Glossary Of Terms

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ABC-X Family Crisis Model

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Reuben Hill's model used to explain whether a stressful event would result in a crisis in some families but not in others; A=stressor, B= family's crisis-meeting resources, C=family's definition of stressor, and X=crisis

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Accommodation

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Describes a variety of engagement techniques, such as joining, used principally by structural family therapists in which the therapist adapts him/herself to the family's style of interacting

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AAMFT

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American Association of Marriage and Family Therapy, Inc., the primary national professional association of MFTs, located in Washington, D.C.; wrote Code of Ethics for all states

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AAMFT Code of Ethics

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Set of ethical guidelines and rules that all members of AAMFT are required to understand and to follow; function is to define the role of the professional, help guide professional conduct, and serve as a basis for sanctions

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Acculturation

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Process by which immigrant group members adjust to the culture of their new country

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Adaptability

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Olson's Circumflex Model, a measure of family's ability to respond and adapt to changes in their lives (aka flexibility); four levels: rigid, structured, flexible, and chaotic

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AIDS (Acquired Immunodeficiency Syndrome)

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Chronic and infectious disease in which the body's immune system is damaged, making a person vulnerable to a number of serious, sometimes fatal, infections and cancers

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Alcoholics Anonymous (AA)

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Self-help group that uses a 12-step program for recovery from alcohol addiction

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Alliance

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1. In the structural and strategic models, a bond or affiliation between two or more family members; alliances differ from coalitions in that they are generally within a subsystem and not hidden

2. In the domestic violence literature, refers to the redemptive phase of the abuse cycle, in which the perpetrator promises never to act violently again and the victim agrees to participate in that goal

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Allopoetic systems

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Originated by postmodern Chilean biologist Humberto Maturana, systems that can be controlled form the outside, such as machines

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Analogic Communication

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A type of communication that is rich in content such as a child's Kinetic Family Drawing

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Analysis of Variance (ANOVA)

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Method of statistical analysis that enables researchers to determine the likelihood that a variable being measured (dependent variable) is associated with a second variable (independent variable) by chance alone; if the deviation (variance) from the norm (frequency of associated expected by change along) is sufficiently large, the variables are likely to be causally related

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Antilibidinal Ego

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From object relations theory, that part of the ego that is formed from interactions with the rejecting object

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Anorgasmia (AKA Coughlan's syndrome)

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Type of sexual dysfunction in which a person cannot achieve orgasm, even with adequate stimulation; in males it's most closely associated with delayed ejaculation; anorgasmia can often cause sexual frustration; anorgasmia is far more common in females (4.7%) than in males and is especially rare in younger men; problem is greater in women who are post-menopause

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Antilibidinal System

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From object relations theory, a repressed system within the ego characterized by aggression, rage, and contempt

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As If Structure

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From symbolic-experiential therapy, family members are encouraged to freely experiment as if they were in the role of the other, so long as they understand that the role play is symbolic; process allows family members to alternately experiment and return to their secure roles

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Autopoetic systems

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Originated by postmodern Chilean biologist Humberto Maturana, systems that are self-organizing and self-maintaining, such as biological and human systems; autopoetic systems can be described by second-order cybernetics

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Aversive Control (aka coercion)

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From behavioral family therapy, one person uses aversive stimuli to control the behavior of another

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Avoider

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From Satir's experiential family therapy, one of five communication styles; avoider tends to distract others from potential conflict by acting helpless, weak, and lacking an understanding

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Basic Self

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From Bowen's Model, this concept consists of the beliefs and convictions held by the person; people at the higher end of the scale of differentiation have more of a basic self than do those at the lower end; they have formed their own beliefs and tend to be clear about the difference between what they think and how they feel

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Balancing power

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Equalizing access to power in a couple that is overly organized by a hierarchy

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Baseline

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Beginning observable, stable performance measure against which change, particularly behavioral change, can be measured

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Battle for Initiative

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Formulated by Whitaker (symbolic-experiential therapy), the Battle for Initiative follows the battle for structure; in this second battle, the family takes back from the therapist its authority to make choices about what is discussed and about decisions that affect their lives

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Battle for Structure

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Described by Whitaker as the therapist's demand that the family capitulate to his/her way of conducting the therapy, particularly during the initial stages; followed by battle for initiative

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Beavers-Timberlawn Model

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An assessment tool used to rate the dimensions of competence and style in a family's functioning; competence dimensions are: adequate, optimal, midrange, borderline, and severely dysfunctional; stylistic dimensions are: centripetal, centrifugal, and mixed

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Behavioral Exchange Theory

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From behavioral family therapy, a way of describing relationships in terms of costs and benefits; functional relationships have plentiful access to rewards and relatively few costs, while distressed relationships have a scarcity of rewards relative to costs

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Behavioral Family Therapy (BFT)

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A theory and therapeutic model developed by Patterson, Reid, and others, based on principles of learning and behavior change; all family members are seen as part of the problem and symptoms are reformulated into concrete observable behaviors, each of which will either be rewarded or extinguished

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Behavioral Parent Training (BPT)

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Program for training parents in the use of contingency management to modify or extinguish unwanted behaviors and reinforce desirable behaviors in children

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Behavioral Redundancy (aka Redundancy)

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From cybernetics, rule-determined repetitive patterns of interaction

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Bicultural

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People who belong to more than one culture and who are able to alternate between the cultures, adjusting temporarily to each depending on the circumstance

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Bilateral Pseudo-Therapy

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From symbolic-experiential therapy, the tendency in some families for family members to be therapists to one another. Therapists demand that therapy be turned over to them, asserting that the family has failed in its efforts at self-therapy

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Bilateral Transference

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A therapeutic stance in symbolic-experiential therapy in which the therapist adopts the language, accent, rhythm, or posture of the family

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Biobehavioral

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Biological factors that influence behavior (e.g. depression) that is caused, in part, by faulty neurochemistry

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Bi-Modal Feedback Mechanism

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From Ashby, the rule-bound mechanism by which a system remains unchanged so long as the internal or external environment is stable, but when the fluctuation exceeds the range of stability the system must respond in some new way; system either breaks down or makes a leap into new levels of functioning; change results in a new set of patterns that, like the old pattern, is bound by rules, and it, too, remains unchanged, so long as the environment is stable

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Binuclear Family

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Families in which the parents are divorced, have remarried, and formed two intact nuclear families

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Biopsychosocial Process

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From George Engle's Biopsychosocial Model, this model prescribes a fundamentally different approach to understanding illness from the still-guiding biomedical aspects (diseases) of all patients; recursive process between psychosocial and biological is known as the biopsychosocial process

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Blamer

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From Satir's experiential family therapy, one of five communication styles; blamer judges and complains, often for the purpose of bullying others into accepting his/her preferences

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Boundary

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Minchin's structural family therapy; boundaries are hypothetical dividers between or among subsystems; they are defined spatially by the ways family members align with one another; they are set by the implicit or explicit rules concerning who participates in which subsystem and in what manner; boundaries and the subsystems they define may change over time and with variable circumstances; in the structural model, boundaries are either rigid, clear, or diffuse

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Boundary Interface (AKA Familial boundary)

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Regions between each subsystem of the family and between the family and the supra system; in family systems therapy, this interface is referred to as the familial boundary

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Boundary Making

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A structural therapy technique in which the therapist established a functional semipermeable (clear) boundary where either a rigid or diffuse boundary had existed previously

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Bowenian Family Therapy

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Bowen's theory and therapeutic model is based on the family's emotional system, the differentiation of self within one's family, and the multi-generational transmission of emotions and family patterns

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Brief Family Therapy

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Model of problem-focused and time-limited therapy developed by the Mental Research Institute in Palo Alto, CA, Milton Erickson, and others

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Caring Days

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From behavioral marital therapy, each partner identifies behaviors that his/her partner finds enjoyable and makes a commitment to increasing those behaviors

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Case-Specific Symptom Prescription

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A therapeutic technique of the strategic model in which symptomatic or other undesirable behaviors are paradoxically encouraged in order to lessen such behavior or bring it under conscious control

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Centers for Disease Control (CDC)

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The U.S. government agency that, among other things, tracks the incidence of communicable disease and defines criteria for diagnosis of AIDS

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Central Ego

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From object relations theory, one of three parts of the ego; Central Ego is conscious, adaptable, and free to deal with future experiences with attachment figures in reasonable ways; central ego maintains it's own object, the ideal object

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Centrifugal

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Defined by Beavers as part of the Beavers-Timberlawn Model, a family system dynamic in which members are expelled or encouraged to operate at the outer periphery and to seek gratification outside the family

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Centripetal

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Defined by Beavers as part of the Beavers-Timberlawn Model, a family system dynamic in which members are tightly bound to one another emotionally and encouraged to seek gratification from one another

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Change

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1. From structural family therapy, perspective change is the process by which elements of a system are transformed to new states or levels of organization

2. developmental system change refers to the family life cycle and the transition of the family from one stage of development to another; strategic models see change as occurring suddenly and resulting from shifts in beliefs (discontinuous change), whereas the structural and transgenerational models see change as occurring through a gradual learning process (continuous change)

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Child Guidance Movement

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This movement (1900s) emerged from Adler's belief that psychological problems must be viewed in a social context. The child guidance movement was highly influential in the history of family therapy. Child guidance clinics were established on the premise that psychological problems begin in childhood and early intervention is the best way to prevent the future occurrence of mental illness.

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Circularity (Circular Causality)

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The notion held by the Milan systemic group that causality in families cannot be thought of as simple, single cause and effect relationship (linear causality). Instead, events, behaviors, and interactions are seen in a more complex way, as mutually influencing one another (feedback loops). Each is the effect of a prior cause and in turn influences future behaviors. Family system events create an endless (and beginning-less) circular chain. In this model it is meaningless to identify an individual as having caused or started a problem. Instead, all elements of the problem coexist and are reciprocally reinforcing. The problem could not be maintained if any one element were to be removed.

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Circular Questioning

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A technique for interviewing and hypothesis validation designed by the Milan systemic group, based on Bateson's idea that people learn by perceiving differences. In this technique, each family member comments on the behavior and interactions of two other members. It is hoped that beliefs will become less rigid when members are exposed to different perspectives.

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Circumplex Model

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A graphic model for observing and assessing families designed by Olson, which measures the family's levels of cohesion and adaptability. Families with too much cohesion tend to function as enmeshed, and those with too little can be disengaged. Too much adaptability can result in excessive and unpredictable change, while too little can result in rigidity and failure to transition through the life cycle. Healthy families will be balanced, having neither too much nor too little of either quality. Olson's evaluation tool, FACES is used to apply the Circumflex Model to family assessment.

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Classical Conditioning

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A learning paradigm studied and practiced in a lab or other controlled environment in which a stimulus called the unconditioned stimulus (US), which naturally elicits an unconditioned response (UCR), is paired with a neutral stimulus that does not initially elicit a response. Through the repeated pairings, the neutral stimulus (now the conditioned stimulus--CS) begins to elicit the desired response (now the conditioned response--CR)

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Closed system

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A self-contained system with impermeable boundaries that resists change and operates with minimal interactions with its outside environment, thereby increasing its dysfunction

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Coaching

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In Bowenian therapy (used by other models as well), the use of an objective person, such as the therapist, to guide a family member to interact with other members in new ways and prevent the family from seducing the person back into older, dysfunctional behaviors; the therapist takes and educative role, rather than an emotional one

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Coalitions

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A concept described by Minchin (structural model) in which two family members form a covert alliance, either temporary or durable, against a third. Coalitions usually for across generational boundaries; for example, between one parent and a child against the other parent or another child; coalitions create power blocks in families, which serve either to balance another coalition or establish control

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Coding schemas

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Used in information management and research, these systems establish an organized and consistent approach to identifying and counting clinical phenomena

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Coercion (aversive control)

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From behavioral family therapy, one person uses aversive stimuli to control the behavior of another

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Cognitive Behavioral Family Therapy (CBT)

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Therapies based on both behavioral techniques, which grew out of scientific, laboratory experiments and on the cognitive therapy models. People learn to modify behaviors both by altering the reinforcement contingencies and/or changing the cognitions that influence their behaviors and interactions

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Cognitive maps

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Mental models by which incoming information is perceived, understood, transformed, and stored, together with a corresponding repertoire of behavioral options. Maps are based on the integration of experiences. Each part of the cognitive map--i.e., input and output--forms the individual's internal representation of reality; cognitive maps shape actions and communication. They may be flexible, able to change and expand cumulatively with new information and experiences, or they may be rigid and limiting; maps have both language and spatial aspects with a private vocabulary and imagery that determines how incoming communication is interpreted.

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Cohesion

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From Olson's circumplex model, a measure of the strength of the emotional bonds between and among family members

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Collaborative couples therapy

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Couples treatment in which each partner is seen by his/her own therapist

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Collaborative Family Health Care

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Bloch and his followers use teams with other medical care providers--nurses, physicians, rehabilitation specialists--to help families cope more effectively with the consequences of medical illnesses

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Collaborative Language Family Therapy

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From Goolishian and Anderson, a model of family therapy based on the idea that problems are maintained in the family's language and may be resolved by changes in their use of language; the therapist asks questions from a not knowing stance, designed to draw out the client's own views of the problem; the problem is "dissolved" as new meanings and actions evolved

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Collusion

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A family system defense mechanism in which members cooperate by unconsciously sharing thoughts and feelings; the defense is used to protect family members from threatening outside forces; for example, both spouses and children may collude to perceive an alcoholic member who induces friends and family to drink with him, as simply a lighthearted partygoer

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Communication Theory

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Originated by the MRI group, the study of the process by which verbal and non-verbalinformation is exchanged within a relationship; communication can be analogic, which little structure, but is rich in content, or digital, which is verbal communication perceived and interpreted based on meaning

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Communities of Concern

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From narrative therapy, groups of clients who are working on similar problems meet in order to continue to construct and maintain new narratives and to support each other's preferred outcomes

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Complementarity

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An interactional pattern in which members of an intimate relationship establish roles and take on behavioral patterns that fulfill the unconscious needs and demands of the other

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Complainant

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From solution-focused therapy, one of three ways to characterize the level of participation and commitment to change; this client brings a specific problem but is currently unwilling to focus on a solution

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Computer

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From Satir's experiential family therapy, one of the five communication styles; computer is rational but often attempts to sway others by referring to outside "authorities"

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Concurrent couples therapy

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Couples therapy in which one therapist works with both spouses at different times

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Conductor

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A therapist whose stance is to be aggressive, confrontational, and charming

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Confidentiality

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Confidentiality refers to the ethical obligation of the therapist to protect the client's identity and other personal information; therapists may not reveal information without the client's consent to third parties except as allowed by the governing licensing body and/or as outlined in the Ethical Guidelines of the American Association for Marriage and Family Therapy

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Conjoint

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Therapy that involve two or more family members, introduced by MRI psychiatrist, Jackson in 1959 to describe marital therapy in which the spouses were seen together

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Conjoint Marital Therapy

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A model of marital therapy developed by Satir in which both partners are seen together by one or two therapists; the treatment is designed for married couples without children and in which one or both of the partners has either a psychiatric disorder or a social diagnosis, e.g., alcoholism, gambling, extramarital affair

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Constitutionalist self

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From narrative therapy, the view of self is plastic and continuously deconstructed and reconstructed through interactions; the sense of self derives from experiences that fit into the dominant narrative; the therapist and client co-construct a new self that is more congruent with the client's preferred outcome

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Constructivist Family Therapy

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A variety of therapeutic models based on postmodern philosophy, which emphasizes the concept that a person's knowledge of the world is based on his/her perception and internal construction of the "truth" and the belief that reality can never really be known

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Content

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A term that describes the topics that people in therapy are discussing

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Contextual Family Therapy

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A theory and therapeutic model developed by Boszormenyi-Nagy based on the ethical dimension of family relationships; the family maintains invisible, intergenerational loyalties, which members hold in their personal ledgers; problems in relationships are thought to result either from an attempt to maintain or change the balance sheet of what members owe to one another

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Contingency contract

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In the behavioral family therapy model, an agreement between two or more family members aimed at increasing mutually rewarding behaviors; the contract, which is usually written, specifies the desired behaviors each will do and under what circumstances

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Co-therapy

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A technique, introduced by Whitaker, in which two therapists work together as a team

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Countertransference

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A concept from analytic theory that relates to the therapist's unconscious emotional reactions to the client which derive from the therapist's own history

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Craziness

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From Whitaker's symbolic-experiential family therapy, a concept in which healthy functioning for both therapists and families includes a high proportion of non-rational, creative, right-brain activity; therapists need to be able to irreverent, to use fantasy freely, to function at a regressed level when it serves the therapy, and to be mature enough to be immature

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Crisis of Accession--Crisis of Dismemberment

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From Hoffman, discontinuous changes in families, like symptom development often occurs at times of stress; changes in the family composition are particularly demanding; there are times of crises of accession when someone joins the family (marriage, birth) and crises of dismemberment when members leave (divorce, death)

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Cross-generational coalition

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From structural therapy, a stable coalition between a parent and child against the other parent

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Cross-sectional studies

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A research design that examines subjects at a single point in time

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Culture

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The set of shared beliefs, behaviors, values customs, meanings, symbols, and the like, transferred form one generation to the next and from the social groups to which the persona belongs (Italian, Jewish, lesbian, etc)

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Cultural consciousness (cultural sensitivity)

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Therapists' sensitivity to the existence and impact of the family's cultural rules and values; such awareness enables easier engagement, reduces misunderstanding and misinterpretation of family members' behaviors, and facilitates the development of trust; therapists should be aware of their biases regarding the cultural backdrop of others and their own

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Customer

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From solution-focused therapy, one of three ways to characterize the level of participation and commitment to change; this client brings a problem and a willingness to work toward its resolution

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Cybernetics

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The study of how systems are controlled by information and feedback loops and the means by which they work

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Curiosity

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From later Milan systemic, a technique and stance with the family in which the therapist withholds judgement, either positive or negative, in an effort to avoid becoming part of the family's struggles; the therapist is indifferent to treatment outcome, recognizing that his/her role is simply to perturb (or have an impact on) the system

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Debts

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Fro the contextual model, ledger sheets keep track of what is owed (entitlements) and what one owes (debts) within a family system

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De-catastrophizing

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A behavioral technique in which the therapist teaches the client to challenge his/her tendency to have catastrophic expectations

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Deconstruction

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The postmodern process of constructing new meanings by examining implicit assumptions

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Decomposition Law

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States that a genuine systemic analysis must include an understanding of system components, which are the two aspects of an individual's participation in a system; the focus is both on what passes among individuals and what goes on within the individuals; essentially, all behavior is communication; one cannot not communicate

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Defense mechanism

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An analytic concept describing the unconscious process by which the ego protects the person from conscious awareness of anxiety-provoking, threatening thoughts and memories

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Detriangle

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The Bowenian concept of withdrawing from an existing triangle so that the person is not drawn into the conflict between the other two, often the parents

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Destructive entitlement

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From Nagy's contextual family therapy, the development of symptomatic behaviors in the pursuit of self-justifying and harmful means to satisfy the perception of what is due as a result of deficient caring and responsibility in parents; for example, a child who was forced into the role of "adult" by his/her parents may feel entitled to engage in irresponsible, adolescent behaviors as an adult

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Detouring

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From structural family therapy, when two family members attempt to preserve their relationship by defining their conflict as a disagreement about a third person, keeping the focus on that person rather than themselves and their problem

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Deviations

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From General Systems Theory and Cybernetics, deviations are changes that occur within a system that either promote growth through positive feedback loops, or are corrected by negative feedback loops

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Diagnostic and statistical manual (DSM V)

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The most recent edition of the diagnostic manual of the American Psychiatric Association, which provides a classification system of mental disorders and syndromes

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Differentiation of self

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In Bowenian family therapy, the separation of intellectual of emotional functioning, which results in being less reactive to family system dynamics and other members' emotional states

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Differentiation of self scale

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A scale developed by Bowen to measure the degree of emotional fusion with others; the scale ranges from 0, or no self, to 100, a hypothetical ideal of being fully differentiated

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Diffuse boundaries

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In structural family therapy, boundaries that are not clearly defined or maintain , resulting in blurred generational roles and responsibilities; diffuse boundaries often lead to enmeshed relationships

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Digital

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A type of verbal communication where meaning is perceived or understood solely on meaning of what was communicated

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Directed masturbation training

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From sex therapist, LoPiccolo, a method of treating primary anorgasmic or preorgasmic dysfunction; the woman is taught to become familiar, more comfortable with, and more accepting of her body and her sexuality; she is encouraged to explore her genitals for tactile quality, then for pleasure; to use erotic materials and fantasy; to use orgasm "triggers" and, the kinds of stimulation that she finds pleasurable; throughout the program, the woman is instructed to do Keel exercises, which are thought to increase orgasmic potential; the couple is also instructed to engage in a variety of mutually pleasurable, non-demanding, and initially non-genital sexual experiences

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Directive

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An intervention developed primarily by Haley and Madanes in which the therapist gives the family a task with the intent of changing stuck sequences; there are two types of directives: straightforward directives are not paradoxical, and the therapist expects the family to carry out the task as given (parents are asked to take control of their misbehaving child); indirect directives are paradoxical and the therapist expects the family to resist the task (the parents are asked to act as if it were impossible to take control of their child); with all directives, the process of negotiating relationships and behavior is more important than whether they are carried out

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Dirty games

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From Milan systemic family therapy, the unacknowledged power struggle between parents and the symptomatic child

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The Dirty Middle

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From Framo's couples therapy, an impasse in treatment when couples have gained some insight about the nature of the problems and the irrationality of their demands on one another but they still have differences as to what each wants from one another and from the marriage

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Discontinuous change

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Sudden, unanticipated change in family organization usually brought on by a crisis (may be therapeutically induced) that causes a change in perception, beliefs, or perspective; this is the opposite of continuous change that is gradual, evolutionary, or developmental

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Discriminative stimulus

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From the operant conditioning paradigm, a cue that signals the availability of a reinforcer

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Disease model of addiction

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According to the disease model, addiction is a brain disease; it is characterized by altered brain structure and functioning; these abnormalities within the brain cause persons with this disease to become addicted to substances or activities, once exposure to these substances or activities occurs; this model considers addiction irreversible once acquired

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Disengagement

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From structural family therapy, emotionally distant and uninvolved family members with overly rigid boundaries in which members are isolated and disconnected from one another

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Disjunctive moves

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From contextual theory, moves away from trustworthy relatedness

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Displacement story

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From Guerin, a follower of Bowen, a technique to help family members gain emotional distance from their problems and to become more self-reflective and less blaming; rather than have a couple discuss their specific problems, the therapist might discuss another couple with similar problems or use films to illustrate an issue

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Distancing

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From structural family therapy, the process of creating emotional space, often in response to enmeshment due to diffuse boundaries; for example, adolescents may distance themselves as a way of solidifying an identity

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Dominant cultural discourses

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From narrative therapy, sociocultural norms that can become internalized and have a controlling effect on one's story of oneself; in treatment these norms are personified (e.g., "Expectations for Men, Women, or African Americans") and their impact is discussed

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Dominant story

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From Narrative Model, a person holds a dominant narratives can become problem-saturated often obscuring a unique outcome or subjugated stories

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Double ABC-X Family Stress Model

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An extension of Hill's early work on stress by McCubbin and Patterson that considers the cumulative effect of stress on families rather than the impact of a single stressor

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Double Bind

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A six-step concept described by Bateson in which an individual receives contradictory commands within an important emotional relationship; the recipient of the information can neither comment nor escape, a "damned if you do, damned if you don't" situation; researchers originally hypothesized that the double bind was a disordered family communication style that led to the development of schizophrenic symptoms

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Dramatizations

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From Maddens, a therapeutic technique in which a parent is directed to request that the child intentionally perform the problem behavior; in this way, the symptom will not draw as much parental attention, and if it no longer serves a purpose, it can be dropped

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Dyad

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A temporary or permanent connection between two persons

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Dysfunction

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A breakdown in the ability of a structure to achieve its goal

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Dysfunctional Hierarchy

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From Haley's strategic model, the primary focus of treatment; family decision-making structures that do not allow the family to accomplish goals and meet the needs of family members; for example, parents who have abdicated their executive function to their children

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Ecosystemic Approach

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The therapeutic view that it is important to attend to the family's relationship to the larger systems: community, school, and work

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Ego

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An analytic concept referring to a hypothetical internal mental structure that both contains the individual's perception of him/herself and also serves as the rational mediator between the instinctual demands of the id and the internalized social prohibitions of the super-ego

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Egodystonic

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Phenomena or experiences at odds with an individual's self-perception

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Egosyntonic

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Phenomena or experiences consistent with the perceived needs, self-perception, or ideals of an individual

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Emergents

Back 130

From general systems theory, distinct entities of the whole family or group, not present in the parts

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Emotional cut-off

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In the transgenerational models, emotional and/or physical distancing from family relationships or a denial of their importance in order to avoid the pain of unresolved emotional conflicts, anxiety, and lack of differentiation; often falsely perceived as the solution to a problem

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Emotional divorce

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From Bowen's family therapy, the cool distance between the parents whose relationships vacillated between overcloseness and overdistance

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Emotional systems

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From Bowen's Model, families are describes as emotional systems; such systems evolve their own specific organization, and develop a set of rules and patterns that are stable over time

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Emotionally focused couples therapy

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An experiential/humanistic couples therapy model from Greenberg and Johnson that posits that problems often stem from an attempt to hide primary emotions such as fear and need for attachment and instead use defensive and coercive reactions known as secondary reactive emotions; the relationship is characterized by negative interactions such as pursuer/distancer or blame; the negative interactions lead to greater suspicion, more fear, and more negative interactions; in therapy the couple accesses the primary emotions so that they are able to reframe their relationship and alter their negative interactions and simultaneously strengthen their emotional bond

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Enactment

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A structural therapy technique used both in the assessment and treatment of families; members are instructed to demonstrate their problem during the therapy session, allowing the therapist to observe the problem and develop strategies to change it

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Enmeshment

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In structural family therapy, what each person is inherently and fairly due and what each accrues based on his/her behavior toward others and other's behavior toward him/her

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Entitlements

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From contextual theory, what each person is inherently and fairly due and what each accrues based on his/her behavior toward others and other's behavior toward him/her

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Entropy

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From general systems theory, the measure of disorder in a system that occurs without imposed controls and inputs; a family functioning randomly might be considered highly entropic

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Epistemology

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The study or theory of the nature, sources, and limits of knowledge; used by family therapists to describe how and what the family members come to believe

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Equifinality

Back 140

A cybernetic principle that states that a similar outcome may result from many different initial events; for example, depression may be caused either by biochemical imbalances or traumatic life experiences

Front 141

Equipotentiality

Back 141

When things with a common origin can go in very different directions of development (i.e., the same clinical intervention yielding very different outcomes)

Front 142

Equitable Asymmetry

Back 142

From contextual theory, the unequal, but healthy, degree of care and consideration given by parents toward children

Front 143

Erectile disorder

Back 143

Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate erection; disturbance causes marked distress or interpersonal difficulty

Front 144

Ethics

Back 144

A set of commonly agreed upon rules and standards for proper professional conduct; distinguished from law in which a governmental body legislates criteria for professional behavior, the violation of which may result in criminal or financial penalties

Front 145

Ethnicity

Back 145

Ethnic origin of a family that incorporates a value system and conscious and unconscious processes and from which members often derive a sense of identity and belonging

Front 146

Exception Question

Back 146

A solution-focused technique used to offset family members' tendency to focus on what is wrong in their lives; therapists ask clients to recall the times when they did not have a problem when they ordinarily would or times they had the problem, but solved it

Front 147

Exciting ego

Back 147

From object relations theory, one of three parts of the ego; it is unconscious, inflexible, in a state of longing for a tempting but unsatisfying object

Front 148

Exciting object

Back 148

From object relations theory, the exciting (or overstimulating) object gives rise to the libidinal ego

Front 149

Existential encounters

Back 149

The therapeutic stance of Whitaker's symbolic-experiential therapy in which the therapist is willing both to receive the family members' reactions to him/her and to fully disclose his/her reactions to them

Front 150

Exoneration

Back 150

From contextual therapy, the goal of treatment in which the therapist attempts to help the client see the positive intent and intergenerational loyalty issues behind even the destructive behaviors of previous generations; also thought of as forgiveness based upon understanding the past; if the behavior can be seen in a human context, the hold of the past is loosened

Front 151

Experiential family therapy

Back 151

A group of therapy models, developed principally by Satir (human validation process model) and Whitaker (symbolic-experiential), that have in common certain tenets such as: experience is more important than intellectual thought; the importance of experiencing a full range of affect; the stance of the therapist as a real person; the importance of spontaneity and creativity; the belief in the freedom of choice; the focus on the here-and-now; the belief in the inherent ability of families to heal themselves; and the description of general rather than specific therapy goals

Front 152

Externalizing the problem

Back 152

A narrative therapy technique described by White in which problem or symptom is conceptualized and discussed as though it originated outside the family or person; the problem is personified, and its powers and designs for the person or family are explored; for example, therapists might then ask questions about the problem, such as, "When did schizophrenia come into your family, and what do you think its plans are for your future?"

Front 153

Expressed emotion (EE)

Back 153

The degree of emotion expressed by family members; it has been observed that families with a schizophrenic member tend to have a high degree of intense and negative emotional interactions

Front 154

Extinction

Back 154

An operant conditioning concept, when a previously learned and reinforced behavior is no longer reinforced it eventually disappears

Front 155

Family Emotional system

Back 155

In Bowenian Family Therapy, the recurrent pattern of emotional reactivity linking family members

Front 156

Facts

Back 156

From contextual theory, the attributes that people are born with (gender, ethnicity, birth defects) and their life experiences (parental divorce, abuse)

Front 157

Family Adaptability and Cohesion Evaluation Scales (FACES)

Back 157

An instrument designed by Olson and others; a questionnaire designed to measure a family's qualities, including cohesion and adaptability

Front 158

Family Group Therapy

Back 158

A model of early family therapy created by Bell in which the therapist stimulates open discussions, leaving the family to solve its own problems; like other groups, Bell found that families in therapy proceed through stages, and he structured his work to concentrate on those stages

Front 159

Family life cycle

Back 159

The series of sequential developmental periods that occur over the course of a family's lifespan, each with transition points and specific tasks that need to be negotiated for healthy development: marriage, child rearing, launching of adolescents, aging, and deal; normal functioning requires adapting to the changes of each stage; families are vulnerable to developing problems during transitions

Front 160

Family Mapping (mapping the system)

Back 160

A structural family therapy assessment tool (structural map) used to depict a family's organization and gain an understanding of its complex structures and sequences (e.g., triangles, coalitions, emotional cut-offs)

Front 161

Family of origin

Back 161

The family into which the person is born or adopted, used most extensively by transgenerational models

Front 162

Family projection process

Back 162

In Bowenian family therapy, the lack of differentiation in parents often results in one of the parents becoming dysfunctional, immature, and fused with one of the children; conflict in the parental sub-unit is avoided, but the child's emotional growth is sacrificed; in this manner, symptom and a lack of differentiation is transmitted from parents to children

Front 163

Family rituals

Back 163

A Milan systemic intervention consisting of a series of actions that involved the whole family in a sequence of steps forming a "play" to be repeatedly enacted under prescribed circumstances; by engaging family members in a sequence in new ways, it is hoped that they will gain new perceptions that will result in changes in beliefs and behaviors

Front 164

Family rules

Back 164

From strategic family therapy, rules that govern family members' behavior or promote specific reactions

Front 165

Family sculpting

Back 165

A psychodramatic technique used by Duhl, Kantor, Satir, and others; one member, acting as "director," places the family in a tableau or enactment of an event, feeling, or family structure in a therapy session; the process reveals patterns of emotional closeness and distance

Front 166

Family structure

Back 166

The interrelationship among system elements that make up the organization of the system; in first-order change, structures can be affected without altering the organization of the system; whereas, in second-order change the organization's rules and structure are changed

Front 167

Family systems theory

Back 167

A broad range of theories and therapeutic models that views the family as an open system that functions in relation to its larger environment and defines individual problems in the context of family dynamics

Front 168

Family typologies

Back 168

A way of classifying families that illustrates members' similarities and differences that may quickly enable the therapist to identify therapeutic goals; for example, the Beavers-Timberlawn model classifies families as centripetal or centrifugal

Front 169

Feedback

Back 169

Information that is returned to the system and exerts a controlling influence on it

Front 170

Feedback loops

Back 170

A circular mechanism whereby feedback is reintroduced into the system in a looping chain of events that influence one another

Front 171

Feedback mechanisms

Back 171

When a system's homeostatic ideals are threatened, the system responds in various ways to bring the system back to a steady state of equilibrium ways i.e. negative feedback loops

Front 172

Female arousal disorder

Back 172

Commonly referred to as Candace syndrome, a disorder characterized by a persistent or recurrent inability to attain sexual arousal or to maintain arousal until the completion of sexual activity; the condition should be distinguished from a general loss of interest in sexual activation and form other sexual dysfunctions, such as the orgasmic disorder (anorgasmia) and hypoactive sexual desire disorder, which is characterized as a lack or absence of sexual fantasies and desire for sexual activity for some period of time; the diagnosis can also refer to an inadequate lubrication-swelling response normally present during arousal and sexual activity

Front 173

Feminist family therapy

Back 173

A treatment philosophy with a nonsexist, egalitarian view in which the social and familial gender roles of women and men are actively considered, including the perspective that social and cultural structures often give men a greater amount of power and control over political and economic resources

Front 174

Field theory

Back 174

From Lewin, the theory that the individual's field or "life-space" is psychologically and emotionally constructed of objects that are perceived to have either positive or negative valence; positively valued objects are approached, while negatively valued ones are avoided; closely related to Gestalt psychology in its interest in how attention to objects is determined

Front 175

Filial loyalty

Back 175

From contextual theory, the loyalty inherent in children toward parents; the care and concern given to children, in turn, results in filial responsibility toward parents

Front 176

First-order change

Back 176

From the MRI school, adaptations and changes in families that may change behavior but do not affect the system's organization; for example, an adolescent begins maintaining his/her curfew as a result of being grounded for breaking curfew

Front 177

Fixation of triangles

Back 177

A term used by Whitaker (symbolic-experiential therapy) to describe a clash of family of origin cultures (a man form a family of isolates marries into a family of social activists); the weakest family member is vulnerable to pathology arising out of family mythology

Front 178

Fixed linguistic statement

Back 178

From solution-focused therapy, the idea that when families begin treatment they often characterize the problem as though it were an immutable fact, generating a sense of hopelessness; to reverse this tendency, the therapist begins by eliciting information about what happens when the problem does not occur

Front 179

Four horsemen

Back 179

From Gottman's Couple Therapy, the Four Horsemen (criticism, defensiveness, stonewalling, and contempt) are predictors of divorce

Front 180

Formula first session task

Back 180

The first intervention of solution-focused treatment in which clients are asked to observe their lives between the first and second session tontine what has happened that they would like to continue to have happen so that they can begin to identify their strengths

Front 181

Functionality

Back 181

The ability of a system or subsystem to achieve its goals

Front 182

Functional analysis

Back 182

A behavioral assessment technique used to determine the interpersonal or environmental contingencies that maintain the problem

Front 183

Filial responsibility

Back 183

From contextual model, this concept describes the special obligations that children have towards their parents

Front 184

Functional family therapy (originally systems behavioral therapy)

Back 184

A model of cognitive-behavioral marital therapy developed by Alexander that integrates systems theory, behaviorism, and cognitive therapy; the two-step therapy includes cognitive work and psych education and its most often applied to adolescents and their families

Front 185

Fusion

Back 185

From Bowen, fusion refers to the blurring of intellectual and emotional features, or boundaries between family members; the opposite of differentiation, it results in a lack of separate self and high levels of reactivity among family members

Front 186

GAP Report

Back 186

In 1970 the Group for the Advancement of Psychiatry (GAP) published a report with a primary finding that demonstrated that the majority of therapists who worked with families identified improved communication as their primary treatment goal

Front 187

Gender and violence project

Back 187

A project at the Ackerman Institute started during the mid-1980s, the goal of which was to describe the relationship between gender and violence using both the feminist and systemic perspectives; an important question considered was whether family therapy could be successful in cases of domestic violence

Front 188

Gender-sensitive family therapy

Back 188

A philosophical position that can be applied to any model of family therapy in which the therapist examines the impact of gender roles on family members in order to help the clients makes choices that are not limited by internalized gender biases or external pressure based on gender

Front 189

Gender systems theory

Back 189

The study of how living systems organize, maintain, and regulate themselves, emphasizing the unity and interrelated hierarchical structure of the parts; adapted from the biological, physical, and communication sciences, primarily though the work of von Bertalanffy

Front 190

Genogram

Back 190

A multigenerational schematic diagram of the family system used by Bowenian and other transgenerational therapists to depict individual and relationship characteristics and behavioral patterns

Front 191

Gestalt Family therapy

Back 191

A model of therapy that focuses on the anxiety inherent in the contact between people; it uses techniques to heighten self-awareness and personal choice

Front 192

Global Assessment of Relational Functioning (GARF)

Back 192

An assessment tool used to rate family functioning along a continuum in three areas: problem solving (decision making and communication); organization (roles and boundaries); and emotional climate (empathy, respect, regard); originally designed by family therapist Lyman Wynne, the GARF is included as an appendix in the DSM-IV

Front 193

Gottman's Couples Therapy

Back 193

A couple's treatment model derived from years of research on what differentiates a happy couple from an unhappy couple destined to divorce; his model emphasizes the importance of building and sound relationship house

Front 194

Good faith contract (aka parallel contract)

Front 195

Grief

Back 195

The range of emotions following a loss that are part of the process of integrating the loss

Front 196

Haptic (or symbolic) communication

Back 196

From communication theory, communication through touch

Front 197

Health care clearinghouse

Back 197

A public or private entity, such as a billing service, that: translates information received from another entity in a nonstandard format or containing nonstandard data into standard data elements or a standard transaction, and receives a standard transaction from another entity and translates it into nonstandard format or nonstandard data content for a receiving entity

Front 198

Hierarchy

Back 198

The control and decision-making structure of a family; it may be based on age, gender, roles, or education; in structural and strategic family therapy, disordered hierarchies result in dysfunction

Front 199

Highly differentiated

Back 199

From Bowenian theory, a person who is able to react to the world rationally and enter into relationships while balancing competing needs for belonging and individuality

Front 200

HIPAA (Health Insurance Portability and Accountability Act)

Back 200

A law passed in 1996 that is also sometimes called the "Kassebaum-Kennedy law" this law expands your health care coverage if you have lost your job or if you move from one job to another; HIPAA protects you and your family if you have pre-existing medical conditions or problems getting health coverage based on past or present health

Front 201

Homeostasis

Back 201

The tendency of a system to strive for balance in order to achieve stability and limit the range of behavioral variability

Front 202

HIV-Human Immunodeficiency Virus

Back 202

The virus that causes AIDS; can be detected in the blood of infected individuals; HIV+ is the designation of seroconversion, indicating that the individual carries the virus; HIV- designates that the test does not reveal the presence of the virus

Front 203

Homophobia

Back 203

An irrational dislike, disregard, or fear of homosexual people

Front 204

Humanistic

Back 204

The therapeutic stance that emphasizes the uniqueness of individuals and promotes their potential for growth

Front 205

Human validation process model

Back 205

An experiential model developed by Satir in which the therapist and family work together to promote open communication and authentic emotional experiences

Front 206

Hypothesis

Back 206

In research, a proposed causal explanation that can be tested and supported or disproved

Front 207

Hypothesizing

Back 207

A technique used by Milan systemic therapists; a trial and error process by which the therapist makes initial suppositions about the presenting problem, then tests the supposition by asking questions or making an intervention based on that hypothesis; the original supposition is then revised according to the new information; this cybernetic process makes use of information resulting from completed feedback loops

Front 208

Id

Back 208

The personality consists of three pats: id, ego, and superego; this id "is the oldest and original function of the personality and the basis of the other two"; the id operates according to the pleasure principle; it is motivated by seeking immediate gratification of sexual drives; it is impulsive, irrational, and reflexive

Front 209

Ideal object

Back 209

From object relations theory, a neutral object freed from exciting and rejecting aspects--maintained by the central ego

Front 210

Identified patient (IP)

Back 210

The family member who manifests the symptoms

Front 211

Inconsistency

Back 211

From symbolic-experiential therapy, an attitude by therapists in which they do not delude themselves into believing that they are consistent with families; they accept inconsistencies and realize that it helps undermine the family's attempt to maintain a rigid pattern of living

Front 212

Incongruous hierarchy

Back 212

From Maddens, a dysfunctional structure in which children use symptoms to try to change their parents

Front 213

Individuation

Back 213

The selecting and accentuating of certain experiences and aspects of the self in the process of becoming a unique human being, includes separating from the larger group or system

Front 214

Informed consent

Back 214

The legal right of clients or research subjects to be told of the purpose and risks prior to agreeing to participate

Front 215

Inhibited sexual desire

Back 215

Inhibited sexual desire (ISD) refers to a low level of sexual interest; a person experiencing ISD will not start or respond to their parent's desire for, sexual activity

Front 216

Inhibited sexual excitement (ISE)

Back 216

A psychological disorder characterized by a persistent lack of sexual arousal or excitement despite adequate sexual stimulation

Front 217

Initial interview

Back 217

A therapy format associated with Haley in which the therapist conducts a structured interview consisting of four stages: social stage, problem stage, interactional stage, and goal-setting stage

Front 218

Insight

Back 218

A goal of psychodynamic therapy, to have clients gain an understanding of the underlying, unconscious dynamic issues that affect their relationships

Front 219

Interactional insight

Back 219

A goal of symbolic-experiential therapy occurring as a result of expanded emotional interactions within the session resulting in less inhibition; insight can be a by-product of change, but is not a curative factor

Front 220

Interface (boundary interface)

Back 220

Points at which the boundary from one system or subsystem meets the boundaries of other subsystems or the environment

Front 221

Intergenerational loyalties

Back 221

In contextual family therapy, the set of emotional obligations to one's family of origin as well as to one's spouse and children

Front 222

Integrative couples therapy

Back 222

An integrated approach using support and empathy to help couples accept differences and disappointments and break the cycle of mutual blame; treatment begins with a formulation consisting of: a theme that defines the conflict and a polarization process describing the dysfunctional pattern of interaction; the problem is externalized and the couple unites against a common enemy; the couple uses behavioral exchange processes such as quid pro quo and good faith contracts, but is also taught to make I-statements, to listen, and to express themselves in direct but non-blaming ways

Front 223

Integrative problem-centered therapy (IPCT)

Back 223

A model developed by Pinsof in which various family and individual approaches are used in sequence, progressing from the simplest here-and-now interventions from structural, strategic, cognitive-behavioral, solution-focused models or pharmacological agents; if those interventions are unsuccessful, the therapist moves deeper into intergenerational issues or object relations; the therapy may use a team approach, bringing in experts in the various techniques or assigning family members individual therapists

Front 224

Intensity

Back 224

A structural family therapeutic stance and technique in which the therapist regulates the degree of impact of his/her messages; intensity can be regulated, for example, by increasing the length of a transaction or repeating the message; tone, pacing, and volume are the tools of intensity

Front 225

Internal Family Systems (IFS)

Back 225

An integrated, collaborative family or individual therapy model created by Richard Schwartz that applies systems concepts and techniques (Gestalt, structural, strategic, experiential) to intrapsychic processes; therapists and clients co-create changes in life stories; the goal of individual therapy is to help the client differentiate his/her core Self and heal the parts; in family therapy the goal is to elicit the family members' Selves and collaboratively deal with the parts of each that are involved in the problem; family members can then have Self-to-Self interactions and begin to see one another as people who have a problem with some of their parts rather than being defined by the symptom

Front 226

Interpretations

Back 226

One of the primary therapeutic techniques of the psychoanalytic and object relations models in which the therapist makes clarifying statements regarding clients' unconscious motives and processes in order to help them understand the significance of the material uncovered; the purpose of interpretations is insight and working through

Front 227

Intervention

Back 227

In general a maneuver on the part of the therapist to test a hypothesis and/or promote change

Front 228

The Intervention

Back 228

A therapeutic process used to confront a substance abuser's denial of his/her substance abuse; friends and family members organize a confrontation meeting, led by the therapist, in which they each problem their commitment to, and concern for, the substance abuser; the goals are to have the substance abuser feel supported, acknowledge the problems the abuse is causing and enter a treatment program

Front 229

Introjects

Back 229

A hypothetical construct from object relations theory referring to the internalized images and memories from past relationships, particularly parents, who continue to exert an influence on current thoughts, feelings, and/or behaviors

Front 230

Introjection

Back 230

A process of normal development in which parts of caretakers are split off and internalized into the child's developing personality; expectations of self and other are based on these internal representations

Front 231

Invariant prescription

Back 231

Created by the Milan systemic group, this unchanging prescription, given to all families with symptomatic children, requests that parents spend time together away from the children; it is intended to break the pattern of destructive "games" and create clearer generational boundaries

Front 232

Invisible loyalties

Back 232

From Nagy's contextual therapy, unconscious obligations that children take on in order to help their families, sacrificing their own interests and well-being in the process

Front 233

I-Position

Back 233

From Bowenian therapy, statements that reflect the speaker's own thoughts and feelings, instead of attempting to blame others

Front 234

Irreverence (aka neutrality)

Back 234

From later Milan systemic, a technique and stance with the family in which the therapist withholds judgement, either positive or negative, in an effort to avoid becoming part of the family's struggles; the therapist is indifferent to treatment outcome, recognizing that his/her role is simply to perturb (or have an impact on) the system

Front 235

Isomorphism

Back 235

A phenomena in which two or more systems or subsystems exhibit similar or parallel characteristics, especially in supervision when roles and interactions between therapist and supervisor mimic those of the family being discussed; for example, a therapist seeing a family that rejects all suggestions for change becomes similarly rejecting of his/her supervisor's suggestions

Front 236

Joining

Back 236

A structural family therapy engagement technique in which the therapist accepts and accommodates to the family and engages with each family members; the goal of joining is to establish a trusting and familiar connection with the family so that the therapist can effect changes from within the system

Front 237

Kinesthetic communication

Back 237

From communication therapy, questions the therapist asks to gather information about the times in clients' lives that they were abel to resist the effects of the roblem

Front 238

Landscape of action questions

Back 238

From narrative therapy, questions the therapist asks to gather information about the times in clients' lives that they were able to resist the effects of the problem

Front 239

Landscape of meaning questions

Back 239

From narrative therapy, questions to help clients consider a new, more heroic self view

Front 240

Leagues (communities of concern)

Back 240

From narrative therapy, groups of clients who are working on similar problems meet in order to continue to construct and maintain new narratives and to support each other's preferred outcomes

Front 241

Ledger (of accountability; of indebtedness)

Back 241

From contextual theory, an internal system in which the relative balance of debts and entitlements is kept; ideally there should be a balance between the repayment of the person's debt to the family of origin and self-fulfillment

Front 242

Legacy

Back 242

From the contextual model, this refers to the notion that because everyone is born to parents, a certain history that emerges from the patterns of interactions and meanings have occurred that form a basis to how one understands relationships

Front 243

Leveler

Back 243

From Satir's experiential family therapy, one of five communications styles; the leveler reacts appropriately to the situation in a flowing and authentic manner

Front 244

Levels of intervention

Back 244

Targeting interventions at a specific family subsystem, such as the children or parents

Front 245

Libidinal ego

Back 245

From object relations theory, an exciting (or overstimulating) object gives rise to the libidinal ego

Front 246

Libidinal system

Back 246

From object relations theory, a repressed system within the ego characterized by need, excitement, and longing

Front 247

Linear causality

Back 247

An assumption of cause and effect in which one event is thought to cause the next; for example, in a classical conditioning paradigm, a particular stimulus elicits a specific response

Front 248

Logical connotation

Back 248

A development in the Milan systemic model that grew as the use of paradox declined; the therapist communicates that the development of a symptom is understandable, given the context; there is no implication that a problem is useful, beneficent, or functional (positive connotation), only that people have gotten used to it and that habits are hard to change

Front 249

Longitudinal studies

Back 249

A research design in which subjects are followed across time, which often allows for greater certainty in causal inference than cross-sectional studies

Front 250

Love days

Back 250

From behavioral marital therapy, on specific days one partner non-contingently increases those behaviors the other parter finds pleasurable

Front 251

Loyalty

Back 251

A central concept in contextual theory, the internalized set of expectations, injunctions, and obligations deriving from interactions with one's family of origin

Front 252

Make believe play

Back 252

From Maddens, a therapeutic technique in which parents are asked to make-believe they need the child's help and the child is to make-believe helping them; since the parents explicitly ask for help and the child overtly helps them, there is no need for the covert symptomatic behavior; additionally, when parents are put in this inferior position overtly, they may feel at odds with what is appropriate and reassert a superior position

Front 253

Managed care

Back 253

A service delivery system in which the third-party payer controls the cost, quality, quantity, and terms of treatment

Front 254

MANOVA--Multiple Analysis of Variance

Back 254

A method of statistical analysis used by researchers for determining which independent variables have a causal relationship with the dependent variable

Front 255

Mapping the relative influence

Back 255

From narrative therapy, the therapeutic technique of asking about the effect of the problem on relationships and the effect of the relationships on the problem; as family members identify their influence on the problem, a second, alternative description of the problem is generated; this alternative description, in turn, is a source for new responses

Front 256

Marital adjustment scale

Back 256

An assessment inventory used to determine the relative strengths and weaknesses of a marriage (e.g. communications skills, the manner and availability of rewards versus punishments, and sexual satisfaction)

Front 257

Marital schism

Back 257

From Lidz, a dysfunctional marriage in which each partner is centered on him/herself, undermines the other, and makes frequent threats of divorce

Front 258

Marital skew

Back 258

From Lidz, a dysfunctional marriage in which one partner is dominant and the other submissive; the couple presents the situation as "normal," leading to a distortion of reality by family members in order to maintain the marriage

Front 259

Marriage encounter

Back 259

A psychoeducational weekend couple's retreat for improved communication, problem solving, sexual intimacy, and spiritual health; originally for Catholic married couples and later adapted for Protestant and Jewish couples

Front 260

Medical family therapy

Back 260

A psychoeducational model in which clients with medical problems and their families are treated by a team including physicians, allied health care professionals, and mental health professionals

Front 261

Merit

Back 261

From contextual theory, what is earned through the accumulation of care and concern toward others

Front 262

Metacommunication

Back 262

Communication messages, usually nonverbal, that qualify or clarify another communication (communication about communication); the nonverbal message may be congruent with the massage or incongruent. with incongruent metacommunication, usually the nonverbal message settles the discrepancy

Front 263

Metaframeworks model

Back 263

A conceptually wide-ranging integrative model that addresses six core domains of human experience: organization, sequences, development, culture, gender, and internal processes; each person and family has the capacity to interact positively and harmoniously unless they are being constrained; the therapist considers the contributions of gender, ethnicity, class, religion, education, or regional backdrop in the development of constraints; the goal is to release constrains, not to focus on deficits

Front 264

Metaphor

Back 264

A symbolic representation of an experience that captures both its basic and essential features by using a description of a completely different category of objects or events; often used to shift a family' perspective

Front 265

Milan Systemic Family Therapy

Back 265

A theory and therapeutic model influenced by Bateson and the MRI Group, originally developed in Italy by Selvini Palazzoli, Boscolo, Cecchi, and Prata; the primary techniques associated with the early Milan group were rituals and positive connotations; the Milan Group split in the early 1980s with Selvini Palazzoli and Prata forming one group, adhering to the strategic model and developing a ritualistic technique, invariant prescription, to counteract the dirty game, or power struggle between the parents and their child; Boscolo and Cecchi moved away from the strategic approach, developing a collaborative style of therapy; in this model, problems are maintained when the family holds to an old epistemology that does not fit its current circumstance; the therapist introduces new information indirectly by asking questions and the family solves problems themselves as they develop a new epistemology; the therapist/client interactions within the session are the treatment; in their interviews they displayed a curious attitude about the family and meanings they derived from their experiences and interchanges

Front 266

Mimesis

Back 266

A joining technique used primarily by structural therapists in which the therapist gains acceptance by mimicking the gestures, communication, and behavioral patterns of family members

Front 267

Miracle question

Back 267

A solution-focused technique used to clarify goals; clients are asked, "Suppose one night while you were asleep, there was a miracle and this problem was solved. How would you know? What would be different when you woke up?"

Front 268

Modeling

Back 268

From social learning theory, learning new behavior or extinguishing old behavior by observing the reinforcement contingencies of the behavior in another person

Front 269

Model integration analysis

Back 269

From Satir, the child's method for making sense of his/her parents' differences and selecting those aspects of parental male/female role models that become a blueprint for his/her behavior and expectations in other relationships; as marital partners, individuals project onto their spouses an image of how they expect them to be, rather than how they are; inevitably, each is disappointed; in treatment, Satir refers to the assessment of these images as Model Integration Analysis

Front 270

Modernism

Back 270

From philosophy, a position in which "truth" consists of a tangible, knowable set of observable or deductible facts; in this philosophy it is assumed that there are universal principles that would guide researchers and therapists toward theoretic tents, diagnoses, and treatment

Front 271

Morphogenesis

Back 271

A system's tendency to change its basic organization or structure

Front 272

Morphostasis

Back 272

A system's tendency to maintain its basic organization and structure

Front 273

MRI/Mental Research Institute

Back 273

A center for the study of families in Palo Alto, CA, whose researchers and practitioners--Bateson, Satir, and Haley--studied schizophrenia and family interactions, communication, and cybernetic theory; they emphasized process and interactional sequences rather than structure, and distinguished between first-order change and second-order change; they developed a version of brief family therapy based on the notion that the "problem" or treatment focus, stems from the failed solution previously attempted by the family; later MRI practitioners include Watzlawick, Weakland, and Fisch

Front 274

Multi-conductor model

Back 274

From network therapy, multiple therapists who share the group leadership as a team

Front 275

Multidirectional partiality

Back 275

From Nagy's contextual family therapy, the clinical stance of the therapist in which the therapist is accountable to, and supportive of, every relevant member, even when it necessitates accepting contradictory positions within a conflict; the therapist strives for neutrality, joined with each family member, and keeps communication open with all members

Front 276

Multigenerational

Back 276

More than one generation of a family

Front 277

Multigenerational family therapy

Back 277

A diverse grouping of theories and therapy models based on psychodynamic principles developed by Ackerman, Bowen, Nagy, Framo, Paul, and others, which identify family patterns that repeat across generations

Front 278

Multigenerational transmission process

Back 278

In Bowenian family therapy, the process by which roles, patterns, emotional reactivity, and family structure are passed from one generation to another; poorly differentiated individuals tend to marry one another, and over several generations produce offspring who are increasingly less differentiated and as a result suffer from severe mental disorders including schizophrenia

Front 279

Multi-partiality (plurality)

Back 279

From social constructivist Hoffman, the therapist's stance in which he/she strives to positively regard each person's point of view, even ned that are repugnant to the therapist or to society, in order to find the meaning behind behaviors, actions, and events

Front 280

Multiple family therapy

Back 280

Therapy with several families with similar problems

Front 281

Narrative solutions approach

Back 281

The integrated approach of Eron and Lund in which the therapists use MRI reframing techniques, narrative therapy techniques, and elements of solution-focused therapy; the therapist believes that people have a preference for how they would like to view themselves and others, which they call the preferred view; they ask clients questions about their preferred view and about their vision of a future without the problem; therapists ask mystery questions, such as, "How did a person who is so hard-working wind up feeling listless and depressed?"

Front 282

Narrative therapy

Back 282

A postmodern therapeutic model developed by White and Epston, that centers on the narrative metaphor; the family member's sense of reality is organized around the stories (personal narratives) he/she tells about him/herself and the world; each culture forms dominant narratives, which influence personal narratives, and therapists and clients discuss their impact; narrative therapists encourage their clients to tell "stories" about themselves and respond by exploring alternative perceptions of reality, leading to new options for solutions to problems, and in the process, "re-story" their lives; for example, the therapist might explore what the family thinks depression or the feminine ideal have in store for them; this way, the therapy process helps people reexamine their stories and re-story their lives to the outcome they prefer

Front 283

Negative feedback loops

Back 283

Corrective information that flows back into the family system that serves to minimize deviation, keep the system functioning within prescribed limits, and discourage change; negative feedback is homeostatic

Front 284

Negative reinforcement

Back 284

From the operant conditioning paradigm, a procedure for strengthening a behavior, i.e., increasing the probability that the behavior will be repeated or increasing its frequent; a stimulus, often aversive, is removed once the target behavior is exhibited; for example, a mother has been nagging a child to clean up her room. if the nagging stops (stimulus behavior is removed) when the child picks up her room (target behavior), it is likely that the child will pick up her room again (frequency increases)

Front 285

Negentropy

Back 285

From general systems theory, the measure of organization in a system; a well-organized system would have high levels of negentropy

Front 286

Network effect

Back 286

This is a goal of network therapy; it is a euphoric connectedness to others, likened to the energy and feelings of connectedness that can occur at religious revivals and rock concerts; the result is to bind the group together into a supportive, purposeful, goal-oriented social network

Front 287

Network therapy

Back 287

A model associated with Speck, Attneave, and Ruevini in which the treatment includes people from a client's social network (often a large group, including family, friends, and neighbors) as well as a team of therapists that come together to solve the client or family problem; treatment consists of six phases: detribalization, polarization, mobilization, depression, breakthrough, and exhaustion-elation

Front 288

Neurolinguistic programming (NLP)

Back 288

NLP practitioners focus on the hidden effects of language, the meaning of non-verbal behavior, and the utilization of communication and trance to create change

Front 289

Nonsummativity

Back 289

The concept that specifies that you cannot combine individual elements of a system to recreate its essential character; the whole is greater than the sum of its parts

Front 290

Not knowing

Back 290

From collaborative language systems, a stance in which therapists do not use diagnoses, give directives, or make hypotheses; they may offer tentative opinions or ideas, but assert that to take a more "expert" or directive stance would limit the solutions the family and therapist might discover through their conversations; the therapist and client engage in conversation and inquiry as partners; the therapist is not separate form the problem system

Front 291

Nuclear family

Back 291

Parents and their children living together as a unit

Front 292

Nuclear family emotional system

Back 292

From Bowen, a fused family that is unstable and unable to cope with stress; characterized by conflict and dysfunction that are transmitted across generations

Front 293

Object relations theory

Back 293

The theory that people are motivated by basic need for human connection rather than basic sexual and aggressive drives, and that repeated parent-child interactions, particularly unsatisfying ones, are internalized in the form of objects (interjects); in development, infants experience and internalize others in a variety of ways

Front 294

Object relations family therapy

Back 294

A model developed by Scarff and Scarff; based on principles in object relations theory that emphasize the internalization of experience as the developmental foundation on which humans form relationships and attachments

Front 295

Odd day/even day ritual

Back 295

From Milan systemic, a technique to encourage irreverence or a more flexible view of the family; the family is given a directive that on odd days one set of opinions would be true, but on even days, false; on the seventh day, the family should act spontaneously

Front 296

Open system

Back 296

From general systems theory, a living system (including families) with functionality porous or flexible boundaries, permitting the free exchange of information and resources with other systems

Front 297

Operant conditioning

Back 297

A behavioral learning paradigm in which a naturally occurring response is reinforced, increasing the probability that it will be repeated

Front 298

Ordeal

Back 298

From strategic family therapy, a directive that is aimed at making the symptom harder keep than give up; the ordeal requires the family member or members to do something they do not want to do but is something that would benefit them in

Front 299

Orgasmic dysfunction

Back 299

A term describing inability for an individual to reach orgasm during sexual stimulation; this disturbance must cause marked distress or interpersonal difficulty; this dysfunction is not better accounted for by another psychological condition, the direct physiological effects of a substance or another general medical condition; a person may be diagnosed with female orgasmic disorder or male orgasmic disorder, though it is less common for men; the condition is referred to as primary when the female has never experienced orgasm through any means of stimulation; it is called secondary if the woman has attained orgasm in the past but is currently non-orgasmic; for men, the disorder might present itself as an inability to reach orgasm during sexual intercourse or as ejaculation only after prolonged intense non-intercourse stimulation

Front 300

Paradigm

Back 300

An example, model, or concept that contains an interrelated set of assumptions

Front 301

Paradoxical injunctions (paradoxical interventions, techniques)

Back 301

A strategic intervention that is built around a statement containing messages at different logical levels that contradict one another; this subtle contradiction is used to perturb the system and to generate change; the symptomatic family member might be asked to keep or intensify his/her depression; if he/she rebels, the symptom must be given up; if he/she complies, the symptom has come under his/her conscious control

Front 302

Paralinguistic communication

Back 302

From communication theory, communicating through tone, pace, and inflection

Front 303

Parallel (or good faith) contract

Back 303

From behavioral marital therapy, a contract in which the behavior of each partner is not contingent on the other (the husband agrees to take out the garbage even if his wife does not make the bed)

Front 304

Parentification

Back 304

From Nagy's contextual model, parentification is the subjective distortion of a relationship that induces one's spouse or child to assume parental responsibilities for that person; these distortions can be achieved either by "wishful fantasy" or by the use of a dramatic dependent behavior; parentification is part of the loyalty system of the family' fro example, a parent's fear of seeing blood leads the oldest child to clean other family member's wounds before the phobic parent might see them; according to Nagy, a modest amount of parentification is a necessary part of helping children eventually assume responsible adult roles, but when the parentification of a child is extreme and reinforced by excessive guilt or obligation, as if the parent wouldn't survive, a psychological bind is created, trapping the child; when an adult parentifies another adult, its s usually done through unconscious regressive fantasy

Front 305

Parentified child

Back 305

From Minchin's structural model, a role set of behaviors, and placement in a family sequence that stems from the functional removal of a child from the sibling subsystem; a parentified child differs from a child with healthy responsibilities when that child's parental responsibilities are poorly defined and, therefore, unlimited and are beyond the child's developmental capabilities; such children become symptomatic when they are given responsibilities they cannot handle or are not given the authority to perform a responsibility they are give; for example, a 17-year-old girl functions as the family's head when her mother sits uninvolved in the corner of the room

Front 306

Parent Management Training (PMT)

Back 306

A psychoeducational program in which parents learn behavior management techniques to reduce the prevalence of troublesome behaviors and increase the frequency of more desired expressiveness

Front 307

Parts party

Back 307

A therapeutic technique from Satir to help clients experience the different parts of their personalities and enable them to see how they operate as an integrated whole; the family member directs others to act out the specific parts, fostering new personal experience and insight

Front 308

Pattern

Back 308

A sequence that repeats over time

Front 309

Performance anxiety

Back 309

Sexual performance anxiety occurs when a person anticipates having some form of difficulty; in men, this can take the form of maintaining erections, or lack of arousal, causing him to be anxious or even panicked approaching or during sex; this can lead to a lack of desire, or an avoidance of sex all together

Front 310

Personal map

Back 310

A conception of interpersonal reality that a person uses to make sense of the world

Front 311

Person-to-person interactions

Back 311

From Bowenian therapy, interactions that characterize differentiated relationships in which individuals talk rationally to one another without blaming the other and handle conflict without attempting to triangulate a third person

Front 312

Perturbation

Back 312

An intervention that introduces a small change or ripple without altering the system's basic organization in an attempt to magnify the change later

Front 313

Placater

Back 313

From Satir's experiential family therapy, one of five communication styles; the placater attempts to pacify and smooth over conflict by being "nice", defending and covering up for others

Front 314

Poorly differentiated

Back 314

From Bowenian theory, a person with a pseudo-self who is ruled by his/her emotions; he/she adopts the values and attitudes of significant others in order to be accepted and loved

Front 315

Positioning

Back 315

From MRI strategic therapy, a paradoxical intervention in which the therapist amplifies or exaggerates the family's explanation of the problem to such a point that the family will disagree

Front 316

Positive connotation

Back 316

From the Milan systemic group, a complex paradoxical reframing technique that includes all family members and the system itself; each family member's contribution to the problem is reframed as an effort to solve problems and help meet the family's needs

Front 317

Positive feedback loop

Back 317

The flow of information back into the system that works to amplify deviations, which increases instability and facilitates change toward meeting new goals; positive feedback is not homeostatic

Front 318

Positive reinforcement

Back 318

From operant conditioning, a process for increasing the probability that a desired (target) behavior will be repeated by adding a reinforcing stimulus after the target behavior is exhibited; for example, when a slot machine pays off (reinforcing stimulus), the likelihood of a gambler putting in another quarter (target behavior) increases

Front 319

Postmodernism

Back 319

A philosophic view held by an eclectic group of family therapy models in which the practitioners consider reality to be subjective and attend to social and political norms within the client's culture; constructivist, narrative, and solution-focused are examples of postmodern models

Front 320

Premark principle

Back 320

From behavioral therapy, a technique in which a high probability behaviors, i.e., one that the subject would voluntarily tend to engage in frequently, is used to reinforce a low probability target behavior in order to increase the frequency of the target behaivor

Front 321

Prescribing the symptom

Back 321

A paradoxical strategic family therapy technique in which the therapist attempts to unbalance the family structure by instructing the members to continue or increase the problem or symptomatic behavior in or to bring the behavior under conscious control or lessen the behavior as the family rebels against the instruction; for example, a client who is unable to complete a work project is encouraged to set times each day in which the project would not be worked on

Front 322

Pretending (pretend techniques)

Back 322

A strategic, paradoxical technique designed by Maddens; clients are instructed to pretend to have the symptom; by pretending to have the symptom, it becomes voluntary, unreal, and subject to being changed

Front 323

Preventive intervention and relationship enhancement program (PREPARE)

Back 323

A psychoeducational program for married couples to improve their relationships before problems set in; participants learn communication and conflict resolution skills and discuss their expectations for marriage; the program can be held weekly for groups of 4 to 10 couples or in a weekend marathon session for 20 to 60 couples

Front 324

Primary reinforcer

Back 324

From the operant conditioning paradigm, biologically determined reinforcers such as food and sex

Front 325

Privilege

Back 325

A legal right that state law gives to clients stating that communications between therapist and client are protected by the law from forced disclosure; that is, only the client, not the therapist, has the legal right to disclose communications that take place within such a relationship

Front 326

Probing

Back 326

A structural technique in which the therapist asks questions and/or makes provocative comments designed to evoke responses that help to obtain information about how the family operates; even failure to obtain the family's cooperation provides information about their boundaries

Front 327

Problem-determined system

Back 327

In collaborative language family therapy, any system in which a problem is so prominent in the family's conversation that few decisions can be made without taking it into account; people who are interesting in talking about the problem constitute the problem-determined system

Front 328

Problem-saturated stories

Back 328

From narrative therapy, constructing a story about oneself by emphasizing problematic experiences and ignoring competencies; individuals and families then function under the influence of such problem-filled stories

Front 329

Process

Back 329

A term used to describe the dynamics of a system,often contrasted with content; for example, in a couple’s argument about whichmovie to see, the content is the activity and choices to be made; whereas, theprocess includes who initiates the conversation, the interaction between them,the meanings each attaches to the disagreement, and the feelings each has aboutit

Front 330

Process addictions

Back 330

This term describes compulsive behavior that is notrelated to a chemical substance; behaviors such as compulsive gambling, sexualaddiction, eating disorders and spending addictions are examples of processaddictions

Front 331

Projection

Back 331

From psychoanalytic and object relations theory, an unconscious defense in which unwanted feelings or beliefs about oneself are split off and then attributed to others

Front 332

Projective hypothesis

Back 332

The notion that the information people reveal caries according to the circumstance; for example, the process of constructing a venogram tends to encourage subjective responses that distort the information that is reveals; therapists should pay attention not only to the information received from the client family, but also to the projections and distortions

Front 333

Projective identification

Back 333

An interactive and dysfunctional defense mechanism, defined b the object relations model, in which unwanted characteristics of the self are unconsciously projected onto (attributed to) another person who colludes by behaving as if these projections are true of them; for example, a father has an impulse to engage in deviant or illegal behavior, but the impulse causes him anxiety; he unconsciously projects the impulse onto his son and subtly reinforces his son's acting-out behaviors

Front 334

Proxemics

Back 334

From communication theory, interpersonal spatial relations, including body language, stance, and preferred physical distance

Front 335

Pseudomutuality

Back 335

From Wynne, a collusive family maneuver for the purpose of maintaining homeostasis, in which family members present a falsely harmonious picture, masking dysfunction

Front 336

Pseudohostility

Back 336

Wynne's term to describe the use of chronic conflict to create a somewhat superficial alienation of family members, thereby masking an individual member's need for intimacy and affection

Front 337

Pseudo self

Back 337

From Bowenian theory, a person who is not differentiated may be fused with another person; as a result, he/she does not reason from his/her own values, but instead borrows the values of the person with whom he/she is fused and commonly makes emotionally reactive choices

Front 338

Psychodrama

Back 338

A combination of group therapy and theatrical techniques created by Moreno; participants engage in lively enactments of troubling events, exploring family relations in the process; the goal is for the clients and families to experience themselves and their histories in new ways; many of Moreno's role-playing techniques have been adapted by family therapists

Front 339

Psychology

Back 339

From contextual theory, what happens within a person such as thoughts, fantasies, emotions, and the meanings that he/she ascribes to the facts of his/her life

Front 340

Punctuation

Back 340

The process by which one arbitrarily identifies the beginning and the end of a behavioral sequence (linear causality) that instead, in MRI terms, should be seen as part of a circular pattern; also a communication pattern in which each participant believes that what he/she says or does is caused by the other

Front 341

Punishment

Back 341

From the operant conditioning paradigm, a process for decreasing an undesirable behavior by applying an aversive stimulus immediately following the target behavior; for example, a teacher reprimands (aversive stimulus) a child when the child throws his sandwich on the floor (target behavior); in response, the child no longer throws food on the floor

Front 342

Qualitative analysis

Back 342

A descriptive analysis of the elements of an interaction

Front 343

Qualitative research

Back 343

A research method that is exploratory, open-ended, and directed more at discovery than at evaluation or justifying a set of hypotheses; its methods are intended to expand and enhance quantitative research techniques, and to provide a context for better understanding the meaning of the quantitative data; qualitative research is often used to generate, rather than test, hypotheses (exploratory research)

Front 344

Quantitative analysis

Back 344

The analysis of the numeric quantity of elements in an interaction

Front 345

Quantitative research

Back 345

A research method that emphasizes experimentation, large samples, data collection, statistical analysis, objectivity, and verification; quantitative research is typically sed to test hypotheses (confirmatory research)

Front 346

Quid-pro-quo contract

Back 346

A form of behavioral contingency contract in which one family member agrees to change a behavior or engage in a desired behavior after the other partner in the contract has made a desired change; the behaviors are, thus, mutually positively reinforced

Front 347

Rational emotive family therapy

Back 347

From Ellis, a cognitive-behavioral model with the goal of helping family members realize that illogical beliefs and distortions cause their emotional distress (linear causality); they are taught to recognize the problem-causing pattern: A-B-C, in which events in the family (A) are influenced by irrational beliefs (B) and result in a problem (C); the goal is to identify and modify the irrational beliefs

Front 348

Reactor

Back 348

A therapeutic stance in which the therapist would be more likely to respond to others than to direct them

Front 349

Reciprocity

Back 349

From behavioral family therapy, the likelihood that the members of a dyad will equitably reinforce one another over time

Front 350

Recursiveness

Back 350

From Cybernetics, this concept speaks to the circular caustic inherent in all systems (circular causality)

Front 351

Redundancy (behavioral redundancy)

Back 351

From cybernetics, rule-determined repetitive patterns of interactions

Front 352

Reflecting team

Back 352

A therapy technique or process involving a team oftherapists using a one-way mirror to observe the family and the therapist; theteam then discusses the family while being observed by the family and thetherapist; the therapist and family then discuss the team’s observations

Front 353

Reframing (relabeling)

Back 353

From strategic family therapy, techniques in which the therapist's language and how he/she labels events gives new, often positive, meaning to a situation; this alteration of meaning invites the possibility of change; for example, reframing a parent's fusion with a child as "caring too much" rather than dependency or separation anxiety; relabeling often refers to the alteration of the meaning of a single event, while reframing usually refers to a larger context

Front 354

Reflexive questions

Back 354

From second-order cybernetics, Tomm designed questions that inspire families not only to reflect on the meaning of their current perspectives, but also to consider new options

Front 355

Relationship enhancement

Back 355

A 10-session psychoeducational program for couples emphasizing empathy, genuineness, and positive regard (non-judgmental acceptance); therapists teach clients to recognize and acknowledge feelings and to express them openly; the program is designed to create a context in which positive changes can occur; the therapist and client share treatment planning and decision-making

Front 356

Rejecting ego

Back 356

From object relations theory, one of three parts of the ego, the rejecting ego is unconscious, inflexible, and frustrated by its rejecting object

Front 357

Rejecting object

Back 357

From object relations theory, the rejecting object gives rise to the antilibidinal ego

Front 358

Rejective moves

Back 358

From contextual theory, the fundamental dynamic force that holds families and communities together through reliability and trustworthiness

Front 359

Relational ethics

Back 359

From contextual theory, the fundamental dynamic force that holds families and communities together through reliability and trustworthiness

Front 360

Restraining techniques

Back 360

From MRI strategic, a paradoxical therapeutic technique used when the family seems ambivalent about changing; the therapist warns the family of the dangers of change, restrains them from trying to change, or ass them to change slowly; thus, the therapist aligns with the side of the ambivalence that resists change so that the family will align with the side that wishes to change

Front 361

Revolving slate (of injustice)

Back 361

From contextual theory, the generational perpetuation of destructive entitlement where one generation damages the next innocent generation; the process is reinforced by earned destructive entitlement and is the chief factor in family and marital dysfunction

Front 362

Ripple effect

Back 362

Refers to how a change that occurs at one level of a system results in changes at other levels of the system

Front 363

Rituals

Back 363

A Milan systemic intervention consisting of a series of actions that involve the whole family in a sequence of steps forming a "play" to be repeatedly enacted under prescribed circumstances; by engaging family members in a sequence in new ways, it is hoped that they will gain new perceptions that will result in changes in beliefs and behaviors

Front 364

Role function discrepancies

Back 364

From Satir, role-inappropriate relationships between the husband and wife who are not only marriage partners, but also form parent/child or sibling/sibling relationships as well

Front 365

Rubber fence boundary

Back 365

Wynne's term for the type of boundaries around some families that may appear open and flexible but that in fact permit little information from the outside to penetrate; in these families, rules are in constant flux

Front 366

Sacrifice intervention

Back 366

A closing statement in a Milan systemic (early Milan) session that includes a statement of paradox; the person with the symptom is characterized as being in the service of the homeostasis; this intervention tends to overcome resistance by causing a rebellion against the system

Front 367

Scaling questions

Back 367

A solution-focused therapy intervention used when presenting problems are vague and goals are difficult to specify; the therapist asks clients to rate on a scale of zero to ten how they are currently feeling compared to an earlier time; if they report feeling better, the therapist asks them how they achieved the improvement; they might also be asked to rate how confident they are that they will be able to maintain their resolve to change a behavior and to identify what they might do to improve their chances of making progress toward their goals

Front 368

Schedules of reinforcement

Back 368

From the operant conditioning paradigm, target behaviors may be reinforced after each occurrence, after a fixed or variable number of occurrences, or after a fixed or variable length of time; behaviors that are reinforced intermittently and unpredictable are most resistant to extinction

Front 369

Schizophrenic mother

Back 369

A now-discredited notion by Fromm-Reichmann regarding the origin of schizophrenia, in which she describes a domineering, rejecting mother whose behavior was thought to contribute to her child's mental illness

Front 370

Sculpting

Back 370

A psychodramatic technique used by Duhl, Kantor, Satir, and others; one member, acting as "director," places the family in a tableau or enactment of an event, feeling, or family structure in a therapy session; the process reveals patterns of emotional closeness and distance

Front 371

Secondary reinforcer

Back 371

From the operant conditioning paradigm, items that have acquired reinforcing properties such as praise, approval, tokens, or money to be exchanged for actual goods

Front 372

Second-order change

Back 372

From the MRI school, a change in the rules that govern the emotions and behavioral patterns of the system, resulting in fundamental system reorganization and permanent changes in interactions

Front 373

Second-order cybernetics

Back 373

A postmodern model that conceives of the therapist and family as one unit; objectivity is not possible; the treatment unit is a meaning system to which the treating professional is an equal and active contributor; the system does not create a problem; the problem creates a system

Front 374

Self of the therapist

Back 374

The therapist's self-knowledge regarding his/her values, beliefs, biases, strengths, and weaknesses; also refers to the ways in which therapists make use of their personal experiences during therapy and the nature of the emotional bond offered to clients

Front 375

Semantics

Back 375

The study of the way language conveys meaning

Front 376

Sensate focus

Back 376

A procedure developed by Masters and Johnson to minimize performance anxiety and spectating; a couple may be encouraged to engage in pleasurable body exploration and massage, with each partner giving feedback to the other as to what feels good but without the expectation of sexual performance or orgasm

Front 377

Separation

Back 377

1. From a psychoanalytic perspective, the emotional transformation of the parent permitting the child to form significant bonds with others

2. In family systems theory, the reduction of enmeshment by the clarification of diffuse boundaries

3. A married couple's decision to live their lives in a more separate, disengaged way that may or may not involve legal arrangements and may be a step toward divorce

Front 378

Sex therapy

Back 378

Pioneered by Masters and Johnson, Kaplan, and LoPiccolo; treatment that focuses on the client's or couple's sexual functioning, often combined with couple's therapy

Front 379

Sexual disorder

Back 379

Disorders of sexual functioning caused by psychological factors such as anxiety, beliefs, or perceptions

Front 380

Sexual dysfunction

Back 380

An impaired physiological response preventing a person from full sexual functioning

Front 381

Sexual orientation

Back 381

A description of the gender or genders of people to whom one is sexually attracted

Front 382

Shaping

Back 382

A behavioral procedure in which successive approximations to a desired, often more complex, behavior are reinforced until the desired behavior is achieved

Front 383

Shaping competence

Back 383

From structural therapy, a method of increasing family members' confidence in being able to solve their problems by pointing out what they have done right, rather than focusing on mistakes

Front 384

Sibling position

Back 384

From W. Toman's work in the late 1960s, Bowen held that sibling position was one factor that should be considered for a thorough understanding of family functioning, since birth order tends to exert an influence on the characteristics that children develop; hence one's sibling position could be somewhat predictive of one's level of differentiation

Front 385

SIDS-Sudden Infant Death Syndrome

Back 385

The unexplained death of an apparently health infant; the actual cause of death may be unknown, but certain risk factors have been identified such as immature lungs, apnea, sleep arousal problems; placing the infant on his/her stomach to sleep; soft bedding, etc; the incidence of SIDS has decreased since parents have been advised to place infants on their backs to sleep

Front 386

Simple bind

Back 386

From Hoffman,a mechanism for change in which a message or request is given and therecipient’s new behavior is rewarded; distinguished from a double bind in whichthe nature of the message ensure that no response will be rewarded; a doublebind is a simple bind that is continually imposed and then continually lifted

Front 387

Social-cognitive model of addiction

Back 387

This modelintegrates the work of Albert Bandura with addiction models emphasizing thatwhat and how one thinks influence the ways in which one behaves, but how webehave also influence what we think, which is known as reciprocal determinism;this model emphasizes quitting, and relapsing with an addiction

Front 388

Social constructivist family therapy

Back 388

A group ofpostmodern therapeutic approaches based on the concept that reality is anintersubjective phenomenon that is constructed in conversation; the theorieshave been referred to as: postmodern, collaborative, constructivist, narrative,reflexive, and second-order cybernetic

Front 389

Social interest

Back 389

An Adlerianconcept emphasizing the importance of having a useful life or purpose thatextends beyond self-focus; people without a social interest are self-absorbedand concerned only with themselves; Adler would name such a style of life as“useless”

Front 390

Social reinforcer

Back 390

From operantconditioning, social interactions (rather than material reinforcers) such aspraise, approval, nagging, or yelling that increase the frequency of a behavior

Front 391

Solid self

Back 391

From Boweniantheory, a person who is well differentiated and is able to function based upona personally defined set of values, beliefs, convictions, and life principles

Front 392

Solution-focused family therapy

Back 392

Theory andtherapeutic model in the tradition of brief therapy, developed by Berg and deShazer, that focuses on finding solutions rather than understanding theproblem; the model evolved from the MRI group’s focus on problems and from thepostmodern interest in the construction of reality; clients are encouraged toincrease behaviors that work well and to notice situations in which the problemdoes not occur

Front 393

Sound Relationship House Theory

Back 393

From Gottman's Couple Therapy Model, a set of seven components that comprise a strong and solid couple relationship

Front 394

Spacilization

Back 394

An Experiential technique having a client system represent aspects of the family systems and its relationships in physical space in the session

Front 395

Sparkling events

Back 395

From narrative therapy, those events that exemplify the client's preferred outcome rather than his/her problem-saturated stories

Front 396

Spectatoring

Back 396

A disorder of sexual functioning caused by monitoring one's performance; it contributes to performance anxiety

Front 397

Split filial loyalty

Back 397

From contextual theory, if parents require the child to choose between them, the child must be loyal to one at the expense of his/her loyalty to the other; the child becomes symptomatic as he/she attempts to bring the parents together

Front 398

Stepparent

Back 398

A person who marries someone with children from a prior relationship

Front 399

Streptic communication

Back 399

From communication theory, communicating through sounds such as whistles and claps

Front 400

Stonewalling

Back 400

From Gottman's couple therapy model, a stance between people when a listener refuses to respond

Front 401

Stop-start technique (squeeze technique)

Back 401

A method of sex therapy developed by Semans for the treatment of premature ejaculation; the client's partner is asked to stimulate his penis until he begins to feel premonitory sensations of orgasm; he then instructs his partner to stop and the cycle is repeated; the method helps the client concentrate on preorgasmic sensations rather than suppressing them

Front 402

Strategic family therapy

Back 402

A theory and therapeutic model developed by Haley and Madanes, with interventions that focus directly on changing the presenting problem; therapy typically begins with the therapist first assessing disorders in the system's hierarchies and/or the dysfunctional coalitions that maintain the symptom; interventions, given as directives, may be straightforward or paradoxical; therapy is not growth-oriented, but change-oriented, and the therapist takes responsibility for the success or failure of the outcome

Front 403

Strategic humanism

Back 403

Haley and Madane's more recent model is oriented toward increasing family members' ability to soothe and love rather than to gain control over one another

Front 404

Structural family therapy

Back 404

The theory and therapeutic model developed by Minchin that focuses on family organization and boundaries and the ways in which these structures govern interactional patterns; dysfunction, in this model, stems from boundaries that are either too rigid or too diffuse, both of which prevent the system and its subsets from achieving goals

Front 405

Structure

Back 405

The interrelationship among system elements that make up the organization of the system; in first-order change, structures can be affected without altering the organization of the system; whereas, in second-order change the organization's rules and structure are changed

Front 406

Subjective units of discomfort (SUDS)

Back 406

A scale used by behavioral therapists on which the clients rate their level of anxiety to a stimulus or situation

Front 407

Subjugated stories

Back 407

From narrative therapy, stories about the client that are obscured by the dominant story; some subjugated stories are helpful and others are not; narrative therapists help clients construct a new, more helpful story, which includes unstoried competencies

Front 408

Substance abuse

Back 408

A wide rate of inappropriate and usually excessive ingestion of mind-altering (psychoactive) chemicals such as alcohol or drugs (prescription, over the counter, or illicit)

Front 409

Subsystem

Back 409

In structural family therapy, an organized component of a system that has a specific role in the functioning of the larger system and is somewhat autonomous from it; for example, a parental subsystem or sibling subsystem

Front 410

Suicide

Back 410

Intentionally taking one's own life

Front 411

Suicidal ideation

Back 411

Images, thoughts, and feelings about committing suicide, often including ways to accomplish it and how it might affect others

Front 412

Suprasystem

Back 412

A higher-level system, such as a community, in which other systems are components

Front 413

Superego

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The last structure to develop in the personality is the superego and incorporates the values, morals, ideals, and standards of society; it is greatly influenced by interactions with one's parents; it consists of two subsystems: the conscience and ego-ideal (ideal self image); it strives for perfection

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Survival skills workshops

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A psychoeducational program for families coping with mental illness in a member; in these workshops, groups of families learn about the etiology, prognosis, psychobiology, and treatment of the illness and learn ways the family can deal with its special demands

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Sweat boxes

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From Hoffman, a mild or severe threat to the continuity of the relationship and the system, a possible precondition to morphogenesis

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Symbolic-experiential family therapy

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A theory and therapeutic approach developed by Whitaker in which the therapist uses his/her own experience and craziness to influence family members' internal meanings, thereby changing dysfunctional patterns

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Symmetry

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From Jackson and the MRI Group, the opposite of complementarity, a relationship in which there is a relatively equal distribution of control and power, often resulting in rapid escalation of conflict

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Symptom prescription

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From MRI strategic therapy, a treatment technique in which the therapist asks the family to continue to perform or even expand a symptom; the intervention may be compliance based if the therapist wants the family to do as suggested or defiance based when he/she wants the family to defy the directive

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Syntax

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The form of a message

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System

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A bounded set of interrelated elements with coherent and patterned behavior; open systems exchange information and resources with their environment, while closed systems restrict such exchanges

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Systematic desensitization

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From Wolpe, a behavioral therapy technique for reducing the capacity of conditioned stimuli or activities to evoke anxiety; the therapist first instructs the client to arrange various anxiety-provoking stimuli or activities on a hierarchy rated according to a subjective units of discomfort scale (SUDS) (e.g. planning a trip that requires crossing a bridge; driving toward the bridge; driving on the bridge; walking onto the bridge); the therapist teaches the client to induce a state of relaxation, then pairs the relaxation response with the anxiety-provoking stimuli, working progressively up the hierarchy

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Talk table

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The "talk table" is a device developed by Gotten in which people could interact and then rate how positive or negative their intentions were and how positive or negative were the effects of the messages they received; importantly, this was the first application of game theory to couples' interaction

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Tarasoff v. Regents of University of California (Duty to Warn)

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A court ruling, adopted by most jurisdictions, that states that when a therapist determines, or should determine, that his/her client presents a serious threat of harm to a specifically identified other person, he/she has an obligation to use reasonable care to protect the intended victim against such danger

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Teaming roles

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From symbolic-experiential family therapy, the notion that there are no well members in a dysfunctional family; members who present as healthy may be paired with more obviously symptomatic members; for example, the apparently well person may be a white knight to the family, sacrificing his/her sense of self

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Temperature reading

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A therapeutic technique of Satir, in which family members express their hopes and wishes each day between sessions to show their appreciation of one another and discuss complaints and solutions

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Temporal sequencing

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The chronological order in which family behaviors occur

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Termination

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The end of the contractual relationship between the therapist and client or family; it may be formal and final or flexible; in some therapies, it is initiated by the therapist, but in others the therapist follows the family's lead; in brief prescriptive therapies, the therapist initiates termination when the presenting problem is eliminated or when the agreed-upon number of sessions is reached; other therapeutic models do not conceive of termination as final; clients and families may return to treatment when a new problem appears or an old problem reappears

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Therapeutic certificates

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From narrative therapy, certificates given to the client or family announcing the client's victory over the problem, which he/she shows to others and reviews, if he/she again feels the effects of the problem

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Therapeutic double bind

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A type of paradoxical technique in which clients are instructed to continue to have the symptom; they are then caught in a bind since to continue the symptom willfully demonstrate that they have control over a symptom that they previously experienced as involuntary

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Therapeutic letters

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From narrative therapy, a procedure created by Epston, used to extend the therapy in which the therapist summarizes in writing the client's competencies with respect to overcoming the problem and acknowledges the sparkling events

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Therapeutic neutrality

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From object relations family therapy, an atmosphere of nonjudgmental exploration; the therapist is not tied to a specific outcome other than insight and working through

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Therapeutic paradox

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From strategic family therapy, an intervention that entails maneuvers that appear to contradict the goals of therapy, yet are actually designed to achieve them

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Therapist stance

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The therapist's position (engagement style) in relation to both the family system and therapist's theoretical foundation; for example, an engaged style in which the therapist tends to disclose personal experiences or disengaged in which the therapist remains emotionally distant

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Third-order change

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Gregory Bateson's term for a dramatic transformation in thinking

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Time out (time out from reinforcement)

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A behavioral technique used to extinguish (eliminate) undesirable behaviors by removing the person from a situation in which the behavior is unlikely to be reinforced

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Token economy

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A behavioral program in which tokes (secondary reinforcers) are dispensed for desirable behaviors; the tokens can later be redeemed for desired items

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Tracking

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From structural family therapy, an engagement technique in which the therapist participates in the existing family dynamic, while privately noting the dysfunctional or unbalanced processes being enacted; the therapist must assume the "median" position--paying attention to him/herself while engaging with the family

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Transaction

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A transaction is an exchange of information between two parties to carry out financial administrative activities related to health care

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Transactions

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From contextual theory, the patterns of family organization: hierarchy, triangles, and transactional sequences

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Transference

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A psychoanalytic term to describe the client's unconscious tendency to attribute to the therapist unresolved drives, attitudes, feelings, and fantasies from previous (often parental) relationships

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Triangle

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A Bowenian concept that refers to the smallest stable emotional unit in a family and describes a process by which two people will recruit a third person into the system to mediate the level of conflict or tension between them

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Triangulation

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From Bowenian family therapy, a dysfunctional process in which an unresolved conflict between two people (often parents) is extended to include a third person (often their child), whose loyalty is fought over

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Unbalancing

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A structural technique designed to disrupt a dysfunctional sequence by lending greater support to one side of a conflict than the other

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Unconditional positive regard

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A therapeutic stance originated by Humanist Carl Rogers that is used by therapists in emotionally focused couples therapy in order to create a safe environment where primary feelings can be revealed

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Undifferentiated family ego mass

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From Bowenian family therapy, a phenomenon in which family members are emotionally fused, highly reactive, and structurally chaotic; emotions overwhelm the intellect and interfere with individual functioning in family members

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Unfinished business

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From experiential therapy originally a concept of Gestalt therapist Fritz Perls, referring to unresolved feelings or disowned parts of the self

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Unique outcomes

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From narrative therapy, instances in which the client did not experience the problem for which he/she seeks therapy; these exceptions to the problem (sparkling events) are highlighted in the therapy to counteract a problem-saturated outlook

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Utopian syndrome

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From Watzlawick's book Change, the myth sometimes brought with clients to therapy that suggests that a single intervention might somehow solve all the client systems problems, that notion that one can manage all problems by embracing a single, all-encompassing solution; this can lead to clients going therapist shopping or solution shopping to fulfill the fantasy

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Unstoried competencies

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From narrative therapy, those competencies that the client possesses that are not part of his/her dominant story and therefore are not expressed until the dominant story is reconstructed

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Visitor

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From solution-focussed therapy, one of three ways to characterize the client's level of participation and commitment to change; a visitor does not bring a specific problem to therapy and does not have a commitment to participating productively in treatment

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Vulnerability stress model (diathesis stress model)

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The notion that while some people have a predisposition or inherited vulnerability to a mental illness, the actual manifestation of the illness is determined by life events, particularly stressful events in the family

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Working through

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From psychodynamic therapy, insight leads clients to engage in new and more productive ways of behaving and interacting