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75 Cards in this Set
- Front
- Back
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What is the postmodernization of family therapy?
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A) loss of faith in unbiased objectivity
B) a movement to deconstruct the established theories C) disillusionment with experts D) interest in the generation of meaning E) interest in diversity and pluralism |
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What is the feminist critique?
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A central premise of the feminist critique is that marriage and family life have inherently subjugated women.
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What did feminist family therapy do?
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Exposed gender bias in family therapy
Equal responsibility Help women and men re-examine gender roles that keep women from realizing their full potential Uses existing forms of family therapy (e.g., Bowenian, solution-focused) as primary treatment Adds in a sensitivity to gender |
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What is social constructivism?
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Explores perspectives
Doesn’t focus on patterns of interaction Social constructionism adds element of interaction Does not assume reality exists, it is created |
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What is narrative therapy?
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How experience creates expectations
How expectations form our self concept |
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Issues in family therapy: family violence
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Domestic violence is a major public health problem
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Issues in family therapy: multiculturalism
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Requires ethnic sensitivity and respect
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Issues in family therapy: race
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Requires understanding of reluctance to engage in treatment
Must face personal attitudes about race, class, and poverty |
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Issues in family therapy: poverty and social class
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Understand implications of being “poor” in the United States
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Issues in family therapy: gay and lesbian rights
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Understand struggles and unique issues
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Issues in family therapy: spirituality
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Can be source of family’s most powerful beliefs
Explore without judgment |
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treatment in single parent families: Goals
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Strengthen hierarchical position in relation to child(ren)
Become more fulfilled in parent’s own life |
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treatment in single parent families
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Addressing the presenting complaint
Helping parent take more effective charge of child(ren) Increasing sources of support |
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treatment in African American families: "family"
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Includes kinship network
Search for areas of strength Enlist support in helping family |
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treatment in African American families: recognize
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Enmeshment with community (e.g., church, school)
Potential anger caused by decades of racism Importance of religion and spirituality Importance of a possible absent father |
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treatment in gay and lesbian families: unique challenges
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Homophobia
Relational ambiguities Developing support |
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treatment in gay and lesbian families: sensitivity to issues of...
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Extreme jealousy
Anger Coming out (to family) |
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treatment in gay and lesbian families: probe for...
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Probe for signs of belief in cultural stereotypes (including instability)
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treatment in gay and lesbian families: atmosphere
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Create atmosphere of safety to explore any shame about their needs for affection or intimacy
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Psychoeducational family therapy
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Establishes collaborative partnership
Support and Empowerment Achieved by… Removing blame Reinforcing family strengths Sharing information |
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Medical Family Therapy
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Preparation for dealing with illness
Gain perspective on effects Examine available resources |
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Cognitive behavioral therapy: first began
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Behavior therapists first began working with families in the 1970s.
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Cognitive behavioral therapy: based on
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Behavior therapy was based on learning theories and was aimed at parent training and couple communication
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Cognitive behavioral therapy: limitations
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Was limited in its approach to families because it often did not take into account the complicated nature of family systems
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Cognitive behavioral therapy: changes
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The approach is now making changes to be more adaptive to the complex systems imbedded in families
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Cognitive behavioral therapy: leading figures
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Ivan Pavlov
Joseph Wolpe B.F. Skinner Gerald Patterson Robert Liebermann Albert Ellis Aaron Beck |
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Cognitive behavioral therapy: Ivan Pavlov
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Classical conditioning
Unconditioned stimulus (UCS) – food Unconditioned response (UCR) – salivation Conditioned stimulus (CS) – ringing bell |
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Cognitive behavioral therapy: Joseph Wolpe
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Systematic desensitization
Anxiety is acquired through classical conditioning De-conditions anxiety through reciprocal inhibition Reciprocal inhibition – pairing responses incompatible with anxiety to the previously anxiety-arousing stimuli (muscle relaxation, visual imagery, etc). |
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Cognitive behavioral therapy: B.F. Skinner
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Operant conditioning
Responses that are positively reinforced will be repeated more frequently Behaviors that are punished or ignored will be reduced or extinguished |
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Cognitive behavioral therapy: Gerald Patterson
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Developed behavioral parent training
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Cognitive behavioral therapy: Robert Liebermann
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Behavioral approaches to couples and family therapy
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Cognitive behavioral therapy: Albert Ellis and Aaron Beck
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introduced cognitive elements into behavioral therapy
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Cognitive behavioral therapy: theory of behavior
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Behavior is maintained by its consequences
Behavioral problems are caused by dysfunctional patterns of reinforcement between parents and children Behavior will remain resistant to change until more rewarding consequences are introduced |
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Cognitive behavioral therapy: social exchange theory
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people strive to maximize rewards and minimize costs in relationships (key for couple relationships)
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Cognitive behavioral therapy: theory of behavioral approaches
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Behavioral approaches are typically limited to two party relationships (parent/child, spouses). Fail to take into account the triadic nature of relationships
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Cognitive behavioral therapy: cognitive theorists
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Cognitive theorists emphasized the need for attitude changes to promote and maintain behavior change
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Cognitive behavioral therapy: cognitive techniques
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Cognitive techniques became more prominent as behavior therapists realized an exclusive focus on behavior often failed to address the complicated dynamics of couple and family interaction
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Cognitive behavioral therapy: healthy families
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Healthy families are those in which positive behaviors are maintained by appropriate consequences and negative behaviors are extinguished through the use of punishment
Healthy families have high ratios of benefits to costs |
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Cognitive behavioral therapy: healthy couples and families
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Healthy couples will be able to engage in effective communication skills, problem-solving skills, and conflict resolution
Healthy families and couples have the ability to adapt, be flexible, and change |
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Cognitive behavioral therapy: development of behavior disorders (behavioral)
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Symptoms are viewed as learned responses
For behavioral therapists, no underlying meanings of symptoms are sought Attention is focused on the symptoms themselves and the environmental responses that reinforce the behavior |
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Cognitive behavioral therapy: development of behavior disorders (cognitive)
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Cognitive-behavioral therapists will include ideas about dysfunctional schemas regarding family roles and relationships that are learned in one’s family-of-origin
Cognitive Distortions (8 types). |
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Cognitive behavioral therapy: Goals
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Behavioral and cognitive changes in the way one behaves toward and thinks about the family
Increase the rate of rewarding interactions in family relationships Decrease the use of negative family interactions; increase positive interaction Teach effective communication and problem-solving skills Alter negative thought patterns that promote or maintain ineffective family interactions |
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Cognitive behavioral therapy: assessment
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A hallmark of behavioral therapy
Evaluations created by defining, observing, and recording the frequency of the behavior to be modified Careful assessments are conducted to determine the contingencies of reinforcement Families and couples – questionnaires and home observations are conducted. For sex therapy, clinical interviews are the main assessment tool |
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Cognitive behavioral therapy: behavioral parent training
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Treatment goals are set based on results of assessment
Behavioral Parent Training Techniques for child and adolescent patients are based on operant conditioning and include: Shaping (reinforcing change in small steps) Token economies (point systems, rewards) Contingency contracting (parents will make changes once they see changes in children) Time-out (ignoring or isolating the child following unwanted behavior) |
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Cognitive behavioral therapy: behavioral couples therapy
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Assessment through the use of standardized measures
Therapist helps couple accept mutual responsibility and mutual possibility for change Behavioral interventions Make lists of things that occur during week Behavior exchange Conflict engagement Quid pro quo contracts Problem-solving training |
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Cognitive behavioral therapy: cognitive behavioral approach
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Cognitive inferences are believed to evoke emotion and behavior (cognitive schema related to family-of-origin and families in general)
Clients learn to recognize automatic thoughts by the use of thought records and diary keeping. Therapists challenge or attempt to change these beliefs to make them more functional. Addresses the limitation in previous behavioral theories that took a highly linear approach to family behavior |
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Cognitive behavioral therapy: cognitive behavioral approach cont.
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This approach shows much promise when working with couples and families
Balances the emphasis on cognition and behavior Focusing in greater depth on family interaction and patterns Overcoming the limitations of past linear / behavioral models as family relationships, cognitions, emotions, and behaviors are thought to exert mutual influence on one another |
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psychoanalytic family therapy: rediscovering psychodynamics
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Most family therapists rejected the psychoanalytical model when it came to working with families
Family therapy rediscovered psychoanalytic theory in the 1980s Object relations theory and self psychology more conducive to family therapists |
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psychoanalytic family therapy: leading figures
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Freud
Melanie Klein, Ronald Fairbairn, Donald Winnicott Henry Stack Sullivan and Edith Jacobson Henry Dicks |
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psychoanalytic family therapy: Freud
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designed therapy that focused on the individual, deliberately excluded family
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psychoanalytic family therapy: Melanie Klein, Ronald Fairbairn, Donald Winnicott
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concentrated on the nature of interpersonal relationships
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psychoanalytic family therapy: Henry Stack Sullivan and Edith Jacobson
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emphasized interpersonal relationships
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psychoanalytic family therapy: Henry Dicks
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first to apply object relations theory to treatment of marital conflict
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psychoanalytic family therapy: Object relation theory
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Focuses on interpersonal relationships
Bridges gap between psychoanalysis and family therapy Selfhood and identity are formed and maintained through relationships in past and present We relate to people in the present based on early experiences with primary caregivers “Internal objects” form the core of our selves |
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psychoanalytic family therapy: normal family development
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Draws from objects relations theory, attachment theory, and theories of the self
Process of growth depends on the ego’s relations with objects First as actual interactions with real objects, later as unconscious residues of those early interactions Reliable and loving support creates a successful completion of separation-individuation Good-enough mothering enables children to achieve a sense of identity |
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psychoanalytic family therapy: normal family development: 2 necessary qualities
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Two necessary qualities of parenting for a secure and cohesive self: empathy and offer a model of idealization
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psychoanalytic family therapy: normal family development: Boszormenyi-Nagy
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Boszormenyi-Nagy believed relational ethics to be a fundamental force that holds family and societal relationships together
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psychoanalytic family therapy: normal family development: psychoanalytic perspective
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Psychoanalytic perspective: family development depends on the early development of the individual personalities that make up the family
If spouses are mature and healthy adults, family will be harmonious |
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psychoanalytic family therapy: development of behavior disorders
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Poor adult adjustment is a result of inadequate separation – parents’ failure to accept their children as separate beings can take extreme forms
Theorists believe that anorexia nervosa results from inadequate separation and individuation Failure to develop a cohesive sense of self and a differentiated identity causes intense emotional attachment to the family Handicaps a person’s ability to develop a social and family life of his own |
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psychoanalytic family therapy: behavior disorders
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One’s choice of marital partners is based partially on the desire to find someone who will complement and reinforce unconscious fantasies
Marital choice also affected by false-self phenomenon False-self develops in insecurely attached children, where they learn to hide their needs and feelings to win approval |
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psychoanalytic family therapy: Goals
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Goal of psychoanalytic therapy is intrapsychic restructuring or personality change
Family members are freed of unconscious restrictions Individual family members are helped to reintegrate split-off parts of themselves in order to become fully integrated or cohesive |
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psychoanalytic family therapy: assessment
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after the roots of the current family conflict have been uncovered, interpretations are made about how family members reenact past
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psychoanalytic family therapy: techniques
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therapist employs four basic techniques to foster insight and facilitate process of working through: listening, empathy, interpretation, and analytic neutrality
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Solution Focused: Leading Figures
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Steve de Shazer
Insoo Berg |
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Solution Focused: Steve de Schazer
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Milwaukee, WI
1979: Started the Brief Family Therapy Center (BFTC) Worked in Palo Alto; influenced by MRI Focuses on solutions that work rather than solutions that do not work as in the MRI model |
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Solution Focused: Insoo Berg
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BFTC
Applied the model to alcoholism, marital therapy, and family-based services to the poor |
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Solution Focused: Theoretical Formulations
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Derived from MRI
Focus on cognitions rather than behavior Focus on presenting the problem Find the simplest solution Focus on exceptions Exceptions to client’s problem are the solution Assumes people are capable of behaving effectively, but are blocked by negative mindset People already have the solution(s) to their problems |
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Solution Focused: Theoretical Formulations cont.
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Look to future where problems can be solved
People constrained by narrow view of their problems Rigid patterns of false solutions People attempt to fit their stories into their existing schemas and societal expectations Language shapes reality |
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Solution Focused: Normal Family Development
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Avoid judgments about “what is normal”
Clients assumed to be experts on their own situations Interest in language How people describe themselves How people describe their problem(s) Focus on complaints presented Should not impose values by suggesting clients address other un-presented problems |
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Solution Focused: Development of Behavior Disorders
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Solutions to problems are unrelated to the development of the problem
Tracking the development of the problem should be avoided Problem-focused thinking prevents effective solutions from being recognized |
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Solution Focused: Goals
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Resolve presenting complaint by helping clients do or think differently
Trust clients to reach their own goals Help clients identify the problem-solving skills they have lost sight of Help clients locate their resources |
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Solution Focused: Conditions for Behavior Change
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Amplify exceptions to their problems – effective solutions that are already in their possession
Construction of solution-oriented narratives Therapist and client engage in a discussion that shifts the language of the problem Encourage positive talk which will lead to positive thinking and positive problem solving |
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Solution Focused: Assessment
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Very little intake information
Avoid any assessment of how problems develop Concentrate on assessing future goals Therapy should only include people concerned about the problem Hear the client’s constructions of their problems without preconceptions |
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Solution Focused: Therapeutic techniques
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Problem Description
Ask clients to describe their problem Ask how they have tried to resolve these difficulties Goal Setting/Miracle Question Activates problem-solving mindset by giving people a vision of their goal Exploring Exceptions/Exception Question Directs clients’ attention to times when they did not have the problem What they can do to expand the exceptions |
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Solution Focused: Therapeutic techniques cont
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Scaling Questions
Help therapist and clients talk about vague topics (e.g., depression) On a scale from 1 to 10, how sad do you feel? Coping questions How have you coped in the past? Compliments Brings attention to the fact that the client has already done something Later sessions are devoted to measuring progress |
