FAMILY:
In the
field's early years, many clinicians defined the family in a narrow,
traditional manner usually including parents and children. As the field has
evolved, the concept of the family is more commonly defined in terms of strongly
supportive, long-term roles and relationships between people who may or may not
be related by blood.
Family denotes a group of people
affiliated by consanguinity, affinity or co-residence. Although the concept of consanguinity originally
referred to relations by "blood”.
Different
schools of thoughts of family therapy have a common belief that, regardless of
the origin of the problem, and regardless of whether the clients consider it an
"individual" or "family" issue, involving families in
solutions is often beneficial. This involvement of families is commonly
accomplished by their direct participation in the therapy session. The skills
of the family therapist thus include the ability to influence conversations in
a way that catalyzes the strengths, wisdom, and support of the wider system.
The Family Therapy:
Family therapy also referred to as Couple and family therapy as an
important factor in psychological health. Family Systems Therapy is used to help
couples and family members experiencing problems in their relationships. The
approach focuses on the interaction between family members and treats these relationships as an importance influence on the psychological well-being of participants.
History
Family Therapy began in the late 1940s during the treatment of schizophrenic patients. It was found that the behavior of the patient's family members influenced the condition of the patients themselves. One of the doctors, Dr Murray Bowen began to see the family as one organism or system with distinct patterns, rules and functions that directly affected the condition of the patient. They were eventually treated with their families as part of the same program.
Approach
Family System Therapy is based on Systems Theory. Family issues and problems are attributed to the systematic relationships within the family group rather than individual members. The human family is seen to behave as a single emotional unit that can be a huge influence on behavior. Therapists tend to shy away from a cause-and-effect approach and instead focus on the manner in which interaction can maintain and prolong certain problems.
Family Systems Therapy is used to help both families and individual family members. It is suitable for treating psychological problems such as Schizophrenia, addiction and eating disorders, and can encourage groups to come to terms with such issues. Divorce and other family crisis are also addressed by the Family Systems approach.
Varieties of
Family Therapy:
Conjoint Family Therapy
Conjoint family therapy
(CFT), treats the entire family simultaneously. The purist who practices this
therapy will only treat the family if all members are present. Sessions with
missing members are typically rescheduled until everyone is there.
Concurrent Family Therapy:
In concurrent family therapy,
one therapist sees all family members, but in individual sessions. The overall
goals are same as in conjoint therapy..
Collaborative Family Therapy:
Collaborative Marriage and
Family Therapy, specializes in addressing anger, conflict, communication and
relationship difficulties. Therapist may provide a safe environment for the
client to address their deeper needs which may underlie symptoms such as
anxiety, depression, anger, jealousy, power struggles, and relationship
breakdowns. Therapist collaborative, compassionate, therapeutic approach unites
the therapist’s competence with client’s strengths in order to find healing
pathways.
Behavioral Family Therapy
Behaviorists
are distinguished by their methodological and directive approach to assessment
and evaluation, their analysis of behavioral sequences before treatment, their
assessment of therapy in progress, and their evaluation of the final results.
Many non-behavioralist therapist use behavior techniques (Minuchin), or combine
cognitive and behavioral techniques.
Originally, behavioral therapists saw only individuals,
such as the wife in a problematic marriage or the child in a problematic
family. However, the basic tenets of behavioral therapy are assumed to be
applicable to them.
There are several
techniques used in family therapy by the therapists.
TECHNIQUES
The following selected techniques
have been used in working with couples and families to stimulate change or gain
greater information about the family system. Each technique should be
judiciously applied and viewed as not a cure, but rather a method to help
mobilize the family. The when, where, and how of each intervention always rests
with the therapist's professional judgment and personal skills.
THE
GENOGRAM
The
genogram, a technique often used early in family therapy, provides a graphic
picture of the family history. The genogram reveals the family's basic
structure and demographics. (McGoldrick & Gerson, 1985). Through symbols,
it offers a picture of three generations. Names, dates of marriage, divorce,
death, and other relevant facts are included in the genogram. It provides an
enormous amount of data and insight for the therapist and family members early
in therapy. As an informational and diagnostic tool, the genogram is developed
by the therapist in conjunction with the family.
THE FAMILY
FLOOR PLAN
The family floor plan technique
has several variations. Parents might be asked to draw the family floor plan
for the family of origin. Information across generations is therefore gathered
in a non threatening manner. Points of discussion bring out meaningful issues
related to one's past. Levels of comfort between family members, space
accommodations, and rules are often revealed. Indications of differentiation,
operating family triangles, and subsystems often become evident. Used early in
therapy, this technique can serve as an excellent diagnostic tool (Coppersmith,
1980).
TRACKING
Most
family therapists use tracking. Structural family therapists (Minuchin &
Fishman, 1981) see tracking as an essential part of the therapist's joining
process with the family. During the tracking process the therapist listens
intently to family stories and carefully records events and their sequence.
Through tracking, the family therapist is able to identify the sequence of
events operating in a system to keep it the way it is. What happens between
point A and point B or C to create D can be helpful when designing
interventions.
COMMUNICATION SKILL-BUILDING TECHNIQUES
Communication
patterns and processes are often major factors in preventing healthy family
functioning. Faulty communication methods and systems are readily observed
within one or two family sessions. A variety of techniques can be implemented
to focus directly on communication skill building between a couple or between
family members. Listening techniques including restatement of content,
reflection of feelings, taking turns expressing feelings, and nonjudgmental
brainstorming are some of the methods utilized in communication skill building.
FAMILY SCULPTING
Developed
by Duhl, Kantor, and Duhl (1973), family sculpting provides for recreation of
the family system, representing family member’s relationships to one another at
a specific period of time. The family therapist can use sculpting at any time
in therapy by asking family members to physically arrange the family.
Adolescents often make good family sculptors as they are provided with a chance
to nonverbally communicate thoughts and feelings about the family. Family
sculpting is a sound diagnostic tool and provides the opportunity for future
therapeutic interventions.
FAMILY PHOTOS
The
family photos technique has the potential to provide a wealth of information
about past and present functioning. One use of family photos is to go through
the family album together. Verbal and nonverbal responses to pictures and
events are often quite revealing. Adaptations of this method include asking
members to bring in significant family photos and discuss reasons for bringing
them, and locating pictures that represent past generations. Through discussion
of photos, the therapist often more clearly sees family relationships, rituals,
structure, roles, and communication patterns.
SPECIAL DAYS, MINI-VACATIONS, SPECIAL OUTINGS
Couples
and families that are stuck frequently exhibit predictable behavior cycles.
Boredom is present, and family members take little time with each other. In
such cases, family members feel unappreciated and taken for granted.
"Caring Days" can be set aside when couples are asked to show caring
for each other. Specific times for caring can be arranged with certain actions
in mind (Stuart, 1980).
THE EMPTY CHAIR
The
empty chair technique, most often utilized by Gestalt therapists (Perls,
Hefferline, & Goodman, 1985), has been adapted to family therapy. In one
scenario, a partner may express his or her feelings to a spouse (empty chair),
then play the role of the spouse and carry on a dialogue. Expressions to absent
family, parents, and children can be arranged through utilizing this technique
FAMILY CHOREOGRAPHY
In
family choreography, arrangements go beyond initial sculpting; family members
are asked to position themselves as to how they see the family and then to show
how they would like the family situation to be. This technique can help a stuck
family and create a lively situation.
FAMILY COUNCIL MEETINGS
Family
council meetings are organized to provide specific times for the family to meet
and share with one another. The therapist might prescribe council meetings as
homework, in which case a time is set and rules are outlined. The council
should encompass the entire family.The agenda may include any concerns of the
family. Attacking others during this time is not acceptable. Family council
meetings help provide structure for the family, encourage full family
participation, and facilitate communication.
STRATEGIC ALLIANCES
This
technique, often used by strategic family therapists, involves meeting with one
member of the family as a supportive means of helping that person change.
Individual change is expected to affect the entire family system. The
individual is often asked to behave or respond in a different manner. This
technique attempts to disrupt a circular system or behavior pattern.
PRESCRIBING INDECISION
The
stress level of couples and families often is exacerbated by a faulty
decision-making process. Decisions not made in these cases become problematic
in themselves. When straightforward interventions fail, paradoxical
interventions often can produce change or relieve symptoms of stress. Such is
the case with prescribing indecision. The indecisive behavior is reframed as an
example of caring or taking appropriate time on important matters affecting the
family. A directive is given to not rush into anything or make hasty decisions.
The couple is to follow this directive to the letter.
PUTTING THE CLIENT IN CONTROL OF THE SYMPTOM
This
technique, widely used by strategic family therapists, attempts to place
control in the hands of the individual or system. The therapist may recommend,
for example, the continuation of a symptom such as anxiety or worry. Specific
directives are given as to when, where, and with whom, and for what amount of
time one should do these things. As the client follows this paradoxical
directive, a sense of control over the symptom often develops, resulting in
subsequent change.
CONCLUSION
The
techniques suggested here are examples from those that family therapists
practice. Counselors will customize them according to presenting problems. With
the focus on healthy family functioning, therapists cannot allow themselves to
be limited to a prescribed operational procedure, a rigid set of techniques or
set of hypotheses. Therefore, creative judgment and personalization of
application are encouraged.
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