Family Therapy

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.