Clinical Therapist Life Coach Adjunct Professor, Grand Canyon
University PhD Student Regent University Counselor Education and
Supervision
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Developed in the 1950 1960s Foundational Premise Individuals
can best be understood within the context of their environments
Influences Cybernetics General Systems Theory
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Family systems theory speaks about the individual members of
the family, and describes both the inter- relationships between and
among members of the family, and the rules that exist to maintain
the family in its current functioning.
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Systems & Subsystems Structure, Roles & Rules Hierarchy
- generational Power Boundaries Feedback loops Homeostasis
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VVirginia Satir (1916 1988) Mother of Family Therapy
CCommunication / Strategic Family Therapy CConjoint Family Therapy
(The Satir Model)
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KEY CONCEPTSKEY TERMS & TECHNIQUES Communication the key to
understanding human behavior Pathology is an interactional process
between family members Function of pathology is homeostatic
maintenance Therapy focuses on change in communication patterns
between individual family members Double Bind Communication
Punctuation Symmetrical / complementary communication Schism
Reframing Prescribing the symptom Reduction ad absurdum Therapeutic
double binds Straight / Paradoxical directives
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Murray Bowen (1913 1990) Psychiatrist Georgetown University
Bowenian Family Therapy Bowenian Family Therapy
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KEY CONCEPTSKEY TERMS Pathology stems from inadequate
differentiation of self from family of origins emotional system
Severe pathology such as schizophrenia is the result of a
multigenerational transmission process Goal of therapy is to
increase differentiation of self Therapists role is to model
differentiated self rather than become caught in family triangles
Differentiation of self Fusion Undifferentiated family ego mass
Triangulation Emotional cut-off Family projection process
Multi-generational transmission process Responding from a
responsible I position rather than we or you
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Salvador Minuchin (1921 - ) Salvador Minuchin (1921 - ) San
Salvador, Entre Rios, Argentina Russian-Jewish Heritage
Psychiatrist trained in individual psychotherapies Theory developed
within the context of the Civil Rights Era Power families have over
psychopathology
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Treatment occurs best within the social and relational contexts
of the family, rather than the individual Delinquency Anorexia
Nervosa - Medical Focus on the here and now rather than the past
Psychological distress caused and maintained by relationships
Family belief structure cognitive schema
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Boundary Continuum DisengagedNormal Enmeshed Family Structure
Family Structure Family Structure Rigid Clear Diffuse Isolation,
Disengagement, limited Frequent Communication, Encroachment on
personal and access between subsystems, weak interdependent,
supportive, healthy system boundaries, loss of family connections,
system closed healthy autonomy, system open to change, autonomy,
system resistant to to change, inflexible organization open to
change, flexible organization, adaptable change, enmeshment, poor
to external change, belonging but separateness differentiation of
self Depression, psychosomatic complaints, antisocial symptoms
Incest
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Active and Directive Aware of structure and rules Focused on
the here and now Problem reframer Individualistic ideology vs
systemic perspective Focus is on the individual within the system
To interpret role of symptoms
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Joining Ongoing process of entering a family system to engage
& influence its members Enactment Process of changing patterns
of interaction in the here and now Blocking of unhealthy
interactional patterns Restructuring Activities that attempt to
change family rules Accommodation Process of adjusting to and
accommodating the rules of the system. Changing family myths
Challenging family belief systems Coaching new communication
patterns
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General considerations Therapists interest in the culture
Impacts joining Family observation
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Specific Populations Chinese and Hispanic families Highly
structured boundaries and roles Emphasis on social context Chinese
American cultural disconnects
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Cultural assessment tools for Therapists Cultural Auditing
through Reflective Practice What are my initial reactions to this
family and what does it tell me about my beliefs, values and
assumptions? In what ways do I assume that we are similar or
different because of our cultural backgrounds? What are my initial
hypotheses about the impact of culture on this familys presenting
concerns? How sure am I of the accuracy of my hypotheses? How open
am I to being wrong, considering new information, and modifying my
assumptions?
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SFT initially failed to address issues of power within same
generation relationships Abuse of power Some disregard the possible
positive function of symptomatic behavior within the family only
sees it as perpetuating problems in family functioning Many focus
on family as a collective disregards need for individuation
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General similarities emphasis on family as essential for
individual growth and development Bowenian Family Therapy most akin
Emphasis on clearly defined family hierarchies parent-child
relationships (Exodus 20:12; Deuteronomy 21:18; Proverbs 22:6;
Proverbs 29:17), family responsibility (1 Timothy 3:1, 4-5; 5:8),
good communication (Ephesians 6:4; Colossians 3:21) marriage like
union of Christ and the church (Ephesians 5:25-30).
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Modern Primary use of techniques like those used in structural
therapy Belief in therapists knowledge, expertise and power to
influence change Post Modern Social constructionist view with focus
on relational, narrative paradigm Therapist takes not knowing
stance Use of language and conversation to elicit clients expertise
and story
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The Para-Modern Stance A both/and approach to family therapy
Dual positioning allows for more effective treatment What is most
relevant is what works in practice rather than adherence to a
theoretical position such as systemic theories or social
construction theory. An ethical stance allows family therapists to
access a range of therapeutic languages and techniques at once. The
priority is not what knowledge we use but how we use itputting
theory to work in the service of others. (Larner, 2009, p. 54)
Concerns Dearth of evidence-based research documenting
effectiveness Does ethical utilization of theories allow for mixing
and matching in the name of integrative practice? Recent
documentation of effectiveness with adolescent depression and
eating disorders
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Conclusion
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Teaching Activities Family Therapy with Single Parents Whos
Afraid of Virginia Wolfe?
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