Conflict resolution Deinstitutionalisation Domestic violence Dysfunctional family Family Life Education Family Life Space • • • • • • • • Internal Family Systems Model Interpersonal psychotherapy Interpersonal relationship Mediation Multisystemic Therapy (MST) Positive psychology Relationships Australia Strategic Family Therapy References 1. Encyclopedia of Mental Disorders. Washington. and Prediction of Paradigm Adherence of Marriage and Family Therapists. Boston: Allyn & Bacon. in Family therapy: concepts and methods.). Family Therapy: Exploring the Field's Past. K. & Bischof.S. In A. P.P. (2001). P.C. Family and Group Work: First Steps in Interpersonal Intervention. G. 23. New York: Karnac.P.S. Family Process. ^ Silverman. and Gender in Clinical Practice. 2. T. Psychiatry Inside the Family Circle. (2002).. A. Ethnicity & Family Therapy. The Myth of Cross-Cultural Competence. D.R. 6. Re-Visioning Family Therapy: Race. ^ Crago. Global Perspectives in Family Therapy: Development. NY: Brunner/Mazel ^ Becvar. ^ Krause. Guildford Press: New York. Boston: Pearson/Allyn & Bacon. N. (2005). 46-51. (1994). Systems Theory.. ^ Dean. D. ^ Ng. P. Present and Possible Futures. In A.

x?journalCode=famp.tb02243. PMID 14220517. doi:10. A. James S (Apr 1999). (2003). S.1939-0025. Vol.). "Individualism. Psychotherapy Networker 26 (Nov-Dec): 26–33. NY: Brunner/Mazel 28. "A feminist approach to family therapy". & Robbins. Kniskern (Eds. Family Relations (National Council on Family Relations) 48 (2): 139–49. ^ Wall J. Psychology Today. ^ Goldenberg. CA: Thomson Brooks/Cole. Weeks. Grand Rapids.1111/j.x. S. 31.2307/585077.. ^ USA Today 6/21/2005 Hearts divide over marital therapy. External links Included in this list are the main professional associations in the US and internationally. Developing Your Ethical Position in Family Therapy: Special Issues. CA: Brooks/Cole/Thomson. W.1545-5300. (2008).. 33. ^ Gottlieb. H. (1995).1177/0959354396061009. P. New York: Brunner-Routledge. doi:10. • • • • • • • • • • • • • • • • American Association for Marriage and Family Therapy: main professional association in US American Family Therapy Academy: main research-oriented professional association in US Association for Family Therapy and Systemic Practice in the UK Australian and New Zealand Journal of Family Therapy: the de facto professional association for Australia and NZ Bowen Theory from the Bowen Center for the Study of the Family.1964.An Overview of Family Therapy and Mediation Dulwich Centre: Gateway to Narrative Therapy & Community Work [4] "Mind For Therapy" group devoted to creative origins of Family Therapy Glossary of Family Systems and intergenerational concepts MFT at Notre Dame de Namur University. Timeline from Allyn and Bacon/Longman publishing. Family therapy: Christian perspectives. ^ Melito. 1995). pp.. Clinical handbook of couple therapy. ^ a b Sexton. ^ Doherty W (2002). 175–207. "Metaphors. New York. Values and ethics in family therapy. 35. 29. ^ Hare-Mustin RT (Jun 1978). Handbook of Family Therapy. (2008). ^ Fowers BJ. Browning DS. Paul NL (Oct 1964). ideological. MI: Baker Book House.. PMID 678351. S. Needham T. R. "Ethical issues in family group therapy". Handbook of family therapy: The science and practice of working with families and couples. California Association of Marriage and Family Therapists European Family Therapy Association International Family Therapy Association Historical overview of the field. ^ Grosser GH.00181. Gurman & D. JSTOR 585077. doi:10. Therapist profiles. R. (2003). ^ Gurman. (2003). Theory & Psychology 6 (1): 121–51. Values in the role of the family therapist: Self determination and justice. 30. (1991). ^ Gehart. R. ^ "Therapy Center:Credentials". Fam Process 17 (2): 181–94. R. 29(1):3-11. Family therapy: An overview. Retrieved 2008-08-13. Pacific Grove. 27. Am J Orthopsychiatry 34 (5): 875–84. Family Support Partnership . G. & Tuttle. 38.C. models. and cross-cultural views of family therapy theory and practice.1111/j. ^ Dueck A (1991). August 11–15. New York: Guilford Press. Journal of Marital and Family Therapy. Richardson FC (1996). they reflect to some degree the different theoretical.. Family Ideology and Family Therapy". 39. & Boss. M. & Goldenberg.25. doi:10. Theory-based treatment planning for marriage and family therapists: Integrating theory and practice. 2. Paper presented at the Annual Meeting of the American Psychological Association (103rd. NY. "The Ethics of Relationality: The Moral Views of Therapists Engaged in Marital and Family Therapy". I. ^ Doherty. 37. A. 36. L. Belmont CA Social Construction Therapies Network 20 . T. D. ISBN 0-8010-9313-9. paradigms and stories in family therapy". 34. "Bad Couples Therapy and How to Avoid It: Getting past the myth of therapist neutrality". In A. Belmont. P.1978. 26. M. In Vande Kemp H. 32.

activities. INTERVENTIONS BY DOMAIN INDIVIDUAL: Life and social skills training FAMILY : Home visits. communication skills) PEER : Peer-resistance education 21 . DESCRIPTION Brief Strategic Family Therapy (BSFT) is a short-term. organized wholes or units made up of several interdependent and interacting parts. For positive change in an identified client. CONTENT FOCUS ALCOHOL. SOCIAL AND EMOTIONAL COMPETENCE. therefore. love. substance use. Parent education/family therapy.g. problematic family relations. They are interested in the balance families maintain between bipolar extremes that characterize dysfunctional families. It is also the Nation’s leading trainer of research-proven. including substance use among adolescents.. that improves youth behaviour by eliminating or reducing drug use and its associated behaviour problems and that changes the family members’ behaviours that are linked to both risk and protective factors related to substance abuse. and association with antisocial peers. Each member has a significant influence on all other members. Parents as a primary target population: The program involves family systems therapy. TOBACCO This program addresses family risk and protective factors to problem behaviour. and purpose as well as high levels of shared values. Families may be considered a system. INDICATED This program was developed for an indicated audience. and attention to the needs of its members. The therapeutic process uses techniques of: Joining—forming a therapeutic alliance with all family members Diagnosis—identifying interactional patterns that allow or encourage problematic youth behaviour Restructuring—the process of changing the family interactions that are directly related to problem behaviours PROGRAM BACKGROUND BSFT was developed at the Spanish Family Guidance Center in the Center for Family Studies. BSFT has been conducted at these centers since 1975. problem-focused therapeutic intervention.Brief Strategic Family Therapy The family is defined by an organizational structure that is characterized by degrees of cohesiveness. ANTISOCIAL/AGGRESSIVE BEHAVIOUR. Parent education/parenting skills training Task-oriented family education sessions combining social skills training to improve family interaction (e. The Center for Family Studies is the Nation’s oldest and most prominent center for development and testing of minority family therapy interventions for prevention and treatment of adolescent substance abuse and related behaviour problems. It seeks to change the way family members act toward each other so that they will promote each other’s mastery over behaviours that are required for the family to achieve competence and to impede undesired behaviours. It targets children with conduct problems. to resolve the presenting problem as quickly and efficiently as possible. ILLEGAL DRUGS. targeting children and adolescents 6 to 17 years old. family therapy for Hispanic/Latino families. loyalty. interests. Strategic refers to the development of a specific strategy. involving all family members. planned in advance by the therapist. family members have to change the way they interact. University of Miami. Family therapists work with the present relationships rather than the past.

TECHNIQUES USED • • • Joining—forming a therapeutic alliance with all family members Diagnosis—identifying interactional patterns that allow or encourage problematic youth behaviour Restructuring—the process of changing the family interactions that are directly related to problem behaviours THERAPY The program involves creating a counsellor-family work team that develops a therapeutic alliance with each family member and with the family as a whole. Step 2: Diagnose family strengths and problem relations. and implementing change strategies and reinforcing family behaviours that sustain new levels of family competence. and practical.5-hour sessions. There are four important BSFT steps: Step 1: Organize a counsellor-family work team..KEY PROGRAM APPROACHES PARENT-CHILD INTERACTIONS : All of the key strategies are focused on improving the interactions between parents and child.and problem-focused. the counsellor is plan. and providing parenting guidance and coaching. moving from problematic to competent interactions). Problem: A common problem in implementing a whole-family intervention involves limited availability of family members. In BSFT. thereby increasing family 1. SKILL DEVELOPMENT : The program fosters conflict resolution skills.e. Sessions may occur more frequently around crises because these are opportunities for change. Step 3: Develop a change strategy to capitalize on strengths and correct problematic family relations. Important change strategies include reframing to change the meaning of interactions. PARENT TRAINING : A key change strategy is to empower parents by increasing their mastery of parenting skills. BSFT is delivered in 8 to 12 weekly 1. and family clinics. health agencies. parenting skills. and parental empowerment. and communication skills. Solution: Sessions often must occur during evening hours and on weekends. Solution: Specialized engagement strategies have been developed to deal with the problem. building conflict resolution skills. including community social services agencies. directionoriented (i. mental health clinics. 22 . Step 4: Implement change strategies and reinforce family behaviours that sustain new levels of family competence. HOW IT WORKS BSFT can be implemented in a variety of settings. Emphasis is on family relations that are supportive and problem relations that affect youths’ behaviours or interfere with parental figures’ ability to correct those behaviours. changing alliances. BARRIERS AND PROBLEMS Problem: The most common problem is engaging and retaining whole families in treatment. developing change strategies to capitalize on strengths and correct problematic family interactions. building conflict resolution skills. changing alliances and shifting interpersonal boundaries. diagnosing family strengths and problematic interactions. Strategies include reframing. Development of a therapeutic alliance with each family member and with the family as a whole is essential for BSFT. This requires counsellors to accept and demonstrate respect for each individual family member and the family as a whole. The family and BSFT counsellor meet either in the program office or the family’s home.

Solving problems. Strategic therapy implements techniques that meet the specific need of a family and their interaction. The therapist works on helping their clients turn their lives around by creating a carefully planned strategy. Clear goals set.Strategic Family Therapy Strategic family therapy is a family-oriented therapy that involves a patient's daily family environment as a major part of treatment. Strategic family therapy is a solution-oriented approach. Symmetrical (similar. often competitive) vs. In the 1950s and 1960s. execution and monitoring progress. depression and substance abuse are a few of examples of issues that can affect a family unit. often counterresponding) interactions. They naturally establish rules and interactions that affect every member. the entire family becomes part of the solution process. Families function just like any other system. They focus on getting to the root of the problem rather than what caused it. Pressure from family. create interventions that meet these objectives. If a child were dealing with any of the previous issues and had become estranged from the family. 23 . Therapy All the family members participate within a safe. complementary (different. Haley and other therapists began experimenting with alternative models of working with families that relied on solution-focused techniques. the therapist would bring everyone together in a clinical setting to watch how they interact. Every interaction is a struggle for control of the relationship's definition. When the affected family member's problems are recognized and addressed. Madanes: "pretend techniques. Haley Model Jay Haley and Salvador Minuchin are considered the pioneers of strategic family therapy. It also give family members a chance to see how their interactions and responses can contribute to a dysfunctional situation. The goal is to fix the problem creating disruption and preserving the family unit no matter what. Behavior Problems Children between the ages eight and 17 are vulnerable to developing behavior problems. The therapy emphasis is on the social situation not the individual. The therapy is based on the idea that people don't develop problems in isolation. Positive connotation (as reframe of symptomatic behaviour). establish goals. When this happens it can throw family dynamics into a state of chaos. therapeutic setting. Metacommunication and repetitive interactions examined. The idea behind this method is that the family has the most influence on a person's life. Then he could work closely with everyone in the family to implement and execute solutions to help correct the dysfunctional behavior. ADD/ADHD. The solution-focused approach was favored over traditional psychoanalysis. Who Does it Help? All families face challenges. The therapy works on helping families discover their unique ability to solve their problems using internal resources they weren't aware they had. symptoms deprived of their relationship-controlling function. The therapist attempts to recreate typical family interactions and conversation through provocative questioning techniques so that the problems can be presented and addressed accordingly. meeting family goals and help change a person's dysfunctional behavior." Circular questioning. The therapy is based on five stages: identify problems that can be solved. Strategic Family Therapy (Madanes and Haley) designs a strategy for each specific problem. analyze the responses. society and peers can create rifts in even the strongest families creating dysfunction. Family Interaction Strategic family therapy considers the family unit as a system. Prescriptive and descriptive paradoxical assignments. Therapist controls the therapy. and examine the results.

The approach does not focus on the past. By bringing these small successes to their awareness. By helping people identify the things that they wish to have changed in their life and also to attend to those things that are currently happening that they wish to continue to have happen. is a type of talking therapy that is based upon social constructionist philosophy. the free encyclopedia Solution focused brief therapy (SFBT). To support this. 24 . Change is constant — Therapists can do a great deal to influence client’s perceptions regarding the inevitability of change and what is supposed to happen during the therapy session. with whom and how pieces of that preferred future are already happening. The SFBT therapist then helps the client to identify times in their current life that are closer to this future. and examines what is different on these occasions. the therapists helps the client move towards the preferred future they have identified. often referred to as simply 'solution focused therapy' or 'brief therapy'. where.Solution focused brief therapy From Wikipedia. focuses on the present and future. Solution focused therapists believe that change is constant. and about exceptions to the problem. It focuses on what clients want to achieve through therapy rather than on the problem(s) that made them to seek help. questions are asked about the client’s story. and helping them to repeat these successful things they do when the problem is not there or less severe. but instead. Solution focused work can be seen as a way of working that focuses exclusively or predominantly at two things. 2) Exploring when. strengths and resources. The therapist/counsellor uses respectful curiosity to invite the client to envision their preferred future and then therapist and client start attending to any moves towards it whether these are small increments or large changes. 1) Supporting people to explore their preferred futures. SFBT therapists help their clients to construct a concrete vision of a preferred future for themselves. While this is often done using a social constructionist perspective the approach is practical and can be achieved with no specific theoretical framework beyond the intention to keep as close as possible to these two things. Contents • • • • • • • 1 Basic Principles 2 Questions 3 Resources 4 History of Solution Focused Brief Therapy 5 Solution-Focused counselling 6 Solution-Focused consulting 7 References Basic Principles: Clients have resources and strengths to resolve complaints — It is therapist’s task to access these abilities and help clients put them to use.

you go home.” If [the change] is in a crucial area.” Focus on what is possible and changeable rather than what is impossible and intractable — Focus on aspects of a person’s situation that seem most changeable. topics focused on or ignored. It simply suggests how people’s lives have become static. to label it as worthwhile.. And in the middle of the night. you get tired and go to sleep. A traditional version of the miracle question would go like this: "Suppose our meeting is over. This imparts a sense of hope and power Questions The miracle question The miracle question is a method of questioning that a coach. this may help to establish goals. a miracle happens and all the problems that brought you here today are solved just like that." To ask the question well this should be met with respectful silence to give the person time to fully absorb the question. When you wake up the next morning. Sometimes all that is necessary to initiate significant change is a shift in the person’s perception of the situation. as a result of our interaction during the first session. Average length of treatment is less than 10 sessions. Rapid change or resolution of problems is possible — “We believe that. our clients will gain a more productive and optimistic view of their situations. And then. occasionally only 1. it can change the whole system. Initial responses frequently include a sense of "I don't know. Learn from clients’ identifying when the problem is not troublesome. It is usually unnecessary to know a great deal about the complaint in order to resolve it — What is significant is what the clients are doing that is working. ask people to establish their own goals for treatment.The therapist’s job is to identify and amplify change — He/She accomplishes this through choice of questions. usually 4 to 5. when you are fast asleep. or counsellor uses to aid the client to envision how the future will be different when the problem is no longer present. Different views may be just as valid and may fit the facts just as well — Views that keep people stuck are simply not useful. But since the miracle happened overnight nobody is telling you that the miracle happened.” Therapists expect them to go home and do what is necessary to make their lives more satisfying (p. “Focus on what seems to be working however small. Clients define the goal — Do not assume that therapists are better equipped to decide how their clients should live their lives. The question must be asked slowly with close attention to the person's non-verbal communication to ensure that the pace matches the person's ability to follow the question. It is not necessary to know the cause or function of a complaint to resolve it — Even the most creative hypotheses about the possible function of a symptom will not offer therapists a clue about how people can change. Ask those who want to know why they have a symptom: “Would it be enough if the problem were to disappear and you never understood why had it?” A small change is all that is necessary: A change in one part of the system can affect change in another part of the system — “We have the sense that positive changes will at least continue and may expand and have beneficial effects in other areas of the person’s life. 45). do whatever you planned to do for the rest of the day.. What else are you going to notice? What else?" Whilst relatively easy to state the miracle question requires considerable skill to ask well. 25 . and to work toward amplifying it. Clients can learn to function that way again to solve the problem. There is no one “right” way to view things. Also. how are you going to start discovering that the miracle happened? . some time in the evening. therapist.

if a client wants to be more assertive it may be that under certain life situations they are assertive. "What will you be doing instead when someone calls you names?" Scaling Questions Scaling questions are tools that are used to identify useful differences for the client and may help to establish goals as well. they cope and coping questions start to gently and supportively challenge the problemfocused narrative. or what they will do. "on a day when you are one point higher on the scale. For example. then perhaps they have an area of their life where they remain calm even under pressure. The initial summary "I can see that things have been really difficult for you" is for them true and validates their story. you manage to get up each morning and do everything necessary to get the kids off to school. but one that counters the problem focused narrative. or be more assertive. Undeniably. problem-free talk can be a useful technique for identifying resources to help the person relax. or what the client did differently. even so. but typically range from "the worst the problem has ever been" (zero or one) to "the best things could ever possibly be" (ten).g. The second part "you manage to get up each morning etc. The goal is for the client to repeat what has worked in the past. rather than what they will not do--to better ensure success. Or if a client is struggling with their child because the child gets aggressive and calls the parent names and the parent continually retaliates and also gets angry. "where on the scale would be good enough? What would a day at that point on the scale look like?") Exception Seeking Questions Proponents of SFBT insist that there are always times when the problem is less severe or absent for the client. yet I am struck by the fact that. is also a truism. Solution focused therapists will talk about seemingly irrelevant life experiences such as leisure activities. The therapist can also gather information on the client's values and beliefs and their strengths. the counsellor may ask. for example. Problem-free talk In solution-focused therapy. and questions are then used to help the client identify resources (e." The counsellor wants the client to develop positive goals. exceptions (e. the counsellor may ask the client. meeting with friends.g. and a miracle happened so that you no longer easily lost your temper. How do you do that?" Genuine curiosity and admiration can help to highlight strengths without appearing to contradict the clients view of reality. The client is asked to rate their current position on the scale. Even the most hopeless story has within it examples of coping that can be drawn out: "I can see that things have been really difficult for you. There are many different versions of the miracle question depending on the context and the client. The poles of a scale can be defined in a bespoke way each time the question is asked. Coping questions Coping questions are designed to elicit information about client resources that will have gone unnoticed by them. In this way the miracle question is not so much a question as a series of questions. This strength from one part of their life can then be transferred to the area with the current problem. what would you see differently?" What would the first signs be that the miracle occurred?" The client (a child) may respond by saying. what would tell you that it was a 'one point higher' day?") and to describe a preferred future (e. "what's stopping you from slipping one point lower down the scale?"). The counsellor seeks to encourage the client to describe what different circumstances exist in that case. In a specific situation. "I would not get upset when somebody calls me names.g. relaxing and managing conflict. "If you woke up tomorrow. So.". and to help them gain confidence in making improvements for the future. on a scale where 0 = worst things have ever been and 10 = the miracle day where are you now? Where would it need to be for you to know that you didn't need to see me any more? What will be the first things that will let you know you are 1 point higher. From this discussion the therapist can use these strengths and resources to move the therapy forward. or maybe they have 26 .Once the miracle day has been thoroughly explored the worker can follow this with scales.

the approach is now known in other fields as simply Solution Focus or Solutions Focus.[3][4] Solution Focused Brief Therapy has branched out in numerous spectrums . among them Milton Erickson. Virginia Satir. beliefs that are useful to them and their capacities. It also relaxes them and helps build rapport. Resources can be Internal: the client's skills. 27 . Donald deAvila Jackson. but also aims to help the client identify new ways of bringing these resources to bear upon the problem. that have been developed over the past 50 years or so. including Europe.or talk about friends or family. Elam Nunnally. Alex Molnar.Even negative beliefs and opinions can be utilised as resources ' [1] Resources A key task in SFBT is to help clients identify and attend to their skills. Wallace Gingerich. Jay Haley. the field of Addiction Counselling has begun to utilize SFBT as an effective means to treat problem drinking. and became popularized in the 1960s and 1970s. Or. abilities. These might be events.g. and it can give you ideas to use for treatment... John Grinder and Richard Bandler provided practical guidelines for the application of some of the hypnotic techniques of Erickson.. External: Supportive relationships such as.. or during exception-seeking. problem-free talk. History of Solution Focused Brief Therapy Solution Focused Brief Therapy is one of a family of approaches.. Paul Watzlawick. and Michele Weiner-Davis. Core members of this team were Eve Lipchik.Everybody has natural resources that can be utilised. Richard Fisch. particularly through their work with Milton Erickson. partners. faith or religious groups and also support groups. are attributed to husband and wife Steve de Shazer and Insoo Kim Berg and their team at the Brief Family Therapy Center in Milwaukee.. social networks). and external resources (e. at least in part. qualities. ND has implemented SFBT as part of their program.. Richard Bandler. Janet Beavin Bavelas and is in the problem free areas you find most of the resources to help the client. and eventually evolving around the world.The idea behind accessing resources is that it gives you something to work with that you can use to help the client to achieve their goal.. first in the USA. friends. John Grinder and Stephen R Lankton have also been credited. wherein they utilize this therapy as part of a partial hospitalization and residential treatment facility for both adolescents and adults. The concept of brief therapy was independently discovered by several therapists in their own practices over several decades (notably Milton Erickson). This process not only helps to construct a narrative of the client as a competent individual. strengths. John Weakland. Dan Jones. Their work in the early 1980s built on that of a number of other innovators.indeed. with the inspiration for and popularization of brief therapy. family.[2] While Jay Hayley and the team at the Mental Research Institute at Palo Alto aimed to uncover the principles that underpinned Erickson's approach to brief therapy. Most notably. was described by authors such as Haley in the 1950s. and the specific steps involved in its practice. USA. The Center for Solutions in Cando. known as systems therapies.. in his Becoming a Brief Therapist book writes: '.trained a dog successfully that now behaves and can identify that it was the way they spoke to the dog that made the difference and if they put boundaries in place using the same firm tonality the child might listen.. Resources can be identified by the client and the worker will achieve this by empowering the client to identify their own resources through use of scaling questions. The title SFBT. and the group at the Mental Research Institute at Palo Alto – Gregory Bateson.

Solution-Focused consulting Solution-Focused consulting is an approach to organizational change management that is built upon the principles and practices of Solution-Focused therapy.Berg and S. D. Handbook of Solution-focused brief therapy.. "Family based services: A solution-focused approach. American Counselling Association 2006. Solution-focused treatment of migraine headache. Weiner-Davis: "In Search of Solutions: A New Direction in Psychotherapy. 1999. References • • • • • • • • • • • • • • • • • • • • • • • • • • ^ Jones. Various similar.). O'Hanlon and M. Jossey-Bass Publishers. VA: American Counselling Association. Mecias. H. D.O’Hanlon and S. M. Hubble. Denborough. I.Solution-Focused counselling Solution-Focused counselling is a solution focused brief therapy model.K. While therapy is for individuals and families. postmodern theories. Mastering the Art of Solution-Focused Counselling." New York:Norton. 2nd edition 2002 P. Peter De Jong. Norton 2001. Investigating Solutions in Brief Therapy. BT Press 1996. Duncan. Solution Focused Therapy. J. "Solution-Focused Therapy: An Interview with Insoo Kim Berg. Miller. "The new language of change: Constructive collaboration in psychotherapy.W.A. Lulu. models have been referred to as solution-focused counselling. For example. Beadle. South Australia: Dulwich Centre Publications. (1982) Patterns of brief family therapy: an ecosystemic approach. Insoo Kim Berg Interviewing for Solutions Brooks Cole Publishers.H. Friedman (Ed.22) ^ Shazer. 2003.W. Alexandria. Duncan. B. Jeffrey Guterman developed a solution-focused approach to counselling in the 1990s. 1990. B. A. from small teams to large business units. A Field Guide to PossibilityLand: possibility therapy methods. maximizing the effect of the first (and often only) therapeutic Norton & Co 1988 E.deShazer: Making numbers talk: Language in therapy. This model is an integration of solution-focused principles and techniques.Iveson.L. 1998. B. Dan Becoming a Brief Therapist: Special Edition The Complete Works. Guterman. W. Adelaide. I. Shazer: Clues. Hubble.Ziegler and T. Jossey-Bass Publishers. M. Solution-Focused consulting is being used as a change process for organizational groups of every size. O’Hanlon: A Brief Guide to Brief Therapy. ISBN 1-55620-267-9 Guterman. Single Session Therapy. C. 1996.Berg.O’Connell. Guilford Press. Collaborative Approach to Couples Therapy. and a strategic approach to eclecticism." New York:Guilford. The Family 28 . American Psychological Association. Problem to solution.K.D. Ainbinder. page 451. (2006). Miller. Hiller: Recreating Partnership: A Solution-Oriented.Berg. B. BT Press. S. B. 1993. Ratner.L. W.Cade and W. J. Present and Possible Futures." WW Norton & CO. yet distinct. S.K. I. brief therapy with individuals and families." Psychotherapy.Talmon.George. 1990.W. Guterman. In S. SD.D.T. what works in therapy. 1994.A. (2005). S. M. Norton & Co New York 1989 J. 2001. W. 2008.T. Sage. Family Therapy: Exploring the Field's Past. Mastering the Art of Solution-Focused Counselling. ISBN 1-40923031-7 ^ See page 671 in Steenbarger (2002) "Single-session therapy: Theoretical underpinnings" In Elsevier Encyclopedia of Psychotherapy ^ (Shazer 1982 p. The Heart and Soul of Change..T.

is another firm proponent of brief therapy. and repeat it till it happens very fast. you do it in five minutes. I didn't realize that the speed with which you do things makes them last... emphasis in original) Richard Bandler. Founding proponents of brief therapy Milton Erickson was a master of brief therapy. Brief therapy is often highly strategic. In brief therapy.. It differs from other schools of therapy in that it emphasises (1) a focus on a specific problem and (2) direct intervention.D. the force of the river will cut a new channel. 1993. exploratory. he wrote: "It's easier to cure a phobia in ten minutes than in five years.Brief (psycho-) therapy From Wikipedia. the therapist takes responsibility for working more pro-actively with the client in order to treat clinical and subjective conditions faster. Brief therapists do not adhere to one "correct" approach. It is less concerned with how a problem arose than with the current factors sustaining it and preventing change. any of which may or may not in combination turn out to be ultimately beneficial." "The analogy Erickson uses is that of a person who wants to change the course of a river." (Haley.. p. and temporary suspension of disbelief to consider new perspectives and multiple viewpoints. however. the free encyclopedia Brief psychotherapy or Brief therapy is an umbrella term for a variety of approaches to psychotherapy.20) 29 . Rather than the formal analysis of historical causes of distress. By becoming aware of these new understandings. That's part of how the brain learns. But if he accepts the force of the river and diverts it in a new direction. using clinical hypnosis as his primary tool. Then they'd come to me and say "It doesn't work!" If. I taught people the phobia cure. They'd do part of it one week." (Time for a change. utilization of natural resources. and solution-based rather than problem-oriented.24. and part of it the week after. the river will merely go over and around him. the primary approach of brief therapy is to help the client to view the present from a wider context and to utilize more functional understandings (not necessarily at a conscious level). "Uncommon therapy". part of it the next. To a great extent he developed this himself. but rather accept that there being many paths. It learns quickly. successful clients will de facto undergo spontaneous and generative change. in the book "Uncommon therapy: The psychiatric techniques of Milton Erickson M. After many years of studying Erickson's therapeutic work. His approach was popularized by Jay Haley. the brain understands. p. the co-founder of neuro-linguistic programming.. It also emphasizes precise observation. if he opposes the river by trying to block it. I discovered that the human mind does not learn slowly. I didn't know that..

the focus is on diagnosing what is wrong with you or what is not working for you. Brief Therapy focuses on the solution to problems. Perhaps the most important thing to remember is that Brief Therapy is effective because people are capable of change in a short amount of time. it does illustrate that Brief Therapy is firmly rooted in the present with an eye toward changing the future. Consider.Short-term counselling with lasting results An Overview of Brief Therapy Brief Therapy is a model of therapy that focuses strongly on your present and future. In traditional therapy. Since our time frame is measured in weeks and months (as opposed to years) we want to find a solution that works in the shortest time possible. Although this is an extreme view. or how frustrated they are by their problems. the seemingly simple task of finding out what you want to achieve in therapy. The last stage (Do something different) will help you when if you realize that one approach is not working effectively. 30 . Because everyone has an almost infinite capacity for creative solutions (even if you don't realize it now) we won't waste time on any approach that's not working for you. Some Brief Therapy experts would go so far as to say they don't even need to know what the past problems were to help the client. Brief Therapists are strong adherents to the "if it ain't broke don't fix it" philosophy. our goal is to help you find out what you do want. as opposed to your past. and they will be the mark against which you will measure your success. You will be in charge of your own therapy and you will decide when you have attained your goals. In the next stage. by contrast. When we find out what parts of your life you're happy with. Find out what you (the client) want 2. Determine what is currently working for you and do more of that 3. what has been troubling them. Do something different. In effect. the goals that you articulate will guide you through the rest of your sessions. the emphasis is on finding out what parts of your life are working just fine. Most people go into therapy knowing all too well what they don't want. The brief therapy solution-focused approach can be summed up in three stages. In the solution-focused model. according to Peller and Walter (1992): 1. which is why it is often called solution-oriented therapy. for example. but you will solve them by using the strengths that you already have. Your therapist will listen to what you have to say. Brief Therapy emphasizes the client as the expert. Identifying your goal (or goals) is perhaps the single most important thing you will do in your Brief Therapy sessions. and together you will develop goals and work collaboratively to find solutions. In contrast. Traditional psychotherapy tends to focus on the past and looks for the cause of problems. In Brief Therapy you will present your problems. The simplicity of these stages belies their effectiveness. we can use them as a strong foundation upon which you can build an improved lifestyle.

The first is togetherness and the second is individuality. He studied schizophrenia. Families are systems of interconnected and interdependent individuals. Murray Bowen that suggests that individuals cannot be understood in isolation from one another. our thoughts about what is "normal" and "healthy. each of which is described below. he explained his theory of how families develop and function. and experiences of each generation. Bowen was a medical doctor and the oldest child in a large cohesive family from Tennessee. one of his students. Bowen was the first to realize that the history of our family creates a template which shapes the values. which created an anxious and unhealthy attachment. 31 . Too much individuality results in a distant and estranged family. but rather as a part of their family. and presented as a case study his own family. as the family is an emotional unit. thinking the cause for it began in mother-child symbiosis. Bowen introduced eight interlocking concepts to explain family development and functioning. At a conference organized by Framo.Bowen’s Strategic Family Therapy ." and our expectations about how the world works. Too much togetherness creates fusion and prevents individuality. thoughts.I Contents • • • • • • • • • • • • • • Introduction Differentiation of Self Triangles The Nuclear Family Emotional Processes The Family Projection Process The Multigenerational Transmission Process Sibling Position Emotional Cutoff Societal Emotional Processes Normal Family Development Family Disorders Goals of Therapy Techniques Family Therapy with One Person Introduction Family Systems Theory Introduction The pioneers of family therapy recognized that current social and cultural forces shape our values about ourselves and our families. none of whom can be understood in isolation from the system. or developing one's own sense of self. as well as how that generation passes down these things to the next generation. However. He moved from studying dyads (two way relationships like parent-child and parent-parent) to triads (three way relationships like parent-parent-child and grandparent-parent-child) afterward. Bowen's theory focuses on the balance of two forces. The family systems theory is a theory introduced by Dr.

32 . Triangles usually have one side in conflict and two sides in harmony. contributing to the development of clinical problems. but it may also push the family towards a different equilibrium.Impairment of one or more children . . but also to dysfunction. Members of the system are expected to respond to each other in a certain way according to their role. 5) Multigenerational transmission process: The transmission of small differences in the levels of differentiation between parents and their children. if a husband is depressive and cannot pull himself together. This new equilibrium may lead to dysfunction as the wife may not be able to maintain this overachieving role over a long period of time. 3) Nuclear family emotional system: The four relationship patterns that define where problems may develop in a family. 8) Societal emotional process: The emotional system governs behaviour on a societal level. which is determined by relationship agreements. The change in roles may maintain the stability in the relationship. There are eight interlocking concepts in Dr. 6) Emotional cut-off: The act of reducing or cutting off emotional contact with family as a way of managing unresolved emotional issues.Dysfunction in one spouse . For example. Maintaining the same pattern of behaviours within a system may lead to balance in the family system. the wife may need to take up more responsibilities to pick up the slack. Within the boundaries of the system. 2) Triangles: The smallest stable relationship system.Emotional distance 4) Family projection process: The transmission of emotional problems from a parent to a child. a family is a system in which each member has a role to play and rules to respect.The family system According to Bowen. Bowen's theory: 1) Differentiation of self: The variance in individuals in their susceptibility to depend on others for acceptance and approval. promoting both progressive and regressive periods in a society. patterns develop as certain family member's behaviour is caused by and causes other family member's behaviours in predictable ways.Marital conflict . 7) Sibling position: The impact of sibling position on development and behaviour.

" the more impact others have on his functioning and the more he tries to control. He defines himself without being pushy and deals with pressure to yield without being wishy-washy. A person with a well-differentiated "self" recognizes his realistic dependence on others. they have difficulty separating their own from other's feelings. The basic building blocks of a "self" are inborn. say.1. Everyone is subject to problems in his work and personal life. and do to please others or they dogmatically proclaim what others should be like and pressure them to conform. and interpret their experiences. feel about people. and rejection to distinguish thinking rooted in a careful assessment of the facts from thinking clouded by emotionality. but he can stay calm and clear headed enough in the face of conflict. Bullies depend on approval and acceptance as much as chameleons. but individuals vary in their susceptibility to a "group think" and groups vary in the amount of pressure they exert for conformity. These differences between individuals and between groups reflect differences in people's levels of differentiation of self. the level of "self" rarely changes unless a person makes a structured and long-term effort to change it. but being able to stay emotionally connected to them. the less the group's capacity to adapt to potentially stressful events without a marked escalation of chronic anxiety. Once established. feel. but bullies push others to agree with them rather than their agreeing with others. Undifferentiated people can not separate feelings and thoughts. not a response to relationship pressures. he can either support another's view without being a disciple or reject another view without polarizing the differences. People with a poorly differentiated "self" depend so heavily on the acceptance and approval of others that either they quickly adjust what they think. He can act selflessly. The more intense the interdependence. 33 . but he pretends to be a "self" by routinely opposing the positions of others. Disagreement threatens a bully as much as it threatens a chameleon. the functioning of others. the families and other groups that make up a society differ in the intensity of their emotional interdependence depending on the differentiation levels of their members. An extreme rebel is a poorly differentiated person too. but his acting in the best interests of the group is a thoughtful choice. but an individual's family relationships during childhood and adolescence primarily determine how much "self" he develops. when asked to think. Confident in his thinking. or the ability to separate feelings and thoughts. Differentiation of Self Families and other social groups tremendously affect how people think. What he decides and what he says matches what he does. criticism. This means being able to have different opinions and values than your family members. but less differentiated people and families are vulnerable to periods of heightened chronic anxiety which contributes to their having a disproportionate share of society's most serious problems. Differentiation is the process of freeing yourself from your family's processes to define yourself. they look to family to define how they think about issues. Further. and then choosing a different response for the future. Consequently. Every human society has its well-differentiated people. and act. It means being able to calmly reflect on a conflicted interaction afterward. Thoughtfully acquired principles help guide decision-making about important family and social issues. actively or passively. Differentiation of Self The first concept is Differentiation of Self. The less developed a person's "self. and have difficulty thinking logically and basing their responses on that. making him less at the mercy of the feelings of the moment. poorly differentiated people. and people at many gradations between these extremes. realizing your own role in it. they are flooded with feelings.

Sure of himself. but realized she could manage." He always told Martha what he was thinking and he listened carefully to her ideas. he responded fairly factually and appreciated her interest. even if only by phone at times. Martha had always been attracted to Michael's sense of responsibility and willingness to make decisions. She had a few physical problems. a moderately differentiated unit. She did not assume Michael usually knew "best. Their exchanges were usually thoughtful and led to decisions that respected the vital interests of both people. By the parents relating comfortably to each other. Michael and Martha were quite happy during the first two years of their marriage.] A female infant was born after a fairly smooth labor. but did not assume he knew "best.Example: The example of the Michael. Each is sufficiently confident in the other's loyalty and commitment that neither needs much reassurance about it. Michael can meet the reality demands of his job without feeling guilty that he is neglecting Martha. (Triangles example ) The description that follows is of how this triangle would play out if Michael. Martha had somewhat heightened needs and expectations of Michael. but she takes responsibility for managing her anxiety and has realistic expectations about what he can do for her. He listened but was not patronizing. Amy triangle reflects how a lack of differentiation of self plays out in a family unit. and Amy were more differentiated people. He recognized his own fears about the coming changes in their lives and acknowledged them to Martha. the less adaptive moderately differentiated marriage and the more adaptive well-differentiated marriage can look similar because the tension level is low. The infant care over the next few months was physically exhausting for Martha. [Analysis: Sure of herself as a person. particularly before the births of children and the addition of other responsibilities. in their case. but their interaction does not escalate the anxiety and make it chronic.] Martha conceived during the third year of the marriage and had a fairly smooth pregnancy. Martha is able to relate to Amy without feeling overwhelmed by responsibilities and demands and without unfounded fears about the child's well-being. but she thought more clearly about her fears when she talked them out with him." [Analysis: Because the level of stress on a marriage is often less during the early years. When she talked to Michael about her fears. but did not ruminate about them to Martha. He liked making the major decisions.] 34 . Stress is necessary to expose the limits of a family's adaptive capacity. Each remains a resource to the other. Martha. She was somewhat anxious about being an adequate mother but felt she could manage these fears. Michael does not get particularly reactive to Martha's expectations and recognizes he is anxious too. [Analysis: The stresses associated with the real and anticipated changes of the pregnancy trigger some anxiety in both Michael and Martha. She does not have a void to fill in her mother's life related to distance between her parents. Although Michael had increasing work pressures he remained emotionally available to her. He was not compelled to "fix" things for her. Martha. He occasionally wished Martha would not get anxious about things. but she also lived by a principle that she was responsible for thinking things through for herself and telling Michael what she thought. Martha weathered the delivery fairly well and was ready to go home when her doctor discharged her. They named her Amy. He worried about work issues. Each spouse recognizes the pressure the other is under and neither makes a "federal case" about being neglected. she did not expect that he would solve them for her. but she was not heavily burdened by anxieties about the baby or about her adequacy as a mother. but dealt with them with equanimity. She continued to talk to Michael about her thoughts and feelings and still did not feel he was supposed to do something to make her feel better. Amy is not triangled into marital tensions. When she asked how it was going.

Their high levels of differentiation allow the three of them to be in close contact with little triangling. Amy grew to be a responsible young child. Michael and Martha discussed their thoughts and feelings about Amy. Michael and Martha were able to find time to do some things by themselves. Michael did not feel critical of Amy very often and Martha did not defend Amy to him when he was critical. There were few demands and no tantrums. She sensed the limits of what was realistic for her parents to do for her and respected those limits. As Amy grew. They have adapted quite successfully to the anxieties they each experienced associated with the addition of a child and the increased demands in Michael's work life. but not constantly praising her in the name of reinforcing Amy's self-image. They were pleased to have her and took pleasure in watching her develop.] 35 . She was positive about Amy. Martha figured Michael and Amy could manage their relationship. Martha did not perceive her as an insecure child that needed special attention. Amy seemed equally comfortable with both of her parents and relished exploring her environment.After a few months. [Analysis: Michael and Martha can see Amy as a separate and distinct person. The beginning differentiation between Amy and her parents is evident when Amy is a young child. but they were not preoccupied with her. Martha found that her anxieties about being a mother toned down and she did not worry much about Amy.

• Think about a couple who has an argument. Triangles contribute significantly to the development of clinical problems. but a triangle creates an "odd man out. you can be intimidating at those times. A triangle can contain much more tension without involving another person because the tension can shift around three relationships. Instead. At a high level of tension. If severe conflict erupts between the insiders. or have to call this relationship quits. triangles usually have one side in conflict and two sides in harmony. the outsider will try to regain an inside position. People who are differentiated cope well with life and relationship stress. The conflict is not inherent in the relationship in which it exists but reflects the overall functioning of the triangle. the outside position becomes the most desirable.. If mild to moderate tension develops between the insiders. Two parents intensely focusing on what is wrong with a child can trigger serious rebellion in the child. it spreads to a series of "interlocking" triangles. If the tension is too high for one triangle to contain. When the tension and conflict subside. you either have to learn to accept this about them. • Think of the person who can listen to the best friend's relationship problems without telling the friend what to do or only validating the friend's view. It is considered the building block or "molecule" of larger emotional systems because a triangle is the smallest stable relationship system.. The insiders solidify their bond by choosing each other in preference to the less desirable outsider. People who are more undifferentiated are likely to triangulate others and be triangulated. Triangles Triangles are the basic units of systems. they will seek a third person to triangulate. Dyads are inherently unstable. two people are comfortably close "insiders" and the third person is an uncomfortable "outsider. or bolster their beliefs and make a decision. their reactions to too much intensity in the attachments." The insiders actively exclude the outsider and the outsider works to get closer to one of them." which is a very difficult position for individuals to tolerate. he gains the more comfortable position of watching the other two people fight. The patterns in a triangle change with increasing tension. one insider opts for the outside position by getting the current outsider fighting with the other insider. People's actions in a triangle reflect their efforts to ensure their emotional attachments to important others. one of the partners calls their parent or best friend to talk about the fight." or "I agree with you but you won't change your partner." Triangles A triangle is a three-person relationship system. a triangle is more stable than a dyad. The third person helps them reduce their anxiety and take action. Anxiety generated by anticipating or being the odd one out is a potent force in triangles. the most uncomfortable one will move closer to the outsider. the differentiated person can tell the best friend "You know. and thus are less likely to triangulate others or be triangulated. At moderate levels of tension. In calm periods.2. 36 .. One of the original insiders now becomes the new outsider and the original outsider is now an insider. The new outsider will make predictable moves to restore closeness with one of the insiders.. and afterward. but nothing gets resolved. and their taking sides in the conflicts of others. Someone is always uncomfortable in a triangle and pushing for change. Spreading the tension can stabilize a system. Paradoxically. or calm their strong emotions and reflect. A two-person system (dyad) is unstable because it tolerates little tension before involving a third person. Getting pushed from an inside to an outside position can trigger a depression or perhaps even a physical illness. When distressed or feeling intense emotions. If the maneuvering insider is successful. Someone choosing another person over oneself arouses particularly intense feelings of rejection. as two people will vacillate between closeness and distance.

Yet. she felt increasingly overwhelmed and extremely anxious about the well-being of the young baby. Michael ruminated about work problems. Michael was patient and reassuring. He gave into Martha's pleas. Martha was exhausted and not ready to leave the hospital when her doctor discharged her. The conflictual side of the triangle then shifts from between Martha and Amy to between Michael and Amy. There was much less time together for just Michael and Martha and. [Analysis: Martha is the most uncomfortable with the increased tension in the marriage. Martha would defend Amy. However. the conflict shifts into the marriage. and Amy gains the more comfortable outside position. They named her Amy. whenever tensions developed between Martha and Amy. she made increasing demands on her mother's time. Michael liked making major decisions and Martha felt comforted by Michael's "strength.Example: Michael and Martha were extremely happy during the first two years of their marriage. Michael sides with Martha by agreeing that Amy is the problem.] 37 . Amy would be less of a problem.] A female infant was born after a long labor. Martha felt she could not give Amy enough time. He views her as having a problem. Martha sides with Amy. Michael is in the outside position in the parental triangle and Martha and Amy are in the inside positions. Over the next few months. She looked to Michael for support. Michael felt that if Martha had his maturity. [Analysis: When tension builds between Martha and Amy. that Amy would never be satisfied." [Analysis: The pregnancy places more pressure on Martha and on the marital relationship. but also began to feel critical of Martha for being "childlike.] As Amy grew. The growing emotional distance in the marriage is balanced by Martha getting overly involved with Amy and Michael getting overly involved with his work. Martha conceived during the third year of the marriage. Michael and Martha spent more and more of their time together discussing Amy rather than talking about their marriage. but. She reacted intensely to his real and imagined criticisms of her. Martha became increasingly preoccupied with making sure her growing child did not develop the insecurities she had. if Michael got too critical of Amy. when there was time. telling Michael he was exaggerating. She was quite nauseous during the first trimester and developed blood pressure and weight gain problems as the pregnancy progressed. Michael usually followed Martha's lead in relationship to Amy. but it was a difficult pregnancy. She tried to do this by being as attentive as she could to Amy and consistently reinforcing her accomplishments." After some difficulty getting pregnant. It was easier for Martha to focus on Amy than it was for her to talk to Michael. She talked frequently to Michael of her insecurities about being a mother. but he was getting home from the office later and Martha felt that he was critical of her problems coping and that he dismissed her worries about the child. but inwardly felt that they were following a policy of appeasement that was making Amy more demanding. Michael agreed with Martha that Amy was too selfish and resented Amy's temper tantrums when she did not get her way. Michael is outwardly supportive of Martha but is reactive to hearing about her anxieties. Martha would press Michael to spend more time with Amy to reassure her that she was loved. If the conflict gets too intense between Michael and Amy. despite this attitude.

depression. He may follow or reject it. or social dysfunction. Dysfunction in one spouse. Likewise. but if family tension rises further. Both spouses accommodate to preserve harmony. The higher the tension. each tries to control the other. The four basic relationship patterns are: Marital conflict. The more the parents focus on the child the more the child focuses on them. Nuclear Family Emotional System The concept of the nuclear family emotional system describes four basic relationship patterns that govern where problems develop in a family. The patterns operate in intact. and so adopts this way of thinking. He is seen in the family as a great businessperson as he did this by taking risks in a time of great economic opportunity. and expectations of the parents. and on a family's connection with extended family and social networks. single-parent. Tension increases the activity of one or more of the four relationship patterns. The daughter thinks her mother is wise.One spouse pressures the other to think and act in certain ways and the other yields to the pressure.The spouses focus their anxieties on one or more of their children. and her success will depend on whether she faces an economic boom or recession. He is more reactive than his siblings to the attitudes. each spouse externalizes his or her anxiety into the marital relationship. but one does more of it. to physical or emotional problems in one family member. Reactions to this process can range from open conflict. The interaction is comfortable for both people up to a point. models this way of thinking.As family tension increases and the spouses get more anxious. He teaches his daughter to take risks. • • Think about a mother who lived through The Great Depression. Problems with family members may include things like substance abuse. has a son. to reactive distancing (see below). Each focuses on what is wrong with the other. the parent passes on an emotional view of the world (the emotional process). Where symptoms develop depends on which patterns are most active. She grows up. Clinical problems or symptoms usually develop during periods of heightened and prolonged family tension.3. how a family adapts to the stress. but the forces primarily driving them are part of the emotional system. medical. stepparent. the smallest possible "unit" of family (the nuclear unit). His daughter may follow or reject her father's advice. and taught her daughter to always prepare for the worst case scenario and be happy simply if things are not that bad. irresponsibility. the subordinate spouse may yield so much self-control that his or her anxiety increases significantly. who built his own father's small struggling business into a thriving company. and other nuclear family configurations. if other necessary factors are present. The Nuclear Family Emotional Processes These are the emotional patterns in a family that continue over the generations. and whether he has a happy or distressed relationship may depend on the kind of partner he finds. "spend money to make money. think of a daughter who goes to work for her father... the more chance that symptoms will be severe and that several people will be symptomatic. The anxiety fuels.. and without realizing it. People's attitudes and beliefs about relationships play a role in the patterns. Impairment of one or more children. In both cases. The process undercuts the child's differentiation from the family and 38 . and each resists the other's efforts at control." and assume a great idea will always be profitable. which is taught each generation from parent to child. They worry excessively and usually have an idealized or negative view of the child. The level of tension depends on the stress a family encounters. the development of a psychiatric. needs.

mostly wine during the evenings. Martha felt he was right. She felt less and less able to make decisions and more and more dependent on Michael. but stopped completely during the pregnancy with Marie. The more anxiety one person or one relationship absorbs. [Analysis: The pattern of sickness in a spouse has emerged. Would Amy be harmed by feeling left out? Martha worried about telling Amy that she would soon have a little brother or sister. People do not want to hurt each other.This pattern is consistently associated with the others. but soon began to worry about whether she could meet the emotional needs of two children. He was. Marie. When Michael would get home at night. Martha had done some drinking before she married Michael and after Amy was born. This means that some family members maintain their functioning at the expense of others. 39 . and being selfish. however. the less other people must absorb. She felt he deserved better. Amy reacts to her parents' emotional over involvement with her by making immature demands on them. but he worried about Martha's ability to cope. People distance from each other to reduce the intensity of the relationship. but when anxiety chronically dictates behaviour. When Marie was a few months old. even during the day. Martha's second pregnancy was easier than the first. social relationships. he too wanted another child. Example: The tensions generated by Michael and Martha's interactions lead to emotional distance between them and to an anxious focus on Amy. someone usually suffers for it." He took over many household duties and was even more directive of Martha. [Analysis: A parent's emotional over involvement with a child programs the child to be as emotionally focused on the parent as the parent is on the child and to react intensely to real or imagined signs of withdrawal by the parent. He was outwardly supportive about the pregnancy. was born without complications. Emotional distance. Michael avoids conflict with Martha by supporting the focus on Amy and avoids dealing with his own anxieties by focusing on Martha's coping abilities. Martha got pregnant again. and even his health. but also resented his criticism and patronizing. [Analysis: Martha externalizes her anxiety onto Amy rather than onto her husband or rather than internalizing it. but risk becoming too isolated. not caring. and much more than in the past. feeling and seeing that Martha seemed "on the edge. Martha began drinking again. he would take Amy off her mother's hands and entertain her. The basic relationship patterns result in family tensions coming to rest in certain parts of the family.] Apart from her fairly intense anxieties about Amy. This time Michael took more time away from work to help at home. Michael thought it was silly but went along with Martha. She somewhat tried to cover up the amount of drinking she did. It is easier for Martha to be the problem than to stand up to Michael's diagnosing her and.makes him vulnerable to act out or internalize family tensions. The child's anxiety can impair his school performance. Michael began calling her an alcoholic. She wanted another child. with Martha as the one making the most adjustments in her functioning to preserve harmony in the marriage. He accused her of not trying. besides. She drank more. wanting to put off dealing with her anticipated reaction as long as possible. Martha and Amy began to get into struggles over how available Martha could be to her.] When Amy was four years old. A daughter. she feels she really is the problem. Martha was obsessed with Amy feeling displaced by Marie and gave in even more to Amy's demands for attention. He also began feeling neglected himself and quite disappointed in Martha's lack of coping ability.. particularly on her mother. feeling Michael would be critical of it.

She began to function much better at home.A. They began fighting frequently.A.A. Michael is as allergic to conflict as Martha is. group. [Analysis: Martha's involvement with A. Martha felt completely accepted by the A. This means the marital pattern has shifted somewhat from dysfunction in a spouse to marital conflict.] 40 . Martha is more inclined to fight with Michael than to go along and internalize the anxiety. She stopped drinking almost immediately and developed a very close connection to her sponsor. Martha gained a certain strength from her new friends and was encouraged by them "to stand up" to Michael. She did. but that she could not talk to him. Martha confided in him about the extent of her drinking. Because of "borrowing strength" from her A. her doctor scared her and she decided to go to Alcoholics Anonymous. The level of family tension has not changed and the emotional distance in the marriage has not changed. opting to function for her rather than risk the disharmony he would trigger by expecting her to function more responsibly. Martha felt more like herself again.A. Martha reached a serious low point. involvement. Her doctor was concerned about her physical health. In other words. friends. but also attended A.A. meetings frequently. an older woman. but Martha had reached a point of resisting almost all of Michael's directives.A. Finally. but it did not solve the family problem. helped her stop drinking. Michael increasingly over functions and Martha increasingly under functions. group and greatly relieved to tell her story. Michael had been pushing her to get help.As the pattern unfolds. However. but now he complained about her preoccupation with her new found A. Martha's level of differentiation of self has not changed through her A. began a part-time job. but her functioning has improved. but the family has not changed in a basic way. Michael had complained bitterly about her drinking.] By the time Amy and Marie were both in school. in a way she could not be with Michael. She felt Michael did everything. She felt she could be herself with the people at A. Michael was bitter.A. She felt worthless and out of control.

and the child's self-esteem grows dependent on their affirmation. the child develops stronger relationship sensitivities than his parents. difficulty dealing with expectations. It will be hard for the son or daughter above to hold their own opinions and values. Similarly. He may act in accord with this view and behave more and more irresponsibly. They join together to worry that she'll never be happily married. She might accept this role and become a workaholic who has only superficial relationships. the son who rejects his mother's pessimistic view may find his mother and sister become closer. These steps of scanning. constantly trying to "prove" himself to be mature and responsible. and treating begin early in the child's life and continue." or "It's a good thing the loan officer felt sorry for him because he couldn't have managed it without that loan. If the projection process is fairly intense. The projection process follows three steps: (1) the parent focuses on a child out of fear that something is wrong with the child. One reason the projection process is a self-fulfilling prophecy is that parents try to "fix" the problem they have diagnosed in the child. for example. The Family Projection Process This is an extension of The Nuclear Family Emotional Process in many ways.. maintain their emotional strength. but the problems they inherit that most affect their lives are relationship sensitivities such as heightened needs for attention and approval. and acting impulsively to relieve the anxiety of the moment rather than tolerating anxiety and acting thoughtfully. diagnosing. feeling responsible for the happiness of others or that others are responsible for one's own happiness. Children inherit many types of problems (as well as strengths) through the relationships with their parents. In the end. The family member who "has" the "problem" is triangulated and serves to stabilize a dyad in the family. she may become depressed as she works more and more. or reject it and take wild risks that fail. 41 .4. and (3) the parent treats the child as if something is really wrong with the child. the daughter who faces harsh economic times and is more fiscally conservative than her father is seen by the parents as too rigid and dull. parents perceive their child to have low self-esteem. or as he struggles with never meeting his family's expectations. as they agree that he is immature and irresponsible. the more it makes him feel excluded and shapes how he sees himself."). The sensitivities increase a person's vulnerability to symptoms by fostering behaviours that escalate chronic anxiety in a relationship system.. they repeatedly try to affirm the child. or as she fails to live up to her father's reputation as a creative and successful business person. He might turn to substance abuse as he becomes more and more irresponsible. The family member who serves as the "screen" upon which the family "projects" this story will have great trouble differentiating. and make their own choices freely despite the family's view of them. • • Thus. He may reject it.. The more they share this view with him. (2) the parent interprets the child's behaviour as confirming the fear. but failing to gain his family's approval because they do not attribute his successes to his own abilities ("He was so lucky that his company had a job opening when he applied.. The parents' fears and perceptions so shape the child's development and behaviour that he grows to embody their fears and perceptions. The projection process can impair the functioning of one or more children and increase their vulnerability to clinical symptoms. Family Projection Process The family projection process describes the primary way parents transmit their emotional problems to a child. the tendency to blame oneself or others.

Like many parents. Martha is meeting many of her own needs for emotional closeness and companionship through Amy. and worry in this child than in his siblings. Martha feared she would transfer inadequacies she had felt as a child. thus gets very distressed if Amy seems unhappy with her. She wanted Michael to help with the task. Amy's upsets triggered guilt in Martha and a fear that they were no longer close companions. In the name of showing love. Both parents are unsure of themselves in relationship to the child.Parents often feel they have not given enough love. Martha looked to Michael to take over at such times. Example: The case of Michael. and Amy illustrates the family projection process. but at the same time feels she is failing Amy. The mother is usually the primary caretaker and more prone than the father to excessive emotional involvement with one or more of the children. [Analysis: Martha blames Amy for the demands she makes on her. but they have invested more time. Martha would try to distance from Amy's neediness. less reactive. It seemed to lock them together even more tightly. The father typically occupies the outside position in the parental triangle. The dilemma of meeting the needs of both children seemed impossible to Martha. and still felt. or support to a child manifesting problems.] At some point in the unfolding of their relationship. and more goal-directed people. except during periods of heightened tension in the mother-child relationship. Martha tries to "fix" Amy's problem by doing more of what she has already been doing and solicits Michael's help in it. Martha began to feel irritated at times by what Martha regarded as Amy's "insatiable need" for attention. She wanted to soothe Amy and feel close to her. Despite calling Amy's need for attention insatiable. She believed a child's road to confidence and independence was in the child feeling secure about herself. but not very successfully because Amy had ways to involve her mother with her. Martha flip-flopped between pleading with and cajoling Amy one minute and being angry at and directive of her the next. she was acutely responsive to Amy's desires for attention. to her own child. As a very small toddler. Martha did not recognize how sensitive she was to any sign in Amy that she might be upset or troubled and how quickly she would move in to fix the problem. Martha felt a mother's most important task was to make a child feel loved. Martha loved Amy deeply. Amy was as sensitive to her mother's moods and wants as Martha was to Amy's moods and wants. Both parents participate equally in the family projection process. Martha felt Amy really needed more of her time and she faulted herself for not being able to give enough. The marital distance accentuates Martha's need for Amy.] Martha's second pregnancy changed a reasonably manageable situation into an unmanageable one. but commonly one parent acts sure of himself or herself and the other parent goes along. attention. Martha was there with an idea or plan. Martha. This was one reason Martha had mixed feelings about being a mother. but in different ways. The intensity of the projection process is unrelated to the amount of time parents spend with a child. How had she failed her? 42 . It bothered Martha if Amy seemed upset with her. [Analysis: Martha's excessive involvement programs Amy to want much of her mother's attention and to be highly sensitive to her mother's emotional state. She felt Amy was already showing signs of "inheriting" her insecurities. Both mother and child act to reinforce the intense connection between them. If Amy seemed bored and out of sorts. energy. The siblings less involved in the family projection process have a more mature and reality-based relationship with their parents that fosters the siblings developing into less needy. Martha's anxiety about Amy began before Amy was born. She and Amy often seemed like one person in the way they were attuned to each other.

consequently. she would lose interest in her work. telling her she should not care so much about what other people think. They hired tutors for Amy in two of her subjects. even though they knew that part of the problem was Amy not working hard in those subjects.] 43 . she was extremely sensitive to that friend paying attention to another little girl. The kindergarten teacher felt she understood children like Amy and took great interest in her. thrived on the teacher's attention. Martha lectured Amy about being less sensitive but also planned outings and parties designed to help Amy with her friendships. Amy's sensitivity to being in the outside position in a triangle with her playmates reflects her programming for such relationship sensitivities in the parental triangle. If Amy balked at going to school. Michael criticized her for not taking advantage of the help they were giving and not appreciating them as parents. She seemed unhappy to Martha. Martha sought long conferences with the kindergarten teacher to plan the transition. none of the school transition problems occurred with her. but if the teacher treated her as one of the group. Amy transfers the relationship intensity she has with her mother to her teachers. Martha became frightened. angry. If the teacher seemed to take an unusual interest in her. Martha and Amy got along much better. As Amy progressed through grade school. Martha talked to Michael and to the pediatrician about getting therapy for Amy. Marie is less involved with her mother and.] Martha and Amy had turmoil in their relationship during Amy's elementary school years. and performed very well in school. If Amy had a special friend. but he basically went along with all of Martha's efforts. Amy was bright. Amy began having academic problems and complained about feeling lost in the larger school. [Analysis: Martha's difficulty being a "self" with her children is reflected in her feeling inordinately responsible for the happiness of both children. [Analysis: Commonly parents get critical of a child with whom they have been excessively involved if the child's performance drops. her adjustment to school seemed to depend heavily on the teacher she had in a particular year. How could Amy disappoint her so much? In the summers when there were no academic pressures. but without that type of relationship. and guilty. Medicine. Martha had none of these fears when Marie started school and. exasperated. She had worked hard to prevent these very problems in Amy.] If Amy complained about the ways other kids treated her in school. They push for the child to have therapy or tutors rather than think about the changes they themselves need to make. Marie's performance did not depend on a particular teacher. When Amy's grades did not improve. but the frequent lectures belie their own anxieties about such issues and their doubts about Amy's ability to cope. Martha scolded Michael for being too hard on Amy. not surprisingly. saying Amy should work out these problems for herself. and the larger society usually reinforce the child focus by defining the problem as being in the child and by often implying that the parents are not attentive and caring enough. her performance is less dependent on the relationship environment at school and at home. Martha focused on making sure Amy got the "right" teacher whenever possible. she performed very well. When a teacher makes her special. Martha and Michael would talk to her about not being so sensitive. but things got worse in middle school.When it was time for Amy to start school. Amy performs less well. she just pursued her interests. Marie did not seem to require so much of the teacher's attention. They lecture Amy about being less sensitive. Michael criticized Martha for this. psychiatry. This makes it extremely difficult for her to interact comfortably with two children. but inwardly she felt even more critical of her than Michael did. Amy performs very well. [Analysis: The parents' words do not match their actions.

[Analysis: The more intense the family projection process has been. She acted out some of her parents worst fears. As a teenager. Similarly. parents often blame the influence of the peer group. they place the problem in Amy. The siblings who are less involved in the family problem navigate adolescence more smoothly. she sides with her parents in blaming Amy for the family turmoil. Amy would lash back at her father in these discussions. which also places the problem outside themselves. pick her own friends. Martha and Amy got into more frequent conflicts." and gave her a car for her sixteenth birthday. not given the freedom to make her own decisions. He wanted to know "why" she disobeyed them. Amy felt controlled by her parents. hoping that would motivate her to do better. They gave her her own phone. and got in with a fairly wild crowd. at which point Martha would intervene. but Amy easily evaded these efforts to control and change her. She challenged Amy about it. Marie is a more mature person than Amy. Amy also had a new group of girlfriends that seemed less desirable to Martha. the more intense the adolescent rebellion.] 44 . but her challenges were met with denials. Amy felt alienated from her parents. Throughout all the turmoil surrounding Amy. Martha felt Amy was telling her less of what was happening in her life and that she was more sullen and withdrawn. but worried that Amy was using drugs and alcohol. The parents' focus on her deteriorating grades included lectures and groundings. for example. but also latched onto any signs she might be doing a little better. [Analysis: The parents' permissiveness is just as important in perpetuating the problems in Amy as the critical focus on her. He accused Amy of not appreciating all they had done for her and of deliberately trying to hurt them. Parents typically blame the rebellion on adolescence. Michael would step in and try to lay down the law to Amy. Peers are an important influence. Amy had also found boys. When Martha felt particularly overwhelmed by the situation. She began lying to her mother in an effort to evade her rules.The big changes occurred when Amy started high school. Marie presented few problems. but she is not free of the family problem. This is why a child who is very intensely connected to her parents can feel distant from them. Amy stayed away from the house more. Many of these things were done in the name of making Amy feel special and important. bought the clothes she "just had to have. but a child's vulnerability to peer pressure is related to the intensity of the family process.] Michael and Martha became increasingly critical of Amy. but did not feel particularly good about herself and about what she was doing. When the parents demand to know "why" Amy acts as she does. Amy is just as critical of her parents as they are of her. The intense family process closes down communication and isolates Amy from the family. told her parents less and less. Martha was no longer drinking herself at this point. She resented her mother's obvious intrusions into her room when she was out. but the parents reactivity to the child fuels the rebellion as much as the child's reactivity.

Amy. marital stability. As the family continues this pattern over generations.she was divorced four times. attitudes. the differences between family lines grow increasingly marked. Level of differentiation of self can affect longevity. The information creating these differences is transmitted across generations through relationships. by reinforcing the beliefs of the family. Martha. but especially to her 45 . health." The combination of parents actively shaping the development of their offspring. and the long dependency period of human offspring results in people developing levels of differentiation of self similar to their parents' levels. From her teen years on. but it also programs how people interact with others. reproduction."). the also refer back to previous generations ("He's just like his Uncle Albert . However. If each sibling then has a child who is more differentiated and a child who is less differentiated than himself. and Marie. The next step in the multigenerational transmission process is people predictably selecting mates with levels of differentiation of self that match their own. one sibling's marriage is more differentiated and the other sibling's marriage is less differentiated than the parents' marriage. Example: The multigenerational transmission process helps explain the particular patterns that have played out in the nuclear family of Michael. if a family programs someone to attach intensely to others and to function in a helpless and indecisive way. This captures how the whole family joins in The Family Projection Process.he was always irresponsible too" or "She's just like your cousin Jenny . Therefore. A key implication of the multigenerational concept is that the roots of the most severe human problems as well as of the highest levels of human adaptation are generations deep. the relationship patterns of nuclear family emotional systems often result in at least one member of a sibling group developing a little more "self" and another member developing a little less "self" than the parents. Multigenerational Transmission Process The concept of the multigenerational transmission process describes how small differences in the levels of differentiation between parents and their offspring lead over many generations to marked differences in differentiation among the members of a multigenerational family. but one who directs others and make decisions for them. Martha did not feel especially close to either of her parents. if one sibling's level of "self" is higher and another sibling's level of "self" is lower than the parents. and occupational success. Relationally and genetically transmitted information interact to shape an individual's "self. educational accomplishments. he will likely select a mate who not only attaches to him with equal intensity. Martha is the youngest of three daughters from an intact Midwestern family. one three generational line becomes progressively more differentiated (the most differentiated child of the most differentiated sibling) and one line becomes progressively less differentiated (the least differentiated child of the least differentiated sibling). the poorly differentiated people have chaotic personal lives and depend heavily on others to sustain them. offspring innately responding to their parents' moods. This impact of differentiation on overall life functioning explains the marked variation that typically exists in the lives of the members of a multigenerational family. The highly differentiated people have unusually stable nuclear families and contribute much to society. The multigenerational transmission process not only programs the levels of "self" people develop. The Multigenerational Transmission Process This process entails the way family emotional processes are transferred and maintained over the generations.5. As these processes repeat over multiple generations. for example. Both types of programming affect the selection of a spouse. For example. The transmission occurs on several interconnected levels ranging from the conscious teaching and learning of information to the automatic and unconscious programming of emotional reactions and behaviours. and actions.

with the encouragement of her father. once after an overdose of tranquilizers. She asked herself how she could grow up in a seemingly "normal" family and have so many problems. but felt his father made the family situation worse by opting for "peace at any price. In time. She worried about making the wrong decision and turned frequently to her mother for help. as one needing special guidance. Martha's mother learned to thrive on taking care of others and being needed. Michael's mother began having frequent bouts of serious depression about the time he started grade school. She managed the intensity with her mother with emotional distance. but Martha largely blamed herself for her difficulties making decisions and functioning independently. but her mother's actions did not match her words. did much of the caretaking of her invalid mother. insisting she could do more for herself if she would try. especially during his adolescence. but he distanced from family tensions. only doing things for her because she demanded it.] Martha's mother is the oldest child in her family and functioned as a second parent to her three younger siblings. As a child. Martha's grandmother responded to the criticism by taking to bed.mother. Martha felt she could not please her mother. Michael related to his mother almost exactly like his father did. She accused him of not really caring about her. and the projection process focused primarily on Martha. a pattern that played out with Martha. 46 . and answered herself that there must be something wrong with her. but the styles of the involvements were different. but viewed her as helpless and incompetent. Martha detested herself for needing the acceptance and approval of others to function effectively and for feeling she could not act more independently. Martha's sisters came to view her much like their mother did and treated her as the baby of the family. He cared about her and felt she would help him in any way she could. [Analysis: The primary relationship pattern in Martha's family of origin was impairment of one or more children. She experienced her mother as competent and caring but often intrusive and critical. She was twice hospitalized psychiatrically. Martha's mother was intensely involved in the triangles with her parents and younger siblings and in the position of overfunctioning for others. He resented her "not trying harder. Martha's mother functioned as a second mother in her family and. He met Martha when he attended college in the Midwest. Her father was often critical of his wife. In other words. When she faced important dilemmas in her life and had decisions to make. These basic patterns were later replicated in her marriage and with Amy. Michael's mother worshiped Michael and was jealous of interests and people that took him away from her. Her mother said Martha should make her own decisions. Martha's mother basked in the approval she gained from both of her parents. Her sisters seemed to feel more secure and competent than Martha. Martha's intense need for approval and acceptance reflected the high level of involvement with her mother. His mother expressed resentment about her husband's passivity. often for days at a time. The mother's overfunctioning promoted Martha's underfunctioning. she learned to meet her strongly programmed needs for emotional closeness by taking care of others. her mother got involved and strongly influenced Martha's choices.] Michael grew up as an only child in an intact family from the Pacific Northwest. Michael felt "allergic" to his mother's many problems and kept his distance from her. [Analysis: Martha's mother probably had almost as intense an involvement with her parents as she subsequently had with Martha. Two relationship patterns dominated Martha's mother's nuclear family: dysfunction in one spouse and overinvolvement with a child." He had a reasonably comfortable relationship with his father." It was easier for his father to give in to his wife's sometimes childish demands than to draw a line with her. especially from her father. Martha's father was sympathetic with her one-down position in the family. One of her mother's biggest fears was that Martha would make the wrong decision. Martha's mother's mother became a chronic invalid after her last child was born.

She met Michael's father when they were both in college. His mother was intensely involved with him and it programmed Michael both to need this level of emotional support from the important female in his life. but also to react critically to the female's neediness. she quit school to marry him. She had a very conflictual relationship with her mother and an idealized view of her father. Michael's parental triangle was similar to Martha's mother's parental triangle. Michael's father had been at loose ends when he met his future wife. He functioned higher in his work life than in his family life.[Analysis: Interestingly. Michael's parental triangle also fostered a belief that he knew best. He built a very successful business career with her emotional support. She was an excellent student and athlete.] 47 .] Michael's mother had been a "star" in her family when she was growing up. a discrepancy that is commonly present in people with mid-range levels of differentiation of self. Her parents were very upset about the decision. He was two years older than she and when he graduated. [Analysis: Michael's father functioned on a higher level in his business life than in his family life. but she was what he needed.

his younger brother may become a "functional oldest. two youngest children are prone to struggle over who gets to lean on whom. The basic idea is that people who grow up in the same sibling position predictably have important common characteristics. The oldest sibling was more likely to be seen as overly responsible and mature. For example. When one partner behaves a certain way. and the youngest as overly irresponsible and immature for example. An oldest child whose parents are both youngests encounters a different set of parental expectations than an oldest child whose parents are both oldests. and thus was more or less likely to fit some projections. she usually has some of the characteristics of both a younger sister of a brother and an older sister of a sister. For example. They may be drawn to each other because both believe the other is mature and responsible. of course. Consequently. oldest children tend to gravitate to leadership positions and youngest children often prefer to be followers." Sibling Position Bowen theory incorporates the research of psychologist Walter Toman as a foundation for its concept of sibling position. however. For example. but their leadership style typically differs from an oldest's style. He is the chronologically younger child. In the second case.6. For example. An older brother of a brother and an older sister of a sister are prone to battle over who is in charge. • • Think of the oldest sibling who grows up and partners with a person who was also an oldest sibling." filling a void in the family system. The concept of differentiation can explain some of the differences. A youngest child who is anxiously focused on may become an unusually helpless and demanding person. an oldest child who is anxiously focused on may grow up to be markedly indecisive and highly reactive to expectations. if an older brother of a younger sister marries a younger sister of an older brother. the rank positions are not complementary and neither spouse grew up with a member of the opposite sex. Alternately. less chance of a divorce exists than if an older brother of a brother marries an older sister of a sister. the other might think "This is exactly how my older/younger sibling used to act. The sibling positions of a person's parents are also important to consider. Sibling Position Bowen stressed sibling order. an oldest sibling might have a relationship with someone who was a youngest sibling. but develops more characteristics of an oldest child than his older brother. People in the same sibling position. The characteristics of one position are not "better" than those of another position. However. two mature youngest children may cooperate extremely effectively in a marriage and be at very low risk for a divorce. Bowen observed the impact of sibling position on development and behaviour in his family research. For example. but are complementary. a boss who is an oldest child may work unusually well with a first assistant who is a youngest child. In contrast. if a girl has an older brother and a younger sister. Youngest children may like to be in charge. Middle children exhibit the functional characteristics of two sibling positions. believing that each child had a place in the family hierarchy. exhibit marked differences in functioning. rather than being comfortable with responsibility and leadership. he found Toman's work so thorough and consistent with his ideas that he incorporated it into his theory. 48 . The sibling or rank positions are complementary in the first case and each spouse is familiar with living with someone of the opposite sex. Toman's research showed that spouses' sibling positions affect the chance of their divorcing.

Martha's mother was a not very well differentiated oldest daughter. Michael's mother was the more focused on child when she was growing up. helpless. even when she was depressed and overwhelmed. As an only child. In many ways. Furthermore. [Analysis: Michael's only child position makes him a somewhat reluctant leader in his nuclear family. a focus that took the form of high performance expectations coupled with considerable family anxiety about her ability to meet those expectations. her father being a youngest and her mother an oldest favored her mother's functioning setting the tone in the family. Michael's Martha's sibling positions and those of their parents adds to the understanding of how things played out in their lives. Michael's father is the younger brother of a sister and his mother is the older sister of a brother. like Martha's mother. Despite being in the one-up position in the marriage. In other words.] father was quite dependent on his wife for affirmation and direction. Her life energy focused on taking care of and directing others to the point that she unwittingly undermined the functioning of her youngest daughter.] 49 . and mostly selfblaming person. has the moderately exaggerated traits of a youngest child. her mother was quicker to act than her father in face of problems.Example: Knowledge of Michael and Martha Michael is an only child who. His emotional programming in that triangle made him a perfect fit with Martha. Martha played out the opposite side of the problem by becoming an indecisive. was raised in a family with a mother who had many problems. Furthermore. He wants Martha to function better and to take more responsibility. Martha's mother is the oldest of four siblings and was raised in a family with a mother who was a chronic invalid. the pattern of functioning of the triangle with his parents was the major influence on Michael's development. by virtue of her mother's focus on her. Martha's father was the youngest brother in a family of five children. he is as dependent on Martha as his father was dependent on his wife. [Analysis: Martha. He is unhappy feeling the pressure himself. Martha is the youngest of three girls and was the most intensely focused on child in her family.

people who cut off their family are more likely to repeat the emotional and behavioural patterns they were taught. but the problems are dormant and not resolved. but they do not know how to be "emotionally free" and raise a family as they believe other families would. This makes him vulnerable to pressuring them to be certain ways for him or accommodating too much to their expectations of him out of fear of jeopardizing the relationship. • • In some cases. they model the same values and coping patterns in their adult family that they were taught in their childhood family without realizing it. Everyone has some degree of unresolved attachment to his or her original family. 50 . For example. It may be easier for the parents if an adult child keeps his distance. The siblings of a highly cutoff member often get furious at him when he is home and blame him for upsetting the parents. but may not recognize some of the problems associated with being so emotionally unrestrained. It may take the form of surface harmony with powerful emotional undercurrents or it may deteriorate into shouting matches and hysterics. siblings. but the old interactions usually surface within hours. Relationships may look "better" if people cutoff to manage them. children. Emotional Cutoff The concept of emotional cutoff describes people managing their unresolved emotional issues with parents. People often look forward to going home. This entails a complete or almost-complete separation from the family. or it can be reduced by people staying in physical contact with their families but avoiding sensitive issues. and may look and feel completely independent from the family. An unresolved attachment relates to the immaturity of both the parents and the adult child. however. the more a man cuts off from his family of origin. but risk making their new relationships too important. For example. People who are cut off may try to stabilize their intimate relationships by creating substitute "families" with social and work relationships. and so it is very hard to "do something different. but the patterns people are trying to escape eventually emerge and generate tensions. or (2) a person feels guilty when he is in more contact with his parents and that he must solve their conflicts or distresses. Because of this. but the sensitivities of all parties preclude comfortable contact. if any. The family gets so anxious and reactive when he is home that they are relieved when he leaves. the more he looks to his spouse. Bowen believed that people tend to seek out partners who are at about the same level of individuation. Emotional Cutoff This refers to an extreme response to The Family Projection Process. Thus. However. They do not have another internal model for how families live. In other cases. and other family members by reducing or totally cutting off emotional contact with them. New relationships are typically smooth in the beginning. Emotional contact can be reduced by people moving away from their families and rarely going home. they fail to realize the adaptive characteristics of their family and role models. People do not want it to be this way. but well-differentiated people have much more resolution than less differentiated people. some parents from emotionally constrained childhood families might discover ways to be "emotionally unrestrained" in their adult families. hoping things will be different this time.7. or (3) a person feels enraged that his parents do not seem to understand or approve of him. The person will have little. An unresolved attachment can take many forms. but people typically blame themselves or others for the problems." Thus. some parents from emotionally constrained families may resent how they were raised. contact. or the benefits of being emotionally constrained in some cases. and friends to meet his needs. as well as the compensatory roles played in a complex family. (1) a person feels more like a child when he is home and looks to his parents to make decisions for him that he can make for himself. they consciously attempt to be very different as parents and partners. People reduce the tensions of family interactions by cutting off. Both the person and his family may feel exhausted even after a brief visit.

but she talked at length about Amy to Michael's mother. Martha. but they talked mostly about Michael's job and what his Dad was doing in retirement. People commonly have a "stickier" unresolved emotional attachment with their mothers than with their fathers because the way a parental triangle usually operates is that the mother is too involved with the child and the father is in the outside position. and the issues in their marriage. [Analysis: Michael blamed his mother for the problems in their relationship and. Amy was more vulnerable because of the anxious focus on her. When Michael got a good job offer on the East coast. Michael did not say much to his parents about Martha's drinking or about the tensions in their marriage. One difference was that her parents came east fairly often. both of them were eager to move east. as her problems mounted. [Analysis: Frequently one or more family members get sick leading up to. She never failed to ask if his company could transfer him closer to home. Michael called home every weekend and managed to combine business trips with brief stays with his parents. emotional cutoff clearly did not solve any problems. Martha's mother would get more worried about Martha and critical of both her drinking and of how she was raising Amy. They did not look forward to the four days they would spend there. but they welcomed the physical distance from their families. It was much less depressing for Michael to talk to his father. Martha's mother pumped Michael for information about Martha when Martha was reluctant to talk. during. but Michael's mother thrived on having them. however. especially Michael's mother. They told their families they were moving away because of Michael's great job offer. despite his guilt. [Analysis: Given the striking parallels between the unresolved issues in Michael's relationship with his family. Martha would sometimes participate in Michael's phone calls home but. He did not look forward to the phone calls and usually felt depressed after them. He would report on how the kids were doing.] In the early years. Martha never said anything to Michael's parents about her drinking or the marital tensions. Martha dreaded these exchanges with her mother and complained to Michael for days after her parents returned home. or soon after trips home. It simply shifted the problems to their marital relationship and to Amy. Michael felt guilty about living far away from his parents and his parents were upset about it. When they came. Martha's relationship with her family. Michael. Deep down. and the kids usually made one visit to Michael's parents each year.Example: Neither Michael nor Martha wanted to live near their families. Martha felt her mother was right about her deficiencies.] Martha followed a pattern similar to Michael's in dealing with her family. Amy often developed middle ear infections during or soon after these trips. Michael was all too willing to discuss Martha's perceived shortcomings with her mother. He felt as if his mother deliberately put him on "guilt trips" by emphasizing how poorly she was doing and how much she missed seeing him. felt justified distancing from her. she usually left the calls to Michael.] 51 .

The current regression seems related to factors such as the population explosion. and persecution must pass on to their children the ways they learned to survive these factors. an increasing divorce rate. Example: It is more difficult for families to raise children in a period of societal regression than in a calmer period. the parents give in to the child more than they hold the line. like a family in a regression. continue until the repercussions stemming from taking the easy way out on tough issues exceeded the pain associated with acting on a long-term view. a greater polarization between racial groups. The parents try to control the child but are largely ineffectual. Bowen predicted that the current regression would.. Many in the juvenile court system considered the delinquent as a victim of bad parents. this is like The Family Projection Process scaled up to the level of a society as a whole. a sense of diminishing frontiers. less principled decision-making by leaders. The "symptoms" of societal regression include a growth of crime and violence. The downward spiral in families dealing with delinquency is an anxiety-driven regression in functioning.8. the behaviours for each gender. discrimination. a more litigious attitude. the legal system. they often face lawsuits from irate parents. an increase in bankruptcy. Human societies undergo periods of regression and progression in their history. such as in schools and governments. The coping practices of the parents and extended family may lead to more or less adaptive emotional health for the family and its members. The concept of societal emotional process describes how the emotional system governs behaviour on a societal level. The child feels controlled and lies to get around the parents. In the litigious climate. and a focus on rights over responsibilities. and their effect on the family. This recognition of a change in one societal institution led Bowen to notice that similar changes were occurring in other institutions. promoting both progressive and regressive periods in a society. A regressive pattern began unfolding in society after World War II. In many ways. 52 . such as work and social organizations. "We love you no matter what you do.. If the delinquent became a frequent offender. The parents in such families give the message. He is indifferent to their punishments. the nature of sexual orientation. Families that deal with prejudice. Cultural forces are important in how a society functions but are insufficient for explaining the ebb and flow in how well societies adapt to the challenges that face them. expressed its disappointment and imposed harsh penalties. They tried to understand him and often reduced the consequences of his actions in the hope of effecting a change in his behaviour. Societal Emotional Processes These processes are social expectations about racial and class groups. A loosening of standards in society makes it more difficult for less differentiated parents like Michael and Martha to hold a line with their children. It worsened some during the 1950s and rapidly intensified during the 1960s. Societal Emotional Process Each concept in Bowen theory applies to nonfamily groups. In a regression. The grade inflation in many school systems makes it easier for students to pass grades with less work. people act to relieve the anxiety of the moment rather than act on principle and a longterm view. Bowen discovered that during the 1960s the courts became more like the parents of delinquents. if schools try to hold the line on what they can realistically do for their students. He predicted that will occur before the middle of the twenty-first century and should result in human beings living in more harmony with nature. The child rebels against the parents and is adept at sensing the uncertainty of their positions. and the depletion of natural resources. much like the parents. Bowen's first clue about parallels between familial and societal emotional functioning came from treating families with juvenile delinquents. the drug abuse epidemic." Despite impassioned lectures about responsibility and sometimes harsh punishments.

When children like Amy report that they feel distant from their parents and alienated from their values. 53 . Parents are criticized for being too busy with their own pursuits to be adequately available to their children. the parents' critics fail to appreciate the emotional intensity that generates such alienation. Using the child's problems as justification for increasing the focus on them is precisely what the child focused parents have been doing all along. The current societal regression is characterized by an increased child focus in the culture.The prevalence of drug and alcohol abuse gives parents more things to worry about with their adolescents. Much anxiety exists about the future generation. People who advocate more focus on the children cite the many problems young people are having as justification for their position. The critics prod the parents to do more of what they have already been doing. both to support them and to monitor their activities. A more constructive direction would be for people to examine their own contributions to societal regression and to work on themselves rather than focus on improving the future generation. An increase in the problems young people are having is part of an emotional process in society as a whole.

such as when a minority family moves from a like-minority neighborhood to a very different neighborhood. The therapist helps the individual stop seeing family members in terms of the roles (parent. the loss of the family home.Normal Family Development To Bowen. all families lie along a continuum.) they played.. and flaws. and thus have members who believe the family is a good one have members who use each other for feedback and support rather than for emotional crutches Family Disorders Bowen believed that family problems result from emotional fusion. sibling. Thus. and thus can support differentiation are aware of influences from outside the family (such as Societal Emotional Processes) as well as from within the family allow each member to have their own emptiness and periods of pain. 54 . The member "absorbs" the anxiety and worries of the whole family and becomes the most debilitated by these feelings. However. and start seeing them as people with their own needs. Families face two kinds of problems. The individual client should have good insight into the family (genograms may be especially helpful in this). and thus the one who has the least ability to resist the pull to become fused with another member. Such therapy typically focuses on differentiation of the person from the family. The worst case for the family is when vertical and horizontal problems happen at once. without rushing to resolve or protect them from the pain and thus prohibit growth preserve a positive emotional climate. the member with "the symptom" is the least differentiated member of the family. and be very motivated to make changes either in his or her own life. This may result from traumas such as a chronic illness. or when a family with traditional gender roles immigrates to a culture with very different views. or in the family. Fogarty offers that adjusted families • • • • • • • • • • are balanced in terms of their togetherness and separateness. The individual learns to recognize triangulation. or from an increase in the level of anxiety in the family. or the death of a family member. and can adapt to changes in the environment view emotional problems as coming largely from the greater system but as having some components in the individual member are connected across generations to extended family have little emotional fusion and distance have dyads that can deal with problems between them without pulling others into their difficulties tolerate and support members who have different values and feelings. Family Therapy with One Person Family therapy can be done with one person. there really are no "types" of families. and must raise their children there. and take some ownership in allowing or halting it when it happens. While you might try to classify families as falling into discreet groups. Vertical problems are "passed down" from parent to child. horizontal stress may also result from Social Emotional Processes. and so pass down their own problems to their children. Bowen believed that optimal family development occurs when family members are differentiated. Typically. strengths. adults who had cold and distant relationships with their parents do not know how to have warm and close relationships with their children. caretaker. and most families of one type could become a family of another type if their circumstances changed. Horizontal problems are caused by environmental stressors or transition points in the family development. and maintain a rewarding and healthy emotional contact with each other. feel little anxiety regarding the family. Bowen was among the first of the culturally sensitive family therapists. In many ways.. or who has the least ability to separate their own thoughts and feelings from those of the larger family.

and models skills. coaches and consults with the family. which is the critical factor in change. especially of the adult couple. as often a single member can spur changes in the larger family. in economic power and gender role socialization (this is a contribution of those who have reconsidered Bowen's theory through a feminist lens) In general.." and help members see the dynamic occurring. using "I" statements is one way to help family members separate their own emotions and thoughts from those of the rest of the family develops a personal relationships with each member of the family and encourages family members to form stronger relationships too encourages cut off members to return to the family may use descriptive labels like "pursuer-distancer. open conflict is prohibited as it raises the family members' anxiety during future sessions remains neutral and detriangulated. Techniques Bowen did not believe in a "therapeutic bag of tricks. transition more effectively to parenthood. and more attention to family patterns of emotions and relationships. as well as how adaptive they can be to future changes addressing the power differential in heterosexual couple based on differences. visiting mother-in-laws. to speed things up." Questioning the family and constructing a family genogram are the closest things to basic techniques all Bowenian therapists would use.. and in effect models for the parents some of what they must do for the family promotes differentiation of members. and encourages letter writing to distant members. for example. while working with the pursuer to create a safe place in the relationship invites the distancer back. distance. so as to increase their ability to manage their own anxiety. following distancers only causes them to run further away. and thus fortify the entire family unit's emotional wellbeing using the therapist as part of a "healthy triangle" where the therapist teaches the couple to manage their own anxiety. He will also use stories or films to present another real or imaginary family with the same problem as the family in therapy. 55 . Guerin accepts the family's opinion of who "has the problem" and works from there with a variety of techniques to help all family members own some responsibility for helping that sick member get better. and highlight how the family in the story or film overcame their difficulties. Carter has assigned tasks to the adult couple to help them realize more about their family history. the therapist • • • • • • • tries to lower anxiety (which breeds emotional fusion) to promote understanding. interrupts arguments. and closeness in healthy ways forming relationships with the family member with "the problem" to help them separate from the family and resist unhealthy triangulation and emotional fusion opening closed ties with cut off members focusing on more than "the problem" and including the overall health and happiness of the family evaluating progress of the family in terms of how they function now. as well as family structures of dyads and triangles.. More specifically..Goals of Therapy Treatment entails • • • • • • • • • reframing the presenting problem as a multigenerational problem that is caused by factors beyond the individual lowering anxiety and the "emotional turmoil" that floods the family so they can reflect and act more calmly increasing differentiation. the therapist accomplishes this by giving less attention to specific problem they present with.

emotional systems (the nuclear family emotional system. unresolved stress between parents reverberates down through all family inter-relations and normally results in coalitions. Example: Mom is a rageaholic.Bowen’s Strategic Family Therapy . whereas a systems approach would focus on the present-time context of Mom's explosions. According to Bowen. Bowen (1966. 1) Bowen paid attention to the spousal relationship and the definition and clarification of the couple's relationship. Of these. Dad and Brother console one another and perhaps agree that she's nuts. emotional parent-child alignments against the other parent and perhaps other children. emotional cutoff). A linear approach would emphasize Mom's upbringing and lack of anger management skills and thereby ignore the coalition process itself and reinforce its tendency to scapegoat. systemwide ripples ("these cause each other") emphasized more than linearity (this causes that). societal regression. the family projection process and the multigenerational transmission process. A basic assumption in Bowen family therapy is that unresolved emotional fusion (or attachment) to one's family must be addressed if one hopes to achieve a mature and unique personality. Interrelations emphasized more than components. looking at the interactions leading up to it and encouraging Dad and Mom to work out new. because a predictable pattern of interpersonal relationships connects the functioning of family members across generations. Whatever its components. the cause of an individual's problems can be understood only by viewing the role of the family as an emotional unit. the major contributions of Bowen's theory are the core concepts of differentiation of the self and triangulation. 1976) identifies eight key concepts as being central to his theory that can be grouped into four areas of assessment: 1) 2) 3) 4) Spousal relationships de-triangulation (triangulation) differentiation (differentiation of the self. 56 . sibling position. He focused on helping families develop individual identities for each member while maintaining a sense of closeness and togetherness with their families. sibling position). so when she explodes.II Murray Bowen’s approach operates on the premise that a family can best be understood when it is analyzed from at least a three-generation perspective. nonescalating ways to talk and negotiate--perhaps in couples therapy--rather than blaming her or him or failing to confront and defuse alliances forming elsewhere in the family.

For example. two people may recruit a third person into the relationship to reduce the anxiety and gain stability. 57 . This refers to the degree to which individuality is maintained in a system. His focus on couples led him to believe that there was directional movement within family triangles that almost always included a pursuer and a distancer. Thus one or more children may become problematic as a result of being triangulated into their parents’ relationship. three people create one triangle. This is called triangulation. The first is the level of differentiation .2) Triangulation – A situation in which two family members involve a third family member in a conflictual scenario. Anticipating and diffusing triangulating maneuvers forces the parties to focus on the problem. but it has only been projected onto the child. When a parent lacks differentiation and confidence in her or his role with the child. This refers to the amount of emotional tension in a system. Under stressful situations. Other successful strategies in remaining de-triangled are seriousness and humor. the underlying conflict is not addressed. whether they are expressed in emotional fusion or emotional cutoff. Triangulation and Nuclear Family Emotional System. or a higher level of anxiety produce more triangling. and in the long run the situation worsens: What started as a conflict in the couple evolves into a conflict within the nuclear family emotional system. Bowen (1978) identifies two variables important in determining why triangles occur in relationships. Similarly. they will tend to couple and create a family in which these unresolved issues can be re-enacted. four people create four interlocking triangles and five people create nine interlocking triangles etc. leading to conflict. When tension arises between two people and a third is engaged to relieve the tension it is called triangulation . they may focus on their offspring. For him. 2000).” and the other parent is often in the position of calming and supporting the distraught parent. The second variable is the level of anxiety . Such a triangle produces a kind of pseudo stability for a while: the emotional instability in the couple seems to be diminished. Although triangulation may lessen the emotional tension between the two people.: when parents have unresolved and intense conflicts. This family projection process makes the level of differentiation worse with each subsequent generation (Papero.g. Each triangle has two positive sides and one negative side. The most common form of triangulation occurs when two parents with poor differentiation fuse. the former was a structure that existed in all families while the latter was an emotional process. The family projection process has now become the foundation for multigenerational transmission. Instead of fighting with each other. anxiety and ultimately the involvement of a child in an attempt to regain stability. E. Bowen (1976) notes that anxiety can easily develop within intimate relationships. A low level of differentiation. The child is now declared to “have a problem. Thomas Fogarty introduced to Bowen theory a distinction between triangles and triangulation. a series of interlocking triangles is created. Bowen considers de-triangulation of self from the family emotional system. When a child leaves the family of origin with unresolved emotional attachments. the conflict between the parents also may involve the triangulation of the child(ren) as interpreters of one to the other. the parents are temporarily distracted by riveting their attention on their child(ren). Family Projection Process and Multigenerational Transmission. the child also becomes fused and emotionally reactive. When tension is greater than what the three person system can handle.

Each subsystem contains its own subject matter that is private and should remain within that subsystem. and . changing alignments replace rigid coalitions. Undifferentiated people have difficulty in separating themselves from others and tend to fuse with dominant emotional patterns in the family. (Disengagement: too much emotional distance between family members. A family may have several subsystems such as a spouse. sibling. Functional families are characterized by each member's success in finding the healthy balance between belonging to a family and maintaining a separate identity. . One way to find the balance between family and individual identity is to define and clarify the boundaries that exist between the subsystems. and behaviours. lines of authority are visible.These were complementary relational positions whereby . rules are overt and flexible. interactions are clear and nonrepetitive. especially during times of stress. Enmeshment: inappropriate. . people at similar levels of differentiation tend to seek out and find each other when coupling. and often finds comfort in necessary tasks rather than relationship. Differentiation – The ability of an individual to separate rational and emotional selves. human systems tend to work best when subsystem boundaries are clear (neither too open nor too closed). 58 .the distancer is less expressive of thoughts and feelings.they are emotionally reactive. The cornerstone of Bowen's theory is differentiation of the self. and parent-child subsystem.they are unable to take a clear position on issues: Self-differentiation was Bowen’s principal goal of family therapy. that is. Differentiated individuals are able to choose to be guided by their thoughts rather than their feelings. One pseudo-self relies on another pseudo-self for emotional stability. Families who do not understand and respect these differences find themselves in a dysfunctional state of conflict. One of the most common family problems is a weak boundary between subsystems Diffuse boundaries can lead to over-enmeshment. 3) Differentiation Of The Self and Emotional Cutoff. boundary-violating closeness in which family members are emotionally overreactive to one another Rigid boundaries allow too little interaction between family members.the pursuer is someone who wants lots of relational contact.) Overall. they have a pseudo-self. Boundaries between subsystems range from rigid to diffuse. feelings. and stressors are confronted instead of pushed onto scapegoats Families who understand and respect differences between healthy and unhealthy subsystem boundaries and rules function successfully. which may result in disengagement. which involves both the psychological separation of intellect and emotion and independence of the self from others.These people have a low degree of autonomy. Bowen would model differentiation to his clients by using "I" statements and taking ownership of his own thoughts. . People who are fused to their families of origin tend to marry others to whom they can become fused.

is easily seen in clients who present themselves as paranoid. Symptoms occur when vertical stressors (old issues. panic stricken. intensely anxious. emotional legacies) impinge on the system during a transition. 59 . They contend that problems that are manifest in one's current family will not significantly change until relationship patterns in one's family of origin are understood and addressed. feelings. and a recognition of feelings. a focus on facts and knowledge. does not imply that one has differentiated. feelings have overwhelmed thinking and reason. and people experience themselves as being unable to choose a different reaction. the sound of a male’s voice in a family session reminds the therapist of his father and immediately triggers old feelings of anger and anxiety as well as an urgency to express them. however. rather than being dominated by them: Such people achieve what Bowen sometimes referred to as a solid self (Becvar & Becvar. Emotional reactivity in therapists almost always relates to unresolved issues with family-of-origin members. Differentiation from the family of origin allows one to accept personal responsibility for one’s thoughts. Individuation. Clarity of response in Bowen’s theory is marked by a broad perspective. Bowen therapists are mainly interested in changing the individuals within the context of the system. past mistakes. 4) Understanding family emotional systems and how they work is central to Bowen's theory. Bowen’s phrase for estrangement or disengagement is emotional cutoff. For example. Emotional reactivity. Change must occur with other family members and cannot be done by an individual in a counseling room. or psychological maturity. The family projection process refers to how parents pass good and bad things on to their children. their reactions are not automatic but involve a reasoned and balanced assessment of self and others. in contrast. Indeed. Although all family therapists are interested in resolving problems presented by a family and decreasing symptoms. Living systems and all the other system-related processes--move forward through key "horizontal" transitional stages (brought about by time and change). perceptions. the key to being a healthy person encompasses both a sense of belonging to one's family and a sense of separateness and individuality. is a lifelong developmental process that is achieved relative to the family of origin through reexamination and resolution of conflicts within the individual and relational contexts.” In these cases.Unproductive family dynamics of the previous generation are transmitted from one generation to the next through such a marriage (Becvar & Becvar. In family systems theory. The nuclear emotional process refers to how the family system operates in a crisis. a strong indication of an undifferentiated self. The distinction between emotional reactivity and rational thinking can be difficult to discern at times. 2003). The multigenerational transmission process refers to how a family passes its good and baggage between generations Bowen focused on how family members could maintain a healthy balance between being enmeshed (overly involved in each other’s lives) and being disengaged (too much detachment from each other). and actions. an appreciation of complexity. or even “head over heels in love. 2003). Those who are not emotionally reactive experience themselves as having a choice of possible responses. Emotional problems will be transmitted from one generation to the next until unresolved emotional attachments are dealt with effectively. Simply leaving one’s family of origin physically or emotionally.

2. Calibration: setting of a present-oriented. and then. children going to school. the male only child. the youngest brother of brothers. for example. is too low. 4. the oldest brother of brothers. the drama escalates. a good dose of constructive intensity might recalibrate the bias and make explosions unnecessary. "Why not skip your AA meeting tonight so we can catch a movie?" Or the mother of a teen who's quit using congratulates him on finding a job--in a head shop. examine his expectations of himself." A typical situation: an unintense family with a cool emotional atmosphere unconsciously selects a member to turn up the heat. Example: a workaholic husband driven to succeed by high internalized standards that equate esteem with production (vertical stressor) puts in even more overtime to stuff the loneliness he feels when his eldest son leaves for college (horizontal stressor). etc. the emotional level setting. Self-regulating via feedback loops--negative (toward stability) and positive (toward change)--that maintain the bias. In addition to noting the unique positions of only children and twins. both parties would enter the marriage with similar expectations about power and gender relationships. brother and sister start fighting. is hypothesized to be the oldest brother of sisters marrying the youngest sister of brothers. coincide with a resurfacing of vertical stressors like old emotional baggage. In this case. In that family the bias. Sibling Position. relapses and resistance to change and examining what family members gain from having a malfunctioning member (control? A scapegoat? Distraction from other conflicts? Someone to rescue?). Every seasoned drug and alcohol counsellor knows that when one member of the family stops drinking or using. and reconnect with his family. a child who plays the role of family ambassador calms everybody down. Introducing positive (= system-changing) feedback loops into these families might include warning them about enabling. 6 – 10 and the same five configurations for females in relation to sisters and brothers. part of the therapeutic agenda would include giving the family tools for negotiating the "empty nest syndrome" while helping the husband get in touch with his mourning. the worst marriage would occur between the oldest brother of brothers and the oldest sister of sisters. but because families. naturally resist changes that might further destabilize the system. Conversely. in this arrangement. Under this conceptualization. like other organisms. changes of jobs. 5. In this case. 3.Families are likeliest to be conflicted and symptomatic when key horizontal transitions like marriage. systemwide range limit around a comfortable emotional "bias. the birth of children. children moving away from home. the family will subtly try to push him back into his old vices--not because they want him sick. Toman focused on ten power/sex positions: 1. both parties would seek and want power 60 . and gender experience determined one’s ability to get along with the other sex. the oldest brother of sisters. before it gets too hot. Bowen adopted Toman’s (1993) conceptualization of family constellation and sibling (or birth) position. the best possible marriage. the youngest brother of sisters. This turns into an argument between the parents. So one day the husband says to his abstaining wife. Toman believed that position determined power relationships.

chronic marital conflict. the lack of it suggests to Guerin that there is intense triangulation between the parents and children. & Kautto. in a child.underadequate reciprocity.positions. is not the same as a happy marriage. his predictions based on birth order start to lose credibility. however. He did not tell clients what to do. mother-child symbiosis when unresolved predisposes to schizophrenia. theory is important. Dysfunctional reciprocal relationships: include overadequate/underadequate. The practice of Bowen family therapy is governed by the following two goals: (1) lessening of anxiety and symptom relief and (2) an increase in each family member's level of differentiation of the self (Kerr & Bowen. The sibling cohesion factor is the capacity of the children within the sibling subsystem to meet without their parents and discuss important family issues. 1996). Other concepts: Emotional divorce (like when a sick child holds the parents together). no one ever really leaves the family system. Healthier families tend to have this factor as part of the family process. Two natural forces: growth of individual and emotional connection. Fogarty. Toman supported his hypothesis by noting that the divorce rate among couples comprised of two oldest children was higher than any other set of birth positions. 61 . Three outcomes of fusion: physical or mental dysfunction in a spouse. 1994. especially when there were more than two children in the sibling subsystem. decisive/indecisive. Emphasized the first. hysterical/obsessive. and neither would have had enough childhood experience with the other sex to have adequate gender relationships. schizoid/conflict. Bowen encouraged his clients to come to know others in their family as they are. pseudoself. it is necessary to open closed family ties and to engage actively in a detriangulation process (Guerin. Fay. Fusion breeds anxiety and increases emotional reactivity. siblings. including their evaluation of their parents. over. When we consider the critical traits in a happy marriage. He instructed them how to be better observers and also taught them how to move from emotional reactivity to increased objectivity. 135). solid self vs. or cutoff between spouses. Guerin (2002) discussed the importance of what he called the “sibling cohesion factor” (p. 2003). Although problems are seen as residing in the system rather than in the individual. allowing for triangles to form. The absence of divorce. Happiness in coupling or marriage is demonstrably more related to attitudinal and behavioural interactions within the spousal system—especially during periods of family stress—than to birth order (Gottman. and extended family members. and he coached or guided them into new behaviours by demonstrating ways in which individuals might change their relationships with their parents. Walsh. 1988). the route to changing oneself is through changing in relationship to others in the family of origin. He helped individuals or couples gather information. but rather asked a series of questions that were designed to help them figure out their own role in their family emotional process. To bring about significant change in a family system. dominant/submissive.

Empirical studies show that on average: • • • Children with behaviour problems are more aligned with their mothers and more disengaged from their fathers than are the well-adjusted adolescents. Detouring: occurs when spouses ignore the issues in their own relationship and focus on the child's issues. Cross-generational coalition: exists when one parent sides with a child against another parent. All three family triangles are considered to have negative developmental effects on the child. The authors reviewed three family triangles: • • • Triangulation: occurs when a parent demands that a child side with her or him against the other parent. differences in dyadic interaction between families with a child with behaviour problems and families with a well adjusted child have been evaluated. mother-father-child triangles) are associated with child behaviour problems. the family triangle was defined as a family systems construct used to describe family communication patterns in which a dyad cannot cope with demands for intimacy or conflict resolution. Tests reveal that. the parents are more supportive of each other than the adolescent. For this reason the study considers the "impact of cross-generational coalitions on interpersonal intimacy and view intimacy as a developmental task relevant to young adults" Children with a cross-generational attachment have larger intellectual-intimacy. Within families of well-adjusted adolescents. In another study . emotional-intimacy and sexual-intimacy discrepancy scores. and promoting more positive father-adolescent relations will weaken the cross-generational coalition and ameliorate the symptomatic behaviour. c) the client becoming more objective and less emotional with his or her parents. This differs from triangulation because it is the parent who initiates the coalition and the attachment between the parent and the child exceeds that between the parents. • • • 62 . 2. Detriangulating involves: a) not talking with one parent about the other parent. triangles occur to reduce tension between two people.MORE ABOUT TRIANGLES 1.e. children are still affected by the family triangle. Cross-generational coalitions also affect the ability to successfully negotiate psycho-social developmental tasks. • They create a false sense of attachment and security and do not give the child the opportunity to develop a healthy separate identity. This suggests that strengthening the parental dyad through the resolution of marital problems. but are problematic because they do not provide solutions. Parents of children with behaviour problems have more discordant relations than the parents of well-adjusted adolescents. In studies of adolescent antisocial behaviour. As such. Cross-generational coalitions (i. b) teaching the client about triangulation patterns. "Detriangulating" can contribute considerably in resolving intimacy issues. even while away from home.

The families used rationalizations to maintain the equilibrium attained when the child took on the parents' problems." Often. This is what Vogel and Bell call "scapegoating". The child has few task which are vital in the maintenance of the family. The parents felt justified in depriving the children of things they wanted and then used the complaints to reinforce the scapegoating. 412) When parents experience crises for which they have no adequate coping mechanisms. parents would encourage opposing types of behaviour. because their life was better than the parents. he helped the two adults establish their own differentiation. They focus their attentions on the problems of the child so they can avoid the pain of admitting their own problems. Children were also picked because they possessed the same undesirable traits (either physically. a change in one part of the system affects the actions of all others involved.W. The child's personality is very flexible and adopts quickly to the assigned role of scapegoat. This set up a self-perpetuating cycle which "normalized" the child's problems. behaviourally or emotionally) as the parent. There were many reasons why the child was selected as the scapegoat.Because the family is not a static entity. N. were the victims. He did not require that every family member be involved in the therapy sessions. 63 . The dysfunction became part of the family. If the therapist becomes emotionally entangled with any one family member. The dysfunction would be both supported and criticized. • • One rationalization was that the parents. The Emotionally Disturbed Child as the Family Scapegoat. Once the child is selected she or he must carry out the role of the problem child.F. The purpose of this study was to learn more about how "the emotionally disturbed child used as a scapegoat for the conflicts between parents and what the functions and dysfunctions of this scapegoating are for the family.or under-achieving) would be targeted. For example. they are likely to revisit those difficulties in every family they see. Many had physical abnormalities. Another was to emphasize how fortunate the child was. E. As a therapist. The authors found that the problem behaviour was reinforced through inconsistent parenting. the child was relatively powerless to leave the family nor to counter the parents triangulation. (1968). Bowen tended to work from the inside out: Starting with the spousal relationship. to be effective. and Bell. they look for ways to discharge some of the tension. parents often project their problems on to the child. If therapists still have unresolved family issues and are emotionally reactive. 3. rather than the children. In some cases. the chosen child would best symbolize the parental conflicts. he attempted to maintain a stance of neutrality. When the third person is their child. One of the most common methods is to involve a third person. In other instances parents promoted different norms. if the conflict was over achievement. the child who stood out most (for either over. The study also found that the scapegoated child had a (considerably) lower IQ than the other children. Vogel. All of the parents reported having had tensions since early in the marriage. the therapist loses effectiveness and becomes part of a triangulated relationship." (p. • • • • • First. "The cost in dysfunction of the child is low relative to the functional gains for the whole family. family therapists have to have a very high level of differentiation. Bowen sometimes worked with one member of a conflictual dyad (or couple). Bowen maintains that.

3) The third is the "Separated" relationship where both people focus their energy on their 3rd corner. the therapist can act as the third corner. The triangle is three points and those can be understood as three tendencies. One of the dysfunctions is that scapegoating creates "realistic problems and extra tasks" for the family." The article introduces seven different manifestations of the dual triangle construct. the placement of the"I" structures the future. Marks. At the same time. Bowen sees the couple as two corners of the triangle. • For the parents. 2) The second is the "Dependency-Distancing" relationship. This coordinates the self with a primary partner. eg job. The couple uses the third corner as a buffer against their tension. Each triangle has three corners. wherein all the energy is focused on the P . • 4. scapegoating serves to stabilize their relationship. A person whose "I" maintains some regular motion around and between all three corners has a high quality marriage. children. At any given moment one corner will be the focus of energy. The "I" is the presentation of the self at that moment or in that situation. That corner will then be the "I". A traditional concept in marriage therapy is "marital quality". (1989). The "Three Corners" model is a systems theory of the self in marriage. He has borrowed Margaret Mead's concept of "I" and "me" in describing the nature of the triangle. the driving force. S. Marks states "Quality of marriage is a consequence of the way married selves are systematically organized. Marks says that while this can be very healthy and stable. This rationalized sever punishment. The authors point out that there are both functions and dysfunctions of scapegoating. friends etc. The first three are low quality relationships. This is a traditional unhealthy female-male situation where the woman places energy on the partner and the partner (the man) places energy on the 3rd corner. Scapegoating permits the family to maintain its solidarity. The situation brings the "I" out of the "me". usually work. 1) The first corner is the Inner-self (I-corner). Marks' conception differs from Bowen's view of triangles in marriage.• Another common belief was that the child could behave if she or he wanted to. The third corner provides a distraction and relieves the marital pressure. Another is that the child often becomes very adept at fighting back and usually directs their aggression towards the everpresent mother. as a marriage is concerned it is low quality. Towards a systems theory of marital quality. 3) The third corner is any area where the self concentrates energy that is different from the first two corners. communities can scapegoat the family with the dysfunctional child. 64 . Marks (1989) suggests that relationships can be understood in terms of two intersecting triangles. This contrasts with the "me" which is an organization of tendencies. or three "me" corners. They were also better able to live up to the societal expectations of a happy marriage. religion. 1) The first triangle is the "Romantic Fusion". This is the traditional beginnings of a relationship. 2) The second is the Partnership (P-corner) corner. the present manifestation of the tendencies. In a marital therapy situation. These are characterized by a concentration of energy on one corner without a flow of energy to all parts. This becomes unhealthy after a while because other areas of the self are neglected. In therapy.

The last four triangles represent high quality marriages. There is a radical shift in the conception of the triangle. Because there is a constant flow of energy, the three points are connected by rounded lines, making a circle. This represents uninterrupted energy flow between the "me's". In a high quality marriage there is a multiplicity of healthy connections which are as dynamic and fluid as the energy. 4) The fourth is the "Balanced Connection" which has an equal concentration of energy. 5) The fifth is "Couple Centered". The energy is focused on the P , but differs from the second triangle in that the other "me's" receive energy. 6) The sixth is "Family Centered". Both people focus their energy on the family, which would be a joint 3rd interest. 7) The seventh is "Loose". The energy is focused on the 3rd , without detriment to the stability of the couple because, again, there is a steady flow of energy to the other corners.

Marks' (1989) concept of the self as a triangle is very useful and deserves more attention. A useful application would be in Slater's (1994) article on triangles in committed lesbian relationships. In his article, Marks does not discuss the possibility of energy revolving around the "I". This might reflect an assumption that there is a sufficient concentration on the "I" naturally, that the inner-self is the base of all the external interactions. This assumes a degree of differentiation that, developmentally, is traditionally more male than female. Slater points out that the affected partner needs consolidate her sense of identity and perceive it as originating within herself. This would result in the "I" in Marks' model to be the focus of energy. Without this option, the therapist would concentrate the affected partner on the "P" and miss the opportunity for individual growth. Criticisms on the triangle theory As exciting and varied as triangle theory is, there are valid criticisms. One is that the majority of the studies focused on dependence as being the dominant catalyst for problems. A good example is West (1986) who states : “In this enmeshed situation the child seems to experience a distorted sense of attachment, involvement, or belonging with the family and fails to experience a secure sense of separateness, individuality or autonomy. “ This implies that independence is more important than attachment, and given what we know about gender roles, that male characteristics are more important than female characteristics. The possible gender bias could be addressed by a study on the role of an overly-detached family member on the creation of triangles. This would look at the role that stereotypical male behaviour has on the other two members.


Salvador Minuchin’s Structural family therapy I
From Wikipedia, the free encyclopedia Structural Family Therapy (SFT) is a method of psychotherapy developed by Salvador Minuchin which addresses problems in functioning within a family. Structural Family Therapists strive to enter, or "join", the family system in therapy in order to understand the invisible rules which govern its functioning, map the relationships between family members or between subsets of the family, and ultimately disrupt dysfunctional relationships within the family, causing it to stabilize into healthier patterns.[1] Minuchin contends that pathology rests not in the individual, but within the family system. SFT utilizes, not only a unique systems terminology, but also a means of depicting key family parameters diagrammatically. Its focus is on the structure of the family, including its various substructures. In this regard, Minuchin is a follower of systems and communication theory, since his structures are defined by transactions among interrelated systems within the family. He subscribes to the systems notions of wholeness and equifinality, both of which are critical to his notion of change. An essential trait of SFT is that the therapist actually enters, or "joins", with the family system as a catalyst for positive change. Joining with a family is a goal of the therapist early on in his or her therapeutic relationship with the family.

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1 Family Rules 2 Therapeutic Goals and Techniques 3 See also 4 References

Family Rules
In SFT, family rules are defined as an invisible set of functional demands that persistently organizes the interaction of the family. Important rules for a therapist to study include coalitions, boundaries, and power hierarchies between subsystems.[1] According to Minuchin, a family is functional or dysfunctional based upon its ability to adapt to various stressors[2] (extra-familial, idiosyncratic, developmental), which, in turn, rests upon the clarity and appropriateness of its subsystem boundaries. Boundaries are characterized along a continuum from enmeshment through semi-diffuse permeability to rigidity. Additionally, family subsystems are characterized by a hierarchy of power, typically with the parental subsystem "on top" vis-à-vis the offspring subsystem. In healthy families, parent-children boundaries are both clear and semi-diffuse, allowing the parents to interact together with some degree of authority in negotiating between themselves the methods and goals of parenting. From the children’s side, the parents are not enmeshed with the children, allowing for the degree of autonomous sibling and peer interactions that produce socialization, yet not so disengaged, rigid, or aloof, ignoring childhood needs for support, nurturance, and guidance. Dysfunctional families exhibit mixed subsystems (i.e., coalitions) and improper power hierarchies, as in the example of an older child being brought in to the parental subsystem to replace a physically or emotionally absent spouse.


Therapeutic Goals and Techniques
Minuchin’s goal is to promote a restructuring of the family system along more healthy lines, which he does by entering the various family subsystems, "continually causing upheavals by intervening in ways that will produce unstable situations which require change and the restructuring of family organization... Therapeutic change cannot occur unless some pre-existing frames of reference are modified, flexibility introduced and new ways of functioning developed."[citation needed] To accelerate such change, Minuchin manipulates the format of the therapy sessions, structuring desired subsystems by isolating them from the remainder of the family, either by the use of space and positioning (seating) within the room, or by having non-members of the desired substructure leave the room (but stay involved by viewing from behind a one-way mirror). The aim of such interventions is often to cause the unbalancing of the family system, in order to help them to see the dysfunctional patterns and remain open to restructuring. He believes that change must be gradual and taken in digestible steps for it to be useful and lasting. Because structures tend to self-perpetuate, especially when there is positive feedback, Minuchin asserts that therapeutic change is likely to be maintained beyond the limits of the therapy session. One variant or extension of his methodology can be said to move from manipulation of experience toward fostering understanding. When working with families who are not introspective and are oriented toward concrete thinking, Minuchin will use the subsystem isolation—one-way mirror technique to teach those family members on the viewing side of the mirror to move from being an enmeshed participant to being an evaluation observer. He does this by joining them in the viewing room and pointing out the patterns of transaction occurring on the other side of the mirror. While Minuchin doesn’t formally integrate this extension into his view of therapeutic change, it seems that he is requiring a minimal level of insight or understanding for his subsystem restructuring efforts to "take" and to allow for the resultant positive feedback among the subsystems to induce stability and resistance to change. Change, then, occurs in the subsystem level and is the result of manipulations by the therapist of the existing subsystems, and is maintained by its greater functionality and resulting changed frames of reference and positive feedback.

See also
• • •

Family systems therapy Salvador Minuchin Systems theory

1. 2. ^ a b Minuchin, S. (1974). Families and Family Therapy. Harvard University Press. ^ Seligman, Linda (2004). Diagnosis and Treatment Planning in Counseling. New York: Kluwer Academic. ISBN 0306485141., p. 246 Minuchin, S. & Fishman, H. C. (2004). Family Therapy Techniques. Harvard University Press. Piercy, Fred (1986). Family Therapy Sourcebook. New York: Guilford Press. ISBN 0898629136. Will, David (1985). Integrated Family Therapy. London: Tavistock. ISBN 042279760X.

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rigid (disengaged). They occur when the symptom is temporarily removed. can be stable or detouring. A symptom services and is rooted in dysfunctional transactions.g. and disengagement.Salvador Minuchin’s Structural Family Therapy II A directive therapy. and transitional anxieties and lack of differentiation are sometimes mislabeled pathological. Key concepts: Enmeshment: Ecological context: Sick child: Common boundary problem: Rules: Boundaries: Power: Coalitions: Transitional anxieties: encourages somatization. bringing it to an entirely new structure and psychological place. This therapy may be characterized by the highly active therapist who gives specific directives for behaviour change that are carried out as homework assignments. First-order changes are those that help the system stay at its current level of functioning. or clear.: Teaching family members how to use "I" statements and listen empathically demonstrate first-order changes that enhance the family's current functioning. They occur when symptom and system are repaired and the need for the symptom does not reappear. determined by authority and responsibility for acting on it. family conflict defuser. the areas of responsibility. 68 . Next he examined boundaries or family rules that define the participants. generic and idiosyncratic rules that regulate transactions govern structure. and restructuring an alcoholic family to eliminate drinking are second-order changes that alter the family fundamentally. His approach was both active and directive. Clients may be asked to intensify the problem as one way of using paradox. the decision making and privacy rules. parents confuse spouse functions with parent functions. The idea is to change the immediate context of the family situation and thereby change the family members’ positions. work. Another way is for the therapists to take a "one-down" position. can be diffuse (enmeshed). He would shift the family focus from the identified client to the therapist to allow the identified client to rejoin the family. Families are constantly in transition. the therapist moves outside the family structure and leaves the family intact and connected without the loss of individual family member identities. Coaching a widow through the loss of her husband. When treatment is complete. change-oriented through changing the family structure (transaction-governing rules of a family). helping a couple let go of the last child to leave the nest. acting out. encouraging the client not to do too much too soon. High resonance. E. based on the assumption that family member behaviour is ongoing and repetitive and can be understood only in the family context. only to reappear later because the family system has not been changed. extended family members. Second-order changes restructure the system to bring it to a different level. • • • • • Salvador Minuchin’s style was to get the family to talk briefly until he identified a central theme of concern and the leading and supporting roles in the theme. the family's church. Counselors must differentiate between first-order and second-order changes. The Structural Family Therapy is a type of family therapy. Paradoxical interventions are often used to harness the strong resistance clients have to change and to taking directives. structure (boundaries). schools.

Rigid triad: Dysfunctional families: Three reasons that make clients move: They are challenged in their perception of their reality. or selfreinforcing new relationships appear once they've tried out new alternatives. assimilate to previous transaction patterns. Rigid boundary around the triad. where parents habitually use a child to lightningrod conflict. adopting family's affective style. joining from a distant position = teaching.Reaction to therapist probes: A family will either dismiss the therapist's probes. make the IP a cotherapist to the overfunctioner. the subsystem's functioning will increase). Family mapping via diagram of current structure. Interventions: Joining and accomodating (same process: joining emphasizes therapist's outer adjustment to family. in which case stress increases and the probe is restructuring. or joining from a close position). common when the children have severe psychosomatic problems. detriangulation of IP by forming a coalition with him against a parent. enactments that simulate transactions to be changed. mimic IP to show that he's like the powerful therapist rather than deviant. 69 . or joining from a median position). advice).. People need some support within a family to move into the unknown. idiosyncratic problems. Goals: clear boundaries as gatekeepers. increase flexibility to alternative transactions. general restructuring techniques (e. clear lines of authority. Sets: repeated family reactions to stress. whole family with extrafamilial forces. tracking (of family communications and behaviour. reframing in terms of structure or interaction.g. unbalancing by escalating stress. mimesis (imitation. Four sources of family stress: One member with extrafamilial forces. systems and subsystems (the parental one is where pathology begins). accomodating therapist's inner adjustment. rearranging how they sit. Spontaneous sets: interpreted like enactments.. blocking certain transactions. maintenance (of the family's current structure). transition points in the family's evolution. A dysfunctional family is one that responds to inner or outer demands for change by stereotyping its functioning. given alternative possibilities that make sense. or respond as to a novel situation. marking boundaries (when they are strengthened. working as a family insider). help negotiate family life cycle transitions.

lethal games. ability to communicate with others. To feel what one feels. contextual. growth games. or will be. context. self-relatedness. instead of choosing to be only "secure" and not rocking the boat. What growth price does each part of the system pay to keep the overall balanced? "Rupture point": where coping skills fail and family needs to change. instead of always waiting for permission. The five freedoms: To see and hear what is here instead of what should be. and spiritual. Mind. Pathology is a deficit in growth. Three parts to every communication: Me. symptoms are a light on the dashboard or a ticket into therapy. To say what one feels and thinks. belonging. instead of what one ought. Broken families follow broken rules. emotional. "Seed" (innate growth potential) worldviews. competence. To take risks in one's own behalf. It is also covertly rewarded. In a dysfunctional family. symptomatic behaviour makes sense. Games: rescue games. instead of what one should. Emphasized the importance of giving families hope and building self-esteem in family members. and our differences make us grow. "Threat and Reward" (rule-makers/followers. body triad: a current basis of self-identity. has eight levels: physical. **** Also read: Behavioural and Conjoint Family Therapy **** Key concepts: • • • Turn roles into relationships. Coping skills increase with self-esteem. Dysfunctional communications leave one of these out of account. rules into guidelines. sensual. father. you. nutritional. was.Virginia Satir’s Humanistic family therapy One of the founders of the MRI communications school. intellectual. A symptom may be distorting self-growth by trying to alleviate family pain. the core. coalition games. interactional. direction. Primary triad (mother. child) is source of self-identity. Our similarities unite us. selfhood. Five components of self-esteem: Security. To ask for what one wants. soul. • • • • • • • • • • 70 . rigid roles) vs. Self. Maturation: development of a clear identity and power of choice. A good therapist works on all levels.

can give a clear message. can interpret hostility. Self-manifestation (congruence) analysis. check. ask. Criteria for termination: when family members can complete transactions. Growth. Labeling assets. Cut games. Sculpting (group posture) technique. straighten transactions. can see how others see them. fears. can learn through practice. Family life chronology (three generations). can free selves from harmful effects of past models. 71 . Parts party: awareness and exercise of mind and body. stories. can tell other member what he hopes. and turning these into relationships. Analysis of how family members handle differentness. can see how they see themselves. who is led by the Guide. Use of drama. be congruent. art. Model analysis of which models have impacted early on. can make choices. Expand experiencing and choice-making. Look at implicit premises that guide perceptions and interactions. expects from the other. Identification of family roles. can disagree. Communication work and esteem building. Family reconstruction: an exercise in which roles in significant family historical events are directed by the Explorer. metaphor. self. can tell each other how he manifests himself.Interventions: Reduce individual and family pain.

Behavioural & Conjoint Family Therapy Family therapists following a communications approach to family therapy hold the view that accurate communication is the key to solving family problems. (Conjoint family therapy = The involvement of two or more members of a family in therapy at the same time. She thought 90% of what happens in a family is hidden. Self-esteem plays a prominent role in Satir's system. motives. His stages include 1) exploration. 72 . and developing close relationships with others.) An open and honest manner of communicating rather than using phony or manipulative roles characterizes good problem-solving families. 3) the system. and accepting differences in others as a chance to learn. Virginia Satir considered herself a detective who helps children figure out their parents. 4) selection of one issue for discussion. She considered people geared to surviving. The family's needs. 5) an analysis of interactions. 4) and the rules of the family. Communication is the most important factor in Satir's system and determines the kinds of relationships people have with one another and how people adjust. 6) negotiation of a contract. She believed that whatever people are doing represents the best they are aware of and the best they can do. 3) perceptions of issues. She discussed response patterns to which people resort as a reaction to anxiety. She believed the four components in a family situation that are subject to change are 1) the members' feelings of self-worth. communicating clearly and effectively. and communication patterns are included in this 90%. The three keys to Satir’s system are 1) to increase the self-esteem of all family members. 2) the family's communication abilities. 2) help family members better understand their encounters 3) and use experiential learning to improve interactions. 2) identification of goals. growing. He used a behavioural interviewing method to teach people about what they are doing that is not working and to help them correct the situation by learning how to get the impact they want from their communication. Gottman built his approach on matching intent and impact of communication. She viewed mature people as being in touch with their feelings.

73 . Dynamic family play therapy engages family members in creative activity by using natural play. to help parents gain the skills of child-centered therapist to use as the parents relate to their children and to improve the parent-child relationship. irrelevant. and communication games are some of the methods she developed to deal with family behaviour. Satir divided families into two types: nurturing and troubled. Simulated family games. She used several techniques to reach her goals of establishing proper environments and assisting family members in clarifying what they want or hope for themselves and for the family. Her method is designed to help family members discover what patterns of communication do not work and how to understand and express their feelings in an open. Filial therapy is a play therapy method based on the principles of child-centered therapy. 2) interaction. The counseling method of conjoint family therapy involves 1) communication. and congruent (or leveling) communicator. Some of Satir’s games are : • • • • Growth model – assumes that an individual’s behaviour changes due to interactions with other people. all the others hide real feelings for fear of rejection. 3) and general information for the entire family. The first four are mostly poses covering lack of self-worth. Strategic family play therapy is a form of counseling in which all family members and the counsellor play. Theraplay is a treatment method modeled after the healthy parent-child interaction in which parents are involved first as observers and then as co-therapists. blamer. Her main objective for her clients was recognition of their type and then change from type or degree. • • The counsellor's role in this model is of a facilitator who gives total commitment and attention to the process and the interactions. systems games. The goals of filial therapy are to reduce the child’s problem behaviours. The counsellor’s goal is to help the family develop and increase spontaneity. The counsellor intervenes to assist leveling and taking responsibility for one's own actions and feelings. Each type had varying degrees. Leveling helps people develop healthy personalities.These universal response roles or communication stances are: Five roles: placater. Medical model – purports that the cause of the problem is an illness of the individual. super-reasonable. Play therapy with families has the advantage of helping children communicate their story to the therapist. level manner. Sick model – proposes that the individual’s thinking and attitudes are wrong and must be changed. 1) the placater 2) the blamer 3) the computer 4) the distractor 5) the leveler : an individual who avoids conflict at the cost of his/her integrity : a person who places blame on others and does not take responsibility for what is happening. : the super reasonable individual who denies his emotions : takes irrelevant stances : Communicates in a congruent way in which genuine expression’s of one’s feelings are made in an appropriate context.

Strategic family therapy is based on the assumption that the family's ineffective problem solving develops and maintains symptoms. 8. Structural family therapy is based on the idea that the family is an evolving. 6. 7. The individual is considered as part of a family and the interactions and relationships within the family are the focus of therapy. The systems approach to family therapy is focused on how family members can maintain a healthy balance between being enmeshed and being disengaged. and the rules of the family. strategic family play therapy and theraplay. 74 . According to structural theorists. defining and clarifying boundaries that exist between subsystems is imperative. filial therapy.KEY CONCEPTS 1. Some of the family play therapy approaches include dynamic family play therapy. 2. Minuchin's approach is directed toward changing the family structure or organization as a way of modifying family members' behaviour. hierarchical organization made up of several subsystems with rules and behaviour patterns for interacting across and within those subsystems. Conjoint family therapy is based on honest communication. 4. 5. 3. members’ feelings of self-worth.

Repetitive interactions: games by which members try to control one another. 75 . Invariant prescription to loosen parent-child collusion. Positive connotation of a behaviour's intent. circular feedback loops.Milan Systemic family therapy or “Long Brief Therapy”: Led by Mara Selvini-Palazzoli. key concepts: Emphasis on information. Pre-session hypothesizing. nonreactive therapist who asks family to generate its own solutions. paradox. families wanting more are trying to control the therapy. Sessions held about once a month to let things incubate. Dysfunctional families make an "epistemological error" that can be corrected. Interventions: Counterparadox. Circular and triadic questioning. Neutral. Assignment of rituals. Therapy: one or two therapists see the family while a team watches from behind a mirror. Change the interactions and the behaviour will too. Sessions broken by an intersession during which the therapist talks to the team away from the family.

A. 1997. 19(1). 76 . may be understood a a form of resistance.” (Wade. rather than a passive "object" that is "acted upon. In response-based therapy. 23-39 ^ Coates. This second principle employs "discourse analysis" and is referred to in response based therapy as the "four discursive operations. ^ Todd." and (2) language is frequently used in a manner that (a) conceals violence. or the conditions that make such acts possible. Therapeutic methods of response-based therapy are based on two theoretical foundations: (1) That alongside accounts of violence in history. withstand. prudent. (1997). stop. Strong & D. 2. 3. L. p. A. or oppose any form of violence or oppression (including any type of disrespect).” (Calgary Women’s Emergency Shelter. they resist. they do many things to oppose the abuse and to keep their dignity and their selfrespect. (2003) 'Coming to Terms with Violence and Resistance: From a Language of Effects to a Language of Responses'. resistance is defined and examples given: “Any mental or behavioural act through which a person attempts to expose. and creative resistance. and (d) blames or pathologizes victims. & Wade." Example: the response-based therapist would not ask a victim "How did that make you feel?". the free encyclopedia Response-based therapy is a relatively new psychotherapeutic approach to treating psychological trauma resulting from violence. Imagining a better life may also be a way that victims resist abuse. and discourse analysis. 1997. standing up against. but instead would ask "When [act of violence] was done to you.[1] Incorporating elements of Solution focused brief therapy. repel. refuse to comply with. (c) conceals victims' resistance. p." [2]. (3) elucidate and honor victims' resistance. strive against. abstain from. the client is viewed as an "agent" who has the capability to respond to an act. Telling It Like It Isn’t: Obscuring Perpetrator Responsibility for Violent Crime."[3] This presupposition of resistance as a natural response to violence is used to engage clients in in-depth conversations about how they responded to specific acts of violence. and trying to stop or prevent violence. 4. Dr. 3-30. This is called resistance. 15(5). in his 1997 article "Small Acts of Living: Everyday Resistance to Violence and Other Forms of Oppression. impede. In response-based literature. Narrative therapy. and (4) contest victim blaming [4]. in T. Small acts of living: Everyday resistance to violence and other forms of oppression. ^ Wade. Pare (eds). there exists an often-unrecognized parallel history of "determined. p. 25) “Whenever people are abused. or oppression.Response-based Family Therapy From Wikipedia. 23 ^ Wade. (b) obscures and mitigates perpetrator responsibility. (2004). prevent. 2007. & Wade. Therapy consists of using language to (1) expose violence. Contemporary Family Therapy. how did you respond? What did you do?" References 1. N. The resistance might include not doing what the perpetrator wants them to do. 5). A. p. Furthering Talk: Advances in the Discursive Therapies. New York: Kluwer Academic Plenum. disrespect. Discourse and Society. it was first proposed by a Canadian family therapist and researcher. Allan Wade. 152. (2) clarify perpetrators' responsibility.. based on the theory that whenever people are treated badly.

(1997). Canada. Todd. & Wade. (2001). HF Wade. and J. In C. (2008. 23–40. Flaskas. Honouring Resistance: How Women Resist Abuse in Intimate Relationships (formerly Resistance to Violence and Abuse in Intimate Relationships: A Response-Based Perspective) Available from Calgary Women's Emergency Shelter. & Wade. NY : Routledge/Taylor & Francis Group. The Response-Based Approach in Working with Perpetrators Of Violence: An Investigation. Ph. A. Renoux. Hope and despair in narrative and family therapy: Adversity. (2005). New York: Kluwer Academic Plenum. & Wade. (2004). & Todd. N. Duncan. Small Acts of Living: Everyday Resistance to Violence and Other Forms of Oppression. Department of Psychology. A. 63–74). and Wade. Sheehan (Eds. Samantaraya.).Related reading • Calgary Women's Emergency Shelter. resistance. Strong & D. British Columbia. 22(7). L. Therapeutic Responses To Violence: A Detailed Analysis Of Therapy Transcripts. Box 52051 Edmonton Trail N. forgiveness and reconciliation (pp. Telling It Like It Isn’t: Obscuring Perpetrator Responsibility for Violent Crime. A. J. A. A. Pare (eds). 3-30. Wade. & Wade. Despair. 2-4. Coates. Wade. (2007). N. P. Coates. A. Calgary. McCarthy. 'Coming to Terms with Violence and Resistance: From a Language of Effects to a Language of Responses'. in T. Journal of Family Violence. Language and Violence: Analysis of Four Discursive Operations. (2007a). The Language of Responses Versus the Language of Effects: Turning Victims into Perpetrators and Perpetrators into Victims. A. 15(5). Master of Arts Thesis. Department of Sociology. 511-522. (1999).[1]. Context. Yaletown Family Therapy: Therapeutic Conversations. Discourse and Society. Journal of Contemporary Family Therapy. (2007). hope: Response-based therapy with victims of violence. A. Research and Community Action. I. A.. Dissertation. 19. New York . unpublished manuscript. [2] Weaver. L. University of Lethbridge. N. Calgary Women's Emergency Shelter [3] • • • • • • • • • • • 77 . 98. Todd. M. Maddeaux-Young. Resistance to Interpersonal Violence: Implications for the practice of therapy. June).O. (2006).. L. (2007b). Resistance to Violence: A Key Symptom of Chronic Mental Wellness. N. Furthering Talk: Advances in the Discursive Therapies. Alberta T2E 8K9. Coming to Terms with Violence: A Response-Based Approach to Therapy. H. Wade. University of Victoria. (2003).D..

thus the narrative motto: “The person is not the problem.Narrative Family Therapy .4 Method o 2. ADHD. narrative practices separate persons from qualities or attributes that are taken-for-granted essentialisms within modernist and structuralist paradigms. largely by Australian Michael White and his friend and colleague. thus destabilizing the hold of negative ("thin") narratives upon the client. By conceptualizing a non-essentialized identity. Contents • • • • • • 1 Overview 2 Narrative therapy topics o 2. the problem is the problem. and other practitioners who have built upon this work.[3] schools [4][5] and higher education [6] Although narrative therapists may work somewhat differently (for example. many authors and practitioners report using these ideas and practices in community work. or any other therapy that uses stories. the free encyclopedia Narrative Therapy is a form of psychotherapy using narrative. 78 . While narrative work is typically located within the field of family therapy.I From Wikipedia. Their approach became prevalent in North America with the 1990 publication of their book.1 Concept o 2. The narrative therapist focuses upon narrative and situated concepts in the therapy. Narrative therapy refers to the ideas and practices of Michael White. David Epston. This process of externalization[1] allows people to consider their relationships with problems.2 Narrative approaches o 2. allowing people to engage in the construction and performance of preferred identities. Narrative Means to Therapeutic Ends. The narrative therapist is a collaborator with the client in the process of discovering richer (or "thicker") narratives that emerge from disparate descriptions of experience.5 Outsider Witnesses 3 Criticisms of Narrative Therapy 4 See also 5 References 6 External links Overview The term "narrative therapy" has a specific meaning and is not the same as narrative psychology. and many other problems.[2] a presentation of six kinds of key conversations.[1] followed by numerous books and articles about previously unmanageable cases of anorexia nervosa. Operationally. of New Zealand. In 2007 White published Maps of Narrative Practice. It was initially developed during the 1970s and 1980s. there are several common elements that might lead one to decide that a therapist is working "narratively" with clients. Epston uses letters and other documents with his clients.” So-called strengths or positive attributes are also externalized. David Epston. though this particular practice is not essential to narrative therapy). narrative therapy involves a process of deconstruction and "meaning making" which are achieved through questioning and collaboration with the client. schizophrenia.3 Common elements o 2.

Another sort of externalization is likewise possible when people reflect upon and connect with their intentions. normal/abnormal. this therapist is interested in co-investigating a problem's many influences. This externalization or objectification of a problem makes it easier to investigate and evaluate the problem's influences. Problem-saturated stories gain their dominance at the expense of preferred. whether uniquely personal or culturally general. narrative approaches hold that identity is chiefly shaped by narratives or stories. The term “narrative” reflects the multi-storied nature of our identities and related meanings. hopes. as when a person and a counsellor co-author "A Graduation from the Blues Certificate". distance is created.Narrative therapy topics Concept Narrative therapy holds that our identities are shaped by the accounts of our lives found in our stories or narratives. In particular. psychiatry/psychology. Common elements Common elements in narrative therapy are: • • • • • The assumption that narratives or stories shape a person's identity. In the end. narrative conversations help people clarify for themselves an alternate direction in life to that of the problem. and life commitments. By focusing on problems' effects on people's lives rather than on problems as inside or part of people. values. relate its earliest history. These marginalized knowledges and identity performances are disqualified or invisibilized by discourses that have gained hegemonic prominence through their acceptance as guiding cultural narratives. reauthoring conversations about values and re-membering conversations about key influential people are powerful ways for people to reclaim their lives from problems. come to know how it operates or works in her life. Furthermore. At the same time. modes of living. one that comprises a person's values. and in the end choose their relationship to it. and functional/dysfunctional ignore both the complexities of peoples’ lived experiences as well as the personal and cultural meanings that may be ascribed to their experiences in context. alternative stories that often are located in marginalized discourses. patriarchy. binaries such as healthy/unhealthy. they help to “reauthor” or “re-story” a person's experience and clearly stand as acts of resistance to problems. hopes. as when a person assesses a problem in their life for its effects and influences as a "dominant story". and possibilities associated with them. Narrative approaches Briefly. evaluate it to take a definite position on its presence. • Responding to personal failure conversations [7] 79 . An appreciation for the creation and use of documents. Examples of these subjugating narratives include capitalism. Identity conclusions and performances that are problematic for individuals or groups signify the dominance of a problem-saturated story. A narrative therapist is interested in helping others fully describe their rich stories and trajectories. and commitments. A focus on "unique outcomes" (a term of Erving Goffman) or exceptions to the problem that wouldn't be predicted by the problem's narrative or story itself. such as by naming a problem so that a person can assess its effects in her life. An "externalizing" emphasis. and Eurocentricity. with a commitment to checking back with the client about the effects of therapeutic styles in order to mitigate the possible negative effect of invisible assumptions or beliefs held by the therapist. Once values and hopes have been located in specific life events. heterosexism. including on the person himself and on their chief relationships. A strong awareness of the impact of power relations in therapeutic conversations.

and they acquire new images and knowledge about it and their chosen alternate direction in life. Here the narrative therapist relies on the premise that. between therapist and consulting person.Method In Narrative therapy a person's beliefs. there always remains some space for questions about a person's resilient values and related. and change their relationship to a problem by acting as an “investigative reporter” who is not at the centre of the investigation but is nonetheless influential. exceptions that lead to rich accounts of key values and hopes—in short. Intertwined with this problem investigation is the uncovering of unique outcomes or exceptions to its influences. these questions might help restore exceptions to the problem's influences that lead to naming an alternate direction in life. nearly forgotten events. the outsider listens without comment. 80 . During the first interview. But for the consulting person the outcomes are remarkable: they learn they are not the only one with this problem. and knowledge in the end help them regain their life from a problem. evaluate. These questions might examine how exactly the problem has managed to influence that person's life. To help retrieve these events. Often they are friends of the consulting person or past clients of the therapist who have their own knowledge and experience of the problem at hand. skills. that is. Lastly. but instead to simply say what phrase or image stood out for them. Outsider Witnesses In this particular narrative practice or conversation. In practice a narrative therapist helps clients examine. and interviews them about what images or phrases stood out in the conversation just heard and what resonances have struck a chord within them. outsider witnesses are invited listeners to a consultation. The narrative therapist. Then the therapist interviews them with the instructions not to critique or evaluate or make a proclamation about what they have just heard. a platform of values and principles that provide support during problem influences and later an alternate direction in life. as an investigative reporter. this therapist poses questions that help people externalize a problem and then thoroughly investigate it. principles. In the end. The main aim of the narrative therapy is to engage in people's problems by providing the alternative best solution. including its voice and techniques to make itself stronger. influential person. So. an outsider witness conversation is often rewarding for witnesses. the therapist turns to the consulting person. it has not yet completely destroyed the person. the outsider is asked in what ways they may feel a shift in how they experience themselves from when they first entered the room[8] Next. the narrative therapist may begin a related re-membering conversation about the people who have contributed new knowledges or skills and the difference that has made to someone and vice-versa for the remembered. has many options for questions and conversations during a person's effort to regain their life from a problem. though a problem may be prevalent and even severe. who has been listening all the while. followed by any resonances between their life struggles and those just witnessed. in similar fashion. On the other hand.

[10][12] Several critics have posed concerns that Narrative Therapy has made gurus of its leaders.[9][10][11] • • • Narrative therapy has been criticised as holding to a social constructionist belief that there are no absolute truths.[10][12] Others have criticized Narrative Therapy for failing to acknowledge that the individual Narrative therapist may bring personal opinions and biases into the therapy session.Criticisms of Narrative Therapy To date. among various other concerns. particularly in the light that its leading proponents tend to be overly harsh about most other kinds of therapy. but only socially sanctioned points of view. there have been several formal criticisms of Narrative Therapy over what are viewed as its theoretical and methodological inconsistencies.[10] Narrative therapy is also criticized for the lack of clinical and empirical studies to validate its many claims.[13] See also Theoretical foundations • • • • • Constructivist epistemology Feminism Hermeneutics Postmodernism Poststructuralism Related types of therapy • • • • Brief therapy Family therapy Response based therapy Solution focused brief therapy Other related concepts • • • Dialogical self Lucid dream Questioning 81 .[13] Etchison & Kleist (2000) state that Narrative Therapy's focus on qualitative outcomes is not congruent with larger quantitative research and findings which the majority of respected empirical studies employ today. This has led to a lack of research material which can support its claims of efficacy. and that Narrative therapists therefore privilege their client's concerns over and above "dominating" cultural narratives.

Family Journal 8(1) 61-67 (2000) 82 . (2000) Narrative Mediation: A New Approach to Conflict Resolution. 1997. 12. 3.E. 6. (2005). ^ White. Norton. 24(4). 13. Adelaide: Dulwich Centre Publications.. (2000). 11. & Epston. 2. Review of Narrative Therapy: Research and Review. ^ Fish. 10. ^ Narrative Means to Therapeutic Ends. Where is the Family in Narrative Family Therapy? Journal of Marital and Family Therapy. 397-403 (1998) ^ Madigan. San Francisco: Jossey-Bass. M. 1998) ^ (Nylund and Tilsen. (1990). New York: WW Norton. D.M. White.. Journal of Systemic Therapies.W. M. 15(1). 4. & Kleist..References 1. V. 9. The Politics of Identity: Considering Community Discourse In The Externalizing of Internalized Problem Conversations. ^ Dulwich Centre.. NY: W. 5. Post Structuralism in Family Therapy: Interrogating the Narrative/Conversational Mode. pp 15. 2006). ^ a b White. 379-385 (1998) ^ a b Etchison. Maps of narrative practice. John & Monk. Maps of Narrative Practice. Reflections on Narrative Practice Adelaide. South Australia: Dulwich Centre Publications ^ White. S. ISBN 0-7879-4192-1 ^ (Lewis & Chesire. M. R. 2000 ^ Winslade. 47-62 (1996) ^ a b Doan. D. Gerald. Family Process 37(3). M. Narrative means to therapeutic ends. The King is Dead: Long Live the King: Narrative Therapy and Practicing What We Preach.. 7. 8. Journal of Family Therapy 19(3) 221-232 (1993) ^ a b c d Minuchin. S. M. Narrative practice and exotic lives: Resurrecting diversity in everyday life. (2007).

This method of communication allows the family therapist to communicate in a way that allows him to sort out the elements in logical sequence out from a chaotic setting. the abstract form of communication becomes effective only to individuals who are at least 8 years old.Narrative Family Therapy . abstract type of communication is in general described as dry and dull because individuals struggle to relate it to reality. What makes this narrative approach a truly effective adjunct of the entire family therapy procedure is that it allows the listener create a parallel event in his own consciousness. We become the stories we tell about our own experience. What happens to such type of therapy is that the person is limited to just two options. This approach connects the individual to time and space. Replace unhelpful stories with helpful ones.II We do not tell stories only: we are stories. Storytelling is now emerging as a critical component of Scottsdale family therapy. Storytelling is considered as an age-old form of expressing ideas and emotions. Individuals always consider the experience of storytelling as lively and entertaining. It is one great way we can accept ideas as it is presented explicitly by a competent family therapist. By contrast. Article Source: http://EzineArticles. With the abstract communication approach. This increases the possibility of acceptance more than the rejection that we normally experience in the abstract type of communication. On the other hand. Abstract type of communication forces on our perceived time and space and sets its own framework and applies such mental framework to another individual. Another critical aspect of storytelling has something to do with tacit knowledge. all or nothing type of confrontation. As living creatures with unique characteristics we are easily attached to things that are animate and reject inert and inanimate things like abstracted concepts. Michael: people's lives are organized by their life narratives. White. Family therapists are able to deliver holistic realities once they adopt storytelling as an integral part of the therapy sessions as opposed to abstract method of communication which normally breaks down the message into fragments. the listeners are able to receive the message in a simple. It is essential that we spend some time and understand some important principles that come into play when storytelling is adopted as a major element of the family therapy approach. Finally. This type of communication is the native language which can be used with persons as young as two years of age.accepting or rejecting the idea relayed by the family therapist. There are now quite a number of Scottsdale therapists who have gained positive results in their sessions with individuals facing varied family issues. logical manner and in one single flow. This narrative element of family therapy is more of a rhythmic dance rather than a communication 83 . storytelling comes out as a collaborative encounter which encourages the listener to participate in an arm-in-arm activity with the family therapist. Storytelling as a major element of family therapy relays ideas and messages holistically. We know more things than we actually believe we have and it is important to acknowledge the importance of tacit knowledge in the overall scheme of things. one ends up with a yes-no. and the direction of the sequence of events becomes clearer enabling the therapist to deliver a more sensible idea or message. As a result to this.

One mark of a healthy family is its capacity to allow members to differentiate. husband. MST can reduce out-of-home placement of disturbed adolescents. Several clinical studies have shown that MST has improved family relations. Differentiation Differentiation refers to the ability of each family member to maintain his or her own sense of self. Children and adolescents often benefit from family therapy that includes the extended family. The extended family field. The limit of how much change a family will tolerate. Triangular relationships Family systems theory maintains that emotional relationships in families are usually triangular. Calibration: Setting of a range limit (bias) in a system. home. has been applied to family therapy and is practiced most often in a home-based setting for families of children and adolescents with serious emotional disturbances. This concept is used to explain the intergenerational transmission of attitudes. and a grandparent. 84 . and one that initiates vertical realignment). The concept of the IP is used by family therapists to keep the family from scapegoating the IP or using him or her as a way of avoiding problems in the rest of the system. The therapist needs to look into who has the power to reset it. wife. like a thermostat in a room. decreased adolescent psychiatric symptoms and substance use. consisting of the various systems with which the family and child interact (for example. Symptoms tend to occur when horizontal and vertical stressors intersect. why a specific member has become the IP. a parent. and community). a child. while remaining emotionally connected to the family. Common family triangles include a child and his or her parents. The extended family field includes the immediate family and the network of grandparents and other relatives of the family. Homeostasis (Balance) Homeostasis means that the family system seeks to maintain its customary organization and functioning over time. problems. while family members still feel that they are members in good standing of the family. and it tends to resist change. Multisystemic Therapy In the early 2000s. The triangles in a family system usually interlock in a way that maintains family homeostasis. three siblings. and other issues. two children and one parent. vertical stressors are transmitted mainly via multigenerational triangling. (Bias: a family's emotional thermostat. school. a family has developmental tasks and key (second-order) transitions like leaving home. increased school attendance. or. Children and adolescents are frequently the IP in family therapy. joining of families through marriage. The family therapist can use the concept of homeostasis to explain why a certain family symptom has surfaced at a given time. behaviours. families in later life. multisystemic therapy (MST).) Family Life Cycle: Just like an individual. and decreased re-arrest rates for adolescents in trouble with the law. Whenever two members in the family system have problems with each other. Key question: "How well did the family do on its last assignment?" Horizontal stressors are those involving these transitional assignments. families with young children (the key milestone. In addition. and an in-law. they will "triangle in" a third member as a way of stabilizing their own relationship. families with adolescents. Divorce adds extra developmental steps for all involved families. MST is frequently referred to as a "family-ecological systems approach" because it views the family's ecology. and what is likely to happen when the family begins to change.DEFINITIONS The identified patient The identified patient (IP) is the family member with the symptom that has brought the family into treatment. a new systems theory. launching children and moving on.

they tend to have a lot of entropy. Lyman: noticed that many families exhibit pseudomutuality (fake togetherness). Weakland): when the content and process of a message don't line up and you're not allowed to comment on that. process over past. reciprocal) causality: When things cause each other rather than just one causing the other (linear causality). restraining ("don't change") . A therapeutic task is to make the covert rules overt. Emphasizes present. one heals and the other becomes a criminal). Circular (mutual. and positioning (exaggerate negative interpretations of the situation). content. rigid ones block even modest attempts to adapt. Can be negative (maintains the current bias and level of functioning) or positive (changes the bias/level of functioning). Closed: Those unfriendly to new information. Punctuation: “The selective description of a transaction in accordance with a therapist’s goals”. Cybernetics: Norbert Weiner (1948) used this term to describe systems that self-regulate via feedback loops. Second-order change: a change that fundamentally impacts the system. Equifinality / Equipotentiality: Equifinality: things with dissimilar origins can wind up in similar places (e. Open/Closed systems: Open: Those that embrace new information and display negentropy (growth). First-order / Second-order change: First-order change: change that helps the system accommodate to its current level of functioning.g. Therefore.. it is verbalizing appropriate behaviour when it happens. Jackson.. No-talk rule: an unwritten family rule against members commenting on certain uncomfortable issues. Double bind (Bateson. Feedback loops: information pathways that help the system balance and correct itself. Three kinds of therapeutic double-binds or paradoxes: prescribing. Haley. thereby taking it to a new level of functioning. Equipotentiality: things with a common origin can go in very different directions of development (e. an abuse survivor and someone from a healthy family can both grow up to be good parents). Good rules maintain stability while allowing some adaptive changes. Can be covert or overt. 85 . Rules: Expectations that govern the system on many levels. of two abuse survivors.Centrifugal/centripetal: Tendency of family members to move toward or away from a family. Pseudomutuality: Wynne.g.

coaching. and directives with a family. The following select techniques have been used in working with couples and families to stimulate change or gain greater information about the family system. Observation is an effective family therapy technique because it offers the psychologist the first real window into the family dynamic. Strategic techniques are designed for specific purposes within the treatment process. tracking sequences. for example. To create an effective treatment plan for the family. using similar interventions with a family. Counsellors at all levels are expected to work effectively with couples and families experiencing a wide variety of issues and problems. A clinical psychologist is trained to observed the family dynamic and monitor both verbal and non-verbal cues. strategic. but that equilibrium can cause an imbalance for individual parts of the family. He or she will compare his or her observations with testing data offered in both subjective and objective forms. The subjective test data is gathered during the interview while the objective test data is gathered via clinical tests that family members are requested to fill out and return to the psychologist. the therapist needs as much data as possible. They value information about past relationships as a significant context from which they design interventions in the present. the family systems psychologist will monitor how the parents interact with each other and how their children react to them. and how of each intervention always rests with the therapist's professional judgment and personal skills. OBSERVATION Family units establish equilibriums to protect the family unit. The when. but for the psychologist to make a fair and accurate assessment. where. emotional balance and initial dysfunction. and transgenerational family therapists at times may seem to be operating alike. 86 . he or she must get a base measurement of the family's interactions. Each technique should be judiciously applied and viewed as not a cure. They tend to use interventions such as process questions. The techniques used will depend on what issues are causing the most problems for a family and on how well the family has learned to handle these issues. but rather a method to help mobilize the family. During the assessment phase and initial interviews. it may be revealed that a mother's depression and need for anti-anxiety medication is due in part to her husband's unemployment and the economic pressure she is overcompensating to fulfill. During observation. Bowen therapists believe that understanding how a family system operates is far more important than using a particular technique. teaching. Background information. Differences might become clear when the therapist explains a certain technique or intervention.Basic Techniques in Family Counselling and Therapy The area of marriage and family counselling/therapy has exploded over the past decade. Structural. IDENTIFICATION Family therapy techniques are used with individuals and families to address the issues that effect the health of the family system. Family therapy may be recommended for any number of causes. Most of today's practicing family therapists go far beyond the limited number of techniques usually associated with a single theory. family structuring and communication patterns are some of the areas addressed through these methods.

Bowen also integrates data related to birth order and family constellation. religious affiliation. Siblings are presented in genograms horizontally. As an informational and diagnostic tool. or with a specific piece of information. each with more of a relationship to the parents than to one another. a genogram becomes a tool for assessing each partner's degree of fusion to extended families and to each other. How do you see your future? Tell me about the children in this photograph. and gives the person answering the question scope to give the information that seems to them to be appropriate. socioeconomic status. a technique often used early in family therapy. By providing an evolutionary picture of the nuclear family. divorce. or geneology. Bowen assumes that multigenerational patterns and influences are central in understanding present nuclear family functioning. the genogram is developed by the therapist in conjunction with the family. dates of marriage. A family genogram consists of a pictorial layout of each partner's three-generational extended family. marriages. GETTING INFORMATION THROUGH USING OPEN-ENDED QUESTIONS. The genogram also includes additional information about essential characteristics of a family: cultural and ethnic origins. and proximity of family members. 87 . provides a graphic picture of the family history. The genogram. death. type of contact among family members. An open-ended question cannot be answered with a simple "yes" or "no".I/ INFORMATION-GATHERING TECHNIQUES At the start of therapy. deaths. What is the purpose of this rule? Why did you choose that answer? THE GENOGRAM Is an information gathering technique used to create a family history. information regarding the family's background and relationship dynamics is needed to identify potential issues and problems. Examples of open-ended questions: • • • • • Tell me about your relationship with your husband. It is a tool for both the therapist and family members to understand critical turning points in the family's emotional processes and to note dates of births. Names. Open-ended questions are sometimes phrased as a statement which requires a response. Both the family and therapist work to create this diagram. and divorces. and other relevant facts are also included. The genogram reveals the family's basic structure and demographics. oldest to youngest.

What happens between point A and point B or C to create D can be helpful when designing interventions. 2) MIMESIS: The therapist becomes like the family in the manner or content of their communications.THE FAMILY FLOORPLAN By having family members draw up floor plans of their home. and rules are often revealed. One use of family photos is to go through the family album together. rules. Information across generations is therefore gathered in a nonthreatening manner. Verbal and nonverbal responses to pictures and events are often quite revealing. The family floor plan technique has several variations. In tracking. Another adaptation of this technique is to have members draw the floor plan for their nuclear family. Parents might be asked to draw the family floor plan for the family of origin. the family therapist is able to identify the sequence of events operating in a system to keep it the way it is. 3) CONFIRMATION OF A FAMILY MEMBER: Using an affective word to reflect an expressed or unexpressed feeling of that family member. Joining is considered one of the most important prerequisites to restructuring. There are four ways of joining in structural family therapy: tracking. Adaptations of this method include asking members to bring in significant family photos and discuss reasons for bringing them. In this process the therapist allies with family members by expressing interest in understanding them as individuals and working with and for them. FAMILY PHOTOS Is an information gathering technique which has the potential to provide a wealth of information about past and present functioning and about how each member perceives the others. they provide information on territorial issues. and locating pictures that represent past generations. Most family therapists use tracking. confirmation of a family member and accomodation. and subsystems often become evident. Through tracking. Interventions used to address family problems can be designed based on the patterns uncovered by this technique. rituals. and communication patterns. Structural family therapists (Minuchin & Fishman. structure. II/ JOINING This is the process of coupling that occurs between the therapist and the family. the therapist follows the content of the family that is the facts. Indications of differentiation. operating family triangles. Levels of comfort between family members. Through discussion of photos. 1981) see tracking as an essential part of the therapist's joining process with the family. the therapist often more clearly sees family relationships. and comfort zones between different members. Points of discussion bring out meaningful issues related to one's past. this technique can serve as an excellent diagnostic tool (Coppersmith. Tracking is best exemplified when the therapist gives a family feedback on what he or she has observed or heard. space accommodations. During the tracking process the therapist listens intently to family stories and carefully records events and their sequence. 4) ACCOMMODATION: The therapist adapts to a family's communication style. 1980). roles. It is a contextual process that is continuous. 88 . Used early in therapy. leading to the development of therapeutic system. mimesis. He makes personal adjustments in order to achieve a therapeutic alliance. The importance of space and territory is often inferred as a result of the family floor plan. 1) TRACKING: The tracking technique is a recording process where the therapist keeps notes on how situations develop within the family system.

III/ DIAGNOSING Diagnosing is done early in the therapeutic process. instead of reactive. therapists become proactive. he expected each partner to talk to him rather than to talk directly to each other in the session. or would you rather feel more in charge of your life?" "What other ways could you consider responding if the present way isn't very satisfying to you and is not changing him?" "Given what has happened recently. questions that emphasize personal choice are very important. In working with a couple. A Bowen therapist is more concerned with managing his or her own neutrality than with having the "right" question at the right time. or is said to have circularity. A therapist attempting to help a woman who has been divorced by her husband may ask: • • • "Do you want to continue to react to him in ways that keep the conflict going. By diagnosing interactions. IV/ FAMILY SYSTEM STRATEGIES A family operates like a system in that each member's role contributes to the patterns of behaviour that make the system what it is. Family sculpting is a sound diagnostic tool and provides the opportunity for future therapeutic interventions. FAMILY CHOREOGRAPHY In family choreography. family members are asked to position themselves as to how they see the family and then to show how they would like the family situation to be. arrangements go beyond initial sculpting. Bowen's style tended to be controlled. His calm style of questioning was aimed at helping each partner think about particular issues that are problematic with their family of origin. This technique provides insight into relationship conflicts within the family. ASKING PROCESS QUESTIONS. for example. representing family members relationships to one another at a specific period of time. This technique can help a stuck family and create a lively situation. One goal is to resolve the fusion that may exist between the partners and to maximize each person's self-differentiation both from the family of origin and the nuclear family system. Certain therapy techniques are designed to reveal the patterns that make a family function the way it does. The goal is to describe the systematic interrelationships of all family members to see what needs to be changed or modified for the family to improve. The most common Bowen technique consists of asking process questions that are designed to get clients to think about the role they play in relating with members of their family. 89 . somewhat detached. The family therapist can use sculpting at any time in therapy by asking family members to physically arrange the family. how do you want to react when you're with your children and the subject of their father comes up?" Notice that these process questions are asked of the person as part of a relational unit. They calm emotional response and invite a rational consideration of alternatives. Family members may be asked to reenact a family scene and possibly resculpt it to a preferred scenario. Still. because the focus of change is in relation to others who are recognized as having an effect on the person's functioning. FAMILY SCULPTING Family sculpting is a technique that's used to realign relationship patterns within the group. Adolescents often make good family sculptors as they are provided with a chance to nonverbally communicate thoughts and feelings about the family. Family sculpting provides for recreation of the family system. Members are asked to physically arrange where they want each member to be in relation to the others. This type of questioning is called circular. and cerebral.

I-positions help individual family members to step-back from the experience and communicate from a more centred.” “Ordinary People. (4) exposes the emotional process. As members carry out these directives. (2) delineates the triangle’s structure and movement. RELATIONSHIP EXPERIMENTS. instead of a problem controlling how the family acts. A father who constantly pressures his son regarding his grades may be seen as a threatening figure by the son. book or story) that relates to the emotional process and triangulation present in the family. video. Films. To coach is to help people identify triggers to emotional reactivity. and emotional reactions increase. Reframing this conflict would involve focusing on the father's concern for his son's future and helping the son to "hear" his father's concern instead of constant demands for improvement. 140). This requires the therapist to give specific directives as to how long members are to discuss the problem. The function of a displacement story is to provide a family or family members with an external stimulus (film. and how long these discussions should last. rational. and (5) addresses the emotional process to augment family functionality. and they are commonly designed to reverse pursuerdistancer relationships and/or address the issues related to triangulation. look for alternative responses. 90 .” or “Avalon” have all been used by Bowen therapists to highlight family interactions and consequences and to suggest resolutions of a more functional nature. and emotional skill in the person. Displacement stories are usually implemented through the use of film or videotape.V/ Intervention Techniques Intervention techniques are directives given by the therapist to guide a family's interactions towards more productive outcomes. encouraging confidence. I-positions are clear and concise statements of personal opinion and belief that are offered without emotional reactivity. Bowen therapists also coach them in the use of I-statements. they begin to develop a sense of control over the problem. courage. Relationship experiments are incorporated within Guerin’s five-step process for neutralization of symptomatic triangles in which he (1) identifies the triangle. When stress. and anticipate desired outcomes. and as family members are able to take charge of their emotions. What this means is. Bowen therapists model I-positions within sessions when family members become emotionally reactive. although storytelling and fantasized solutions have also been used. tension. 2002. Reframing is a method used to recast a particular conflict or situation in a less threatening light. Detriangulation. Bowen used coaching with well-motivated family members who had achieved a reasonable degree of selfdifferentiation. I-POSITIONS. but is not a rubber-stamp: It seeks to build individual independence. (3) reverses the direction of the movement. Coaching is supportive. Most often. COACHING. but allows them to be considered in a less defensive or reactive manner. who they discuss it with. “Relationship experiments are behavioural tasks assigned to family members by the therapist to first expose and then alter the dysfunctional relationship process in the family system” (Guerin. these experiments are assigned as homework. DISPLACEMENT STORIES. the family controls how the problem is handled. and stabilized position. which helps them to better deal with it effectively. p. like “I Never Sang For My Father. Another technique has the therapist placing a particular conflict or situation under the family's control.

The therapist may recommend. • • • In step 1. attempts to place control in the hands of the individual or system. This technique attempts to disrupt a circular system or behaviour pattern. of the mediator and side-taker". another influential family therapist. FAMILY COUNCIL MEETINGS Family council meetings are organized to provide specific times for the family to meet and share with one another. 91 . Specific directives are given as to when. In one scenario. Attacking others during this time is not acceptable. Because triangles constantly move around. paradoxical interventions often can produce change or relieve symptoms of stress. & Goodman. Expressions to absent family. and children can be arranged through utilizing this technique. involves meeting with one member of the family as a supportive means of helping that person change. The council should encompass the entire family.TAKING SIDE & MEDIATING. and any absent members would have to abide by decisions. The agenda may include any concerns of the family. The mediator is one person mediating between at least two others.. Such is the case with prescribing indecision. When straightforward interventions fail. The side-taker joins one person in coalition against another. a sense of control over the symptom often develops. PRESCRIBING INDECISION The stress level of couples and families often is exacerbated by a faulty decision-making process. in which case a time is set and rules are outlined. Decisions not made in these cases become problematic in themselves. The goal of the therapist is to change the pathogenic relating around into a more productive way of relating. then play the role of the spouse and carry on a dialogue. the therapist assumes the role of side-taker. resulting in subsequent change. STRATEGIC ALLIANCES This technique. A directive is given to not rush into anything or make hasty decisions. the therapists moves into the role of the go-between. for example. and with whom. the continuation of a symptom such as anxiety or worry. The therapist might prescribe council meetings as homework. Zuk (1981) discusses practical applications of working with triangles in family therapy. Zuk (1981) outlines three steps involved in the go-between process (p. and facilitate communication. Past events preclude the therapist's involvement in mediating or side-taking. and for what amount of time one should do these things. encourage full family participation. widely used by strategic family therapists. 38). The couple is to follow this directive to the letter. THE EMPTY CHAIR The empty chair technique. a partner may express his or her feelings to a spouse (empty chair). In step 3. As the client follows this paradoxical directive. Zuk terms his triadic-based technique go-between process because it relies on the therapists "taking and trading roles. PUTTING THE CLIENT IN CONTROL OF THE SYMPTOM This technique.. the current permutation might be different from the past. 1985). the therapist works on initiating conflict. Family council meetings help provide structure for the family. The individual is often asked to behave or respond in a different manner. Individual change is expected to affect the entire family system. where. often used by strategic family therapists. In contrast to Bowen's belief in the importance of neutrality. parents. most often utilized by Gestalt therapists (Perls. Hefferline. In step 2. In all three steps it is important to keep the interactions focused on the present. The indecisive behaviour is reframed as an example of caring or taking appropriate time on important matters affecting the family. has been adapted to family therapy.

Effective family therapy techniques treat the entire family as an emotional unit of which each family member is a part of and acknowledges that what affects one member of the family affects the whole family. For example. Family contracts are a positive tool in the arsenal of a family systems psychologist because they are facilitated agreement that a family makes to avoid future dysfunction. Specifically. 1986). By actively role playing other members of the family. reframing involves taking something out of its logical class and placing it in another category (Sherman & Fredman. Problem solving may seem like a common sense resolution. But does changing our symbolic representation of the real world actually change anything in the real world itself? Kolb describes the four basic creative dimensions as Meaning. "Caring Days" can be set aside when couples are asked to show caring for each other. Reframing is a process in which a perception is changed by explaining a situation in terms of a different context. Relevance or Fact by altering context or perspective. 92 . All parties commit to working together to build self-esteem and a healthy lifestyle. the family also becomes a part of the solution. It changes our perceptions. by altering its context or description Reframing is a powerful change stratagem. In such cases. eating and social perception. FAMILY CONTRACTS The family contract is a therapeutic tool that allows families to negotiate terms and come to an agreement on how they want to handle future family problems and to commit to positive change. but it requires a willingness on the parts of all parties to contribute to the solution. parents playing the part of the children or dad taking on the role of mom to a child's dad and a mom's child. REFRAMING Technique used to create a different perception of reality. and family members take little time with each other.SPECIAL DAYS. Most family therapists use reframing as a method to both join with the family and offer a different perspective on presenting problems. For example. A family contract. reframing is altering Meaning. Family members may also be required to play the part of other family members. MINI-VACATIONS. Reframing is altering the meaning or value of something. a negative often can be reframed into a positive. particularly if elements of the contract are not being upheld. Problem solving is a family therapy technique that requires effective communication and often comes later in therapy sessions as the therapist challenges family members to role-play situations previously deemed irresolvable. each member is required to see that person's point of view. Boredom is present. for example. the therapist can reframe a disruptive behaviour as being naughty instead of incorrigible allowing family members to modify their attitudes toward the individual and even help him or her makes changes. By treating the whole family as a unit. develop plans and create resolutions for future problems. Value. Her parents will then commit to listening and not dismissing her feelings. may detail that a child who copes with an eating disorder commits to talking about her feelings on weight. PROBLEM SOLVING Problem solving is an effective therapy technique not because it teaches the family how to resolve the issue that brought them to see the family systems psychologist. but it teaches them how to identify. and this may then affect our actions. family members feel unappreciated and taken for granted. This leads to learning how to disagree in positive and respectful manner and to not allow those disagreements to impede problem solving efforts. a mother's repeated questioning of her daughter's behaviour after a date can be seen as genuine caring and concern rather than that of a nontrusting parent. In these terms. Value. Through reframing. Relevance and Fact. SPECIAL OUTINGS Couples and families that are stuck frequently exhibit predictable behaviour cycles. The family contract also helps family members recognize when problems are occurring. 1980). Specific times for caring can be arranged with certain actions in mind (Stuart. This is summarized in the diagram above.

Context reframing takes an undesired attribute and finds a different situation where it would be valuable. By forcing the father to equate his own stubbornness with hers. 2. He thus created a powerful positive image of the joys of grandparenthood. Independence is of course a negative goal. There are situations where she will need stubbornness. Therefore it is verbalizing appropriate behaviour when it happens. The parents have to gradually stop supporting their children. and the children have to gradually stop relying on their parents. babysitting. in which Satir points out two things to the father: 1. and the grandparents visited frequently. when she got married (At this time. When the daughter subsequently got married. UNBALANCING Technique used to create a different perception of reality. a young woman consulted him. toddlers crawling through the living rooms. In meaning reframing.blackwellreference. but not too frequently. toys strewn across the house. yet for some reason. In a typical case. she was away at college. This results in a double reframe. When this technique is used to support an underdog in the family 7048821_ss1-9 PUNCTUATION Technique used to create a different perception of reality. to protect herself or achieve something. and congratulated them for their willingness to participate so actively in the rearing of their (hypothetical) grandchildren. this creates a context in which he either has to recognize the value of her stubbornness.Milton Erikson One of the common challenges of family therapy is to help the parents to let their children go. where she was to live. and had no steady boyfriend. Reframing . a chance for change within the total hierarchical relationship is fostered. 93 . or deny the value of his own. and save the money to support their grandchildren’s education.Bandler & Grinder (NLP) identify two forms of reframing: meaning and context.) Erikson met the parents. Reframing switches to a context that makes the stubbornness relevant. you take an undesired attribute and find a description where the attribute takes on a positive value. having babies crying through the night. she lived in a city some distance away with husband and baby. It is from the father himself that she has learned to be stubborn. her parents had used their life savings to build an extension to their house. the couple decided to rent the extra rooms out to mature lodgers instead.Virginia Satir A classic example of a reframe by Virginia Satir concerns a father who complains at the stubbornness of his daughter. Milton Erikson often used the approach of creating an alternative goal for the parents: of preparing themselves to be grandparents. Reframing . Punctuation is “the selective description of a transaction in accordance with a therapist’s goals”. This is a procedure wherein the therapist supports an individual or subsystem against the rest of the family. http://www.

INTENSITY Intensity is the structural method of changing maladaptive transactions by using strong affect. 94 . ADDING COGNITIVE CONSTRUCTIONS Advice & Information are derived from experience and knowledge of the family in therapy. BOUNDARY FORMATION Technique used to create a different sequence of events. In examining their roles. WORKING WITH SPONTANEOUS INTERACTION In addition to enactment. and boundary formation. It is accomplished through the use of enactment. depending upon the family’s situation. unapologetic manner that is goal specific. more functional ways of acting. The result is that family members experience their own transactions with heightened awareness. The focus is on process not content. Paradox is an apparently sound argument leading to a contradiction. The process of enactment consists of families bringing problematic behavioural sequences into treatment by showing them to the therapist a demonstrative transaction. ENACTMENT Technique used to create a different sequence of events. or change the boundaries within the family. It is used to motivate family members to search or alternatives. Pragmatic fictions are formal expressions of opinion to help families and their members change. Part of the therapeutic task is to help the family define.RESTRUCTURING Technique used to create a different sequence of events. The goal is to make the family more functional by altering the existing hierarchy and interaction patterns so that problems are not maintained. The procedure of restructuring is at the heart of the structural approach. repeated intervention. structural family therapists concentrate on spontaneous behaviours in sessions. It is important that therapists help families recognize patterns of interaction and what changes they might make to bring about modification. This method is to help family members to gain control over behaviours they insist are beyond their control. Intensity works best if done in a direct. They are used to calm down anxious members of families or reassure these individuals and families about certain actions. unbalancing. or prolonged pressure. such as members yelling at one another or parents withdrawing from their children. Also used to tell the family what to do with the expectation of noncompliance. SHAPING COMPETENCE The family therapists help families and individuals in becoming more functional by highlighting positive behaviours. The therapist also helps the family to either strengthen or loosen boundaries. It occurs whenever families display behaviours in sessions that are disruptive or dysfunctional. Family members may defy the therapists and become better or they may explore reasons why their behaviours are as they are and make changes in the ways members interact. members often adapt new.

it's a family's communication patterns and styles that lead to conflict and division. TAKING TURNS EXPRESSING FEELINGS taking turns expressing feelings NONJUDGMENTAL BRAINSTORMING nonjudgmental brainstorming If each member of the family is interdependent on other members of the family it stands to reason that dysfunction with one will affect the whole. Communication techniques are used to build skills that allow for effective communication between family members. REPEATING Repeating is also a listening technique.VI/ COMMUNICATION SKILL BUILDING TECHNIQUES More often than not. generalized anxiety disorder. repeating. Effective communication allows a family to dialogue on their problems. A large portion of effective communication resides in active listening. To create an effective solution to any dysfunction or problem in the group dynamic requires effective communication so that all members of the group or family are in touch with each other. the mother who commits to more and more tasks in order to compensate for her family's overextending commitments may stretch herself to the limits because she lacks the ability to communicate how stretched thin she is. The family therapist constantly looks for faulty communication patterns that can disrupt the system. Instead. substance abuse and more. concerns and feelings without lashing out or feeling obligated to resolve the problems being shared. Some of these methods include reflecting. 95 . fair fighting and nonjudgmental brainstorming. then having another member repeat back what he heard that person say. It involves having a member state how he feels. This leads to disappointment and disagreement in the family. Effective communication is an important lesson that family systems psychologist incorporate into group and individual family therapy sessions. Therapists teach effective communication skills and the importance for mom to let the family know she is overextended and that she either needs help or they need to rearrange priorities in order to break out of the circular causality of this family's problems. Communication patterns and processes are often major factors in preventing healthy family functioning. she promises to do more and more. In every way. Faulty communication methods and systems are readily observed within one or two family sessions. while another member repeats back what was said. For example. REFLECTING Reflecting is a listening technique which involves having a member express her feelings and concerns. however. the family is not happy. exerting increasing emotional and mental stress upon herself when she cannot meet all the commitments she is making. this impacts her already damaged sense of self-worth leading to a vicious cycle that may result in depression. When other members of the family express their disappointment. FAIR FIGHTING Fair fighting techniques focus on attentive listening and expressing feelings and concerns in a nonthreatening manner. a skill that must be learned. Repeating and reflecting techniques allow members to better understand where the other is coming from and why she feels as she does.

financial problems. grief. Instructions 1. o Research and Background 1 Ask the family member who initiated the family session why he feels the family needs the therapy. It is best to reschedule if one family member cannot make it to a session. Family therapy sessions help with issues like divorce. As a counselor. anger and sadness in some family members. Inquire if they have any issues with the family or any individual members of the family. Sometimes a family therapy session is the only place where each family member can have a voice. you will need to have all voices heard to find out what issues or problems each of the family members bring to the family dynamic. depression. 2 Find out which family members are involved. Let each family member know that the therapy will not be effective if anyone misses a session. As children grow and marriages evolve. o o o o o 96 . so it is critical to resolve their issues to help the family unite. and invite them to the sessions. 3 Conduct an individual and private session with each family member before commencing the family session. 6 Recommend individual counseling for those members who have problems stemming from trauma or childhood problems. 4 Ask all family members why they think they need a family session.This will give you his perspective on the situation and on what is happening to the family. They will continue to bring their issues to the family dynamic. stress and substance abuse. Make sure you write down each family member's thoughts and concerns for future reference.Structure of a Family Therapy Session By an eHow Contributor Family communication is an evolving and complicated issue for most families. 5 Take notes on each session. the lack of communication within a family may cause issues.

o o o o o o Read more: How to Conduct a Family Therapy Session | 4 Ensure that each member is allowed to speak without interruption.html#ixzz1J7TX2G6W 97 . You will be acting as a mediator on how the session is conducted. others may stem from trauma or childhood problems. Let each person contribute. and invite individual family members to contact you to ask questions. You will also be enforcing the rules the family has set in advance. You can ask them if they prefer a family that is close. 7 Meet with individual family members to see if the resolution is what they expected. Inquire if they feel problems are resolving. or perhaps there may be a time limit set for each person. 3 Begin by asking each member what kind of family dynamic they prefer. o Family Session 1 Review your notes from each session you had with individual family members. 6 Apply values and standards to the solutions to the family issue that fit within that family's value http://www. 5 Start to resolve each individual issue that the family has brought up. Some members may insist on having one person at a time speak. This will refresh your memory and let you understand more background information before you conduct your family session. Devise a followup to find how the solutions are working. laughs a great deal and takes fun-filled family vacations without drama. Ask members to contribute to how the session will be conducted. Give each family member an opportunity to provide a solution.2. 2 Set rules for the family therapy session. Some issues may be based from family disputes.

Presenting 3. Orientation Their expectations Our expectations Rationale for seeing the family 2. Problem Clarification Obtain agreement on list from above Problem (for each problem) Nature and history of problem Affective/emotion al components Precipitating events Who is involved and how b. Any other problems? 98 . Data Gathering a. Other Investigationsbiop sychosocial: medical d.Stages and Steps of Problem-Centred Systems Therapy Assessment Orientation Data gathering Problem descriptions Clarification and agreement on a problem list Contracting Orientation Outlining options Negotiating expectations Contract signing Treatment Orientation Clarifying priorities Setting tasks Task evaluation Closure Orientation Summary of treatment Longterm goals Follow up (optional) A Guideline for Family Assessment Areas Covered 1. General Family Functioning: McMaster model dimensions Problem solving Roles Communication Affective involvement Affective responsiveness Behavior control c. Problem List Family's list Doctor adds his 4.

. Identification of the problem 2. Provision of Resources Postulated Most effective: flexible behavior control. Absence of involvement 2. Chaotic To maintain the style.Least effective: masked and indirect Roles Two family function types -necessary and other Two areas of family functions -instrumental and affective Necessary family function groupings A. . Least effective: chaotic behaviour control 99 . Narcissistic involvement 4. Dangerous situations 2. Meeting and expressing psychobiological needs and drives (eating. Action 6. drinking.Summary of Dimension Concepts Problem-solving Two types of problems instrumental and affective B. Least effective when cannot identify problem (stop before step 1) Postulated Most effective when all necessary family functions have clear allocation to reasonable individuals(s). Masked and Direct 4. Clear and Indirect 3. Monitoring the action 7. Symbiotic involvement Seven stages to the process 1. sleeping. given the context Postulated Most effective: clear and direct. Instrumental 1. Flexible 3. Affective Involvement Six styles identified 1.Least effective: -symbiotic and absence of involvement Postulated Most effective when all seven stages are carried out. Mixed 1. Behavior Control Applies to three situations 1. Involvement devoid of feelings 3. sex and aggression) 3. Interpersonal socializing behaviour inside and outside the family Standard and latitude of acceptable behavior determined by four styles 1. Systems Maintenance and management Other family functions: -adaptive and maladaptive Role functioning is assessed by considering how the family allocates responsibilities and handles accountability for them. Decision of one alternative 5.Least effective when very narrow range (one or two affects only) and/or amount and quality is distorted. and accountability built in. Adult Sexual Gratification C. Masked and Indirect Affective Responsiveness Two groupings -welfare emotions and emergency emotions Postulated Most effective when full range of responses are appropriate in amount and quality to stimulus. Nurturance and Support 2. Evaluation of success Postulated Most effective: empathic involvement. various techniques are used and implemented under role functions (systems maintenance and management) Communication Instrumental and affective areas Two independent dimensions 1. Rigid 2. . Empathic involvement 5. Life Skills Development 2. Affective 1. Communication of the problem to the appropriate person(s) 3. Over-involvement 6. Clear and Direct 2. Least effective when necessary family functions are not addressed and/or allocation and accountability not maintained. eliminating. Laissez-faire 4. Development of action alternatives 4.

Cloe Madanes. Theoretical formulations . but they will show it to you in their interactions. Other coalitions may be subtle. also worked in the USA with Don Jackson with middle class families. Marianne Fishman. Structure — the organized pattern in which family members interact. Every member may play many roles in various subgroups. Fist generation of family structural therapists: Braulio Montalvo. Jay Haley. The advent of children requires that the structure of the family change 100 . predictable sequences of family interaction. age or common interests. Each person is a member of one or more subsystems in the family. in the USA trained in child psychiatry and psychoanalysis with Nathan Ackerman. clear to unclear. 2. served in the Israel army as a physician. Carter Umbarger. Family are individuals who effect each other in powerful but unpredicatable ways 2. disengaged to enmeshed D. 1970 headed Philadelphia Child Guidance Clinic where family therapists have been trained in structural family therapy ever since 4. Always concerned with social issues 2. 5. C. Boundaries are invisible barriers that regulate the amount and nature of contact with members. Couples are influenced by the structure of their families of origin 3. 3. Some groupings are obvious and based on such factors as generation. Marriage begins with accommodation and boundary making 2. Subsystems — Families are differentiated into subsystems of members who join together to perform various functions. gender. Salvador Minuchin 1. The emotional boundaries and coalitions are important B. The consistent repetitive organized and predictable patterns of family behavior are important 3. Harry Aponte. Developed a theory of family structure and guidelines to organize therapeutic techniques 3. worked in Israel with displaced children. They range from rigid to diffuse. Born in Argentina . patterns of interaction.three essential constructs 1. Bernie Rosman. Normal family development 1. Structure involves a series of covert rules. and Stephen Greenstein. Assumptions 1. Couples also form boundaries with their families of origin 4. Families may not be able to tell you the family structure.Structure of Family Therapy —Outline by Patty Salehpur A. There are universal and idiosyncratic constraints.

The development of behavior disorders 1. map. Family dysfunction results from stress and failure to realign the structure to cope with it. Joining and accommodating. Using enactment to understand and clarify c. 5. 6. Listen to "I" statements 2. 7. Goals of therapy 1. transform structure 1. 2. 3. Looking at the power hierarchies b. then taking a position of leadership a. Power hierarchies may develop which may be weak and ineffective or rigid and arbitrary. Enmeshed families have diffuse boundaries and family members overreact emotionally and become intrusively involved with one another. Short-range goals may be developed to alleviate symptoms especially in life threatening disorders such as anorexia nervosa. Changing family structure . Diagnosing a. 4. These actions hinder mature actions to resolve stress. Looking at the boundary structures 4. Symptomatic change . Disengaged families have rigid boundaries and excessive emotional distance. Symptoms in one family member may reflect dysfunctional structural relationships or simply individual problems. Techniques — join.altering boundaries and realigning subsystems 2. They fail to mobilize to deal with the stress. Working with interaction and mapping the underlying structure a. 9.E. Generational coalitions may also prevent effective problem solving. Family structure may fail to adjust to family developmental processes.growth of the individual while preserving the mutual support of the family 3. A major change in family composition demands structural adaptation. Conflict avoidance prevents effective problem solving. structural diagnosis 101 . G. individual vs. Enactment for understanding and change 3. subgroup b. 10. 8. F. but for long-lasting effective functioning the structure must change. Behavioral techniques fit into these short-term strategies. Subsystems in the family may be disengaged or enmeshed.

g. Seating b. Directives 8. 9. "It’s too noisy in here. Boundary making and boundary strengthening a. Shape competence. Teaching may be necessary b. Therapist sometimes must challenge the way family members perceive reality. Challenging the family’s assumptions may be necessary a." 6. Challenging c. repetition and duration b. Pragmatic fictions c. changing the way family member relate to each other offers alternative views of reality. apologizing or rambling c. Clarify circular causation 7.5. Seeing subgroups or individuals to foster boundaries and indivduation c. e. Highlighting and modifying interpersonal interactions is essential a. Taking sides b. Unbalancing may be necessary a. Control intensity by the regulation of affect. Would you quiet the kids. Therapists must create techniques to fit each unique family 102 . Paradoxes d. Don’t dilute the intensity through overqualifying.

Peter Stratton Prof. Paula Boston Prof. Helen Pote Dr. Number G9700249  No part of this document should be reprinted without the permission of the authors. LS2 9JT This manual was developed through an MRC Small Project Grant. 103 . David Shapiro Ms Helga Hanks Leeds Family Therapy & Research Centre School of Psychology University of Leeds Leeds. David Cottrell Ms.Systemic Family Therapy Manual Ms.

4 Reflecting Teams 4.1 Linear Questioning 4.3 Statements 4.3 Connections and Patterns 2. Guiding Principles 2.1 Origins of the Manual 1.5 Child Centred Interventions 14 14 14 15 16 18 104 .8 Power 2.Table of Contents 1.1 Systems Focus 2.1 Models of Therapeutic Change 3.5 Clinical Examples 6 6 6 7 8 8 2.2 Overview of Specific Goals 12 12 13 4.11 Strengths and Solutions 9 9 9 9 10 10 10 10 10 11 11 11 3.2 Circular Questions 4.2 Circularity 2.7 Cultural Context 2. Introduction 1.3 Notes on use of manual 1. Outline of Therapeutic Change 3.5 Constructivism 2.6 Social Constructionism 2.4 Narratives and Language 2.2 Aims and applicability of the manual 1.9 Co-constructed therapy 2.10 Self-Reflexivity 2. Outline of Therapist Interventions 4.4 Ethical and Culturally Sensitive Practice 1.

4 Pre-therapy Preparation 5.2 Continue to work towards change at the level of behaviours and beliefs 8.1 Develop engagement 7.3 Gather and Clarify Information 6.2 Engage and Involve all family members 6.6 Correspondence 5.8 Session Notes 19 19 19 20 20 21 22 22 22 6. Initial sessions 6.3 Develop family understanding about behaviours and beliefs 8. Therapeutic Setting 5. End sessions 8.4 Establish Goals and Objectives of Therapy 4 Initial Session Checklist for Therapists 23 23 24 25 25 26 7.5 Return to Objectives and Goals of Therapy 4 Middle Sessions Checklist for Therapists 27 27 27 28 30 37 38 8.4 Collaborative ending decisions 8. Middle sessions 7.1 Outline Therapy Boundaries & Structure 6.5.1 Gather Information and Focus Discussion 8.2 Gather Information and Focus Discussion 7.2 Team 5.3 Identify & Explore Beliefs 7.3 Video 5.7 Case Notes 5.4 Work towards change at the level of behaviours and beliefs 7.5 Pre and Post Session Preparation 5.5 Review the process of therapy 4 End Session Checklist for Therapists 39 39 40 41 41 42 42 105 .1 Convening Sessions 5.

8 10.9 10.2 10.3 10.5 Correspondence 43 43 43 43 44 44 10.5 10.12 10.4 Assessing risk 9.6 10.15 10.16 Advice Interpretation Un-transparent/Closed Practice Therapist monologues Consistently siding with one person Working in the transference Inattention to use of language Reflections Polarised position Sticking in one time frame Agreeing / not challenging ideas Ignoring information that contradicts hypothesis Dismissing ideas Inappropriate affect Ignoring family affect Ignoring difference 45 45 45 45 45 45 46 46 46 46 46 46 46 47 47 47 47 106 .2 Clarifying therapy with referrer present 9.13 10.14 10.11 10.3 Identifying network and clarifying relationships 9.9.1 Child Protection 9.1 10.10 10. Proscribed Practices 10. Indirect Work 9.7 10.4 10.

Appendices Appendix 1: Sample Appointment Letter Appendix II: Sample Video Consent Form Appendix III: Sample Referrer letter Appendix IV: Post-assessment letter to referrer Appendix V: Closing letter to referrer 48 49 50 51 52 Figures Figure 1: Models of Therapeutic Change 12 Tables Table 1: Perceptions that are helpful in achieving change 13 107 .

in developing skills for trainee family therapists. Introduction 1. The team developing the manual comprised of a group of experienced family therapists working at Leeds Family Therapy & Research Centre (LFTRC). The manual’s function is to guide therapeutic work with families in a clinic setting. and would now describe their practice as being influenced by Post-Milan and Narrative Models.2 Aims and applicability of the manual The manual is principally designed as a research tool for outcome studies in which the effectiveness of systemic therapy can be assessed. and how they may translate into their own practice. υSection 4.2 The manual can also be used less formally as a framework for training and supervision. After these more theoretical aspects have been addressed. The therapists contributing to this manual have historically been influenced by Milan Systemic family therapy models. 1.3 Notes on use of manual As with any interpersonally focused therapy. thinking carefully about the descriptions of these interventions. 1.1 Origins of the Manual The manual was developed through a research project funded by the Medical Research Council. LFTRC is a centre working systemically with individuals. the therapist should begin to consider the general interventions used. They should consider the guiding principles which are influencing them currently and the connections they make between these principles. For research purposes the manual is designed for use by trained family therapists or other trained therapists with experience in family therapy. In using the manual therapists should consider the following guidelines: • Therapists should first become familiar with the guiding principles which will influence all aspects of the therapy that they carry out using this manual. υ Section 2. For this purpose the manual should be used in conjunction with the accompanying adherence protocol. υ Section 5. They should then consider the section concerning models of change. as well as with professional systems. Therapists using the manual will be expected to be working as part of a systemic family therapy team. couples and families across the age span. systemic family therapy does not follow a rigidly prescribed treatment sequence (Lambert & Ogles 1988). so that therapists can offer a unified version of therapy. υ Section 3. with some flexibility to express their own creativity. 108 • • • . This is designed to assess the degree to which therapists are able to adhere to the methods outlined throughout the manual. and consider the model of change that is influencing their own therapeutic practice. It therefore aims to offer a framework and guidelines for the implementation of systemic family therapy. Details on the composition of therapy teams are outlined later. and setting up the therapy itself.1. The manual then turns to guidelines for convening sessions.

and this may be especially important where the individuals/families are of a different gender. We would like to thank all of the families and therapists who have given permission for the therapy they undertook to be used for research. • Therapists should then use the manual to more specifically guide therapy sessions. Their practice should comply with the Association for Family Therapy and Systemic Practice (AFT): Code of Conduct and Ethical Guidelines. reading the practical guidelines outlined for the beginning middle and end of therapy. 109 . or more formally by an independent researcher to assess adherence when the manual is being used as a research tool. • • This manual has an accompanying questionnaire for therapists and an adherence protocol to assess the degree to which therapist practice reflects that of the manual. υ Section 9. Identifying details have been removed from the material.Therapists should therefore begin to follow the guidelines of the manual from the moment they take referrals. Care should be taken in the assumptions and agendas therapists develop during therapy in this regard. υ Section 10. Therapists’ checklists are provided at the end of each of these sections to help therapists consider whether they have covered all aspects of the guidelines. Without this permission the research project to develop this manual would not have been possible. and refer back to these during the course of therapy to ensure proscribed practices do not emerge during the course of therapy. This may be used as a personal check for therapists or trainers using the manual. Finally. & 8. 1. and the dialogue modified to protect confidentiality.5 Clinical Examples All of the clinical material used in this manual has been adapted from extracts of therapy undertaken at Leeds Family Therapy & Research Centre. Therapists should remain curious and open minded in working with families.4 Ethical & Culturally Sensitive Practice In using this manual therapists should pay keen attention to ensuring their practice is both ethical and culturally sensitive. in order to consider systemic issues in convening therapy. Therapists should go on to consider the aspects of indirect work that support the family therapy which should still be managed following the systemic guiding principles. and following the goals defined for each of these stages. therapists should consider the proscribed practices which should not form a significant proportion of their work. υ Section 5. cultural or societal background to that of the therapist. υ Sections 6. 1. 7.

10 In devising this manual therapists considered their own constructions of how these principles might connect. particularly in relation to the difficulties and issues that the family system brings to therapy.2. being affected by and affecting all members of the system. Therapists should consider for themselves the connections they are currently making between these principles and the effect this may have on their work with families. The therapist should consider the principles flexibly and decide which might best fit with the issues with which the family are struggling and the therapists own current constructions. around. 2. 2. The language that is used to describe these narratives and the interactions between individuals constructs the reality of their everyday lives.1 Systems Focus In working systemically the central focus should be upon the system rather than the individual. 2. The principle of self-reflexivity may be particular helpful in enabling the therapist to reach this. and the connections between the beliefs and behaviours within systems.2 Circularity Patterns of behaviour develop within systems.3 Connections and Patterns In understanding relationships and difficulties within systems it will be important for the therapist to consider the connections between circular patterns of behaviour.4 Narratives and Language Behaviours and beliefs form the basis of stories or narratives. υSection 2. which are constructed by. which are repetitive and circular in nature and also constantly evolving. The stories that people live often match the stories that are told about individuals. Thus there is only the possibility of perturbing other people’s meaning systems. 2. 2. and between individuals and the system itself. interactions and language that develop between individuals. and should be used to guide therapists’ practice whilst using this manual in work with families. but at times when stories lived and stories told are incongruous change may occur. Guiding Principles These principles are based at the level of theory. Therapists should be familiar with all of the principles though they may privilege different principles according to their current interests and the needs of the family with which they are working. In social interactions understanding is constrained and affected by this meaning system. Behaviour and beliefs that are perceived as difficulties will also therefore develop in a circular fashion. and people cannot make assumptions about what meaning will be attributed to the information they offer/contribute to others. 110 . The process of therapy should enable family members to consider these connections from new and/or different perspectives. The system may be A consistent view is that these difficulties do not arise within individuals but in the relationships.5 Constructivism This is the idea that people form autonomous meaning systems and will interpret and make sense of information from this frame of reference. at the levels of lived behaviours and/or the construction of new narratives.

It is important for the therapist to recognise that there is a multi-versa of possibilities available for each family in the process of change.11 Strengths and Solutions The therapist should take a non-pathologising. in relation to the cultural meanings and narratives within which people live their lives. 2.2. gender.9 Co-constructed therapy In therapeutic interactions reality is co-constructed between the therapist (and team) and the people with whom they meet. functioning and prejudices so that they can use their self effectively with the family. including issues of race. The therapist can facilitate this process by attending to the strengths and solutions in the stories that the family system brings to therapy. this takes precedence over the concept of a single external reality. it will be important to consider ideas of social constructionism. 2. disability and class etc. They form part of the same system.6 Social Constructionism In working with systems in the process of change at the level of behaviour or narratives. Selfreflexivity focuses especially on the effect of the therapy process on the therapist and the way that this is a source of (resource for) change in the family. 2.8 Power The therapist should take a reflexive stance in relation to the power differentials that exist within the therapeutic relationship. In order to use self-reflexivity it will be necessary for the therapist to be alert to their own constructions. 111 . The relationship between these narratives. and share responsibility for change and the process of therapy.10 Self-Reflexivity The therapist should aim to apply systemic thinking to themselves and thus reject any thinking about families and their processes that does not also apply to therapists and therapy. 2. positive view of the family system. and the current difficulties they are struggling with. as well as the wider context for the therapeutic team and the family should be an important consideration at the point of referral and throughout the therapy. Particular attention should thus be paid to the contributions that all members of the therapeutic system make in the process of change.7 Cultural Context The therapist should consider the importance of context. and within the family relationships. Relevant is the idea that meaning is created in the social interactions that take place between people and is thus context dependent and constantly changing. A family system that enters the therapeutic system should be considered as a system that owns a wealth of strengths and solutions in the face of difficult situations. and the family themselves will be in the best position to generate suitable solutions. the therapeutic relationship and its context. 2.

Once change is beginning to occur. are outlined in Table 1. It will be important for therapists to consider the model of change with which they are currently working and consider what aspects of this model of change they are currently privileging. beliefs or stories that have developed in family systems. What is their overall aim during the process of therapy? 112 . beliefs or stories. New perceptions that are often helpful to families in achieving change.1 Models of Therapeutic Change In systemic work many different models of change have been hypothesised. The information will affect the development of behavioural patterns. It therefore helps the family to develop new perceptions or actions that they can use to tackle the difficulties with which they are struggling. therapists highlight this process to families. Model of Therapeutic Change Cybernetics Redundant patterns / beliefs Narratives Meaning through Langauge Understand patterns / beliefs / stories Develop different patterns / beliefs / stories Amplify change Therapists are working with families to understand the patterns of behaviour. Through the process of understanding these behaviour patterns. This will develop the family’s resources in coping with future struggles. Outline of Therapeutic Change 3. enabling them to develop further changes and develop their understanding of how change was possible. In using this manual therapists should consider the model of change outlined in Figure 1. Therapists may also use active strategies to introduce this new information. Figure 1. and the wider context in which they live. therapists will begin to introduce new or different information. beliefs and stories and the influence they have on the family.3.

5. 3. 2. 4. The goals are listed here and elaborated within sections 6. 2. 4. 4. Outline Therapy Boundaries & Structure Engage and Involve all family members Gather and Clarify Information Establish Goals and Objectives of Therapy Goals during middle sessions 1. 7 & 8. 5. 2. 3.Table 1: Perceptions that are helpful in achieving change Initial Perception of Struggles Located in the individual Uncontrollable/Unchangeable Intrinsic Blameworthy Sinister Linear Partisan Developing Perception of Struggles Arising from the system Temporary Accidental Redundant Well meaning but mistaken Circular Neutral 3.2 Overview of Specific Goals Within each stage of therapy there are also specific goals that the therapist should be considering. Goals during initial session 1. Develop and Monitor Engagement Gather Information and Focus Discussion Identify & Explore Beliefs Work towards change at the level of beliefs and behaviours Return to Objectives and Goals of Therapy Goals during ending sessions 1. Gather Information and Focus Discussion Continue to work towards change at the level of behaviours and beliefs Develop family understanding about behaviours and beliefs Secure Collaborative Decision re: Ending Review the process of therapy 113 . 3.

The degree to which each of these interventions will be used will vary throughout the course of therapy. and therapists’ should follow the guidelines below regarding this. 4. present. A variety of circular questions may be used by the therapist as outlined in Table 2. ⇒ Sections 6. They are effective at illuminating the interconnectedness of the family sub-systems and ideas. Outline of Therapist Interventions Therapists have a range of interventions open to them in working with the family to co-create change.4. & 8. future. The use of particular types of circular questioning at different stages of the therapy will be highlighted throughout the manual.2 Circular Questions Circular questions are aimed at looking at difference and therefore are a way of introducing new information into the system. These may be more or less appropriate as therapy progresses. The time scale of circular questions often changes fluidly between the past. Linear questions can be built up in a circular manner around the family by asking different family members the same/similar linear questions. 7. Linear Questions Examples • • • • How old are you? Where do you go to school? What do you do if you are upset? What do you do after that? 4. Circular Question Examples Type of Circular Question Examples About another’s state / behaviour / What do you think John is feeling? beliefs What do you think John is feeling when he shouts at you? What ideas do you think John might have about that? Offering alternative perspectives What does John think of your school performance? 114 .1 Linear Questioning Direct linear questions can often be useful in gathering information from the system and clarifying information given. The 4 interventions listed below are those which are most commonly used in systemic family therapy and should be used in therapist’s practice throughout the course of therapy. especially at the beginning of therapy. Additional interventions that are used less frequently are highlighted in the appropriate stage of therapy.

and about how sometimes you had struggled with developing trust as a child. you feel if you didn’t go out at all. υSection 4. your mum and dad would feel reassured that you would be safe. and do not become therapist monologues. Statement Examples • • • So let me make sure I have understood this. Statements should also be delivered in such a manner that they are open to question or comment from the family and not viewed as conclusive statements.indirect Do the girls really dislike each other? How do the children react when they see you arguing? When you and John raise your voices and Jill starts crying what does John do then? What will you think in 5 years time? Miracle question: Imagine you woke up tomorrow morning and all the difficulties you were experiencing currently had disappeared. may find it cognitively impossible to view events from another person’s perspective. and who next is most upset? On a scale of one to ten.5 4.If I asked a teacher what would they say about it? About relationships . how would things be different? What effect would that have upon your relationship with x? Who is most likely to get upset when father is away. Have I got that right? I can see this is very upsetting. and remains an area of great distress for you.4 Reflecting Teams 115 .direct . how close do you think James and Sue feel when they argue? Circular Definitions About possible futures Ranking Though many family members will be able to answer circular questions. and later as an adult. Who would be most likely to comfort you when you are feeling like this? You were talking a lot about trust. and think about information in a circular manner.4 In using statements therapists should ensure that they are not of long duration. Statements are sometimes used as a way of organising information before a question is formulated to the family. υ Section 4. How much do you feel trust is around now in your relationship with John? 4. younger children or those with developmental difficulties. directly or in the form of a reflecting team.3 Statements Statements are used by the therapist for 3 main functions: • To clarify and acknowledge a communication from the family • To comment on the position or emotional state of a member of the family • To introduce therapist/team ideas.

Feedback should be gained from the family about how comfortable and useful they found the process of the reflecting team. A general model for introducing and implementing reflecting teams is outlined below. 7. Reflecting team joining family and therapist in room. Reflecting Team Example A reflecting team is used at the end of a session with a father. Reflecting teams can be introduced during the therapy session or at the end of the session. 2. team members should ensure they: • • • • • • • 6. 1. Much of the session has been focused on the difficulties the parents are experiencing in setting consistent boundaries for the children. without wanting too come down too hard on their freedom. and their two teenage children. hold a tentative and curious stance. use age appropriate language. 3. and in turn these are often adapted to suit the wishes and needs of the family in therapy. 4. therapist and team members. The therapist should take responsibility for monitoring the effect of the reflecting team on the family. The format of the reflecting team should be negotiated with the family. The family should always be given the opportunity to offer their comments on the therapy team’s reflections and ideas. 8. There are many different models for reflecting teams. and the ideas the reflecting team shared. especially as they have different parenting styles. Family and therapist observing reflecting team through the one way screen. keep the duration of the reflecting team to no more than 10 minutes. RT2: I was wondering how this pulling together process is affected by the fact that John had to do a lot of the decision making and parenting on his own for a number of years. stay connected with the language used by the family. The reflecting team may consist of some or all of the therapy team as seems appropriate relative to the size of the team and wishes of the family. stay connected to the ideas of the previous contributor. RT1: I suppose what struck me in listening to the discussion today was how much Jean and John seem to have been thinking about pulling together as parents to help give Jack and Jodie clear boundaries of what they can and can’t do in this family.Reflecting teams aim to introduce the therapy team’s ideas into the therapy in a reflexive manner. They have touched on the transition to becoming a stepfamily. do not overwhelm the family with too many ideas. Does it feel like a 116 . stepmother. are respectful of family. In offering their reflections to the family. The family should be offered a range of formats including: • • 5.

and I wonder if this period of negotiation is what the family are still struggling with. play. because Jean was saying she and Jodie have developed a closer relationship. It may also be necessary for therapists to clearly and explicitly explain parts of the therapeutic process which children may find confusing. A parent might enjoy a special relationship of understanding because they have been closer to the child for longer. Sometimes a stepparent can bring a fresh perspective on things. and try not to raise issues which are likely to provoke anxiety. It may be that these differences could be used to complement each other. 4. and have plenty of ideas themselves about how things should be. This is particularly relevant for circular questions which require respondents to take another’s perspective. I mean I was wondering whether they see the role of a stepparent as being any different from that of a parent in their family. partly because they were both women.welcome relief to share things with Jean. each one having its pros and cons. or do they feel the negotiation will just evolve naturally? Th: Perhaps we can leave it there then. both cognitively and emotionally.2 Children are likely to use multiple channels for communication. and there were different expectations of the things Jean might be able to do as a step-mum. • • 117 .5 Child Centred Interventions It will be important for therapists to bear in mind the needs of children within therapy session. It is important for therapists not to rely solely on verbal channels in communicating with children. and puppetry may all be helpful in enabling children to communicate their ideas. with us. Drawings. RT2: It feels like these things take time to negotiate though. Interventions will need to be tailored to fit their development level. Is it something they would like to discuss here. because it might take longer when the children are teenagers. Engagement should therefore focus on aspects of the world which the child is familiar or is likely to enjoy. or does the extra negotiating make it harder? RT3: I suppose that would depend on what are the family’s ideas about sharing out roles. RT1: Yes sometimes the roles can be quite different. Particularly: • The process and implicit rules of therapy may be particularly confusing and anxiety provoking for children. Therapists should use a friendly manner. RT3: I was thinking these things might be influenced a lot by gender. This may require therapist’s to give concrete examples or use names of individuals to whom they are referring. and therapists should be comfortable in using these methods with children. like Jean felt she often did. υ Section 4. take a step back and look at things in a different way. Questions will need to be adapted so that children can understand the meaning of questions and the form of answers that are required. if it is something they feel might be worthwhile pursuing. RT1: I wondered what ideas the family had of how to take this negotiation further. and I will take your ideas up with the family.

g. to convey the message to the rest of the family. • Would it be helpful to initiate a professional / network meeting prior to the therapy commencing? Therapists should first write to the family. in room observation • Teams should have at least one method of communication between team and therapist. • Therapist’s interest in hearing everyone’s ideas • Video recording • Confidentiality 5. who will be coming. The presenting issues. As it is likely that the therapist will only speak to one member of the family during this phonecall. 118 . • Team members should have read and incorporated the guiding principles into their thinking. A follow up phone call should then be made one week before the initial session to discuss the therapy. therapists should ask whoever they speak to. using the letter template provided. Other issues.g. one way mirror. Therapeutic Setting 5. e. interruptions. and ambivalence about attending. • Teams should have at least one method for observing the therapist. telephone. earbug. that may affect attendance e. The topics to be covered in the phone call are: • Team working • Attendance issues. υ Section 2 • Teams should include therapist and family activities in their observations. In deciding whom to invite to the first session attention should be paid to the following factors: • Who is living in the household? • Who else is mentioned as important members of the family system? • Recent family life events.5. e. ii.g.1 Convening Sessions In setting up the initial therapy session. such as child protection.2 Team The team within which you are working should comply with the following guidelines: • Include at least two qualified family therapists (eligible for UKCP registration) • One of the qualified therapists should meet with the family whilst the other forms part of the observing team. therapists should begin by discussing the referral information within the therapy team. • Is further information required from referrers before therapy can commence? • What professional systems are involved with the family? In relation to: i. υ Appendix I. how to get there. childbirth / separation.

7. They should include the following information: • All members of the family system. with dates • Pregnancies.5.54 43 L eon 38 B r ia n 28 26 J oa n dob: ? n u r se 31 C har les dob: ? dob: 30.3 Video There should be capacity to video therapy sessions and permission to video therapeutic work should be sought from the family in a manner which clearly discusses the video permission they are granting.4.84 S t J am es G r a m m er S ch ool 119 .32 54 L eona r d dob: ? 44 C ar m el dob: 3. 5. with dates • Separations and divorces.2.82 14 R ach elle 14 Monica dob: 12.5. with dates • Occupations / Schooling Any information that is missing from the referral information should be noted and enquired about during the initial session of therapy.5. υ Section 6. miscarriages.27 died : 1967 h ea r t a ttack m : 1977 d: 1988 Ma r cia 66 P au l 71 dob: 20.60 J ean dob: ? P ain ter n u r se du e : F eb 1999 18 T obias dob: 10. including adopted/fostered members • Delineation of the household • All members of the wider system • Dates of birth • Deaths. and terminations. and define who is in the network • Brainstorm themes/hypotheses/formulations which may be relevant to the family Genograms Genograms are a means to visually conceptualise the family and wider system.6. υ Appendix II.4 Pre-therapy preparation In preparing for the first session the therapist and the team should meet for at least 15 minutes before the session begins and address the following issues: • Construct a genogram from referral information υ Genogram example • Summarise the main themes from the referral • Consider the recent life events of the family • Consider difficulties which may arise around engagement and how to address these • Consider broader system issues. with dates • Partnerships and marriages. in terms of its members and relationships.80 ban k w or k er 16 J acob dob: 19.55 dob: 13.Permission should be confirmed by using the form provided.1 . T obias m : 1952 dob: 12.1.8.

and reflect the contributions of the family to therapy. III. e. as illustrated in this manual. Particular attention to the language used will be important so that correspondence can be both easily understood. the team’s writing of the letters should always consider the guiding principles outlined in Section 2. υAppendices I. facts to check • Feedback to therapist of team observations • Therapist’s reflections on issues evoked for them by the session • Review of important information shared. IV. 5. Alterations and Corrections should be clearly marked and signed. Particularly important are issues of connecting with the whole system and not locating pathology within individuals. dated. E. V. life events.g.6 Correspondence Letters should be used throughout therapy to maintain contact with the family system and the wider network. legible. themes/issues to follow up. Issues to be addressed in these discussions should include: Pre-Session • Summary of the main themes from previous session • Information which requires clarification from previous session • Between session contact the therapist has had with the family/wider system • The current formulation/themes/hypothesis of the issues with which the family are bringing • Ways forward for the current session which are being considered • Any team – therapist issues which need to be addressed • Any family – family/team issues which need to be addressed Post-session • Review of main interventions and family’s response • Ideas for future sessions. signed.g. elements of genogram 5.7 Case notes All written records should be non-pejorative. Throughout this contact. with no abbreviations. narrative prompts. unexplored areas. Case notes should include: • Family information sheet • Genogram • Referral information/letter • All other written communications to and from the centre • Record of attendance • Sessions notes • Notes on telephone contacts to and from the centre 120 .5 Pre & Post Session Preparation The therapist and therapy team should allow 15 minutes before and after each session to prepare for their meeting with the family and review the progress of therapy.5.

In this way case notes form an observational record of the process of therapy.5. ⇒Appendix VI 121 . Session notes should include : • Date and number of session • Who attended therapy • Therapist/Team member names • Main themes of the session – including key language used by family • Team observations – clearly labelled as impressions • Record of interventions • Key points/ideas/decisions to follow up in later sessions Team members should record session notes on the record form provided.8 Session notes The therapy team should make session notes for each meeting between the therapist and family/wider system.

these should include: • Introductions The therapist should introduce himself or herself as a team member and explain the role and context within which they work (the team and the centre). and orientates them to the first meeting. • Video The therapist should explain that family sessions are usually videod. and who has access to the tapes. 3. The therapist should explain how many team members there are. as should the storage of videotapes. Outline Therapy Boundaries & Structure During the initial stages of therapy it is important for the therapist to set the boundaries of therapy by sharing some information with the family / professional system which informs them about the process of therapy.1. The purpose of the filming (research / review) should be explicitly stated.6. and the forms completed at the end of the meeting. • Team working The therapist should explain that they work as part of a team. Initial sessions Initial sessions of therapy consist of the first and second session of therapy. 4. and if all of the goals for initial sessions have been covered during the first session. If this is not the case therapists’ should continue to focus on the goals for initial session for a second session. If a family seems well engaged. and with regard to child protection issues. giving the family a chance to decide then that the video can be erased. • Structure of the session 122 . Outline Therapy Boundaries & Structure Engage and Involve all family members Gather and Clarify Information Establish Goals and Objectives of Therapy 6. Specific statements about the boundaries of confidentiality should be made in relation to other systems. Goals during initial session 1. 2. υ Section 7. This information is most easily shared by simple statements made by the therapist. The choice of whether to proceed with video should then be given. and the professional background of the team members. υAppendix II • Confidentiality The confidentiality of the videotapes and any information discussed in the session should be outlined. The technical equipment used should be explained including the use of the one way screen / phone / earbug. therapists may proceed to the goals for middle session. and that the team’s role is to generate ideas and help the therapist understand the family / system. but that the cameras are NOT yet switched on.

Explain that the length of therapy will be decided together by the family / team in accordance with their needs and wishes. This may include making the room comfortable and safe for younger children. • • 6. accepted. supportive and empathic environment. Explain that during the break. videoing will stop and the screen will be covered. how old are they etc. on the same day. Information should be obtained on the following topics: • The Context of therapy: decision to come to therapy.Information should be given on the length of the meeting. from either verbal or non-verbal cues.. that the meetings will be approximately every 4 weeks. relationship with referrer.2 Engage and Involve all family members • Supportive environment: Initially it is very important for the therapist to provide a warm. initially connecting with them all at an individual level. Hear from everyone: Therapists should try to hear from all members of the system/family. to increase trust and rapport and to build the therapeutic relationship. • Structure of therapy Explain that if the family/team decide to meet again.4 The Presenting difficulties or issues: If the family are introducing information about the 123 • . and the same place. The therapist must work to help the family feel understood. comfortable and less anxious. previous experiences of therapy. 6. and their expectations of what would be a successful therapy outcome. the breaks. and the use of team feedback through messages or reflecting teams. Neutrality: The therapist is trying not only to hear everyone’s views but also to establish their interest in different perspectives that may be held within the system. Information concerning the system should be collated and added to the genogram generated in pre-therapy preparation. At this point unless serious concerns arise regarding safety/confidentiality the therapist should remain neutral to the difficulties and issues that the family are presenting and their views about them. and family patterns. but also the relationships and roles they have developed within the system. The therapist should try to make sure that everyone in the system is able to contribute to the discussion if they wish. concerns or dilemmas. Agreement to proceed with videoing should be confirmed. and the family informed that the video will now be switched on. υSection 5. Information should therefore not only be factual.3 Gather and Clarify Information Information should be gathered by the therapist to orientate them to the system and enable them to hear more about the issues the family is bringing to therapy. in relation to who is in the system. history. • The System: Gathering information about the system and its relationship to other systems will be important in beginning to develop a broader picture of the family composition. relationships. • Questions Time should then be spent giving the family an opportunity to ask questions and meet the team. and assessing the level of contribution they feel they are able to make to the discussion. and making it clear they are free to play/draw during the session.

and their evaluation of the effectiveness of these measures. What are the family hoping to get from the meeting today and the therapy in broader terms. Although it will be appropriate to ask linear questions in collecting information. and likely to occur. and what are their different views about this and how might this impact on the therapy? The establishment of goals should be achieved in a way which expresses the Possibility of Change. though some exploration of explanations and beliefs that have developed around the difficulties may be appropriate.difficulties it will be important to follow this up. Attention should be paid at this early stage to tracking the behaviour patterns that are defined as difficult. Initial Session Checklist for Therapists Now you have finished the initial session/s of therapy: 4 Do you know who is in the family? 4 Have you outlined the way you work and the setting? 4 Have you introduced the therapy team to the family? 4 Have you discussed issues of confidentiality? 4 Have you given the family a chance to ask questions about the therapeutic process? 4 Have you begun to engage all members of the family? 4 Do you know the important people in the wider system/network? 4 Do you have a clear idea of the difficulties/issues with which the family are struggling? 4 Have you heard views of the difficulties from each family member? 4 Do you have an idea of the solutions and strategies that the family have tried so far? 4 Do you have an idea about the family’s strengths? 4 Do you have an idea about what the family would like to change or be different? 4 Have you remembered to obtain written video permission? 4 Have you written to the referrer to inform them of the appointment? υ Appendix III 124 . especially at this early stage of therapy. and open up a wider dialogue about the difficulties. If the family are finding it difficult to generate concrete examples of things they have tried. • Solutions and Successes to date: It is important to gain some awareness of the actions the family has taken to try and address the difficulties. circularity can be maintained by linking multiple linear questions between family members in a circular way. Attention should be paid to collecting information in a circular manner.4 Establish Goals and Objectives of Therapy The therapist should consider with the system what are their goals and objectives for therapy. that the therapy team may be able to work with the family towards this. and should convey the expectation that change is possible. 6. This intention is to build the family’s confidence in their ability to make changes. hypothetical ideas for future solutions may bring ideas forward for discussion. hearing everyone’s perspective.

so that issues and areas for discussion from the initial broad discussions may be looked at in greater detail or from different perspectives. As the therapist becomes more familiar with who is in the family and their roles. Therapists’ should be collecting this information in a manner that enables circular descriptions of behaviour to develop. 4. 5. and giving feedback to the family about the behavioural or emotional interactions and sequences which are discussed or observed. This will require therapists to allow sufficient time for team discussions pre and post sessions (υSection 5. attention should be paid to: • Creating and offering choices about the process of therapy • Resolving issues in the family-therapist-team system as they arise. and time within sessions to discuss the process of therapy with families and any concerns or questions they have in relation to this. They will look more closely at the consequences/effects of behaviours. In addition to attending to the three aspects of engagement from the initial meeting (supportive environment/hearing from everyone/neutrality). • • 125 . Middle Sessions Goals during middle sessions 1. Solutions & Successes: The focus on the successes and solutions available to the family should be steadily increasing throughout therapy. The therapist plays a role in developing this discussion to develop themes and keep the discussion focused.7. The gathering of information about the family should have reduced considerably from the initial sessions.2 Gather Information & Focus Discussion Information is still gathered by the therapist. The family and wider system: The therapist will still gather information about the family and wider system as is necessary to understand the information and stories being presented by the family. Develop and Monitor Engagement Gather Information and Focus Discussion Identify & Explore Beliefs Work towards change at the level of beliefs and behaviours Return to Objectives and Goals of Therapy 7. but more of an emphasis should be paid to focusing this discussion. Information may often focus on the following topics: • The presenting difficulties or issues: The therapist will still be gathering information about the difficulties and issues presented.1 Develop engagement The therapist should pay particular attention to developing a co-constructed therapeutic relationship.5). 7. 2. They should be tracking behavioural patterns. the focus of information should turn more to relationships. 3.

7.3 Identify & Explore Beliefs
The therapist should identify and explore the family’s thoughts, beliefs, myths or attitudes, which may be contributing to their dilemmas and difficulties. The therapist should be beginning to develop a picture of the ideas and beliefs that inform and influence behaviour, as they are gathering a circular description of the difficulties with which the family are struggling. Circular questions which build up circular descriptions of behaviour can also be used to explore the beliefs and assumptions which lie behind those behaviours.

Example: Father and stepmother in the family are talking about their parents’ beliefs about childcare, in relation to being offered numerous solutions from grandparents and friends about how to manage the teenage years. The therapist is trying to explore ideas about childcare, where these have developed from, and how they might develop in the future. Fa: Well my mother would have a lot to say about that. I mean if we were ever like that there was a firm hand. We would have never have got away with it. Th: And where do you think your ideas and values about how to manage the children come from, your own parents? Fa: Well, not really so much from my parents, I mean I would disagree with a lot of their ideas about how to do things. I think really I have got more of my guides from the church, that’s what has really shaped me. Th: And when was it you started to take on the ideas of the church. Fa: Well I suppose in my late teens, early twenties really, but I have always been interested. Jane (stepmother) has been going since a child and I would say your family were more strongly Christian than mine were, wouldn’t you? Mo: Yes, I have always gone to church. Th: What are the values from the church that have influenced you as parents? Mo: Well really a sense of sharing, we feel it’s important for us both to take some interest in the children, and show them we care, not just one or other of us. But, I don’t know whether we always manage it. Th: (to the teenage children) When you two are parents where do you think your values will come from? Son: Well neither of them, well… I suppose I am a bit like dad, maybe I’d be a bit like him. Th: (To son) And if you were a parent, in their situation as parents now, what might you advise them to do?

The exploration of family beliefs should be used by the therapist to look at a range of family activities, and not just the presenting difficulties. Therapists should explore the family’s beliefs in relation to: • The presenting difficulties. E.g. What ideas has your wife come up with to explain the behaviour John is showing? How do you understand the idea that James is less concerned about the behaviour than Jill? 126

Relationships within the family and with the wider system. E.g. Who feels it is most important to keep liasing with the school over this issue? What would your church say about how families cope with loss and bereavement? Solutions that have been tried or hypothesised. E.g. What gave you the confidence to keep going with this new idea? What gave you the idea to try and tackle things in this manner? Successes in all areas of family life and relationships to the wider system. E.g. Would that be judged as a success in your family? If John’s grandparents were here would they see that as a success, or would they have different ideas about success? Therapy process, beliefs about therapy E.g. What led to your decision not to bring the children to today’s meeting? In what ways do you think Jill was disappointed with the therapy she went to last year? Family behaviour during therapy. E.g. Jill is looking distressed, what do you think was so upsetting for her in talking about the difficulties you are experiencing? How do you understand John’s anger with the way that things have gone in today’s meeting?

7.4 Work towards change at the level of beliefs and behaviours
• Challenge existing patterns and assumptions: To move with the family to a position where they are able to query their own beliefs, perceptions and feelings. The therapist should actively query the family’s existing beliefs, assumptions or behaviours. The use of circular questioning, alternative perspective and possible futures questioning may be particularly helpful in achieving this.

Example: A 12-year-old child (John) is discussing how he feels to blame when things in the family go wrong, or there are arguments between he and his mother. The therapist begins by clarifying what are the child’s assumptions, then begins to challenge some of the linear aspects of them. John: Well I know it must be me, cause I am the one who always gets shouted at. Th: So do you sometimes feel you are to blame for things that happen at home? John: Well mainly. Th: Who would be able to convince you otherwise? John: Well sometimes Nan says things are not my fault, and that me and mum should listen more to each other, but, I figure it must be me or mum who is at fault. Th: Does it have to be either your mum to blame or you to blame? John: Well I don’t know, we are all right together sometimes. Th: How would your Nan explain the times when you and your mum do get on well together? John: Well she says we are alright when we stop and listen, sometimes we can just bite off each other’s heads you see, over nothing, when no-one has really done anything wrong.


Provide distance between the family and the problem: Providing distance to try and free the family from the pressure of the difficulties, so that they are more able to consider and reflect upon them. Alternative perspective circular questions and those aimed at looking at possible futures can often be helpful in achieving this.

Example: The therapist is talking alone to a mother who has been attending therapy with her children. Since the separation from her partner she has been finding coping with the demands of the childcare increasingly arduous, and at times has felt very low about her ability to carry on and cope. The therapist is trying to work towards creating some distance between the mother and the situation in which she finds herself, to allow a space for reflection on the position she is in. Mary: Sometimes I feel so inadequate as a mother, I find myself constantly doubting my own judgement. Th: If we met with a group of single parents, do you think that would be a concern for most of them? Would they say making parental decisions alone is very demanding because they may not have immediate confirmation from another adult? Mary: Well maybe, but it is so hard because though there is not another adult there, the children are quick enough to say, other mums don’t do that, or so and so’s mum would let them do this or that. Th: When your children grow up, do you think they will more fully appreciate the job you do, and your determination to do your best by them? Mary: Well I hope so, I think sometimes they know now how hard things are for me on my own, how much more running around I have to do, and sometimes how exhausted I am. Th: When they become parents of their own children, do you think they will see how hard you have been trying to be both mum and dad at times?

Externalise One specific way of providing distance between the family and the difficulties, which is particularly useful if the difficulties are seen to reside within one family member is to externalise the problem. That is to give the problem an external, objective reality outside of the person. This can be useful in mobilising the family’s resources to unite in working towards solutions and new ways of thinking which challenge the difficulties.

Example: The therapist is talking to a 10-year-old boy (Max) during the course of a family meeting. Max has been describing how bad tempered he can be, especially at school. Family members have been agreeing that Max is bad tempered. The therapist is working to externalise the temper from Max, in order that he and his family find ways they can have an influence on the tempers. Th: Can we give this bad temper a name? Max: Well, it’s a sort of me at my angriest, a mad max I suppose. Th: When mad max is around, what effect does he have on your friendships at school? Max: Well, that when it can be at its worst, mad max can get me to be very argumentative, my friends stay well away from me. Th: So when mad max is around they stay away. What happens when mad max isn’t there? Max: Well I tend to play football with my mates.


what are some of the helpful things about your dad just reacting sometimes? • Open up new stories/explanations: Either by facilitating the family’s evolution of new ideas and narratives. Example A father is defining himself and his parenting behaviour as the ‘problem’ in relation to his children’s teenage struggles. Cl: I think I’m basically just too inconsistent. this inconsistency. They don’t know where they stand half the time. Th: Tell me Jane. Th: I am just wondering. and get on in some way even after she had failed her exams. The therapist works towards redefining the descriptions of behaviour as less problematic and offering some positives for the family. She always does things the hard way. which are aimed at offering alternative perspectives. it can often be helpful to emphasise neglected information by therapist statements and reflecting team messages. and the life of the family. it depends what mood I am in. she really sounds determined. Relabelling in a positive way. Where does she get that determination from? 129 . Example: Mother: Cindy has always wanted to be a nurse. Th: Does it leave people not knowing where they stand or does it leave people having to make up their own minds? Cl: Well both. Exploration of neglected information may open up the development of stories which are more helpful to the family in coping with their concerns. I’ve never really thought about it like that. can be helpful to this aim. All family members will have stories about their lives. in a manner which is consistent with their realities. Information which is neglected often concerns: • Successes • Solutions • Exceptions • Alternative views from the network • Other strengths The therapist should pay particular attention to enquiring about this information as therapy progresses. or how busy I am. but I feel like I don’t always think before I react.• Reframe: Reframe some of the constraining ideas presented by the family. or by the introduction of these ideas by the therapist. and not let herself get discouraged. It seems impressive that she has found another way to fulfil her ambition. She continued to dream of going away to college. Often circular questions. She entered nurse training but as usual she made a mess of it. using circular questions so that the information is provided in a non-threatening manner. As information is likely to remain neglected by the family even if introduced into the therapeutic conversation. Circular questions are often most helpful in opening up reframes with the family. They will prioritise certain information from the world around them to build these stories and neglect other aspects. as to what answer the kids will get from me. ideas and descriptions given by family members. the lives of other family members. I think. who is it a problem for? Cl: Well them. Th: She has continued to work as an auxiliary nurse. She is now doing volunteer auxiliary nursing.

130 . which didn’t last long. so that they wouldn’t be in and out of each other’s rooms. you name it we have tried it. and said no TV and stuff like that. Th: Jane. Th: Well can you think of other things you think might help which you haven’t tried yet? Jack: No. what would have had to happened to make that possible? Jack: Well mum might have really told them off when they did it. But it’s just seemed to cause more arguments. Ideas generated by them are usually most helpful and linear questions are often used to develop an overview of solutions that the family have tried or thought of. Initially these aspects may be minimal. but they never did. I said Jack and Jodie had to knock on my door. especially him. Th: Imagine in a month’s time Jane and Jodie had stopped coming into your room. because when I had a friend round I wanted to go upstairs. can you tell me any other things that have been tried? Jack: Nothing else. which is intensified by the cramped living accommodation. Th: Jodie do you think that would stop Jack coming into your room if your mum said that to him? Jodie: No. What ideas have you come up with to achieve this? Mo: Well we tried letting the children lock their rooms. Example: The therapist is talking to a mother and her three children. they would just stand outside each other’s doors screaming to be let in. They are having difficulties getting along together. • Amplify change: In order to maximise the change or potential change that is occurring throughout the course of therapy it will be important for the therapist to focus on statements the family present about progress. If the family are finding it difficult to generate successes circular future orientated questions – such as the miracle question . to have space that is your very own. The therapist should focus on descriptions of actions where the family could be seen to have initiated or implemented change. Th: So Jack. Th: What do you think might help Jack to stop coming in? Jodie: No computer. Th: So what else did you try then? Mo: Well we have tried just about everything. what does your mum mean? Tell me a bit more about all the things your family have tried. arguing about stuff. However at times it may be useful for the therapist or therapy team to offer ideas to begin a process whereby the family can generate solutions. and their feelings that they don’t have space for themselves. Th: So it seems important for you to be able to keep things private. your sister says you have all being trying hard with ideas about this. or presented in a manner by the family which denies the magnitude of the effort or progress they have made. So mum said we would have to play down stairs all the time. in a manner which is positive but sensitive to the family’s level of confidence that change has occurred.can be helpful.• Elicit Solutions: It will be helpful to gather information from the family about solutions for the difficulties that they have tried or would consider useful. he would do it anyway. If this is necessary ideas should be tentative and flexible enough to allow the family to disregard them or build upon them. nothing seems to work. Jane: Well when the keys got taken off us.

their thoughts. really. but I don’t know sometimes I still feel low. about things being up and down at this stage. and I wasn’t wound up so much. Jake: Well last Thursday we went to the park. Especially when most of them seem to be having the desired effect. Th: That sounds like a really nice time. • Enhance mastery: To encourage the family to gain a sense of mastery or control over their situation. how did you feel he responded to that? Fa: I was quite surprised actually. Th: (to mother) So you were able to show Jake how pleased you were. I wonder whether I am doing ok. to feel more relaxed and talk. and he told me about the day. which is a bit of a first for him. I told her what the teacher had said. against a context of difficulties in relationships and communication with his father. I hesitate to advise a family who have come up with such good ideas and solutions on their own. What have you been thinking of trying most recently? 131 .Example: A 10-year old boy (Jake) is talking about a time when he and he had been pleased about his behaviour. The parents separated 3 years ago. Mo: Well I feel like things have been going quite well with the kids. The therapist and family have been working together through the therapy to identify the things that the mother is doing well in relation to managing the children’s behaviour and managing her own low feelings. and we got to go on a fair ride. This should enable the family members to take responsibility for their own roles and actions. In addition should enable family members to gain an awareness of the actions and motivations of other people in their family in achieving change. feelings and behaviours. and for the process of change. and the mother has been finding managing the children’s behaviour difficult since this time. as well as difficulties at school. we had a bit of time together because we were out just the two of us. Th: How did you know? How could you tell your mum was pleased? Jake: She looked quite happy. and I went on a school trip. they have been behaving really well most times. Th: Did you notice you were more relaxed at all? Fa: Well I suppose that did help. The therapist explores the event in more detail to emphasise the success and implications of this for their relationship. and she said we could go to McDonalds on the way home. Th: So you noticed you were able to talk more together. and the teacher said I had been really good. what made that possible? Fa: Well I don’t know. Example: A mother and her two children aged 5 and 7 years are attending a late middle session of therapy. does your mum know about this? Jake: Yeah. What do you think? Th: We would predict many of the things you have been telling me about today. we went to McDonalds and he didn’t play up at all. The therapist is commenting on this process and highlighting the mother’s own stories of competence which are often lost. Th: How did your mum react to the good news? Jake: She was pleased I think. cause I was really pleased that he had behaved himself all day? Th: What would make it possible for you to both find other times in the week when you could have a bit more time just the two of you.

for a variety of reasons. lots. and I did for a while.g. Th: What gave you the strength to put the kids first. Including: • Normalise difficulties • Move the family to new ideas • Connect family’s ideas • Suggest ways to organise the discussion. but then I weakened and let him back even though I thought why I am I doing this? What about the kids? I really should have tried to be stronger. Did that happen for you? Mo: Yes. or difficulties. the therapist normalises her reactions to the violence. The mother begins to discuss her experiences of violence from her ex-partner when she was first married. to try to begin to open up less critical stories and reframe the mother’s actions at the time as understandable rather then ‘weak’. and I just told her to leave and lost patience with her. Th: So when did you decide to be a bit more flexible about how you dealt with the situations at home? • Introduce therapist/team ideas: May include the therapist sharing their ideas and hypothesis about the family. Th: From talking to other women who have lived with violence like you have. Mo: That was it really. Example: A mother. I often hear a similar story that they feel they should leave. Th: Women tell me they hold onto a hope that if only they did a bit better. then other times I come down on them hard. you know. their partner will change. and not let him trample all over me. individual. but it is easier said than done when you are living with that fear on a day to day basis. I did try. and I loved him. because all the same stuff had happened to her. As the mother is taking a rather critical stance towards her own actions at that time. it kept me weak. I mean they don’t pull the wool over my eyes. if they are playing up. I took him back more than once you see. Th: If Josie (mother’s friend) were looking in on how you were managing them now. Enactments. I know when they are just playing up or when they are really upset. the fear. would she say you are combining these two approaches. and then I ended up being just as weak as she was. My mum used to say just get out. her social worker and the therapist are having a session. leave him.Mo: Well I’m not sure sometimes I feel it’s right to take a sympathetic approach to the kids. in her early twenties. Th: So do you feel you are becoming more confident in trusting your judgement about what is right for the kids and when? Mo: Well a bit yes. but then I thought no more. I mean I try and judge each situation as it comes. were a bit stronger. e. so they keep trying over and over again. or are you sticking with one or the other? Mo: Well she’d see a mix of the both I think. Th: Was your mum the only person with whom you shared this? Mo: Well I tried to talk to my friend but I felt a bit bad. and keep sticking to it? 132 . Mo: I suppose I should have been stronger. not with the kids seeing things and all that.

she was in her room for hours at the weekend. Fa: Me and your mum think if you could talk a bit though. and I figured that was because I was beginning to trust her again. but I think maybe we need to think about how to help Janice cope with all the stuff that goes on at school. Example: Things are beginning to improve for a family whose initial concerns were the suicide attempt made by their daughter. so that goals can be renegotiated. If goals change due to changing circumstances for the family. The therapist discusses with the family whether they are happy with this progress. Janice: Well I will give it a go. Now these changes are taking place. or a decision to move towards the end of therapy is made iii. and Janice you said you felt a bit happier at school. and whether they are left with other issues they would like to bring to therapy. If goals are achieved. has it left you with different ideas about what it could be helpful for us to discuss here? Janice: Nothing much else to say. and I realised at the end of the day that I hadn’t gone and checked on her once. Th: So it seems like all of you are feeling that your concerns that Janice will harm herself are less now. Th: Would it be helpful to think with you and your family how we could make talking about it easier? Janice: I’m not sure. I did talk to mum once and I felt better. or worry what she was up to. is that one of the most difficult things for you to talk about? Janice: Yes. I mean I didn’t have to watch her every 5 minutes. She is no longer suicidal and seems to be getting happier at home and at school. Th: Do you feel you mum and dad might be able to help support you Janice? Janice: Yes I suppose so. If goals seemed unclear during the initial stages of therapy.5 Return to Objectives and Goals of Therapy The therapist should return to the issues of goals for therapy as therapy progresses: i. ii. Th: Janice. there is nothing they can do anyway. and I think that’s half the trouble. all the bullying. Th: Would that be something we could try to develop here. or to find priorities for change. it may take some time and thought with the family for them to consider the areas they want to change in therapy. Th: John do you think there are things which Janice might appreciate us talking about here? John: Well I know she doesn’t like talking about it. Fa: I mean I think we are all lot more relaxed about Janice now. you would like have a shoulder to cry on and not feel alone.7. 133 . perhaps for change at a wider system level.

134 .Middle Sessions Checklist for Therapists Now you are nearing the end of the middle sessions of therapy: 4 Have you continued to engage the family in the work together? 4 Have you addressed problems in working together as they have arisen? 4 Have you developed a circular description of the interactions and difficulties with which the family are struggling? 4 Are you developing a clear idea about the strengths and resources the family are drawing upon? 4 Are you working with the family to generate new solutions for the issues they are bringing? 4 Have you begun to explore the family’s beliefs and ideas about the interactions and relationships in their family? 4 Has there begun to be a shift in the interactions in which the family are engaged? 4 Have you challenged the family’s beliefs about the issues that they are discussing? 4 Have you worked with the family to open up new stories/explanations about the difficulties they are experiencing? 4 Have you worked to reframe the difficulties or struggles that the family are experiencing? 4 Have you introduced distance between the family and the difficulties or tried to externalise the difficulties? 4 Have you tried to amplify the successes and change that the family achieved? 4 Are you working with the family to try and increase the sense of mastery and control they feel they have over the difficulties? 4 Have you reconsidered with the family if they are achieving change in the way they had hoped? 4 Have you written to the referrer to inform them of the progress of therapy? υ Appendix IV.

• • 135 . The System / Wider system: There should be a considerable decrease in the amount of information shared about the system and wider system. which the family are currently neglecting. and those they are looking forward to in the future. 3. Of the information that is shared it is likely to be in relation to how the difficulties are showing/decreasing in other contexts. though the focus will be on changes that have arisen concerning these issues over the course of therapy. If the family are slipping into focusing on the difficulties. Solutions and Successes to date: There should be a considerable amount of discussion about the solutions that the family are now implementing in relation to the difficulties. it will be important to enquire further about the successes about which the therapist has heard over the course of therapy.1 Gather Information & Focus Discussion Information gathering and focusing the information brought by the family to sessions is still important towards the end of therapy. Also supports in the wider network which may be drawn upon once therapy has concluded are often explored. 4. 5. 2. though the focus of the information is likely to be considerably different. Gather Information and Focus Discussion Continue to work towards change at the level of behaviours and beliefs Develop family understanding about behaviours and beliefs Secure Collaborative Decision re: Ending Review the process of therapy 8.8. End sessions Goals during ending sessions 1. • The Presenting difficulties or issues: There will still be a lot of information shared about the difficulties with which the family are struggling. as well as the successes they feel they have achieved so far.

• Understanding of a family member’s reactions to other’s behaviours. However it is more common in end sessions for the focus to be on the following methods: • Amplifying change: In order to maximise the change or potential change that is occurring throughout the course of therapy it will be important for the therapist to focus on statements the family present about progress. • Motivations for assumptions. in a manner.4. Enhancing mastery: To encourage the family to gain a sense of mastery or control over their situation. The methods they use can incorporate any of those highlighted in the middle session. feelings and behaviours. but sensitive to the family’s level of confidence that change has occurred. Initially these aspects may be minimal. or the introduction of these ideas by the therapist. In addition should enable family members to gain an awareness of the actions and motivations of other people in their family in achieving change. in a manner which is consistent with their realities. Circular questions are often most helpful in opening up reframes with the family. or presented in a manner by the family which denies the magnitude of the effort or progress they have made. The therapist should focus on descriptions of actions where the family could be seen to have initiated or implemented change. ideas and descriptions given by family members. their thoughts. They will prioritise certain information from the world around them to build these stories and neglect other aspects. The use of circular questioning. Reframing: Reframe some of the constraining ideas presented by the family. assumptions or behaviours. See section 7. Particular attention should be paid to: • Underlying family interactional patterns. and possible futures questioning may be particularly helpful in achieving this. which is positive. All family members will have stories about their lives. the lives of other family members. and for the process of change. This may be helpful in equipping the family with the ability to recognise the development of such processes in the future. Challenging existing patterns and assumptions: To move with the family to a position where they are able to query their own beliefs. Exploration of neglected information may open up the development of stories to become stories that are more helpful to the family in coping with their concerns. alternative perspective. Developing new stories and explanations: Either by facilitating the family’s generation of new ideas and narratives.2 Continue to work towards change at the level of behaviours and beliefs As in middle sessions the therapist and family are continuing to work towards change at the levels of belief and behaviour. Relabelling in a positive way. and the life of the family. behaviours and feelings. perceptions and feelings.3 Develop family understanding about behaviours and beliefs As therapy ends it will be important for the therapist to work with the family to develop and encourage their understanding of the process of the development of difficulties. The therapist should actively query the family’s existing beliefs. 136 . Information which is often neglected often concerns: • Successes & Solutions • Strengths • Exceptions • Alternative views from the network • • • • 8. This is to enable the family members to take responsibility for their own roles and actions.8.

• What follow up arrangements will be made. The family report having made changes in other areas of their lives. for example they are beginning to use new narratives. or the progress they are making. school. or are beginning to comment in a different way on their relationships and the issues with which they are struggling.8. This may be useful for the team and family in relation to prevention of future difficulties. e. • What might the family do differently if future difficulties arise? End Sessions Checklist for Therapists 137 .4 Collaborative ending decision The timing of ending is not always obvious and in aiming to make the ending process a collaborative process the therapist and therapy team should be alert to a number of signals in sessions which may indicate that therapy may soon draw to a close.5 Review the process of therapy It will be helpful for the therapist to invite the family to review the process of therapy. would they like a follow up appointment or would they like to re-contact the team if necessary? Might the family feel it would be important to engineer systems of support. • What the family might do if difficulties should arise again. These include: • Positive feedback from the family: the family situation or the issues they presented are reported as improved or improving. A useful and engaging way of saying goodbye to the family. and attributing change to this. Therapist notices changes: Missed sessions by the family. • Reasons for therapist’s behaviours and procedures used. Therapist notices positive changes in the way the family are interacting during sessions. 8. resources and solutions. The team should consider the following issues and then gather the family’s views on these. before therapy ends? With whom should the team share information about the therapy and what has been achieved. • • If it seems that ending therapy is indicated it is important for the therapist to hear from everyone their thoughts and feelings about ending therapy and make this a collaborative decision. and to empower the family in any future contact with therapeutic services. • Who will be contacted post therapy. Negative feedback from the therapy: The family report dissatisfaction about the therapy.g. Changes in the level of engagement in therapy. with the family becoming more confident in their own abilities. The relationship to therapy may change. Once this information has been shared decisions should be reached about: • When therapy will end. This is often done through expressing the views of a family member absent from therapy. do they feel they have achieved what they set out to achieve? How might the family prefer to end therapy. referrer. • • • • • Whether the family might feel it was appropriate to end therapy. To do this the therapist and therapy team must share their thoughts about ending with each other and the family. Issues that should be considered include: • What has been gained/lost for the family through therapy? • Any misunderstandings not addressed during therapy should be clarified and addressed.

enhance mastery. and listened to their wishes about ending? 4 Have you reviewed with the family the goals outlined in the initial and middle stages of therapy? 4 Have you considered contingency plans for the family when future difficulties arise? 4 Have you reviewed with the family what was useful and not useful about therapy? 4 Have you discussed how to re-engage with therapy if required? 4 Have you written a closing summary of the work to the referrer? υ Appendix V 138 .Before you end therapy check: 4 Do the family have an understanding of the issues which they are happy with? 4 Are the family happy with the ways of interacting that they are currently developing? 4 Have you continued to amplify change. and develop new stories and explanations of difficulties? 4 Have you discussed ending therapy with the family. reframe concerns and difficulties. challenge existing patterns and assumptions.

and the co-construction of the relationship. separate contacts should be used to clarify therapy. Particular attention should be paid to bearing the needs of the system in mind whilst still prioritising the needs of the child for protection. complex. therapists should discuss the child protection issues with the family. or issues of advocacy may limit the family’s ability to communicate their ideas and wishes. it may be necessary to clarify the nature and boundaries of the referral over the telephone. the boundaries of the work should be clarified in relation to the current goals for family therapy. Important life events such as illnesses. and not preclude the possibility of moving back into the domain of therapy at a later stage. Directions for conducting this non-direct work are therefore outlined below. friendships and occupational aspects of the family’s life. 9. the language and narratives about abuse and protection. This ideally should be done with the referrer and family at a pre-therapy meeting. In addition. where the multiple views about therapy. 9. If the family are participating in any other therapeutic activity during the time they are attending family therapy. hospitalisations.1 Child Protection Therapists should abide by the local child protection procedures outlined by their area. If at all possible. This includes professional and extended family contact. without placing the child at further risk. and periods of separation can be built into this picture. and keep them informed of any protective procedures that the therapist is to instigate. before therapy commences. for example individual or couple therapy. in identifying the network and clarifying relationships. This should be done for current relationships as well as important contacts in the family’s history.9.4 Assessing risk At times during therapy it will be necessary to consider the risk which one or more member of the family poses in relation to their own well being or the well being of a family member. as well as other relationships. 9. Therapists should inform the family that they are now not talking with them in their therapeutic role as they have serious concerns about the safety of a family member. It may be necessary to move from the domain of therapy to the domain of protection but the manner in which this is achieved should retain a systemic focus. can be shared between all members of the system. which although they do not directly involve the presence of the family. The risk 139 . However in referrals where there may be tensions in the referring relationship. are essential in supporting the ongoing work with the family.2 Clarifying therapy with referrer present In situations where referrals are vague. or involve a network of professionals. or in person.3 Identifying the network and clarifying relationships It is important for the therapy team to identify the components of the family’s network from the referral information given and during the assessment process. Indirect Work There are many areas of systemic work. Therapists are reminded that the guiding principles outlined at the beginning of this manual will also be applicable to the non-direct work outlined in this section. Wherever possible the local procedures should be carried out using the systemic principles described in section 2. 9. This information should be used in relation to the therapeutic goals and in relation to contact with the wider system that the therapy team and family participates in during therapy. its utility and limits. the boundaries of confidentiality and the family’s wishes concerning this should be discussed and clearly stated to all members of the network.

Again this should be a process in which the family are actively involved and therapists should inform the family that they are now not talking with them in their therapeutic role as they have serious concerns about the risks to a family member. or suicide attempts. Therapists should bring their concerns into the discussion with the family to hear their own views of the risks. for example. It is important that the therapist’s and family’s concerns are identified. domestic violence. or refer to someone able to complete this. child protection. 140 . in a manner which opens up communication and leads to the establishment of contingency plans to monitor or prevent further risks.may be in relation to a number of issues. In relation to suicidal ideation it may be necessary for the therapist to move outside the domain of therapy and complete a full psychiatric risk assessment.

10. advice may be offered in a non-directive or reflexive manner. and during therapy as appropriate. using the guiding principles outlined at the start of this manual.2 Interpretation Psychodynamic interpretations about the meaning of symptoms or interactions in relation to individual or trauma would not be usual for systemic therapists. together with any justification. 10. 10.5 Consistently siding with one person In taking a neutral stance therapists should not find themselves consistently siding with one person in the family. 10. and the meanings attributed to these. meanings are explored in relational and interactional terms between members of the system.1 Advice As a systemic therapist you would not usually offer direct advice to the family about their interactions or the difficulties they are experiencing. It may be necessary at times. 10. in session notes? ⇒ Section 5.4 Therapist monologues In the co-created process of therapy therapists should not find themselves lecturing or using long monologues in their interactions with the family. 10. Proscribed Practices The proscribed practices described below are things that would not be included in a routine therapy session. however they must be used within a systemic framework. It may be that on one or two occasions it is appropriate to use one of these approaches. ways of thinking and understanding the difficulties with which the family are struggling. and between family members. this should not be a constant state.7 Inattention to use of language Therapists should not be inattentive to the use of language used by the family. that is.8 Reflections Therapist’s simple reflections of the points or phrases that are used by the family should be kept to a minimum. and record these. 10. for ethical or therapeutic reasons. 10.3 Un-transparent/Closed Practice Therapists should not remain closed about their working practices.6 Working in the transference Therapists should be paying attention to the relational and engagement issues between themselves and the family with which they are working but they should not use the relational aspects between themselves and the family as the tool of therapy. that is work within the transference. They should try to remain transparent by explaining their practices at the beginning of therapy.8 10. to align oneself with a member of the family. The process should be more like a sharing of ideas between therapist and family. but if therapy is to continue. Options should be presented as choices about which the family can make their own decisions. If the family ask for advice about a particular issue with which they are struggling or the therapist feels advice may be appropriate in helping the family work towards their goals. They should pay attention to the both the words and phrases used. Team members should monitor sessions for proscribed interventions. Reflections may be used to enhance engagement and to develop the family’s sense of 141 . Rather.

and increased curiosity about the issues presented. 10.12 Agreeing / not challenging ideas Therapists should not be in a continual state of agreement with the family’s ideas.11 Sticking in one time frame Therapists should not stick in one time frame. 10. or a position which is likely to escalate to a polarised position. gender. These may be differences in views. and allowing them to remain curious. whilst still questioning those ideas. and the therapist remained pessimistic. rather they should take this information seriously and use it to modify and expand their working ideas. 10. when a mismatch of affect is used transiently.15 Inappropriate affect The therapist’s affect should match that of the family.13 Ignoring information that contradicts hypothesis Therapists should not ignore. There may be times. The therapeutic team can enable the therapist to achieve this by presenting the multiple perspectives from which the family situation can be understood. but when used. class or race.being listened to and understood. 10. abilities. 10. 10. in order for the therapists to take a position in relation to the family as a way of questioning or challenging their ideas.9 Polarised position Therapists should avoid taking a position which is polarised from that of the family. 142 . and not ignore strong expressions of affect during the sessions. Therapists should be thinking about how to take a position which connects to the ideas of the family. and would be considered inappropriate if it remained dissimilar from family for an extended period of time. and should be raised by the therapist in a sensitive and open manner for further exploration. beliefs. or minimise information presented by the family which contradicts their own ideas and hypotheses. They should remain curious and challenging about the nature and content of these ideas. present and future. This may be particularly relevant when a member of the family shows distress during the meeting. One example might be if the family were feeling optimistic about change and the progress they were making.14 Dismissing ideas The ideas presented by the family about the difficulties with which they are struggling. but move the focus of their questions and discussion between the past. in order to introduce new unexplored possibilities and ideas. either by sad or angry behaviour.17 Ignoring difference Therapists should not ignore issues of difference between themselves and the family or within the family.16 Ignoring family affect Therapists should pay attention to the affect that the family is showing in the session. or the process of therapy itself should not be dismissed by the therapist. reflections should be followed by questions. 10. 10.

Appendix 1: Sample Appointment Letter Appointment letters should include: • • • • • • • Referral source and name of referrer Invitation to the whole family Reasons why all the household should attend Date. We have heard from your GP. We hope to see as many of you as possible for this first appointment. as soon as possible by telephoning our secretary on the above number. Enclosed is a map giving directions to the clinic. We find it helpful to meet all members of the family or household so that we can learn how things are from everyone's point of view. time and place Confirmation request Brief explanation of teamwork Main therapists name Dear Mr & Mrs Smith & Jodie and Jonathan.30pm. Jones. Dr Peter Stratton Family Therapist On behalf of Leeds Family Therapy Team 143 . that it might be worthwhile exploring whether family therapy could be of help to you all. which is situated in the Department of Psychology at Leeds University. Please let us know whether or not you can attend. We would therefore like to offer you an appointment to come along and meet us at our Family Therapy and Research Centre on Wednesday 13th July at 4. Peter Stratton. It is important that you give us this information as we have a waiting list for appointments. Dr. This first session would be to discuss the issues that concern you and to decide whether family therapy might be useful. There are about 5 people in the team. Yours sincerely. We work as a team in order to generate more ideas which we hope to share with you. but the person who will be talking with you most directly is Dr.

All Family Members Dated: …………………………………………………………………………. 2. Dated: …………………………………………………………………………. Signed: ………………………………………………………………………… …………………………………………………………………………………. Please delete as appropriate. For the purposes of supervision and in order to plan future therapy sessions. All video material is stored in locked cabinets and every effort will be made to ensure confidentiality. For teaching & research. in order to develop our service through training other therapists. To help the team deliver a more effective service to our family. and improving the service for families through research. Confidentiality will always be maintained.Appendix II: Sample Video Consent Form Consent Form for the Use of Video Tape We give consent for the use of these video recordings for the following purposes: 1. Viewing will be confined to the regular members of your family therapy team. Such tapes are only shown to audiences of professional clinicians and researchers who are warned about the importance of confidentiality. No video material will be identified using your family’s name. Member of Family Therapy Team 144 . You are entitled to change your mind about the consent given above at any time. Signed: ………………………………………………………………………… ………………………………………………………………………………….

If in the meantime you have any further issues regarding this family please contact Dr.Appendix III: Sample Referrer letter This letter is to be sent to the referrers when first appointment sent out. Peter Stratton. Yours sincerely Dr Peter Stratton Family Therapist On behalf of Leeds Family Therapy Team 145 . It should include: • • • • • • Referral date Referral reason Family name & address Date of appointment Proposed future contact Contact person Dear Dr. Leeds. Jones Re: Smith Family 11 James Avenue. LS2 Further to your referral of the Smith family. we have offered them an appointment at the Leeds Family Therapy and Research Centre on Wednesday 13th July at 4. for help concerning bereavement issues. We will keep you informed of their progress should they go ahead with family therapy. in March 1998.30pm.

This letter should include: • • • • • • • • Number of assessment sessions attended Who attended Brief family composition Referrers concerns Family’s concerns Systemic Formulation/Understanding of Difficulties Agreed Goals for Therapy Agreed liaison with other systems 146 .Appendix IV: Post-assessment letter to referrer A letter should be sent to the referrer once an assessment is completed or when the initial goals of therapy are clarified with the family.

Leeds. as they were concerned to give us a picture of the difficulties without upsetting the children. This was followed up with a meeting with the whole family. I will contact you again once therapy has ended to discuss the utility of these interventions for the family. and expressed a desire not to upset their parents further by talking about Julie’s death. and their 2 children Jodie (6 years) & John (9 years). and expressed a wish that they were more able to talk about the issue as a family. The children had carried this silence to school. Yours sincerely. It seemed that although this was a topic all the family felt would be helpful to discuss more openly. Jones Re: Smith Family . As you know the family consist of Mr & Mrs Smith. The eldest child of the family.11 James Avenue. as they were concerned not to bring further distress to members of their family. The children very much wanted this to be at their pace.Dear Dr. It was therefore decided to try and begin to talk about Julie’s death and the impact this had had on the whole family in our meetings. We also plan to make links with Jacob school. no one dared to begin the conversation. died in a car crash in September 1997. LS2 I have now seen the Smith family on 2 occasions following your referral for help with bereavement issues following the death of the eldest child in the family. to discuss how the children might show their distress in different ways at school. yet consistently showed distress through their behaviour and lack of concentration. both of whom are attending Jacob School. and would not talk to any of Julie’s old friends about her. The children were quite cautious about discussing this issue initially. Mr & Mrs Smith attended alone for the first meeting. Julie. They were concerned about how the loss was affecting them in both their achievement and behaviour at school. Julie. Dr Peter Stratton Family Therapist On behalf of The Leeds Family Therapy Team . Mr & Mrs Smith outlined to us their concerns that their children were expressing no grief relating to the death of their elder sister Julie. and we have been thinking with them about ways to help the process of talking easier.

The family attended for 5 appointments. You will remember you referred the Smith family for family therapy in March 1998. for help with bereavement issues. We saw them last in November 1998 and a further appointment for December was cancelled. with family’s permission Dear Dr Jones Re: Smith family 11 James Avenue.Appendix V: Closing letter to referrer A letter should be sent to the referrer after therapy has ended and should include: • Reasons and date of original referral. when distracted or upset at school. Mr & Mrs Smith were concerned about how the loss was affecting them in both their achievement and behaviour at school. At the family’s request we also invited the Headmistress of the children’s school. Jacob school 148 . to look at ways the children could express their grief about Julie’s death within the school setting. Leeds.c. but the family phoned and left a message to say they felt things had improved at home and at school and they would contact us again if the need arose. We left it with them that we would be very happy to see them again if requested. were expressing no grief relating to the death of their elder sister Julie. Mrs Small. The children also reported feeling happier at school. Mrs Small. The family used all of the meetings to their fullest. All members of the family attended meetings following an initial meeting with Mr & Mrs Smith alone. We had planned to continue. In addition we thought about ways they might be supported to develop their concentration. and communication concerning the bereavement improved very rapidly. • Number of meetings held • Who attended the meetings • The family’s concerns • Systemic Formulation/Understanding of Difficulties • Themes covered in meetings • Utility of therapy for the family • Evaluation of current state • Future plans • Copies to other agencies involved. and the stories they had developed for understanding what had happened. LS2. Our 5 meetings were spent looking at the effect Julie’s death had had on both the parents and the children. and expressed a wish that they were more able to talk about the issue as a family. who died in a car crash in September 1997. The parents outlined to us their concerns that their 2 children Jodie (6years) & John (9years). Yours sincerely Dr Peter Stratton Family Therapist On behalf of The Leeds Family Therapy Team c. Headmistress.

Appendix VI : Session Notes Record Form SYSTEMIC FAMILY THERPY MANUAL SESSION NOTES Record Sheet Date of Session Who attended therapy? Session Number Therapist name Team member names Main themes of the session Include key language used by family Main themes continued Team observations Clearly labelled as impressions 149 .

3. 2. Proscribed Practices included in session Justification 1.Interventions Interventions continued Key points/ideas/decisions to follow up in later sessions 1. 3. 150 . 2.

BASIC FAMILY THERAPY TECHNIQUES IN ALPHABETICAL ORDER Basic Techniques in Family Counselling and Therapy 151 .

Accommodating is: adapting to a family's communication style. 152 . strong sense of agency when talking with the therapist. throughout the interview. They are used to calm down anxious members of families or reassure these individuals and families about certain actions. Many clients feel compelled to answer these questions. The goals may be a/ to raise clients' awareness when they do not know how they are contributing to the problem. Asking permission to ask a question goes against the prevailing assumption that therapists can ask any question they want tot gather information they purportedly need to help the client. • AFFECTIVE CONFRONTATION Affective Confrontation of Rigid Patterns and Roles is used to interrupt rigid pattrns. Example: "Would it be okay if I ask you some questions about your sex life?" In addition. Examples: "When did you divorce your husband and marry your son?" "You are aware that you have abandoned the family to advance your career?" "What do you think would be more detrimental for your daughter: missing dance practice once a week for a few months or having her parents divorce? Do you want to ask your child what her preference is?" • ASKING PERMISSION Narrative therapists use permission questions to emphasize the democratic nature of the therapeutic relationship and to encourage clients to maintain a clear. • ADVICE & INFORMATION These are derived from experience and knowledge of the family in therapy. or c/ to increase motivation to make changes when there is cognitivie awareness but no change in action.BASIC FAMILY THERAPY TECHNIQUES IN ALPHABETICAL ORDER Basic Techniques in Family Counselling and Therapy • ACCOMMODATION The therapist makes personal adjustments in order to achieve a therapeutic alliance. Narrative therapists show their sensitivity by asking permission before asking questions that are generally taboo or concern difficult objects. b/ to raise a taboo subject that the client and others have been avoiding. the therapist may ask for client input and permission to continue with a particular topic or line of questioning. even if they are not comfortable doings so.

you were having difficulty . or change the boundaries within the family.• BEGINNER’S MIND "In the beginner's mind there are many possibilities. It is receptive. more positive words. . etc. rather than doing it). Family members may defy the therapists and become better or they may explore reasons why their behaviours are as they are and make changes in the ways members interact. Also. USE OF VERB FORMS Create a reality where the problem is in the past and possibilities exist for the present and in the future. They are used to calm down anxious members of families or reassure these individuals and families about certain actions. “When you had this problem before. (Example: Use the words “transitional period” as this give the client the opportunity to take solace in hearing that a problem is temporary. A beginner's mind is very open. 153 . depending upon the family’s situation. It is not filled with ideas and notions. attend to client’s metaphors and utilize them also to extend observations. CHANNELING THE CLIENT’S LANGUAGE Channel away from jargon into action descriptions used in every day language. Paradox is an apparently sound argument leading to a contradiction. very alert. • COMMUNICATION TECHNIQUES MATCHING THE CLIENT’S LANGUAGE Example: Use the exact words the client uses to describe the problem in asking questions about what they have done before. MATCHING SENSORY MODALITIES Use words pertaining to “seeing” or “hearing” how things are and use words in the same vein. • ADDING COGNITIVE CONSTRUCTIONS Advice & Information are derived from experience and knowledge of the family in therapy. Pragmatic fictions are formal expressions of opinion to help families and their members change. in the expert's mind there are few" Position of curiosity. truths and dogmas. This has the effect of depathologizing or normalizing clients’ situations. The therapist also helps the family to either strengthen or loosen boundaries. . when it is not so serious a problem.” Help clients make distinctions that are helpful (feeling like or thinking about . It is used to motivate family members to search or alternatives. Viewing experiences as though for the first time. learn about their interests or hobbies to use metaphors that involve them. you used to . . Gradually change your terminology to less serious. how did the old you . . . • BOUNDARY FORMATION Part of the therapeutic task is to help the family define. helps shape their expectations for the future). .

anger. Repeating and reflecting techniques allow members to better understand where the other is coming from and why she feels as she does. F. “I am scared” (of what) “He is lazy” (compared to whom) respect. none. 154 . A variety of techniques can be implemented to focus directly on communication skill building between a couple or between family members. creative judgment and personalization of application are encouraged. Vague statements Unspecified verbs : Specify comparison: Empty nouns: Generalization: “He ruined the relationship” (how. then having another member repeat back what he heard that person say. Counsellors will customize them according to presenting problems. A. B. FAIR FIGHTING TECHNIQUES focus on attentive listening and expressing feelings and concerns in a nonthreatening manner. doesn’t /did not Characterizations Challenge claims: lazy. and nonjudgmental brainstorming are some of the methods utilized in communication skill building. C. REFLECTING involves having a member express her feelings and concerns.GIVE CLOSE EXAMINATION TO THEIR LANGUAGE AND YOURS.Listening techniques including restatement of content. Communication techniques are used to build skills that allow for effective communication between family members. love. taking turns expressing feelings. a rigid set of techniques or set of hypotheses. H. Faulty communication methods and systems are readily observed within one or two family sessions. never Cannot/will not vs. • CONCLUSION The techniques suggested here are examples from those that family therapists practice. D. reflection of feelings. while another member repeats back what was said. Communication patterns and processes are often major factors in preventing healthy family functioning. G. depression all. therapists cannot allow themselves to be limited to a prescribed operational procedure. REPEATING techniques involves having a member state how he feels. always. what way?). it's a family's communication patterns and styles that lead to conflict and division. With the focus on healthy family functioning. E. Therefore. aggressive “How do you know you feel depressed” • COMMUNICATION SKILL-BUILDING TECHNIQUES More often than not.

• DIFFERENTIATION OF SELF Psychological separation of intellect and emotions and independence of self from others. PUNCTUATION: Punctuation is “the selective description of a transaction in accordance with a therapist’s goals”. For example. Therefore it is verbalizing appropriate behaviour when it happens. UNBALANCING: This is a procedure wherein the therapist supports an individual or subsystem against the rest of the family. When this technique is used to support an underdog in the family system. a chance for change within the total hierarchical relationship is fostered. • DETRIANGULATION The process by which an individual removes himself or herself from the motional field of two others. The goal is to describe the systematic interrelationships of all family members to see what needs to be changed or modified for the family to improve.• CONFIRMATION OF A FAMILY MEMBER: Using an affective word to reflect an expressed or unexpressed feeling of that family member. instead of reactive. REFRAMING: The technique of reframing is a process in which a perception is changed by explaining a situation in terms of a different context. (triangulation is: Detouring conflict between two people by involving a third person. opposite of differentiation. the therapist can reframe a disruptive behaviour as being naughty instead of incorrigible allowing family members to modify their attitudes toward the individual and even help him or her makes changes.) • DISEQUILIBRIUM TECHNIQUES The following techniques are used to create a different perception of reality. The therapist validates the reality of the family member(s) he joins.) • DIAGNOSING Diagnosing is done early in the therapeutic process. In the close position of proximity. The therapist can join families from different positions of proximity. stabilizing the relationship between the original pair. He searches out positives and makes a point of recognizing and awarding hem. (Fusion is a blurring of psychological boundaries between self and others and a contamination of emotional and intellectual functioning. he can affiliate with family members. opposite of fusion. therapists become proactive. 155 . Probably the most useful tool of affiliation is confirmation. perhaps even entering into coalition with some members against others. By diagnosing interactions.

has been adapted to family therapy. This method is to help family members to gain control over behaviours they insist are beyond their control. 1980). Family council meetings help provide structure for the family. space accommodations. and children can be arranged through utilizing this technique. Used early in therapy. Parents might be asked to draw the family floor plan for the family of origin. members often adapt new. operating family triangles. • FAMILY FLOOR PLAN The family floor plan technique has several variations. This technique can help a stuck family and create a lively situation • FAMILY COUNCIL MEETINGS Family council meetings are organized to provide specific times for the family to meet and share with one another. Information across generations is therefore gathered in a nonthreatening manner. Family members may be asked to reenact a family scene and possibly resculpt it to a preferred scenario. • FAMILY CHOREOGRAPHY In family choreography. in which case a time is set and rules are outlined. Attacking others during this time is not acceptable. this technique can serve as an excellent diagnostic tool (Coppersmith. and any absent members would have to abide by decisions. parents. more functional ways of acting. • ENACTMENT The process of enactment consists of families bringing problematic behavioural sequences into treatment by showing them to the therapist a demonstrative transaction. and facilitate communication. In one scenario. encourage full family participation. 156 . Indications of differentiation.• EMOTIONAL CUT-OFF Bowen's term for flight from an unresolved emotional attachment • THE EMPTY CHAIR The empty chair technique. In examining their roles. Expressions to absent family. arrangements go beyond initial sculpting. The council should encompass the entire family. and subsystems often become evident. The agenda may include any concerns of the family. Another adaptation of this technique is to have members draw the floor plan for their nuclear family. and rules are often revealed. Points of discussion bring out meaningful issues related to one's past. The result is that family members experience their own transactions with heightened awareness. most often utilized by Gestalt therapists (Perls. & Goodman. family members are asked to position themselves as to how they see the family and then to show how they would like the family situation to be. Hefferline. The therapist might prescribe council meetings as homework. 1985). Levels of comfort between family members. The importance of space and territory is often inferred as a result of the family floor plan. a partner may express his or her feelings to a spouse (empty chair). then play the role of the spouse and carry on a dialogue.

Family sculpting is another technique that's used to realign relationship patterns within the group. and Duhl (1973). This technique provides insight into relationship conflicts within the family. Carter and mcgoldrick elaborated the family life cycle a. families in later life. The family therapist can use sculpting at any time in therapy by asking family members to physically arrange the family. Jjust like an individual. Launching children and moving on f. joining of families through marriage. • FAMILY SYSTEM STRATEGIES A family operates like a system in that each member's role contributes to the patterns of behaviour that make the system what it is. finally. retirement. roles. vertical stressors are transmitted mainly via multigenerational triangling. 157 . and one that initiates vertical realignment). Adolescence e. structure. a family has developmental tasks and key (second-order) transitions like leaving home. Members are asked to physically arrange where they want each member to be in relation to the others. laving children. Families in later life • FAMILY PHOTOS The family photos technique has the potential to provide a wealth of information about past and present functioning. Verbal and nonverbal responses to pictures and events are often quite revealing. One use of family photos is to go through the family album together. Divorce adds extra developmental steps for all involved families. Interventions used to address family problems can be designed based on the patterns uncovered by this technique. Adaptations of this method include asking members to bring in significant family photos and discuss reasons for bringing them. Joining of families through marriage c. and communication patterns. family sculpting provides for recreation of the family system. Key question: "How well did the family do on its last assignment?" Horizontal stressors are those involving these transitional assignments. • FAMILY SCULPTING Developed by Duhl. death. The tracking technique is a recording process where the therapist keeps notes on how situations develop within the family system.• FAMILY LIFE CYCLE Stages of family life from separation from one's parents to marriage. Certain therapy techniques are designed to reveal the patterns that make a family function the way it does. families with young children (the key milestone. Through discussion of photos. Leaving home b. launching children and moving on. rituals. Families with young children d. representing family members relationships to one another at a specific period of time. Symptoms tend to occur when horizontal and vertical stressors intersect. Adolescents often make good family sculptors as they are provided with a chance to nonverbally communicate thoughts and feelings about the family. and locating pictures that represent past generations. Kantor. An activity in which family members place themselves in postures symbolic of the family dynamics. Satir placed people in position herself to activate right-brain experiencing. and. Family sculpting is a sound diagnostic tool and provides the opportunity for future therapeutic interventions. growing older. the therapist often more clearly sees family relationships. families with adolescents.

divorce. It provides an enormous amount of data and insight for the therapist and family members early in therapy. Example: “What is different about those times when things are working?” • THE GENOGRAM One of the best ways to begin therapy and to gain understanding of how the emotional system operates in your family system is to put together your family genogram. and how they relate to those of your multigenerational family. while you were asleep. reveals new and more effective options for solving problems and for changing your response to the automatic role you are expected to play. Perceptions of problems then change significantly in this context. (McGoldrick & Gerson. it offers a picture of three generations. Through symbols. THE MIRACLE QUESTION: Suppose that one night. They may discover solutions they had forgotten or not noticed. and resources. 2. The therapist gives guidelines and information to help the client go directly to a more satisfactory future. 158 . Background information. dates of marriage. => “What will not would be different?” 3. and other relevant facts are included in the genogram. THE EXCEPTION QUESTION: Asks the client to focus on times when problem does not occur or has not occurred when they expected it would. As an informational and diagnostic tool. • GOAL SETTING Start small — “What will be the first sign that things are moving in the right direction?” Goals must be concrete. (The miracle question or a magic wand question). the genogram is developed by the therapist in conjunction with the family. Clients are asked to envision a future without the problem and describe what that looks like. FAST-FORWARDING QUESTIONS can be used when clients can’t identify exceptions or past solutions. death. provides a graphic picture of the family history. • IDENTIFICATION Family therapy techniques are used with individuals and families to address the issues that effect the health of the family system. The genogram. Studying your own patterns of behaviour. abilities. The genogram reveals the family's basic structure and demographics. there was a miracle and this problem was solved. a technique often used early in family therapy. The therapist might find clues on which to build future solutions. Strategic techniques are designed for specific purposes within the treatment process. The techniques used will depend on what issues are causing the most problems for a family and on how well the family has learned to handle these issues. How would you know? What would be different? This type of question seems to make a problem-free future more real and therefore more likely to occur. 1. Names. family structuring and communication patterns are some of the areas addressed through these methods. 1985).• FRAMING QUESTIONS Questions asked can elicit information about strengths.

A father who constantly pressures his son regarding his grades may be seen as a threatening figure by the son. Another technique has the therapist placing a particular conflict or situation under the family's control. or prolonged pressure. Mimesis: The therapist becomes like the family in the manner or content of their communications. the family controls how the problem is handled. It is a contextual process that is continuous. Confirmation of a family member: Using an affective word to reflect an expressed or unexpressed feeling of that family member. Tracking is best exemplified when the therapist gives a family feedback on what he or she has observed or heard. In this process the therapist allies with family members by expressing interest in understanding them as individuals and working with and for them. the therapist follows the content of the family that is the facts. repeated intervention. and how long these discussions should last. • • • 159 . and comfort zones between different members. • • The genogram is a technique used to create a family history. • Tracking: In tracking. leading to the development of therapeutic system. Getting information through using open-ended questions. There are four ways of joining in structural family therapy. Both the family and therapist work to create this diagram. they begin to develop a sense of control over the problem. Having family members bring in meaningful family photos is also a technique used to gather information as to how each member perceives the others. unapologetic manner that is goal specific. • JOINING This is the process of coupling that occurs between the therapist and the family.• INFORMATION-GATHERING TECHNIQUES At the start of therapy. Intensity works best if done in a direct. What this means is. As members carry out these directives. Reframing is a method used to recast a particular conflict or situation in a less threatening light. instead of a problem controlling how the family acts. Joining is considered one of the most important prerequisites to restructuring. or geneology. • • INTENSITY Intensity is the structural method of changing maladaptive transactions by using strong affect. One other technique involves having family members draw up floor plans of their home. This exercise provides information on territorial issues. who they discuss it with. which helps them to better deal with it effectively. This requires the therapist to give specific directives as to how long members are to discuss the problem. rules. • INTERVENTION TECHNIQUES Intervention techniques are directives given by the therapist to guide a family's interactions towards more productive outcomes. Accommodation: The therapist makes personal adjustments in order to achieve a therapeutic alliance. information regarding the family's background and relationship dynamics is needed to identify potential issues and problems. Reframing this conflict would involve focusing on the father's concern for his son's future and helping the son to "hear" his father's concern instead of constant demands for improvement.

focus on when it is not so serious a problem). 160 . A directive is given to not rush into anything or make hasty decisions. where. The indecisive behaviour is reframed as an example of caring or taking appropriate time on important matters affecting the family. widely used by strategic family therapists. • PRAGMATIC FICTIONS Formal expressions of opinion to help families and their members change. Frame towards the idea that clients have all the abilities and resources to solve the problem: Create an atmosphere that facilitates the realization of strengths and abilities. It is used to motivate family members to search or alternatives. Specific directives are given as to when. As the client follows this paradoxical directive. and with whom. Such is the case with prescribing indecision. • PUTTING CLIENT IN CONTROL OF THE SYMPTOM This technique. • PRESCRIBING INDECISION The stress level of couples and families often is exacerbated by a faulty decision-making process. a sense of control over the symptom often develops. Therefore it is verbalizing appropriate behaviour when it happens. and for what amount of time one should do these things. Family members may defy the therapists and become better or they may explore reasons why their behaviours are as they are and make changes in the ways members interact. 3. Punctuation: thinking that you cause what I say. Dissolve the idea that there is a problem: Help people see their situations in new ways. for example. • PUNCTUATION Punctuation is “the selective description of a transaction in accordance with a therapist’s goals”. 2. • PROBLEM SOLVING TECHNIQUES 1. paradoxical interventions often can produce change or relieve symptoms of stress. Decisions not made in these cases become problematic in themselves.• PARADOXICAL INJUNCTIONS A paradox is an apparently sound argument which leads to a contradiction. attempts to place control in the hands of the individual or system. The therapist may recommend. the continuation of a symptom such as anxiety or worry. resulting in subsequent change. When straightforward interventions fail. The couple is to follow this directive to the letter. Negotiate a solvable problem: Reduce the size of the problem in the client’s eyes. (Get specific about the problem.

Through reframing. • SPECIAL DAYS. This co-creates the experience that the problem is solvable and the client has some ability to solve it. involves meeting with one member of the family as a supportive means of helping that person change. MINI-VACATIONS. and boundary formation. For example. 1980). • REFRAMING PROBLEM DEFINITIONS Solution Oriented therapists offer new. • SHAPING COMPETENCE The family therapists help families and individuals in becoming more functional by highlighting positive behaviours. more workable problem definitions that are within the power of the client and therapist to solve. It is accomplished through the use of enactment. "Caring Days" can be set aside when couples are asked to show caring for each other. 1986). family members feel unappreciated and taken for granted. In such cases. often used by strategic family therapists. 161 . For example. Individual change is expected to affect the entire family system. SPECIAL OUTINGS Couples and families that are stuck frequently exhibit predictable behaviour cycles. a mother's repeated questioning of her daughter's behaviour after a date can be seen as genuine caring and concern rather than that of a nontrusting parent. The goal is to make the family more functional by altering the existing hierarchy and interaction patterns so that problems are not maintained. This technique attempts to disrupt a circular system or behaviour pattern. • RESTRUCTURING The procedure of restructuring is at the heart of the structural approach. They usually help the client reframe the problem definition to a more positive one or listen for a hint of something in the client’s complaint that can be solved. unbalancing. The individual is often asked to behave or respond in a different manner. Specifically. • STRATEGIC ALLIANCES This technique. and family members take little time with each other. a negative often can be reframed into a positive.• REFRAMING Most family therapists use reframing as a method to both join with the family and offer a different perspective on presenting problems. Boredom is present. Specific times for caring can be arranged with certain actions in mind (Stuart. reframing involves taking something out of its logical class and placing it in another category (Sherman & Fredman. the therapist can reframe a disruptive behaviour as being naughty instead of incorrigible allowing family members to modify their attitudes toward the individual and even help him or her makes changes. The technique of reframing is a process in which a perception is changed by explaining a situation in terms of a different context.

1981) see tracking as an essential part of the therapist's joining process with the family. 162 . the therapist follows the content of the family that is the facts. When this technique is used to support an underdog in the family system. The focus is on process not content. What happens between point A and point B or C to create D can be helpful when designing interventions. During the tracking process the therapist listens intently to family stories and carefully records events and their sequence. It is important that therapists help families recognize patterns of interaction and what changes they might make to bring about modification. Getting information through using openended questions. structural family therapists concentrate on spontaneous behaviours in sessions. the family therapist is able to identify the sequence of events operating in a system to keep it the way it is. Tracking is best exemplified when the therapist gives a family feedback on what he or she has observed or heard. • UNBALANCING This is a procedure wherein the therapist supports an individual or subsystem against the rest of the family. In tracking. • INTRODUCING UNCERTAINTY The therapist can introduce some uncertainty into the problem definition by asking “What gives you the impression that things seem difficult to handle?” Or he/she can imply that there are days when the problem is nonexistent by asking “What is different about the days when things seem manageable?” • WORKING WITH SPONTANEOUS INTERACTION In addition to enactment. Through tracking. Structural family therapists (Minuchin & Fishman. It occurs whenever families display behaviours in sessions that are disruptive or dysfunctional. such as members yelling at one another or parents withdrawing from their children. Interventions used to address family problems can be designed based on the patterns uncovered by this technique Most family therapists use tracking.• TRACKING The tracking technique is a recording process where the therapist keeps notes on how situations develop within the family system. a chance for change within the total hierarchical relationship is fostered.

Thomas Detriangulation. Examining Irrational Beliefs Cognitive Behavioural Family Therapy John Gottman. This can lead to irrational beliefs and a faulty family schema. Lynn knowing” stance intended to illicit new meaning Hoffman. Modeling. Being Public. Attachment Theory John Bowlby. Modeling 163 . Family members Carter. The Psychoanalysis. Resignificance toward a fictional final goal with a private logic. and emotional cutoff.Summary of Family Therapy Theories & Techniques Theoretical Model Theorists Summary Techniques Adlerian Family Therapy Alfred Adler Also known as "Individual Psychology". Problems are the result of operant conditioning that reinforces negative behaviours within the family’s interpersonal social exchanges that extinguish desired behaviour and promote incentives toward unwanted behaviours. Charting. Coaching McGoldrick. Collaborative therapy is an approach that avoids a particular theoretical perspective in favor of a client-centered philosophical process. Not Knowing. Tom dialogue about inner thoughts with a “notLanguage Systems Andersen. Systematic Desensitization. Sees the person as a whole. Typical Day. Curiosity. Albert Bandura Individuals form meanings about their experiences within the context of social relationship on a personal and organizational level. Reflecting Teams Equality. John All people are born into a primary survival triad Dialogical Conversation. causing anxiety. Friedman. Shaping. are driven to achieve a balance of internal and Michael Kerr. Edwin affected by nuclear family emotional processes. external differentiation. Bowenian Family Nonanxious Presence. Used as a foundation for Object Relations Theory. Philip Guerin. Albert Ellis. Collaborative therapists help families reorganize and dis-solve Harry Goolishian. Reorienting. Fogarty. Birth order and mistaken goals are educating explored to examine mistaken motivations of children and adults in the family constellation. Play Strange Situation experiment with infants involves Therapy a systematic process of leaving a child alone in a room in order to assess the quality of their parental bond. their perceived problems through a transparent Collaborative Harlene Anderson. Mary Ainsworth Also known as “Intergenerational Family Therapy” (although there are also other schools of Murray Bowen. Betty intergenerational family therapy). Communications Virginia Satir. Daniel sibling positions and multigenerational Papero transmission patterns resulting in an undifferentiated family ego mass. Families are Genograms. Peggy Penn through conversation. Therapeutic Contracts. Monica Systems triangulation. Individuals are shaped by their experiences with caregivers in the first three years of life. Ideas include compensation for feelings of inferiority leading to striving for Psychoanalysis.

mutuality and merit are Filial Debt Repayment breached. Maria Gomori between themselves and their parents where they adopt survival stances to protect their self-worth from threats communicated by words and behaviours of their family members. entitlement. August Napier Battling. trust. biases and cultural stereotypes and to model an egalitarian perspective of healthy family relationships. Couples and families can develop rigid patterns of interaction based on powerful emotional Reflecting. Redefining Symptoms. David Kieth. Milan Systemic Family Therapy A practical attempt by the “Milan Group” to establish therapeutic techniques based on Gregory Luigi Boscolo. Neutrality. Therapists are encouraged to be aware of these Equality. Stemming from Gestalt foundations. Metaphors. often in a playful and sometimes absurd way as a means to foster flexibility in the family and promote individuation. CoTherapy. Laura Roberto. Modeling. psychological and social difficulties that require a specialized skills of a therapist who understands the complexities of the medical system. fairness. Consultations. experiences that hinder emotional engagement and Heightening. change and growth occurs through an existential encounter with a therapist who is intentionally “real” and authentic with clients without pretense. Validation. John Warkentin. Families facing the challenges of major illness experience a unique set of biological. Mara Selvini Palazzoli. Constructive Anxiety. Humor Feminist Family Therapy Sandra Bern. Jeri Hepworth & William Doherty Grief Work. Circular Gianfranco Cecchin. Treatment aims to enhance empathic Restructuring capabilities of family members by exploring deepseated habits and modifying emotional cues. Bateson’s cybernetics that disrupts unseen Hypothesizing. Jane Gerber. mind and feelings in order to promote congruence and to validate each person’s inherent self-worth. Family Meetings. Personal influences in order to avoid perpetuating hidden Accountability oppression. Les Therapy Greenberg Experiential Family Therapy Carl Whitaker. systemic patterns of control and games between Questioning. Communication. Family Reconstruction Contextual Therapy Ivan BöszörményiNagy Families are built upon an unconscious network of implicit loyalties between parents and children that Rebalancing. Walter Kempler. Susan McDaniel. Thomas Malone. Reframing. Validation. trust. Emotion-Focused Sue Johnson.Approaches Banmen. Family Sculpting. as well as the full spectrum of mental health theories and Medical Family Therapy[39] Goerge Engel. Collaborative Approaches 164 . Family Life Chronology. family members by challenging erroneous family Counterparadox Giuliana Prata beliefs and reworking the family’s linguistic assumptions. Affective Confrontation. Experiential therapists are interested in altering the overt and covert messages between family members that affect their body. Complications from social and political disparity between genders are identified as underlying causes of conflict within a family system. Family can be damaged when these “relational ethics” of Negotiations. Demystifying.

but the problem is the problem. People use stories to make sense of their experience and to establish their identity as a social and political constructs based on local knowledge. Asking Permission Object Relations Therapy Individuals choose relationships that attempt to Hazan & Shaver. Established by the Mental Research Institute (MRI) as a synthesis of ideas from multiple Gregory Bateson. Reframing. Psychoanalysis. Externalizing Problems. maintaining homeostasis in the family hierarchy as Metaphoric Tasks. diminishing their hope and causing them Goal Setting. psychopathologies of the family members and seek Confrontation to improve complementarity The inevitable onset of constant change leads to negative interpretations of the past and language Future Focus. Prescribing the Symptom. Paul Watzlawick Strategic Therapy Jay Haley. Directives. Scharff & Jill Scharff. (object) are projected onto their partners. Cloe Madanes Salvador Minuchin. Unbalancing Kim Insoo Berg. Heinz by families to create first and second order change von Foerster by persisting with “more of the same. David Narrative Therapy Epston Deconstruction. governs their interactions. Restraining (Going Slow). Detriangulation. Family Family problems arise from maladaptive Mapping. Paradoxical Symptoms of dysfunction are purposeful in Injunctions. Positioning. Mapping. Joining. Beginner’s that shapes the meaning of an individual’s Mind.techniques. Michelle Therapy Weiner-Davis. Harry Aponte. David heal insecure attachments from childhood. Miracle Question. Scaling to overlook their own strengths and resources. situation. theorists in order to interrupt misguided attempts Milton Erickson. CoTherapy. Steve de Shazer. Relabeling.” MRI Brief Therapy Reframing. Braulio Montalvo 165 . Slow) Joining. Charles Structural Therapy Fishman. Narrative therapists avoid marginalizing their clients by positioning themselves as a co-editor of their reality with the idea that “the person is not the problem. Holding Environment Psychoanalytic Family Therapy Nathan Ackerman By applying the strategies of Freudian psychoanalysis to the family system therapists can Psychoanalysis. it transitions through various stages in the family Restraining (Going life cycle. boundaries and subsystems that are created within Hypothesizing. gain insight into the interlocking Authenticity. William Solution Focused O'Hanlon. the overall family system of rules and rituals that Reenactments.” mixed signals from unclear metacommunication and paradoxical double-bind messages. Bellac Ploy Michael White. Negative patterns established by their parents James Framo.

Family Therapy Survey
Nichols and Schwartz (1998)

I. The Foundations of Family Therapy - Outline by David Peers
A. The myth of the hero 1. The individual is unique and autonomous 2. Breaking free from childhood 3. The myth of rising above the human condition and individuation 4. Individuals are sustained by interpersonal relationships 5. Families are both withholding and uplifting - sometimes at the same time B. Psychotherapeutic sanctuary 1. Therapy in isolation or in groups? 2. Freud and Rogers emphasized private patient/therapist relations 3. Freud: real family who needs it? The use of transference - the therapist as parent 4. Rogers: exploration of self and self - actualization. The need for approval 5. Rogers: support, unconditional positive regard, and the art of listening C. Family vs. Individual therapy 1. Both are approaches to treatment and understandings of human behavior 2. Individual therapy a. Concentrated focus b. Internalization of personal dynamics 3. Family therapy a. External focus b. Changing organizations - change on the entire family, systemic 4. Are we separate entities or embedded in a network of relationships? D. Psychology and social context 1. Family therapy flourishes because of success and recognition of interconnectedness 2. Is psychotherapy intrapsychic or interpersonal? Perhaps both or neither? 3. Family therapy as an orientation rather than a technique 4. Uncovering family influences 5. Individuals within a system


E. The power of family therapy 1. Evolution from 1950’s to today 2.1975 - 1985 as golden age - shared optimism and common purpose 3. Problems may originate from interaction so change focuses on interactions 4. Questions: a. Constructivist notions? b. Narrative therapy? c. Integrative techniques? d. Social issues? F. Contemporary cultural influences 1. Managed health care a. Crisis intervention versus ongoing personal exploration? b. Confidentiality?. Prejudicial employers? 2. Postmodern skepticism a. Integrated schools of thought b. Approaches to clients or clients to approaches? G. Thinking in lines vs. Thinking in circles 1. Cause and effect perspectives - unilateral influence 2. Circles of thought as empowering 3. Transforming interactions 4. Major advantage of family therapy: works directly on unhappy relationships 5. The difficulty of change 6. Personal participation in problems 7. Circular problems - the cause is the result and the result the cause 8. Learning life’s painful lessons and understanding the family’s story


II. The Evolution Of Family Therapy - Outline by Lori Rice
A. The undeclared war 1. 1950’s - - change in one person changes the system 2. Brown research with schizophrenic patients returning home (1959) 3. Current psychiatric hospital therapy and possible family segregation B. Small group dynamics 1. William Mcdougall - group mind 2. Lewin - group is more than the sum of its parts - - group discussions superior to individual instruction for changing ideas/behavior 3. Bion (1948) fight - flight, dependency, and pairing 4. Process/content in group dynamics 5. Role theories 6. Similarities between group and family therapies C. Child guidance movement 1. Scholars publishing more than clinicians 2. Movement assumption: Emotional problems begin in childhood, therefore treat the child 3. Shift to include families in treatment, but typically blame parents for child’s problems Fromm Reichmann’s schizophrenogenic mother D. The influence of social work 1. Family casework - families must be considered as units 2. Social workers among most influential in family therapy E. Research on family dynamics and the etiology of schizophrenia 1. Gregory Bateson a. Researched communication among animals b. Functions of communication: report and command, metacommunication c. Bateson joined by others to investigate conflicts between messages and qualifying messages d. Double bind 2. Theodore Lidz 3. Lyman Wynne - rubber fences, pseudomutuality, and pseudohostility 4. Role theorists marriage counseling


perpetuates problems by maintaining status quo 15. Family homeostasis . Midelfort. Family therapy has a history of being condescending B.and inter . Sketches of leading figures 1. Subgroups 4. Early Models And Basic Techniques: Group Process And Communications Analysis Outline by Sarah 1. Family rules .Role theory . Command .based on differences that fit together 12. A. Complementary relationships .organizes behavioral events and reflects observer bias 14. Negative feedback loop .clarity. Communication punctuation . Re ort . private or shared communication systems.III. Haley. Skynner 2. Bateson. People are always communicating 7.acceptable behavioral balance within the family 11. Symmetrical relationships .every group has roles that have "rules" for conduct (intra . Satir C.statement about the definition of the relationship 9. Group/family leaders 2.conflict is an ‘inevitable part of group life 5.. Dreikurs. Group family therapy (group) . Pragmatics . Semantics .ways words are put together to make sentences 4. Foulkes.based on equality and mirroring of behavior 13. Family defense mechanisms 3. Circular causal (disregard past) 3.disregards individual complexity to focus on input and output (communication) 2. Positive feedback loop .alters the system to accommodate novel input 169 .Bell.(content) conveys information 8.description of regular interactions 10. concordance versus confusion 5. Black box .communications 1. Theoretical formulations . fit between personality and role) D. Syntax .Jackson. Field theory (Lewin) . Communications family therapy (communication) .behavioral effects of communication 6. Theoretical formulations .role conflict.

Development of behavior disorders 1.individuation of group members. making implicit rules explicit and using therapeutic paradox 170 . Communications . network therapy family members talk to each other. Communications a.centered.multiple group therapy. personal growth. Group a. Normal families become unbalanced during transitions in family life cycle F."identified patient" as a role with counterroles and complimentary roles that maintain the system . family .(using "I". Conditions for behavior chang 1. Teaching rules of clear communication .caused by pathological communication such as paradoxical injunctions/ double binds G.not about) 3. Structured family interview (5 tasks) 2. multiple impact therapy. Group . then explore those feelings 2.anything that interfered with balanced self . concentrating more on process than content.change/prevent maladaptive interactions viii. parent . Group . and improved relationships 2. symptoms may be perpetuated into a role and group organizes around a "sick" member 2..symptoms as products of disturbed and disturbing group processes .making covert messages behind symptoms overt. affection c. Communications . Feedback loops b. Cohesiveness d. Group . Techniques of communications family therapy 1.E. Communications . Therapist as process leader 2. Normal family development 1.if needs continue to go unmet.centered. Techniques of group family therapy 1. Need compatibility 2. Goals of therapy 1.expression J. Used family’s moment to circumvent resistance 4.centered 3. Therapist as referee and reframer. Three phases of group development: inclusion.. H.child . Therapist may manipulate the family be prescribing the symptom or therapeutic double binds. introducing positive feedback loops I. Instrumental and expressive leaders b. Types of therapy . Resistance . stating facts. talking to . control. Stages .

Identifying systemic context (interpersonal context of presenting concern) 4. Working with managed care . so cooperate 171 . System’s anxiety 1. Middle phase of treatment . Stages of life cycle 5. dynamics. Group . First interview . Early phase of treatment .families aren’t egalitarian 2. connective interpretations. Gender (roles. Communication 7. but tend to dismiss selfhood as an illusion M.refining hypothesis and beginning to work on problems 4. Understanding referral route 3. process/content distinction. Extramarital involvement (not just sexual affairs) 10. expectations. feedback loops. reflective interpretations. Ethical dimension (therapist and family’s ethics) O. normative interpretations. rules.double’s necessary. paradoxical directives. Lessons from early models 1. focus on marital pair L. Stages of family therapy (checklists in text) 1. free and open discussion. therefore. caveat begins to take more active role 5. metacommunication. Cybernetics and general systems theory helped clinicians understand families. and society) 11. Drug and alcohol abuse and consolidate N. Domestic violence and sexual abuse 9.keep it short 2. networking. Family structure alliance and hypothesize 3. cybernetics. the enemy 2. roles.K. Initial call . altering patterns of communication. Presenting problem 2. symptoms . Communications . confronting. Cultural factors (including mainstream) 12. reconstructive interpretations. Therapists viewed family as being to blame for a "victim’s" illness and were. Family assessment 1. Termination .

Cybernetics applications to families: family rules.Malinowski and Brown ."us against them" 3.introduced concept to family therapy . Physiology vi. Social work iv. Feedback loop i.don’t really know how to explain it iii. What did family therapy forget? Larger systems c. Reaction to evolutionary method of removing from context b. Functionalist premise .correcting systems b.communicating about communicating e.Haley control and power vs. Functionalist influence on family therapy i. Community mental health ii. neg. Many influences on family therapy i.a misinterpretation a.families are organisms adapting to environment in context . Systems theory .(scapegoats) ii. Functionalism a.. Weiner’s idea of self . positive feedback loops when neg. Negative feedback loop . Bateson 172 .movement from linear circular causality f.. The Fundamental Concepts Of Family Therapy Outline by Anabella Pavon A. Cybernetics of families a. Psychosomatic medicine 2. Positive feedback loop . Problem .problems with family show problems with adjustment to environment iii. way of thinking rather than established doctrine b. Anthropology . Anthropology iii. Opening thoughts a. All systems are subsystems b.most influential in development ii. Feedback loops don’t work d.the adaptive value of any activity can be found if the behavior is viewed in the context of the environment" (pg. Brass tacks .need to study in context c.amplifies deviation or change c. Evolutionary theory and psychoanalysis e. Biology v. Bateson f. General systems theory .". Feedback. Consensus among family therapists about systems theory . Deviant behaviors may be functional . Cybernetics vii. Systems theory i.Bertalanffy . Bateson .reduces deviation or change ii. Is it important for family therapists to consider values? 4. Metacommunicating . sequences of interactions.IV. 110) d. Consensus among family therapists about systems theory . Split . Conceptual influences on the evolution of family therapy 1.abstract concept.

Family life cycle B. change individual d. The nonpathological view of people 7. From cybernetics to structure a. Haley .chance structural context. Basic premise . The influence of culture 173 . Undifferentiated family ego mass b.cartographer of family structure 6. Focussing on solutions 9. Enduring concepts and methods 1.look at nurturance instead of control 7. Function of the symptom 5.coalitions b. Indirect communication 3. Family structure 4. Minuchin . Changing a family’s narrative 10.5. Structural concept of families .subsystems with boundaries c. Family of origin 8. Interconnectedness 2. Multigenerational transmission process 8. Circular sequences c. Sequences of interaction a. Circumventing resistance 6. Triangles b. Satir’s humanizing effect . Differentiation of self c. Bowen and differentiation of self a.

Societal emotional process C.adjusted families in "systems concepts and the dimensions of self’ (1976) 4. Murray Bowen 2. Families with young children d. Optimal family development: good differentiation. Second . Thomas Fogarty 4. Hallmark of well adjusted person is rational objectivity and individuality 5.V. Bowen Family Systems Therapy Outline by Jared Warren A. Carter and mcgoldrick elaborated the family life cycle a. Nuclear family emotional process 4. First . Triangles 3. parents in good emotional contact with families of origin 3. All families lie on continuum from emotional fusion to differentiation 2.order change vs. Philip Guerin 3. Sibling position 7. low anxiety. Family projection process 5. Emotional cutoff 8. James Framo B.order change 174 . Multigenerational transmission process 6. Theoretical formulations 1. Betty Carter 5. Leaving home b. Differentiation of self 2. Fogarty elaborates 12 characteristics of well . Michael Kerr 8. Joining of families through marriage c. Launching children and moving on f. Normal family development 1. Adolescence e. Monica McGoldrick 6 Edwin Friedman 7. Families in later life 6. Sketches of leading figures 1.

Use of displacement b. Goal of differentiation b.D.position" d. Keys to therapy: process and structure 2. Displacement stories 175 . Didactic teaching 2. Primary goals: decrease anxiety and increase differentiation of self 3. Relationship experiments 4.Seven prominent techniques 1. Identifying triangles. Creation of new triangle in therapy between husband. Therapist concentrates on process of couple’s interactions c. Techniques 1. According to bowen. Summary . Development of personal relationship with everyone in family G. Major shortcoming: can neglect importance of working directly with nuclear family 2. Goals of therapy . Goals for extended family: developing one . The therapy triangle 3. Conditions for behavior change 1. reentry into family of origin H. Use of the "i .one relationships and avoiding triangles 5. wife. Symptoms develop when level of anxiety exceeds system’s ability to cope 2. and avoid being reactive to inevitable emotionality in families 2. Genograms c. Change requires awareness of entire family 3. Therapists must avoid taking sides and promoting triangulation. Evaluation has relied more on clinical reports than empirical data I. Coaching 5. Multiple family therapy 7. Bowenian therapy with couples a. behavior disorders result from emotional fusion transmitted from one generation to the next E. Guerin and fogarty put more emphasis on relationship with symptomatic child and nuclear family triangles 5. The "I-position" 6. Most vulnerable individual is most likely to develop symptoms 3. Genogram 2. Bowenian therapy with one person a. Approaches of Guerin and McGoldrick F. Development of behaviour disorders 1. and emotionally neutral therapist 4. Bowen’s primary approach: calm down the parents and coach them to deal more effectively with the problem 4. Evaluating therapy theory and results 1.

individuals’ goals and values. freedom. personal awareness. placating. Bunny and Fred Duhl 6.VI. Intrapsychic defenses that lead to interpersonal problems 9. privacy. Continuous growth and change and flexibility b. Current figures: Leslie Greenberg and Susan Johnson B. Mystification . Loyalty to family stressed over loyalty to self 5.smothering emotion and desire 6. Virginia Satir (yes. the same one from communications family therapy) 4. individuality. and being super reasonable 176 . Normal family development a. Nurtures and supports individual growth and experience (which leads to increased growth in the family) open (say anything) and constructive problem solving c. David Kantor 7. "wrong" communication: blaming. but largely atheoretical 2. and personal fulfillment. Marriages consist of two people trying to work out conflicts that arise from each trying to reconstruct his or her family of origin and their differences frighten them causing them to cling closer together 7. Family and societal pressures prevent naturally occurring self . Seeking security and stability (rigid) rather than satisfaction 4. Commitment to freedom. Natural and spontaneous.actualization 2. Development of behavior disorders 1. Theoretical formulations 1. Walter Kempler 5. There is a wide variety of perspectives that a rather loosely connected under the heading of experiential family therapy C. Denial of impulses and suppression of feelings (emotional deadness) 3. Carl Whitaker 3. Emerged in the 1960s from humanistic psychology and drew heavily from gestalt therapy and encounter groups (it is not very popular today) 2. being irrelevant. and togetherness D. Leading figures and background 1. self expression. Includes "normal" difficulties such as infidelity or "quiet desperation"and "invisible" (culturally accepted) symptoms such as overwork and smoking 8. Lack of warmth >>> avoidance >>> preoccupation with outside activities 11. Getting stuck during a life transition or change 10. Experiential Family Therapy Outline by Sarah Sifers A.

esteem. Growth. Therapist teaches by example how to be open. Clarifying communication (often through directives) 2. Use of co . personal integrity. and well . Shifting the focus to an individual is a way to stop family bickering 177 . "psychotherapy of the absurd" 9. Openly acknowledge support.) To create therapeutic change by opening people up or discover hidden emotions 2. but some anecdotal support 2. Use of touch 6. "expanded experience. and spontaneous 4." increased sense of competence. Nonverbal cues) 5. Support all family members’ self . experienced. Family therapists would benefit from being more honest and open with clients 3. Asking questions about emotions that are not expressed clearly (ind. family art therapy. family puppet interviews. less dependence. become a family member. No empirical studies. Very little formal assessment or history taking 8. Conditions for behavior change 1. Increased self .and then techniques. Find fulfilling roles for self that don’t override concern for the needs of the family as a whole (personal growth and family integration) 2. etc. Being spontaneous. Including as many family members as possible (3 generations and kids) 5. Interrupting family dialogues to work with individuals H.esteem 4.E. conjoint family drawings. Evaluation 1. Therapist needs to be mature. Therapist must be warm and supportive. Evocative measures (resulting in anger.being 4.therapists to manage counter . gestalt therapy techniques. be a "real person" 3. role playing. freedom of choice. "crazy" F.awareness and expression that facilitates open family communication (you can’t communicate what you’re not aware of) 3. Specific techniques (see book for description): family sculpture. Goals of therapy 1. symbolic drawing of family life space. self . and make use of individual differences 5. anxiety. there . and have a satisfying family life G. techniques 1.transference 7. Focus on solutions rather than past grievances and point out positives 3. honest.

Ivan Boszormenyi . Normal family development 1.. family therapy the family. Sullivan.. Parents need to be empathetic and model idealization of family therapy at the eastern Pennsylvania Psychiatric Institute.Nagy . Nathan Acherman . Wait . Sketches of leading figures 1.VII. Erik Erikson ..first book dealing strictly with diagnosis and treatment of families 6. Object relations theory . and contemporary psychoanalytic family therapists therapists looked at the individual again 4. Separation/individuation . Paradox: psychoanalysis is for the individual.concerned with the ethics of families "loyalty and trust provide the glue that holds families together" 178 .sociology and ego psychology 4. Psychoanalytic Family Therapy Outline by Anabella Pavon A.parents .. Lots of talk about the mother and early mother/child attachment 3.forerunners. Introduction 1.people want to be appreciated 4.sexual and aggression 3. Theoretical formulations 1. Several psychodynamic therapists completely turned away from looking at the individual 3. Dicks . Four groups of contributors to psychoanalytic family therapy . Healthy psychological development based on good early environment .worked with couples in England 8. John Bowlby C.the psychodynamics of family life (1958) . Wynne. Many early family therapists have their roots in psychoanalytic training 2. Freudian drive psychology .gaps in personal morality passes on by parents 3. Self psychology .provision of reliable support from mother is necessary 4.. How can there be Psychoanalytic family therapy? B. 7. Ivan Boszormenyi .Nagy .Erich Fromm predecessor of Bowen. There’s more .relate to people in the present partially based on expectations we develop in early relationships D. 80s . "Practical essence of psychoanalytic theory is being able to recognized and interpret Unconscious impulses and defenses against them . Adelaide Johnson .good object relations 2. Lidz.contextual therapy . Acherman strongest tie to psychoanalytic theory 5. 2.superego lacunae . psychoanalytic ideas and thoughts when the field turned from psychoanalytic ideas. psychoanalytically trained pioneers.bridge between psychoanalysis and family therapy .

" . silence is important. . Where non . Conditions for behavior change 1. Don’t focus on reassuring or advise or confronting. Goals of therapy 1. go on to be showy and seek admiration 5.when these needs aren’t met from parents. If they do intervene it’s to provide empathic understanding to help member of the family open up. Some problems can occur with parents not accepting children’s separation 4. Kernberg . Nnagy . Development of behavior disorders 1." 2. people can go back to behaviors seen when they were younger 6.blurred boundaries occur when connections are formed with family members F. Therapists focus on the feelings associated with problems.listening. Kohut . . healthy persons on the basis of current realities rather than Unconscious images of the past. Therapy focuses on supporting defenses and helping communication instead of analysis of defenses and finding repressed needs and impulses G. Techniques 1. 228) 7. not the causality to begin questioning about what’s at the root of the problem 5. Explore in four areas with couples: internal experience.after marriage. Mostly used with couples. Important for the therapist to establish a sense of security H. 4.E.psychoanalytic family therapist look at problems in interactions between people while psychoanalytic therapists look at problems in the actual people in the family 2. interpretation. history of the experience.symptoms occur when trust breaks down in relationships . and how the context of session and therapist’s input might contribute to the situation 6. Fixation and regression in families . Therapist has to have a hypothesis 179 . "Family dynamics are more than the additive sum of individual dynamics" (p. 2.mirroring and idealization . empathy. Free family members of unconscious restrictions so that they’ll be able to interact with one another as whole. Want family members to understand and accept repressed parts of personalities. Four basic techniques . Symptoms come from attempting to cope with unconscious conflicts and the Anxiety that signals the emergence of repressed impulses" 3. Insight is necessary . and keep analytic neutrality 2. Analysts also clarify things that appear to be hidden or need clarification 3. how partner can trigger the family therapy expand that insight knowing that psychological life goes beyond conscious experiences. Need to work through those things.individuals feel the effects 7.

Assumptions 1. These actions hinder mature actions to resolve stress. 6. Marianne Fishman. Some groupings are obvious and based on such factors as generation. 1970 headed Philadelphia Child Guidance Clinic where family therapists have been trained in structural family therapy ever since 4. Born in Argentina . Structure — the organized pattern in which family members interact. gender. Boundaries are invisible barriers that regulate the amount and nature of contact with members. The emotional boundaries and coalitions are important B. Family are individuals who effect each other in powerful but unpredicatable ways 2. Jay Haley. worked in Israel with displaced children. Subsystems in the family may be disengaged or enmeshed. 2. Carter Umbarger. predictable sequences of family interaction. They range from rigid to diffuse. disengaged to enmeshed D. also worked in the USA with Don Jackson with middle class families. Structure involves a series of covert rules. age or common interests. They fail to mobilize to deal with the stress. served in the Israel army as a physician. 3. 3. Theoretical formulations . Normal family development 1. 5.VIII. Subsystems — Families are differentiated into subsystems of members who join together to perform various functions. Power hierarchies may develop which may be weak and ineffective or rigid and arbitrary. Every member may play many roles in various subgroups. Conflict avoidance prevents effective problem solving. Bernie Rosman. Salvador Minuchin 1. 4. in the USA trained in child psychiatry and psychoanalysis with Nathan Ackerman. 5. The development of behavior disorders 1. Families may not be able to tell you the family structure. Couples also form boundaries with their families of origin 4. The advent of children requires that the structure of the family change E. Fist generation of family structural therapists: Braulio Montalvo. Each person is a member of one or more subsystems in the family. patterns of interaction. Marriage begins with accommodation and boundary making 2. Other coalitions may be subtle. Always concerned with social issues 2. Couples are influenced by the structure of their families of origin 3. clear to unclear. Harry Aponte. Enmeshed families have diffuse boundaries and family members overreact emotionally and become intrusively involved with one another. Disengaged families have rigid boundaries and excessive emotional distance. C. Structure Family Therapy — Outline by Patty Salehpur A. Family dysfunction results from stress and failure to realign the structure to cope with it. 2. and Stephen Greenstein. There are universal and idiosyncratic constraints. Cloe Madanes. The consistent repetitive organized and predictable patterns of family behavior are important 3. Developed a theory of family structure and guidelines to organize therapeutic techniques 3.three essential constructs 1. but they will show it to you in their interactions. 180 .

Control intensity by the regulation of affect. Listen to "I" statements 2. 9. Techniques — join. Changing family structure . Paradoxes d. Looking at the power hierarchies b. Seating b. Enactment for understanding and change 3. Goals of therapy 1. Therapist sometimes must challenge the way family members perceive reality. Taking sides b. F. Therapists must create techniques to fit each unique family 181 . changing the way family member relate to each other offers alternative views of reality. Symptoms in one family member may reflect dysfunctional structural relationships or simply individual problems. Seeing subgroups or individuals to foster boundaries and indivduation c. Behavioral techniques fit into these short-term strategies. transform structure 1.altering boundaries and realigning subsystems 2.g. A major change in family composition demands structural adaptation. Joining and accommodating. repetition and duration b. e. Teaching may be necessary b. Boundary making and boundary strengthening a.growth of the individual while preserving the mutual support of the family 3. Family structure may fail to adjust to family developmental processes. Symptomatic change . Using enactment to understand and clarify c. individual vs. Generational coalitions may also prevent effective problem solving. G. subgroup b. Unbalancing may be necessary a. Challenging the family’s assumptions may be necessary a. Don’t dilute the intensity through overqualifying. then taking a position of leadership a. Clarify circular causation 7. but for long-lasting effective functioning the structure must change. Challenging c. apologizing or rambling c." 6. Working with interaction and mapping the underlying structure a. 10. Pragmatic fictions c. structural diagnosis 5. Would you quiet the kids. 8. Diagnosing a. "It’s too noisy in here. Looking at the boundary structures 4. Directives 8. Shape competence. Highlighting and modifying interpersonal interactions is essential a. Short-range goals may be developed to alleviate symptoms especially in life threatening disorders such as anorexia nervosa.7. map. 9.

182 .

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