I'm almost positive that nothing this complicated could possibly be on the test, but I wanted to make a note for anyone interested in family social work that there is a book I have used that will BLOW YOUR MIND. Seriously. I had an entire class on this book and I still can't get my head around it completely. It's called "Metaframeworks: Transcending the Models of Family Therapy" by Breulin, Schawartz, and Kune-Karrer. The book opens with a chapter on reality. Is there an unquestionable reality? Is reality subjective? Is reality something that doesn't exist at all? And if any of these are true, what does it mean for therapy?
It then progresses to break family dynamics and behavior down into hard science. Charts, graphs, sequences... it's like reading a biology book. They make arguments that there are four overarching patterns in our lives that all occur at different times and last different lengths of time. They range from face to face short occurrences (Class 1) to intergenerational patterns that transcend decades (class 4). All four patterns are related.
My favorite chapter is on gender. The authors point out five "gender evolution positions". In the first, traditional, "women may experience some oppressed and angry parts." (p. 250). (I should mention here that 'parts' of people are HUGE in this book. Angry parts, sad parts, abandoned parts, child parts... it's awesome.) The polarized part of the evolution has very angry women parts and very defensive and guilty man parts. The gender evolution isn't what is so awesome about this chapter. The awesome part is the discussion on how gender affects therapy. If the stage of gender evolution is seemingly causing problems, or if gender is part of a maladaptive sequence (pattern), how does a therapist begin to challenge the way gender is expressed in a family? How does culture affect gender patterns, and should culture be challenged if it is part of a distressful pattern? Strategies to move families through the next stage of the evolution are included.
Now, this short blurb is not displaying the true awesomeness that it is. I can't describe it well because I have a hard time understanding it myself. But you you're into family therapy and really stretching your brain, seriously, get this book. It's not an expensive textbook. I think I bought it for $12.
Showing posts with label families. Show all posts
Showing posts with label families. Show all posts
Friday, December 5, 2008
Tuesday, November 25, 2008
Basics of Family Therapy
Despite which technique or theory you use, typically the beginnings of family therapy will look the same. Usually, family therapy includes everyone who lives in the household, and sometimes extended family members. The therapist begins by establishing report with all the members. Greet the contact person first, and greet everyone, including children, individually. After everyone has settled, summarize the initial contact conversation and ask for input. Listen and reflect every point of view. When someone does not offer input in the initial conversation, ask for it directly. Establish a bond with every family member to reduce anxiety. You want to convey the message that you are not going to scapegoat anyone or jump to conclusions. Develop a hypothesis about the family; are there triangles? How do they benefit from the presenting problem? What is the cycle of the presenting problem? Is there a scapegoat? What are the boundaries like?
To minimize yelling, establish a rule that only one person may speak at a time. If emotions are becoming too volatile too early, change directions. Exploring strengths is always a good idea. Imagine a couple who entered therapy as a last resort to avoiding divorce. The wife is counting off a list of complaints about the husband, saying he's emotionally distant, ignores her, etc etc. The husband is becoming tense and annoyed hearing a reiteration of his failings. When the wife slows down, the therapist could say, 'I can see how that would be frustrating. I'm just curious; what do you think his strengths are in this family?' The wife switches directions and begins to talk about how good of a father he is, how he responds to his children's needs. First, the husband has probably heard his list of failures many times, but probably not heard his wife praise his parenting skills recently. The tension between the two deescalates. The strengths question and answer here could also be taken down the solution focused path and search for exceptions. But I'll come back to the solution focused technique in a later entry.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
To minimize yelling, establish a rule that only one person may speak at a time. If emotions are becoming too volatile too early, change directions. Exploring strengths is always a good idea. Imagine a couple who entered therapy as a last resort to avoiding divorce. The wife is counting off a list of complaints about the husband, saying he's emotionally distant, ignores her, etc etc. The husband is becoming tense and annoyed hearing a reiteration of his failings. When the wife slows down, the therapist could say, 'I can see how that would be frustrating. I'm just curious; what do you think his strengths are in this family?' The wife switches directions and begins to talk about how good of a father he is, how he responds to his children's needs. First, the husband has probably heard his list of failures many times, but probably not heard his wife praise his parenting skills recently. The tension between the two deescalates. The strengths question and answer here could also be taken down the solution focused path and search for exceptions. But I'll come back to the solution focused technique in a later entry.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
Friday, November 21, 2008
Bowen Family Systems Therapy
Key conceptions of Family Systems Therapy are Differentiation of Self, Emotional Triangles, Fusion, and Emotional Cutoff
Differentiation of Self is a term that refers to an individual's ability to think clearly and logically, even in the face of anxiety. Undifferentiated people react automatically with emotions. Undifferentiated people "... find it difficult to maintain their own autonomy, especially around anxious issues. Asked what they think, they said what they feel; asked what they believe, they echo what they've heard... Differentiated people are able to take stands on issues because they're able to think things through, decide what they believe, and then act on those beliefs." (p. 87)
How people become differentiated will be addressed soon.
Emotional triangles are when two people are locked in conflict and bring in a third party who then because fixed in the conflict. This forms a dysfunctional, three party relationship. The third party relieves some of the anxiety involved with the conflict, but also prevents the conflict from being resolved. An example of this could be a married couple who are having conflict and instead of dealing with the conflict, involve themselves with their child who acts as a distraction and someone to involve ("your father is so unemotional", "your mother spends too much money"). Emotional triangles can also form between a young married couple and a set of inlaws.
Emotional fusion is when two people become so over-involved in each others lives they lose their autonomy. Bowen, the man who originated this theory, first saw the concept of emotional fusion when working with young men with schizophrenia. He saw this concept between the men and their mothers, but after practicing in different fields, noticed this concept was in all types of families.
Emotional cutoff "The greater the emotional fusion between parents and children, the greater the likelihood of cutoff. Some people seek distance by moving away; others do so emotionally by avoiding personal conversations or insulating themselves with the presence of third parties." (p. 89) The book equates parents with kryptonite for some seemingly well adjusted adults.
Back to how a person ends up differentiated or undifferentiated. When a family is involved in fusion, the child most involved with the fusion becomes more undifferentiated and also experiences a high level of emotional anxiety. The child who is least involved in the fusion experiences the highest level of differentiation. THE REASON FOR THIS is because the child most involved in the fusion is forced to either "conform or rebel" (p. 89), emotionally while the child not involved in the fusion is able to learn to think for themselves.
Therapy
The goals of Family Systems Therapy are to help those involved realize the difference between thinking and feeling, lower anxiety, and to increase the realization of how the individual affects the family.
The therapy begins with the assessment of the families function and the relationships between the family members. Genograms are appropriate here.
Process questions are also the staple of Family Systems Therapy. Process questions are questions designed to move people towards differentiation. They help the person think logically and less emotionally about their problems and their involvement in them. An example exchange could be,
Therapist: "When your husband doesn't return your calls, what goes on inside you?"
Wife: "I get scared. And then I feel disrespected."
Therapist: "And how does that manifest?"
Wife: "I withdraw from him."
Therapist: "What are you trying to tell him when you do that?"
Wife: "That I'm hurt."
Therapist: "Does it work?"
The therapist is NEVER to take sides between couples. The therapist's job is not interfere with the content of the arguments, but to help the couple work on the process of their arguments. The therapist should work to keep those involved in therapy calm and rational, because when discussions become emotional, those involved are not able to think about their processes objectively.
Individual therapy with this theory involves helping the individual gain autonomy and to remove themselves from triangles.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
Differentiation of Self is a term that refers to an individual's ability to think clearly and logically, even in the face of anxiety. Undifferentiated people react automatically with emotions. Undifferentiated people "... find it difficult to maintain their own autonomy, especially around anxious issues. Asked what they think, they said what they feel; asked what they believe, they echo what they've heard... Differentiated people are able to take stands on issues because they're able to think things through, decide what they believe, and then act on those beliefs." (p. 87)
How people become differentiated will be addressed soon.
Emotional triangles are when two people are locked in conflict and bring in a third party who then because fixed in the conflict. This forms a dysfunctional, three party relationship. The third party relieves some of the anxiety involved with the conflict, but also prevents the conflict from being resolved. An example of this could be a married couple who are having conflict and instead of dealing with the conflict, involve themselves with their child who acts as a distraction and someone to involve ("your father is so unemotional", "your mother spends too much money"). Emotional triangles can also form between a young married couple and a set of inlaws.
Emotional fusion is when two people become so over-involved in each others lives they lose their autonomy. Bowen, the man who originated this theory, first saw the concept of emotional fusion when working with young men with schizophrenia. He saw this concept between the men and their mothers, but after practicing in different fields, noticed this concept was in all types of families.
Emotional cutoff "The greater the emotional fusion between parents and children, the greater the likelihood of cutoff. Some people seek distance by moving away; others do so emotionally by avoiding personal conversations or insulating themselves with the presence of third parties." (p. 89) The book equates parents with kryptonite for some seemingly well adjusted adults.
Back to how a person ends up differentiated or undifferentiated. When a family is involved in fusion, the child most involved with the fusion becomes more undifferentiated and also experiences a high level of emotional anxiety. The child who is least involved in the fusion experiences the highest level of differentiation. THE REASON FOR THIS is because the child most involved in the fusion is forced to either "conform or rebel" (p. 89), emotionally while the child not involved in the fusion is able to learn to think for themselves.
Therapy
The goals of Family Systems Therapy are to help those involved realize the difference between thinking and feeling, lower anxiety, and to increase the realization of how the individual affects the family.
The therapy begins with the assessment of the families function and the relationships between the family members. Genograms are appropriate here.
Process questions are also the staple of Family Systems Therapy. Process questions are questions designed to move people towards differentiation. They help the person think logically and less emotionally about their problems and their involvement in them. An example exchange could be,
Therapist: "When your husband doesn't return your calls, what goes on inside you?"
Wife: "I get scared. And then I feel disrespected."
Therapist: "And how does that manifest?"
Wife: "I withdraw from him."
Therapist: "What are you trying to tell him when you do that?"
Wife: "That I'm hurt."
Therapist: "Does it work?"
The therapist is NEVER to take sides between couples. The therapist's job is not interfere with the content of the arguments, but to help the couple work on the process of their arguments. The therapist should work to keep those involved in therapy calm and rational, because when discussions become emotional, those involved are not able to think about their processes objectively.
Individual therapy with this theory involves helping the individual gain autonomy and to remove themselves from triangles.
Adapted from:
Nichols, M. (2009). The essentials of family therapy (4th ed.) Boston: Pearson.
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