FAMILY AND MARITAL THERAPY

MODULE 1:-
Family therapy, also referred to as couple and family therapy, marriage and family
therapy, family systems therapy, and family counseling, is a branch of
psychotherapy that works with families and couples in intimate relationships to
nurture change and development. It tends to view change in terms of the systems
of interaction between family members. It emphasizes family relationships as an
important factor in psychological health. The different schools of family therapy
have in common a belief that, regardless of the origin of the problem, and
regardless of whether the clients consider it an "individual" or "family" issue,
involving families in solutions often benefits clients. This involvement of families is
commonly accomplished by their direct participation in the therapy session. The
skills of the family therapist thus include the ability to influence conversations in a
way that catalyses the strengths, wisdom, and support of the wider system. In the
field's early years, many clinicians defined the family in a narrow, traditional
manner usually including parents and children. As the field has evolved, the
concept of the family is more commonly defined in terms of strongly supportive,
long-term roles and relationships between people who may or may not be related
by blood or marriage.
HISTORY:-
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.
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 the United Kingdom and the United States. 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 counseling. The formal
development of family therapy dates from the 1940s and early 1950s with the
founding in 1942 of the American Association of Marriage Counselors (the
precursor of the AAMFT), and through the work of various independent clinicians
and groups - in the United Kingdom (John Bowlby at the Tavistock Clinic), the
United States (Donald deAvila Jackson, John Elderkin Bell, Nathan Ackerman,
Christian Midelfort, Theodore Lidz, Lyman Wynne, Murray Bowen, Carl Whitaker,
Virginia Satir, Ivan Boszormenyi-Nagy), and in Hungary, D.L.P. Liebermann - who
began seeing family members together for observation or therapy sessions. 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 behavior 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. The movement
received an important boost starting in the early 1950s through the work of
anthropologist Gregory Bateson and colleagues at Palo Alto in the United States,
who introduced ideas from cybernetics and general systems theory into social
psychology and psychotherapy, focusing in particular on the role of
communication. 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. 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 behavioral approaches,
psychodynamic and object relations approaches, attachment and Emotionally
Focused Therapy, intergenerational approaches, network therapy, and
multisystemic therapy (MST).Multicultural, intercultural, and integrative
approaches are being developed.
OPEN SYSTEM AND CLOSED SYSTEM AND FAMILY DYNAMICS:-
The basic difference between a closed system and an open system is how it reacts
to change.
A closed system tries to remain static. It’s rigid and follows the same rules even
though they are no longer appropriate. There is no flow of information, so people
don’t share thoughts, interests, or dreams. Thus, no new ideas come into the
system to keep it fresh and vibrant.
As an open family, there are no barriers between you because you work through
conflicts as they come up. You see each other with caring and forgiving eyes
instead of judgmental and critical eyes. There are no secrets between you
because you maintain a constant flow of information among your family
members.
Here are five characteristics of an open family:

• People Are Celebrated: Existence of individuals pertaining to their

individuality is celebrated and nurtured in an open family system.
• Relationships Are Nurtured: In a healthy family system, relationships are
strong. Open families welcome spouses into the nuclear family and make them
feel valued and important. They know it is essential to incorporate new members
into their culture and to give them time to assimilate their ways.
• Communication Flows: Individuals are able to communicate freely and
express themselves effectively in an open family system.
• Rules Can Be Changed: Family members are open to the ideas and views of
other family members and
• Change Is Embraced

Here are some tips for developing a more open family system.
1. Adopt an attitude of acceptance. Teach everyone in your family that differences
are not a threat, but an opportunity for increased tolerance, understanding, and
wisdom.
2. Take time to get to know every member of your family more intimately —
including spouses and grandchildren. Learn about their interests, talents, ideas,
and dreams. Let them know that you value them just the way they are, even
though they may be different from you.
3. Spend time building relationships among family members. Plan activities that
put different generations together and make extended family members feel as
important as nuclear family members.
4. Don’t gossip about other family members. Encourage each person to speak
directly to the person with whom they have an unresolved issue, and don’t allow
two people to take sides against a third.
5. Be flexible in changing old traditions, rituals, and rules that have become
outdated. Listen to the input of younger generations and create new rules that fit
more appropriately with the needs and desires of your family.
6. Embrace change. It’s inevitable. Learn to go with the flow and enjoy the ride!
Fear permeates the environment of a closed system. But an open system
operates on a foundation of closeness, growth, and the ability to choose. These
are gifts that will allow you and every member of your family to prosper, both
individually and collectively
Family Dynamics
Family dynamics are the patterns of relating, or interactions, between family
members. Each family system and its dynamics are unique, although there are
some common patterns. All families have some helpful and some unhelpful
dynamics. Even where there is little or no present contact with family, a young
person will have been influenced by dynamics in earlier years. Family dynamics
often have a strong influence on the way young people see themselves, others
and the world, and influence their relationships, behaviours and their wellbeing.
An understanding of the impact of family dynamics on a young person's self-
perception may help workers pinpoint and respond to the driving forces behind a
young person's current needs.
What influences family dynamics?
Some of the many influences on family dynamics include:
• nature of the parents' relationship
• having a particularly soft or strict parent
• number of children in the family
• personalities of family members
• an absent parent
• the 'mix' of members who are living in the same household
• level and type of influence from extended family or others
• a chronically sick or disabled child within the family
• events which have affected family members, such as an affair, divorce,
trauma, death, unemployment, homelessness
• other issues such as family violence, abuse, alcohol or other drug use,
mental health difficulties, other disability
• family values, culture and ethnicity, including beliefs about gender roles,
parenting practices, power or status of family members
• nature of attachments in family (ie secure, insecure)
• dynamics of previous generations (parents and grandparents families)
• broader systems- social, economic, political including poverty

MODULE 2: FAMILY THERAPIES AND ASSESSMENT:-

1. Systematic therapy:-
 Systems theory : Using a biological analogy, systems theory proposes
that various activities of the body are composed of interconnected
but distinct systems of components that operate together in an
integrated and coordinated way to maintain stability (von Bertalanffy
1968; Bateson 1972). This coordination is achieved through
communication between the components or parts of the system. To
take a simple example, the regulation of body temperature involves
an interaction between the sweat glands and perspiration, physical
activity, breathing rate and control mechanisms in the brain. These
components act together (much like a thermostat) to maintain the
temperature of the body within tolerable and ‘safe’ limits. Very
simply, a system is any unit structured on feedback (Bateson 1972).
More fully, a system is seen as existing when we can identify an
entity made up of a set of interacting parts which mutually
communicate with and influence each other. The parts are
connected so that each part influences and is influenced by each
other part. In turn these continually interacting parts are connected
together such that they display identifiable coherent patterns. These
overall patterns are not simply reducible to the sum of the actions of
the individual’s parts – a system is more than simply the sum of its
composite parts. It is the observed pattern that connects the parts in
a coherent and meaningful way. Aspects of mechanical models were
also applied to families, with Jackson (1965a) suggesting that a family
was similar to a central heating system in that it operated on the
basis of a set of rules, with deviations from these rules being resisted.
For example, there might be a pattern of interaction which featured
an escalating conflict between mother and daughter during which
the father would withdraw in exasperation. Eventually the mother
would turn to him in anger, accusing him of not helping or caring.
Following some hostile exchanges between them, the mother would
turn to accuse her daughter of upsetting the whole family. The family
members would not be aware of this pattern of behaviours acting as
a rule, but in effect their repetitive and predictable pattern of
interaction would suggest that some such rules were in place. This
led to the idea that such groupings of components constituted a
system. Emergent properties of system are:-
1. Circularities : Paul Watzlawick and his colleagues (1967, 1974)
coined the term circularities to capture these essentially repetitive
patterns of interaction. This represented a fundamental shift from
how relationship difficulties had previously been explained. In
effect the question of looking for a starting point – who started it
 is seen as unproductive. Related to this is the common pattern
found in families and other relationships, when, as a result of an
escalating conflict between two members, a third person is drawn
in. This may occur at a largely unconscious level so that all of
them may be unaware that the third person is repeatedly
involved in this way. These repetitive patterns, these circularities,
stress a continual, mutually determined pattern of action over
time.
2. Triads, triangulation and conflict detouring : When therapists
observed that what one spouse did provoked the other, who
provoked the first in turn, they began to see that a dyad was
unstable and it required a third person to prevent a ‘runaway’. For
example, if two spouses competed over who was most ill, total
collapse could only be prevented by pulling in a third party.
Rivalrous quarrels that amplified in intensity required someone
outside the dyad to intervene and stabilize it. If a third person is
regularly activated to stabilize a dyad, the unit is in fact not a dyad
but is at least a triad. With this view, the unit becomes a unit of
three people. Similarly if a husband and wife regularly
communicate to each other through a third person, the unit is
three people instead of a married ‘couple’.
BEHAVIOURAL FAMILY COUNSELING

Behavioural family therapy is a type of psychotherapy that applies the principles

of learning theory to the treatment of family problems. It is most frequently used
to treat parent-child problems, with the parents being taught to apply
behavioural techniques to correct their children’s misbehaviour.
Behavioural family therapy represents an extension of the use of behavioural
techniques from the treatment of individual problems to the treatment of family
problems.
The model was originally developed by Professor Ian Falloon and colleagues in the
early 1980’s. It is a practical, skills based intervention that usually takes 10 to 14
sessions to deliver. It typically involves sharing information with the service user
and their family about the service user’s mental health issues, experience and
treatment. The family also complete work on recognising early signs of relapse
and develop a clear staying well plan. BFT promotes positive communication,
problem solving skills and stress management within the family. The needs of all
family members are addressed, and each family member is encouraged to identify
and work towards clear personal goals.
The main focus of delivery has been around working with families where a
member experiences psychosis or bipolar disorder. However, family interventions
may be helpful for families experiencing a range of mental health problems,
including anxiety, depression, eating disorders, the dementias and learning
disabilities. The overall aims of BFT are increased understanding, stress reduction,
and improved communication and problem-solving skills within the family.
Development of Behavior Disorders
A.Incorrect Reinforcement
Often parents don't know how to reinforce desirable behaviors and reinforce
undesirable behaviors. This is a pretty much linear model, which may reach high
levels of complexity (interlocking reciprocal behaviors), but is still linear.

B.Aversive Control Techniques

Spouse attempts to control other spouse use of aversive techniques (nagging,
threatening, withdrawing), to which the other spouse responds with aversive
techniques.

C.Poor Problem-Solving Skills

Family work using the Behavioural Family Therapy model will typically include:
• Meeting with the family to discuss the benefits of the approach
• An agreement with the family that they are willing to try the approach
• Assessment of individual family members
• Assessment of the family’s communication and problem solving skills
• Review of the assessment information on the family’s resources, problems
and goals
• Meeting with the family to discuss/plan how to proceed and the
establishment of family meetings
• Information-sharing about the mental health issue and reaching a shared
understanding
• Early warning signs and relapse prevention work – development of ‘staying
well’ plans
• Helping the family to develop effective communication skills
• Supporting the development of the family’s problem solving skills
• Booster sessions
• Review and on-going support or closure

TECHNIQUES-
1. Behavioural parent training: It is a family of treatment programs that aims
to change parenting behaviours, teaching parents positive reinforcement
methods for improving pre-school and school-age children's behaviour problems
(such as aggression, hyperactivity, temper tantrums, and difficulty following
directions).
Providing positive reinforcement for appropriate child behaviors is a major focus
of PMT. Typically, parents learn to reward appropriate behavior through social
rewards (such as praise, smiles, and hugs) as well as concrete rewards (such as
stickers or points towards a larger reward as part of an incentive system created
collaboratively with the child).
PMT also teaches parents to appropriately set limits using structured techniques
in response to their child's negative behavior. The different ways in which parents
are taught to respond to positive versus negative behavior in children is
sometimes referred to as differential reinforcement. For mildly annoying but not
dangerous behaviour, parents practice ignoring the behavior. Following unwanted
behaviour, parents are also introduced to the proper use of the time-out
technique, in which parents remove attention (which serves as a form of
reinforcement) from the child for a specified period of time.
Parents also learn to remove their child's privileges, such as television or play
time, in a systematic way in response to unwanted behaviour.
Specific treatment programs that can be broadly characterized as PMT include
Parent–child interaction therapy (PCIT), the Incredible Years parent training
(IYPT), Positive parenting program (Triple P), and Parent management training –
Oregon model (PMTO).
Behavioral Marital Therapy (BMT)
This is the application of cognitive-behavioral and social learning principles to the
treatment of marital distress. Behavior Exchange (BE) and problem solving (PS)
techniques have been the traditional interventions. The couple feel helpless, and
each feels therapy is to change the other.
The idea of BE is to increase the positive experiences between them such that
they are reinforced for being with each other.

STRUCTURAL FAMILY COUNSELLING

Structural family therapy (SFT) is a method of psychotherapy developed by
Salvador Minuchin which addresses problems in functioning within a family.
Structural family therapy (SFT) is a treatment that addresses patterns of
interaction that create problems within families. The goal of SFT is to improve
communications and, interactions among family members and to highlight
appropriate boundaries to create a healthier family structure.
The basic premise of SFT is that the root of most childhood problems is not within
the child but within the family unit. Its focus is on the structure of the family,
including its various substructures.
Dysfunctional Transactions
Structural family therapists identify a wide range of family dysfunctional
transactions. The two main types at each end of a behavioral spectrum are:
o Enmeshed. This dysfunction identifies a family structure that is smothering
and overly close.
o Disengaged. This dysfunction identifies a family structure that is extremely
distant.
A third type of dysfunctional pattern therapists often encounter is:
o Triangulation. This dysfunction identifies a structure where one family
member gets torn between two others, as in the case of parents placing a child
between them while fighting.
Interventions:
Structural therapy uses family mapping to join and accommodate the family
setting. In addition, these areas pertain to family rules, patterns, and structure.
Minuchin describes six areas of observation that are identified in the family
structure. These areas include transactional patterns, flexibility, resonance,
context, family development stage, and maintaining family interactions. In
reference, intervention methods are based on directives that feed the symptom
by giving a set of instructions to emphasize communication.
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.

STRATEGIC FAMILY THERAPY

Using the word “strategy” before any number of terms always signifies a well
thought out happening or occurrence - initiated, conducted, and completed with
a great amount of forethought and planning. “Strategic” before the therapeutic
practice of “family therapy” means exactly that and more.
Strategic family therapy (SFT) combines two major therapeutic models - strategic
therapy and family therapy - a combination of therapies that necessitate a
carefully crafted plan to effectively manage or ameliorate a family’s particular
problems or issues.
Perhaps the best explanation for strategic therapy is to describe what it is not:
strategic therapy is not a person laying on a couch describing what kind of inner
turmoil or thoughts he or she is having or experiencing, what past childhood
experiences contributed to a sense of self, or how a particular psychological issue
could have arisen from past experiences.
The goals of strategic family therapy are to solve problems, achieve the family’s
goals, and ultimately, change an individual’s dysfunctional or problematic
behaviours.
Strategic therapists are problem-solvers and solution-finders. They are the
referees and coaches, not the spectators passively observing the action played
out before them. They aren’t concerned with where or how the problem started,
only how to address it and solve it at this point in time.
Within the safety of therapeutic settings, strategic family therapists replicate
family interactions and conversations, prompting and engaging participants with
provocative questions and discussions. During these sessions, problems present
themselves, and the therapist engineers the situation so that participants come to
realize and understand the socially impaired interactions taking place.
The therapist also knows how to uncover the family’s strengths and abilities at
solving its own problems, drawing on internal resources that they hadn’t before
acknowledged or even realized that each family member possessed.
During the 1950s and 1960s, Haley along with a number of others began
developing alternative models for working with families employing more solution-
focused techniques, and Haley’s model became known as strategic family
therapy. However, a significant part of the strategic therapy model incorporated
the work of another family therapy pioneer, Salvador Minuchin.
Techniques
The Strategic approach focused mostly on strategies adapted to the specific
situation of the person and problem, as did Erikson. Each of the three models is
somewhat different.
A.MRI Techniques - there are basically 6 steps to treatment
1.introduction and setup - MRI's limit session to 10 and set up a powerful
motivator
2.definition of the problem in clear behavioural terms
3.estimation of the behaviour (run away positive feedback loops) maintaining the
problem
4.setting goals
5.selecting and making interventions
a.Reframing - providing the family with a rational for treatment. The MRI
therapist may not believe what they tell the family, but that is unimportant as
long as its a rational explanation. The point of it is not to bring insight, but to
induce compliance
b. Outpositioning - having someone take the role other family members place on
them to the extreme
c. paradoxical interventions - compliance based, to simply get the family to
change their behavior by complying with a directive, or defiance based, in the
hopes that the family will defy the directive and improve
d. symptom prescription or an exposure based paradox - to expose the family's
hidden relationships
e. restraining techniques - telling the family they can't move very fast because
they aren't ready
6.termination
Experiential family therapy is an intuitive approach that utilizes active,
multisensory techniques. These techniques, such as role plays and drawings,
increase the family's expression of affect and uncover new information. Increased
affect and uncovered information stimulate change and growth in the family
system. Experiential techniques are especially useful when more traditional,
verbal-based communication is not effective.
Experiential therapy is a therapeutic technique that uses expressive tools and
activities, such as role-playing or acting, props, arts and crafts, music, animal care,
guided imagery, or various forms of recreation to re-enact and re-experience
emotional situations from past and recent relationships. The client focuses on the
activities and, through the experience, begins to identify emotions associated
with success, disappointment, responsibility, and self-esteem. Under the guidance
of a trained experiential therapist, the client can begin to release and explore
negative feelings of anger, hurt, or shame as they relate to past experiences that
may have been blocked or still linger.
Experiential therapy emphasizes the importance of the relationship between the
therapist and the family. The experiential therapist seeks to create a personal
connection with the family, rather than remaining aloof or appearing
unreachable. The therapist immediately and clearly establishes the parameters
and conditions of treatment. The parameters communicate boundaries to the
family regarding the role of the therapist. The therapist serves as a coach and
guide for the family. The therapist does not seek to become a member of the
family or to take personal responsibility for the family. In fact, the therapist seeks
to maintain distance from the family in order to maintain a full view of the family
as one unit. It is critical that the experiential therapist maintain an ability to both
join with the family and to individuate from them.
The therapist communicates the importance of the family’s commitment to hard
work during the therapeutic process. The family is made to understand that
therapy itself is not a cure. Experiential theorists believe that meaningful change
will come from the hard work of the family under the tutelage of the psychologist.
The therapist is not the central figure around which the family focuses in the
therapeutic process. Rather, the therapist positions himself as a separate entity
that is coaching the family unit.
The therapist identifies the entire family as the patient, rather than focusing on
one particular individual as the source of the family discord. The therapist
deliberately avoids focusing on the individual problems of specific family
members in a manner that suggests that the resolution to these problems will
heal the family.
The therapist encourages the family to fully connect with how they experience
the world and to gain insight regarding how these perceptions influence their
thoughts, behaviors, and interactions. These insights become the basis for
meaningful, therapeutic change within the family. The therapist urges the family
to express their potentials of experiencing by describing how they experience
themselves, each other, and the family unit in the external world.
The therapist attempts to help the family understand that they exist in an
uncertain, complex, and unfair world. Whitaker encourages families to confront
this difficult truth about the world. In doing so, he often employs the use of
humor to underscore the unpredictable and crazy nature of the external world in
which all human beings exist. He suggests that incorporating a sense of humor
regarding such uncertainties helps to minimize the tension that uncertainty can
create. He further suggests that humor and teasing during the process of family
therapy can facilitate more open and honest communication amongst the family.
The experiential model encourages clients to experience the full range of
thoughts, feelings, and emotions in order to develop more adaptive and
productive ways of being in the world.

Theoretical
Theorists Summary Techniques
model
Also known as "individual
psychology". Sees the person as
a whole. Ideas include
compensation for feelings of
Psychoanalysis,
inferiority leading to striving for
Adlerian family typical day,
Alfred Adler significance toward a fictional final
therapy reorienting, re-
goal with a private logic. Birth
educating
order and mistaken goals are
explored to examine mistaken
motivations of children and adults
in the family constellation.
Individuals are shaped by their
experiences with caregivers in the
first three years of life. Used as a
foundation for Object Relations
John Bowlby,
Attachment Theory. The Strange Situation Psychoanalysis, play
Mary Ainsworth,
theory experiment with infants involves a therapy
Douglas Haldane
systematic process of leaving a
child alone in a room in order to
assess the quality of their parental
bond.
Bowenian family Murray Bowen, Also known as "intergenerational Detriangulation,
systems therapy Betty Carter, Philip family therapy" (although there are nonanxious
Guerin, Michael also other schools of presence,
 intergenerational family therapy).
Family members are driven to
achieve a balance of internal and
external differentiation, causing
Kerr, Thomas
anxiety, triangulation, and
Fogarty, Monica
emotional cutoff. Families are
McGoldrick, Edwin genograms, coaching
affected by nuclear family
Friedman, Daniel
emotional processes, sibling
Papero
positions and multigenerational
transmission patterns resulting in
an undifferentiated family ego
mass.
Problems are the result of operant
conditioning that reinforces Therapeutic
negative behaviors within the contracts, modeling,
Cognitive John Gottman, family’s interpersonal social systematic
behavioral family Albert Ellis, Albert exchanges that extinguish desired desensitization,
therapy Bandura behavior and promote incentives shaping, charting,
toward unwanted behaviors. This examining irrational
can lead to irrational beliefs and a beliefs
faulty family schema.
Individuals form meanings about
their experiences within the
context of social relationship on a
personal and organizational level.
Collaborative therapists help
families reorganize and dis-solve
Harry Goolishian, Dialogical
their perceived problems through
Collaborative Harlene Anderson, conversation, not
a transparent dialogue about inner
language Tom Andersen, knowing, curiosity,
thoughts with a "not-knowing"
systems therapy Lynn Hoffman, being public,
stance intended to illicit new
Peggy Penn reflecting teams
meaning through conversation.
Collaborative therapy is an
approach that avoids a particular
theoretical perspective in favor of
a client-centered philosophical
process.
All people are born into a primary
survival triad between themselves
and their parents where they
adopt survival stances to protect
their self-worth from threats
Equality, modeling
communicated by words and
Virginia Satir, communication,
behaviors of their family members.
Communications John Banmen, family life chronology,
Experiential therapists are
approaches Jane Gerber, family sculpting,
interested in altering the overt and
Maria Gomori metaphors, family
covert messages between family
reconstruction
members that affect their body,
mind and feelings in order to
promote congruence and to
validate each person’s inherent
self-worth.
 Families are built upon an
unconscious network of implicit
Rebalancing, family
loyalties between parents and
Contextual Ivan Boszormenyi- negotiations,
children that can be damaged
therapy Nagy validation, filial debt
when these "relational ethics" of
repayment
fairness, trust, entitlement,
mutuality and merit are breached.
Couples and families can develop
rigid patterns of interaction based
on powerful emotional
Reflecting, validation,
experiences that hinder emotional
Emotion-focused Sue Johnson, Les heightening,
engagement and trust. Treatment
therapy Greenberg reframing,
aims to enhance empathic
restructuring
capabilities of family members by
exploring deep-seated habits and
modifying emotional cues.
Stemming from Gestalt
foundations, change and growth
Carl Whitaker,
occurs through an existential
David Kieth, Laura Battling, constructive
encounter with a therapist who is
Roberto, Walter anxiety, redefining
Experiential intentionally "real" and authentic
Kempler, John symptoms, affective
family therapy with clients without pretense, often
Warkentin, confrontation, co-
in a playful and sometimes absurd
Thomas Malone, therapy, humor
way as a means to foster flexibility
August Napier
in the family and promote
individuation.
Target population adolescents
with conduct and behavioral
problems. Based on schema
theory. Integrate mindfulness to
Cognitive behavioral
focus family on the present.
therapy, mindfulness,
Validate core beliefs based on
acceptance and
Family mode past experiences. Offer viable
commitment therapy,
deactivation Jack A. Apsche alternative responses. Treatment
dialectical behavior
therapy (FMDT) is based on case
therapy, defusion,
conceptualization process;
validate-clarify-
validate and clarify core beliefs,
redirect
fears, triggers, and behaviors.
Redirect behavior by anticipating
triggers and realigning beliefs and
fears.
Feminist family Sandra Bem Complications from social and Demystifying,
therapy political disparity between genders modeling, equality,
are identified as underlying personal
causes of conflict within a family accountability
system. Therapists are
encouraged to be aware of these
influences in order to avoid
perpetuating hidden oppression,
biases and cultural stereotypes
and to model an egalitarian
 perspective of healthy family
relationships.
A practical attempt by the "Milan
Group" to establish therapeutic
techniques based on Gregory
Luigi Boscolo,
Bateson's cybernetics that Hypothesizing,
Gianfranco
Milan systemic disrupts unseen systemic patterns circular questioning,
Cecchin, Mara
family therapy of control and games between neutrality,
Selvini Palazzoli,
family members by challenging counterparadox
Giuliana Prata
erroneous family beliefs and
reworking the family’s linguistic
assumptions.
Established by the Mental
Research Institute (MRI) as a
synthesis of ideas from multiple
theorists in order to interrupt Reframing,
Gregory Bateson,
misguided attempts by families to prescribing the
Milton Erickson,
MRI brief therapy create first and second order symptom, relabeling,
Heinz von
change by persisting with "more of restraining (going
Foerster
the same", mixed signals from slow), Bellac Ploy
unclear metacommunication and
paradoxical double-bind
messages.
People use stories to make sense
of their experience and to
establish their identity as a social
and political constructs based on
Deconstruction,
local knowledge. Narrative
Michael White, externalizing
Narrative therapy therapists avoid marginalizing
David Epston problems, mapping,
their clients by positioning
asking permission
themselves as a co-editor of their
reality with the idea that "the
person is not the problem, but the
problem is the problem."
Individuals choose relationships
Hazan & Shaver, that attempt to heal insecure Detriangulation, co-
Object relations David Scharff & attachments from childhood. therapy,
therapy Jill Scharff, James Negative patterns established by psychoanalysis,
Framo, their parents (object) are projected holding environment
onto their partners.
By applying the strategies of
Freudian psychoanalysis to the
family system therapists can gain Psychoanalysis,
Psychoanalytic
Nathan Ackerman insight into the interlocking authenticity, joining,
family therapy
psychopathologies of the family confrontation
members and seek to improve
complementarity
Solution focused Kim Insoo Berg, The inevitable onset of constant Future focus,
therapy Steve de Shazer, change leads to negative beginner's mind,
William O'Hanlon, interpretations of the past and miracle question,
 language that shapes the
Michelle Weiner- meaning of an individual's
Davis, Paul situation, diminishing their hope goal setting, scaling
Watzlawick and causing them to overlook their
own strengths and resources.
Directives,
Symptoms of dysfunction are
paradoxical
purposeful in maintaining
injunctions,
Jay Haley, Cloe homeostasis in the family
Strategic therapy positioning,
Madanes hierarchy as it transitions through
metaphoric tasks,
various stages in the family life
restraining (going
cycle.
slow)
Family problems arise from Joining, family
Salvador
maladaptive boundaries and mapping,
Minuchin, Harry
Structural family subsystems that are created hypothesizing,
Aponte, Charles
therapy within the overall family system of reenactments,
Fishman, Braulio
rules and rituals that governs their reframing,
Montalvo
interactions. unbalancing
Bowen's Steps and Stages of Family Therapy:
Differentiation of self, the core concept of Bowen’s approach, refers to the
manner in which a person is able to separate thoughts and feelings, respond to
anxiety, and cope with the variables of life while pursuing personal goals. An
individual with a high level of differentiation may be better able to maintain
individuality while still maintaining emotional contact with the group. A person
with a low level of differentiation may experience emotional fusion, feeling what
the group feels, due to insufficient interpersonal boundaries between members of
the family. Highly differentiated people may be more likely to achieve
contentment through their own efforts, while those with a less-developed self
may seek validation from other people.
An emotional triangle represents the smallest stable network of human
relationship systems (larger relationship systems can be perceived as a network of
interlocking triangles). A two-person dyad may exist for a time but may become
unstable as anxiety is introduced. A three-person system, however, may provide
more resources toward managing and reducing overall anxiety within the group.
Despite the potential for increased stability, many triangles establish their own
rules and exist with two sides in harmony and one side in conflict—a situation
which may lead to difficulty. It is common for children to become triangulated
within their parents’ relationship.
The family projection process, or the transmission of a parent’s anxiety,
relationship difficulties, and emotional concerns to the child within the emotional
triangle, may contribute to the development of emotional issues and other
concerns in the child. The parent(s) may first focus anxiety or worry onto the child
and, when the child reacts to this by experiencing worry or anxiety in turn, may
either try to “fix” these concerns or seek professional help. However, this may
often have further negative impact as the child begins to be further affected by
the concern and may become dependent on the parent to “fix” it. What typically
leads to the most improvement in the child is management, on the part of the
parent(s), of their own concerns.
The multigenerational transmission process, according to Bowen, depicts the way
that individuals seek out partners with a similar level of differentiation, potentially
leading certain behaviors and conditions to be passed on through generations. A
couple where each partner has a low level of differentiation may have children
who have even lower levels of differentiation. These children may eventually have
children with even lower levels of differentiation. When individuals increase their
levels of differentiation, according to Bowen, they may be able to break this
pattern, achieve relief from their symptoms of low differentiation, and prevent
symptoms from returning or occurring in other family members.
An emotional cutoff describes a situation where a person decides to best manage
emotional difficulties or other concerns within the family system by emotionally
distancing themselves from other members of the family. Cutting emotional
connections may serve as an attempt to reduce tension and stress in the
relationship and handle unresolved interpersonal issues, but the end result is
often an increase in anxiety and tension, although the relationship may be less
fraught with readily apparent conflict. Bowen believed emotional cutoff would
lead people to place more importance on new relationships, which would add
stress to those relationships, in turn.
Sibling position describes the tendency of the oldest, middle, and youngest
children to assume specific roles within the family due to differences in
expectation, parental discipline, and other factors. For example, older children
may be expected to act as miniature adults within the family setting. These roles
may be influenced by the sibling position of parents and relatives.
The societal emotional process illustrates how principles affecting the emotional
system of the family also affect the emotional system of society. Individuals in
society may experience greater anxiety and instability during periods of
regression, and parallels can be noted between societal and familial emotional
function. Factors such as overpopulation, the availability of natural resources, the
health of the economy, and so on can influence these regressive periods.
The nuclear family emotional process reflects Bowen’s belief that the nuclear
family tends to experience issues in four main areas: intimate partner conflict,
problematic behaviors or concerns in one partner, emotional distance, and
impaired functionality in children. Anxiety may lead to fights, arguments,
criticism, under- or over-performance of responsibilities, and/or distancing
behavior. Though a person’s particular belief system and attitude toward
relationships may impact the development of issues according to relationship
patterns, Bowen held them to be primarily a result of the family emotional
system.
MALADJUSTMENT IN FAMILY AND RELATED DISORDERS:-
Socially, children that comes from broken homes often are maladjusted. Feelings
of frustration toward their situation stems from insecurities, and denial of basic
needs such as food, clothing and shelter. Children whose parents are unemployed
or possess a low socioeconomic status are more prone to maladjustment. Parents
who are abusive and highly authoritative can cause harmful effect towards
psychological need which are essential for a child to be socially well adjusted. The
bond between a parent and child can affect psychological development in
adolescent. Conflicts between parent and child relationship can cause adolescents
to have poor adjustment. The level of conflict which occur between a parent and
child can affect both the child's perception of the relationship with their parents
and a child's self-perception. The perception of conflict between parent and child
can be attributed to two mechanisms: reciprocal filial belief and perceived
threats. Reciprocal filial belief refers to the love, care and affection that a child
experience through their parent, it represents the amount of intimacy a child has
with his or her parent. High levels of perceived conflict between parent and child
reduces feelings of empathy, a child may feel isolated and therefore alienate
themselves from their parent, this reduces the amount of reciprocal filial belief.
Adolescent with lower levels of reciprocal filial belief are known to shown
characteristic of a maladjusted individual. Perceived threats can be characterized
as the anticipation of damage or harm to oneself during an emotional arousing
event that induce a response towards stress. Worry, fear and the inability to cope
with stress during conflicts are indicators of a rise in the level of perceived threat
in a parent and child relationship. Higher levels of perceived threats in a parent a
child relationship may exacerbate negative self-perception and weaken the ability
to cope, this intensifies antisocial behavior which is a characteristic associated
with maladjustment.
DISORDERS IT CAN CAUSE:-
 Affective ( mostly depression)
 Antisocial personality disorder
 Conduct
 Substance abuse
 Eating disorders
 Stress and anxiety related disorders