One of the most trying aspects of training professionals to work with couples using solution-focused therapy is expecting professionals to go slowly and to develop a connection with their couples before moving on. In fact, the therapist is working to uncover the positive aspects of the couple’s life, and how they were living before their problem. Lipchik calls this process listening with a constructive ear probing for evidence of strengths, resources, and past success, learning what life was like before or without the problem, what the clients want, or anything at all that can be reinforced as a positive aspect of the client’s lives going forward. Every couple comes from a past when the relationship was working much better. The therapist listens for clues about how the relationship was built to understand what worked in the past and continues to work today.
Your search for all content returned 103 results
This chapter includes the guiding tenets of solution-focused therapy (SFT). Solution-focused (SF) practice differs from other therapeutic approaches in its use of solution building rather than problem solving. The solution-building process is about creating what is most desired by the couple, and not about problem solving. For a couple to be seeking therapy together, there has to have been a time in the past when the relationship was working better for both the parties. By focusing on the relationship and the skills that each partner uses to contribute to the relationship, the therapist conveys a level of hope to the couple. Solution-building conversations must be co-constructed with input from all participants. Motivation should never be in doubt, even if one member of the couple claims that he or she is only there because the other partner “made” them come to therapy.
In our success-oriented culture, optimal development of giftedness often is construed as fulfilling one’s potential for greatness. In humanistic psychology, optimal development has been conceptualized differently. Self-realization can be understood in terms of Maslow’s self-actualization, Dabrowski’s secondary integration, Jung’s individuation, or other theoretical perspectives of human development. The goals of inner development involve deepening the personality, overcoming conflicts, and actualizing one’s potential for becoming one’s best self. Many parents of the gifted complain that their children are the ones exerting the pressure. Their speed of learning and quest for knowledge often exceed their parents’ comfort level. The purpose of parent guidance is to foster “optimal development” through early intervention and prevention of social and emotional problems. Assessment can act as a prelude to family therapy. Family therapy usually involves a commitment to several successive sessions to deal with family interactions.Source:
Wrapping up a solution-building session is about trusting the clients and trusting the process. Reflection teams play an important role in solution-focused therapy at the Brief Family Therapy Center in Milwaukee, but by taking a break to develop well thought-out compliments and suggestions for a couple, individual therapists can act as their own reflection teams. Using the couple’s own words is the most important step in formulating helpful feedback. It requires that the therapist pay close attention to the language used throughout the conversation and to stick with it. Feedback should be related to the couple’s strengths and the traits that have the potential to lead them away from their problem toward the preferred future. In early family therapy literature as well as early solution-focused literature, making suggestions and invitations was referred to as assigning tasks.
Rational emotive behavior family therapy follows the principles and practice of rational emotive behavior therapy (REBT). REBT and cognitive-behavior therapy (CBT) have a good record as far as their basic personality hypotheses and claims for clinical effectiveness are concerned. The author began to do conjoint marital counseling and family therapy but found the techniques to be much more efficient and less time-consuming as he replaced analytical with REBT. Hassles and frustrations of living are the inevitable human condition. Parent or child one has to go along with many domestic restrictions, including room arrangements, money expenditures, meal scheduling, and a hundred other limitations. Family systems therapy tends to require an active-directive therapist who makes clear-cut interventions and who engages in a great deal of problem solving. Clients are held to be responsible for their attendance at family therapy sessions and for doing their homework assignments.
The field of family therapy has been moving ever onward toward attempting to address the complex, multidimensional, diverse, and multicultural needs of the profession. This chapter presents a summary of Systemic Cognitive-Developmental Supervision (SCDS) and integrates a case study to illustrate basic concepts and use of the SCDS supervision model. Systemic Cognitive-Developmental Supervision is a supervision model that was developed upon the same theoretical foundations as Systemic Cognitive-Developmental Therapy (SCDT). SCDS is a supervision model that is built upon the theory of SCDT and is grounded in integrative, developmental, co-constructive, holistic, and systemic assumptions. The intersecting domains of class, gender, race, ethnicity, ability, sexual orientation, spirituality, and so forth also provide important context to supervision and therapy. Although the general SCDS model provides an important framework as a beginning, value is added by a knowledge of the developing literature on culturally sensitive therapy and supervision.
Murray Bowen Family Systems Theory attempts to explain life and the human phenomenon, rather than specific families. As with many early family therapists, the development of Bowen’s theory grew out of the decision to include family members in the treatment of patients diagnosed with schizophrenia. Bowen Family Systems Theory is based on the need for intrapersonal and interpersonal balance, with chronic anxiety and differentiation serving as the foundational constructs for the theory. These constructs are opposing: the former causing symptoms and the latter acting as the antidote. Bowen believed that family systems theory was describing life, not merely families, arguing that the constructs of his theory were universal to all genders and cultures. The implication of this belief is that culture-including race, ethnicity, gender, and the specific beliefs, values, and traditions that vary between people-does not matter and does not affect the ability for change to occur in therapy.
This chapter examines both the history and benefits of teaching specific models in Marriage and Family Therapy (MFT) supervision and then focuses on an integrative, moderate common-factors approach. MFT as a profession originated in the late 1950s and 1960s with a series of rebellious pioneers who rejected the dominant individual-based behavior and psychoanalytic models of the time in favor of something new. Supervisors who intend to integrate common factors into the supervisory experience and education have several tasks, possibly the most important of which is to provide education to supervisees about the factors that truly are common to all psychotherapy modalities. The chapter describes the seven common factors: client factors, therapist factors, the therapeutic alliance, hope and expectancy, allegiance of the therapist, feedback, and interventions, such as behavioral, cognitive, affective that cut across all models.
Adolescence is an extremely unique and critical stage of development. In order to provide the helping professional with a clear understanding of typical adolescent development, and to fill the gap many have in understanding adolescence in general, this book offers a concise, in-depth, scientific overview of adolescent development specifically geared toward those applying the information in the helping professions. The intended audience for the book is helping professionals such as psychologists, mental health counselors, social workers, marriage and family therapists, educators, and nurses. The book covers adolescent developmental theories that provide a basis for understanding observations about the nature of adolescents. These theories include the intrapsychic, cognitive, behavioral/environmental, and biological theories. Puberty is also the signal indicating the beginning of physical and neurological growth. The hormonal changes of puberty initiate drastic growth in the body and organs of adolescents. The book reviews several aspects of overall adolescent health, including the issue of adolescent sleep and its importance and how adolescent diet and nutrition impact development. In addition to the “hardware” transformation in an adolescent’s brain, adolescents undergo important changes in their ability to think. The book also examines Piaget’s adolescent stage of cognitive development, the formal operational stage, and how changes in the way adolescents think impact their interactions with others. It introduces the multiple social changes with family and friends that occur during adolescence and examines how adolescents interact with TV, media, and technology and deals with the issue of cyberbullying and reviews the most common adolescent problems, such as drug use, risky behaviors, eating issues, and depression. Each chapter integrates several features to guide helping professionals in applying adolescent development in practice.
This chapter provides a theoretical background for Medical Family Therapy (MedFT) as the systemic approach to integrated care as well as unique considerations for supervision in the integrated care settings where MedFTs typically practice. It consists case example to offers a frame and illustration for the application of this important approach. MedFTs master the elements of a traditional mental health intake to assess any psychopathology, history of past treatments, use of medications, family and social history, and relational dynamics that influence the exacerbation or maintenance of individual, relational, and/or health problems. In integrated care settings, a course of treatment typically unfolds episodically because the patients and their family members will have onsite access to return to psychotherapy when the need arises again. For most MedFTs, clinical care and supervision occur in an integrated health care setting.
Conduct disorder in childhood and adolescence is considered to be a significant mental health concern because of its connection to numerous other social, emotional, and academic outcomes, both in terms of concurrent and future functioning. This chapter focuses on the examination and explanation of the treatment strategies for the conduct disorder. There are four main groupings of behavior for conduct disorder: aggressive conduct, nonaggressive conduct, deceitfulness or theft, and serious rule violations. The chapter examines the role of genetic, neurological, and environmental factors implicated in the development of conduct disorder. Psychosocial treatment programs such as multisystemic therapy (MST), functional family therapy (FFT), and multidimensional treatment foster care that combine parental management training (PMT), structural family therapies, and skill-building appear to have a moderate to large-effect size in reducing aggression and symptoms of conduct disorder.
School absenteeism refers to physical absence from school, but school refusal behavior refers more broadly to child-motivated refusal to attend school. This chapter focuses on child-motivated school refusal behavior. Youth with school refusal behavior evince substantial heterogeneity in behavioral characteristics or symptoms. This population is notably high in internalizing behavioral problems, such as general and social anxiety, fear, worry, depression, self-consciousness, fatigue, and somatic complaints. Interventions for school refusal behavior can be arranged along a multitiered system similar to a Response to Intervention (RtI) model. RtI involves problem-solving-based interventions that focus on prevention, early intervention for emerging cases, and intense intervention for severe cases. The chapter contains a step-by-step process for several evidence-based interventions that address school refusal behavior in youth, including child-based therapy that focuses on anxiety management, parent- and family-based therapy that focuses on contingency management, and a broader approach that incorporates school personnel and other professionals.
- Go to chapter: Evidence-Based Interventions for Separation Anxiety Disorder in Children and Adolescents
Anxiety disorders are the most common mental health conditions to impact school-aged children. A particular diagnostic subtype termed “separation anxiety disorder” accounts for the majority of referrals seen within child and adolescent psychological service delivery systems including schools. The developmental connection between childhood separation anxiety disorder and adolescent/ adult panic disorder has also been well documented in the literature. Associated features of separation anxiety include parent-child dysfunction, school attendance difficulties, and challenges to social functioning. Biological and environmental factors play a role in the development of separation anxiety disorder. Evidence-based interventions for children and adolescents with separation anxiety disorder include cognitive behavioral therapy (CBT), family therapy, pharmacological treatments, or a combination of these biopsychosocial therapies. Parental behaviors and parenting style are associated with increased risk for childhood anxiety, including separation anxiety disorder.
This chapter explores how pastoral counselors might work with queer-identified persons. It reviews theories of sexual orientation and literature establishing gay/lesbian-affirming approaches to pastoral counseling. The chapter considers emerging theories regarding “queer” identities and how such identities are related to prevailing constructs of gender and sexuality in psychotherapeutic discourses. Pastoral counselors working with queer-identified persons especially in couples and family therapy are challenged to critically reflect on and intentionally deconstruct the ways in which dominant discourses of gender and sexuality have become embedded in operative psychotherapeutic approaches. It is critically important for queer-affirming pastoral counselors to clearly identify the theological, scientific, psychological, anthropological, and sociological conclusions about human sexuality because each of these assumptions shapes the clinical practice. Pastoral counselors are encouraged to seek continuing education and specialized training before working with persons who are transgender, especially those who are actively seeking gender transition.
This chapter presents cognitive behavioral therapy (CBT)-based techniques specifically for practicum and internship students and other trainee clinicians. Problem solving is another staple of CBT. The methodology for problem solving is a little bit different if it is done with an individual kid or in a family session. In research looking at what mediates benefits in family therapy, communications training and problem solving come out on top. This is a monstrously helpful technique. And it saves individuals and families all kinds of time and distress. The author appreciates that a mental health professional (MHP) gets extra data and can also try to be helpful with a wider range of problems that could be affecting the identified child client. The factors to be considered to introduce communications training and problem solving in a family or an individual session are: age, maturity level, and psychological mindedness of the child.
One of the most widely known, researched, and disseminated therapeutic interventions for traumatized children and adolescents is trauma-focused cognitive behavioral therapy (TF-CBT). The TF-CBT model being implemented today began when several clinical researchers combined their similar trauma-focused interventions into a single model with the most efficacious components. The new model combined well-established cognitive behavioral, learning, and family therapy theory and techniques with emerging research on childhood posttraumatic stress disorder (PTSD), neuroscience, and child development. The result was a relatively short-term, manualized intervention that included both the child and the nonoffending caregiver in the treatment process and could be implemented in a wide variety of settings. TF-CBT contains specific goals for the child and the nonoffending caregiver. TF-CBT caregiver goals include helping nonoffending caregivers cope effectively with their own emotional distress while supporting their child’s recovery.
Concerns over the increasing prevalence and severity of children’s mental health issues have led to calls for interventions that focus on the family. In a report of the Surgeon General’s Conference on Children’s Mental Health, the United States’ national action agenda included the development of cost-effective, empirically validated prevention and intervention strategies that engage families. Similarly, during a Surgeon General’s workshop on the prevention of child abuse, speakers declared a need for age-appropriate, family-centered, and culturally competent services and reached a consensus that educating parents early is essential in the prevention of child maltreatment. A form of filial therapy, child parent relationship training (CPRT) teaches parents to use child-centered play therapy (CCPT) skills with their children. Based on attachment theory, CPRT espouses that a secure bond between parent and child is mandatory for children’s healthy development.
This book provides a comprehensive model for effectively blending the two main postmodern brief therapy approaches: solution focused and narrative therapies. It harnesses the power of both models the strengths-based, problem-solving approach of solution focused therapy (SFT) and the value-honoring and re-descriptive approach of narrative therapy to offer brief, effective help to clients that builds on their strengths and abilities to envision and craft preferred outcomes. The book provides an overview of the history of both models and outlines their differences, similarities, limitations, and strengths. It then demonstrates how to blend these two approaches in working with such issues as trauma, addictions, grief, relationship issues, family therapy, and mood issues. Each concern is illustrated using a case study from practice that focuses on individual adults, adolescents, children, or families. Sample client dialogues and forms are included to help the clinician guide clients in practice. SFT has provided therapists with new tools for working with clients who are dealing with substance abuse. The book provides a summary of research findings that have shown the effectiveness of the solution focused approach over the problem-focused approach. The narrative model invites clients to construct a new presentation in a problematic story (narrative) and develop a script for a preferred future (solution focused), with a newly crafted character, instigating new strategies for actions (solution focused), based on exceptions.
Working with families can be helpful for promoting long lasting change in individuals, as it provides the therapist with a glance at the system in which the problematic behavior emerged. This chapter focuses on working with families as an efficient method of creating long lasting change in individuals and in the systemic interactions of a family. It reviews the cases that are seen in private practice and in many agencies today, therapists are incorporating family therapy into treatment plans. The contribution of Shannon Semersky, a Licensed Marriage and Family Therapist, demonstrates the applicability of Virginia Satir’s family sculpting within a solution focused framework. The chapter shows how using the SFNT approach helps couples reconnect with the times when they met and felt attractive to each other, thus, introducing a lens through which even the most distressed couples are able to view who they were and who they could be.
This chapter reviews the evolution of internet gaming addiction and how it has impacted adolescents and children. It outlines how online gaming provides a medium for youth to indulge in gaming as a form of mental escape. The chapter also describes signs of internet gaming addiction, reasons that gaming is especially addictive, and how to apply brief strategic family therapy (BSFT) to treat adolescents and children addicted to games. This chapter reviews diagnostic and treatment considerations associated with Internet gaming addiction among children and adolescents. BSFT is a short-term, problem-focused therapeutic intervention, targeting children and adolescents 6 to 17 years old, which improves youth behavior by eliminating or reducing maladaptive internet use and its associated behavior problems and changes the family members behaviors that are linked to both risk and protective factors related to online use. This model can also be applied to internet gaming addiction among adolescents and children.
Most families exist in some type of homeostatic balance, and the loss of a significant person in the family group can unbalance this homeostasis and cause the family to feel pain and to seek help. Specific factors that affect the mourning process and influence the degree of family disruption have been identified. These include stages in the family life cycle; roles played by the deceased; power, affection, and communication patterns; and sociocultural factors. This chapter discusses how family dynamics can hinder adequate grieving. The concept of family therapy is based on the belief that the family is an interactional unit in which all members influence each other. The characteristics of individual family members help determine the character of the family system, but this family system is more than the sum of its individuals’ characteristics.
This chapter describes the Family, Integrated Treatment, Social Connection–Internet Addiction (FITSC-IATM) approach as an intensive, community-based, integrated approach to the treatment of adolescent Internet addiction. FITSC-IA assesses and treats adolescents in the context of their functioning within their families and social systems in order to implement real-time intervention and treatment approaches to stabilize the addictive behaviors and common co-occurring diagnoses, such as social anxiety and depression. The chapter discusses clinical assessment, parenting style and integrated treatment approach. It describes key components of the family agreement, including setting expectations, negotiation meeting, and agreement active period. Harm reduction and abstinence approach are also applicable in the treatment of Internet addiction. The chapter also describes social recovery and effective treatment approaches such as cognitive behavioral therapy, exposure therapy, community-based support groups, motivational interviewing, transition, and technology reintroduction plan in the treatment of adolescent Internet addiction.
One of the most promising implementations of eye movement desensitization and reprocessing (
EMDR) therapy is within primary addiction treatment settings as a primary psychotherapy. Mindfulness and EMDRTreatment Template for Agencies ( MET(T)A) Protocol accomplishes this by training all the clinicians in EMDRtherapy and mindfulness and all other staff in the principles and application of mindfulness-based trauma-focused care. MET(T)A Protocol centers use the eight-phase protocol and the Adaptive Information Processing Model as the template for all that occurs at a treatment center, from individual, group, and family therapy to operations management, to admissions and intake, all the way to discharge planning and long-term recovery assistance. MET(T)A Protocol is just one of the ways that EMDRtherapy is being brought further into the mainstream and in some instances to the very center of addiction care.
Rehabilitation counseling, based on trait-factor philosophy and grounded in the psychomedical paradigm, was a conglomeration of methods that were used to assess and to treat clients. Family relationships and family dynamics plays a major role in the rehabilitation process and rehabilitation outcomes. This chapter describes the influence of relational factors in the rehabilitation process, and focuses primarily on the effect of disability from the perspective of the family. Debilitating progressive diseases or serious permanent loss of function are some of the most difficult situations for families to face. A family practice model involves the counselor anticipating, planning, and participating in full family involvement in the rehabilitation process. Rehabilitation counselors (RCs) should be educated about social systems theory and family therapy. Although cross-training in family therapy would be ideal, RCs must at least be willing to obtain continuing education and appropriate training to identify relationship factors impinging the rehabilitation process.
This book brings together the work of experts from a variety of fields such as adult development, adult education, family science, family therapy and counseling, gerontology, psychology, social work, and sociology. It is organized into four sections, each of which contains chapters reflecting a given theme as it pertains to grandparenting. Section one explores the breadth of the grandparent role from multiple theoretical perspectives, explores both quantitative and qualitative research methodologies in the study of grandparenting. It examines cohort effects and emphasizes the multigenerational developmental contexts in which grandparents and grandchildren are situated. In addition, it presents variations on grandparenting: grandfathers, great-grandparenting, and step-grandparents. Section two focuses on the diversity among grandparents, examining such issues as variations in sexual orientation in such persons, grandparents who are raising their grandchildren, and changing gender roles among grandparents. Section three examines the difficulties and challenges that grandparents face in enacting their roles as well as the resources and strengths they bring to bear. It discusses the impact of having to cope with both acute and chronic illness on intergenerational relationships, the design and implementation of interventions to positively affect emotional functioning. It discusses the clinical case study approaches to helping grandparents, resilience and resourcefulness in the face of stress. Section four emphasizes the societal and cultural aspects of grandparenting, exploring issues of race and ethnicity, grandparent education, global grandparenting, and many dimensions of social policy as they relate to grandparents. The last chapter pulls the material together in presenting a multidimensional, multileveled, and dynamic picture of grandparenting stressing the influence of evolving historical and interpersonal contexts on such persons and their grandchildren. It also offers suggestions for future research over the next two decades.
This chapter presents a case study of a 9-year-old Caucasian child who lived with his paternal grandparents in a small rural community. The patient attended a local private school where he received individualized education accommodations based on school-level evaluations, asserting that his learning is being impacted by behavioral deficits. Media outlets also played a large role in his life as he reportedly spent a large amount of his formative years locked inside of his bedroom with a television and video games. According to Erikson’s theory of psychosocial development, at 9 years of age the patient was in the industry versus inferiority stage of development. Based on his developmental level and age, the author used a child-centered play therapy modality to facilitate the therapeutic process. Based on his grandmother’s report of the patient’s behavior, he developed some of the skills needed for treatment to be considered successful.
This chapter focuses on the clinical treatment of four impaired grandfamilies in rural areas. The approach and experience are similar to grandfamilies in urban areas, especially inner cities, but their social/economic situation may be more desperate and culturally enhanced, and with few resources. The first case study involves the treatment of a child from a toddler through his adolescent years the lens is on resilience. The second one looks at grandfamilies from a family systems approach. The third explores the impact of early trauma and transgenerational influences on the adult children and grandchildren. The fourth case study examines the role of the judicial system and the need for clinicians to advocate in the courts on behalf of grandfamilies. In all four of the cases, the chapter implements a holistic, but personalized, approach to mitigate the negative impact of substance- and alcohol-use disorders, family abuse, transgenerational effects, and cultural influences.
Cognitive behavioral family therapy (CBFT) involves assisting clients with changing their self-defeating or irrational beliefs to change their feelings and behaviors. It assumes that family relationships, cognitions, behaviors, and emotions have a mutual influence on one another; cognitive inference evokes emotion and behavior; and emotion and behavior can influence cognition. When this cycle occurs among family members, dysfunctional cognitions, behaviors, or emotions can result in conflict. CBFT includes the family members who are needed to help bring about change in the family. This chapter takes a close look at how cognitive behavioral therapy (CBT) and other behavioral therapies developed. The CBFT template is meant to be used as a guideline to learning the process of CBT with families. The template provides the beginning therapist with steps to take and questions to ask that promote collaboration between the therapist and the client.
There is a natural hierarchy within most families, with parents and primary caregivers as leaders. When the family hierarchy is unbalanced, serious problems arise. It is the strategic family therapist's job to realign the family by teaching parents and primary caregivers how to lead. Once the natural balance and order in the family is achieved, problems dissipate. Strategic therapists took the concept of the positive feedback loop and made it central to their model. Strategic family therapists believe that to change family organizational patterns and therefore alleviate the identified problem, the routine in which the clients communicate with one another must be altered. This chapter discusses the tools therapist may use: directives, prescribing the symptom, unbalancing, therapeutic double bind, reframing, restraining, and using metaphors throughout the session to assist the family or individual to make changes in their lives.
Symbolic-experiential family therapy focuses on here-and-now experiences, playfulness, humor, intuition, craziness, spontaneity, and personal growth. As with other therapies, the goal is to get the client "unstuck". Unlike other therapies, symbolic-experiential therapy achieves this by creating a different experience in the current moment rather than dissecting the past or projecting forward into the future. The main goal of the theory is not to provide insight, but rather to focus on experiencing the process of therapy to produce change in the family. There are four stages to symbolic-experiential therapy, beginning with the initial phone call. Because the stages are not meant to flow in a linear direction throughout therapy, it is common for clients to move back and forth between stages throughout the course of treatment. It encourages each family member to reveal deep emotions and engage in deep conversations that otherwise might not occur.
Solution-focused therapy (SFT) is a future-focused, postmodern approach to psychotherapy that is based on how the therapist and client co-construct language in order to shift the conversation from a focus on problems to a focus on solutions. In SFT, it is not essential to know the source of the problem in order to help the client create a solution. The assumption in SFT is that a small change will produce larger change. Therefore, the goal is to solve the problem by making small changes. SFT takes a distinctly postmodern approach, focusing on developing a preferred future. While the preferred future is the focus, there are opportunities, once the preferred future is defined, to explore past experiences in the form of exception gathering. Seeking exceptions with family members once the preferred future is defined empowers individuals to notice the strength within themselves and their family members.
Contextual therapy originated from the work of Ivan Boszormenyi-Nagy, who was a prominent pioneer in the family therapy movement. Contextual therapy has not been as popular with training therapists in recent decades. The waning in popularity is not because the theory is not effective or robust, but the theory and approach has been criticized for being possibly too intellectual. This chapter attempts to provide historical information on the development of contextual family therapy and the recent evolution of the model as it pertains to restoration therapy. It discusses the concepts of contextual family therapy: entitlement; loyalty; parentification; revolving slate; and ledger of merits. The contextual therapy approach is historically an integrative process of four dimensions of reality: facts, individual psychology, systemic interactions, and relational ethics. The main conceptualization of the contextual family therapy is that the present dynamic is typically a continuation of past loyalties, injustices, and entitlements.
This chapter presents the strengths and limitations of the Milan model. The Milan model has been helpful for working with difficult and severely disturbed families, including family members with anorexia or schizophrenia. The Milan model was among the first to teach therapists to think systemically, even conceptualizing the therapist as part of the evolving system. Uniquely, the Milan model makes use of reliance on the team behind the mirror, positive connotation, the use of prescription or ritual at the end of the session, and the 1-month gap between sessions. The Milan systemic family therapy template is meant to be used as a guideline to learning the process of Milan systemic family therapy. The template provides the beginning therapist with steps to take and questions to ask that promote collaboration between the therapist and the client.
Murray Bowen and his family systems theory was a new and innovative way of conceptualizing human behavior. One of the founding fathers of the family movement, Bowen developed a theory of human functioning that conceptualizes the inherent potential of humans for growth and change. Bowen's contributions permanently altered our way of thinking about humans in the same way Darwin altered the landscape of evolution. The Bowen family systems template is meant to be used as a guideline to learning the process of Bowen family systems therapy. The template provides the beginning therapist with a review of steps to take and questions to ask that promote collaboration between the therapist and client. This chapter briefly discusses eight interlocking concepts of Bowen family systems theory. The concepts include: differentiation of self; triangles; nuclear family emotional system; family projection process; multigenerational transmission process; sibling position; emotional cutoff; and societal emotional process.
The chapter discusses elements of Afrocentricity; pointing out that Afrocentric scholars de-emphasize the marginalization of people of African ancestry and place them at the center of all discourses. It focuses on the need to contextualize a treatment framework that encompasses the confluence of a family’s idiosyncratic processes and the Nguza Saba, the seven principles of Kwanzaa. The chapter explores how an Afrocentric perspective can be used in family treatment with African Americans, and focuses on how the construct of intersectionality can be used to contextualize the lives of this group. It provides an overview of slavery, highlighting the multiple ways in which families have been affected. Slave trauma syndrome and posttraumatic slave syndrome are two relatively new constructs that are receiving attention from social scientists who have argued that the horrendous acts of physical and psychological violence perpetrated under the institution of slavery have culminated in psychic trauma.
In the field of family therapy, there is a need for working with families struggling with medical problems. The collaboration of both medicine and psychology in addressing the particular familial and individual issues that occur in dealing with illness have led to the medical family therapy (MedFT) model. MedFT represents a meta framework that encompasses overarching principles within which any mode of psychotherapy can be practiced. What sets MedFT apart from other family therapy theories is the routine collaboration with medical professionals as well as seeing illness as part of the systems. Collaboration is a primary aspect; medical family therapists need to have an understanding of the medical system to embrace a multidisciplinary team approach with physicians and other healthcare providers. The hope is that the MedFT therapist will aid the family, along with the medical staff, traverse illness and journey united together in coping with the effects of illness.
Social work practice requires a full understanding of people in all contexts. Romantic partnerships are an important aspect of many client’s lives and social worker practitioners should be knowledgeable on how to work within this context. This chapter discusses theories and interventions that help inform social work practitioners when working with couples. With an estimated 50% of all relationships ending in divorce and the documented negative impact of divorce on the family, the necessity for social workers to have at minimum precursory idea of couples theory and interventions is high. With many approaches to couples counseling available, this chapter focuses on the most widely used current approaches as well as discusses some of the newly emerging models. This chapter explores attachment theory, sound relationship house theory, Imago theory, transgenerational theory, and structural theory as related to couples counseling. Case studies are provided to give contextual glimpses into these theories’ use in practice. The chapter also seeks to describe the role of couples’ work in the context of the generalist-eclectic framework and its alignment with the National Association of Social Workers Code of Ethics (2018). It is of the utmost importance, both academically and ethically, that social work practitioners maintain competence in the area of couples work as romantic relationships comprise an important portion of many clients’ lives.
Cognitive behavioral theory (
CBT) and treatment has evolved over three phases: (a) behavioral principles of human behavior, (b) cognitive constructs and cognitive mediation, and (c) mindfulness including acceptance and commitment. The principles are firmly based in evidence-informed and evidence-based practice. The concepts describe how behavior and cognitions are learned and how they can be changed. CBTprinciples provide practitioners with effective interventions for a variety of issues such as child and adult development, cognitive processing, as well as addressing problematic behavioral and mental health issues.
Becoming a family therapist involves more than reading and understanding theory. It takes drawing a genogram, listening intently for client language and goals, and stepping into a system that will teach us how it operates. It takes choosing a family therapy model that feels right to us and embraces our view of how families work. This chapter briefly discusses the practice of marriage and family therapy. It explains some basic tenets of family therapy that may be helpful to the new family therapy student who desires to understand the process of thinking and acting systemically. The chapter provides more excerpts from the king's family therapy session to explain the tenets of family therapy in the most understandable manner. Tread softly into family territories and do so with curiosity and understanding. Families will welcome the family therapist who empathizes and shares their concern, and then gently guides them toward change.
The professional code of ethics governing marriage and family therapy was developed by the American Association for Marriage and Family Therapy (AAMFT). This chapter provides the reader with background on common ethical issues—such as client confidentiality, informed consent, record keeping, technology, dual relationships, treating minors, and termination—and their applications in family therapy. In couple or family therapy, it is up to the therapist's discretion whether he or she would like to keep issues disclosed by each family member individually confidential, however, the individual must be told the therapist's decision to be discreet or not before engaging in therapy. Some therapists take the stance that confidentiality does not apply between couples and family members when seen for individual sessions. The chapter concludes with a case study of an ethical complaint and interviews with two therapists known for their work and interest in ethical issues.
Family therapy is often the most value-conflicted and ethically challenging of therapies because family therapy often evokes strong countertransference of feelings in the practitioner. Although professionals may not have had the same experiences as their individual clients, almost all family therapists share a similar experience with their clients as the former have also grown up in families. This concluding chapter discusses the ethical issues and future directions of family therapy. It briefly describes how the new edition of this book integrates new research and understandings related to family therapy. In this book, there are four new chapters written by psychologists, which address important emerging issues in family therapy such as multiracial families. Furthermore, it adopts an intersectional approach to deepen the understanding of families from diverse backgrounds, a most necessary and important consideration, as the number and combination of cultures expand. The culturagram, which is a family assessment tool, has been expanded to include this intersectional approach.
Informed by the tenets of the ecological perspective and the life model of social work practice, this chapter presents an overview of clinical practice with Hispanic families. The ecological perspective helps to promote clinicians’ understanding of the psychosocial problems experienced by culturally diverse client populations as well as the socio-environmental variables (e.g., racism, discrimination, poverty) that impede optimal physical, psychological, and social well-being. Because the process of individual or family treatment cannot separate personality structures and issues from the cultural factors that influence the emotional health of the individual, the chapter also underscores the key cultural characteristics of Hispanic individuals and families and their relevance for culturally competent clinical practice. It emphasizes treatment recommendations and strategies for effective psychosocial intervention with Hispanic families.
This chapter highlights the systemic practices of supervision. This process of "live supervision", unique to systemic supervision, made use of an observing treatment team and a one-way mirror. The incorporation of these components provided the opportunity for seamless observation of counseling sessions and instant supervisory feedback, which shaped the concurrent counseling session. The process of live supervision additionally provided increased support during times of therapeutic crises through "in vivo" interactions between supervisory observers, the clinical trainee, and the client(s). Although counseling and supervision are distinctly different interventions, they may appear similar in practice to the untrained eye due to a shared emphasis on the interpersonal relationship, provision of feedback, acquisition of knowledge and skills, and the desire to engender hope. The current body of research champions the use of a common factors approach to supervision, synthesizing commonalities of a variety of efficacious counseling and supervision models into a comprehensive whole.
This chapter introduces an approach that is unique to counseling theory, based on its focus on solutions rather than problems. It gives an example of a model that is based on social constructivism philosophy. Solution-Focused Brief Therapy (SFBT) represents a significant break with the underlying philosophy at the core of traditional psychologically oriented psychotherapy approaches. It also represents a unique philosophy that extends beyond that of classic social systems theory, which is at the base of the classic family therapy approaches. The goal of SFBT is the replacement of symptomatic or problem behaviors with functional and wanted healthy behaviors. SFBT can be accomplished as an individual psychotherapy, as couple counseling, or as family therapy. Research is beginning to show that SFBT has great potential and is a viable, efficient, and effective approach to treating mental health issues.
Solution-focused therapy, also called solution-focused brief therapy and solution-oriented therapy, is a short-term, strengths-oriented practice model that identifies and enhances clients’ resources for coping with life’s difficulties. This chapter provides a brief overview of solution-focused practice, the historical development behind the model’s formulation by de Shazer and associates, and the phases of the helping process, including some of the key theoretical constructs. Its compatibility with a generalist-eclectic framework is then explored, along with a critique of the model. Finally, a case example of solution-focused therapy with a young woman suffering from social anxiety is presented.
This chapter introduces a systemic-relational therapy that focuses on family structure. It provides a biographical summary of Salvador Minuchin, the founder and proponent of Structural Family Therapy. The chapter outlines the basic theory of the structural approach and provides guidance on application of the theory. Structural family therapy is unique among the systemic-relational therapies because of its emphasis on the structure of families as a focus of study and as a target of intervention. Minuchin worked from the assumption that individuals are not bound by mentality into set ways of reacting; rather, he views the individual as an “acting and reacting member of social groups”. Minuchin believed that the therapist must take a leadership role as he or she joins the family in therapy. Minuchin’s Structural Family Therapy has emerged as a major player among the predominant family counseling theories.
Emotionally focused therapy (EFT) is based on attachment theory and uses elements of experiential-humanistic approach and systems theory. Its work has primarily been used with couples, and it is applicable to family therapy. EFT is aimed at reducing stress and anxiety in adult relationships and creating (or recreating) more secure attachment bonds. EFT presents, as a theoretical basis, that therapy needs to engage the "real relationship of the inner psychological world of both partners to their interaction" and the contextual relationship as also a basis of each person's behavior in relationship to his or her intrapsychic experience. The EFT template is meant to be used as a guideline to learning the process of emotionally focused family therapy. The template provides the beginning therapist with steps to take and questions to ask that promote collaboration between the therapist and client.
This chapter provides a history of research in Marriage and Family Therapy (MFT) and explores the future of such research. It presents philosophical frameworks for research methodology and explains methodologies as well as research techniques. The chapter then provides practical knowledge for those interested in doing research, and discusses current research that is impacting the field. It discusses in more detail about quantitative and qualitative research methodologies and definitions. Current MFT research has made great strides particularly in improving assessment tools. Historically, MFT has had difficulty producing empirically based research as a result of its systemic approach to therapy. Unlike linear measurement, systemic measurement requires highly sophisticated statistical methods that can measure multiperson, multilevel, and multicontext over multiple time points with an extended follow-up assessment. Many gains have been made to develop such assessment tools.
This chapter talks about Phase I of the family systems trauma (FST) treatment model: Identify Symptoms (Stressors) and Set the Goals for Therapy. The main goals and objectives of Phase I are to (a) identify the child’s or adolescent’s problem symptom through an FST technique known as a stress/symptom chart; (b) use what is called a seed/tree diagram to illustrate the causes of the child’s or adolescent’s symptoms through what are called unhealthy undercurrents and four toxic seeds (c) ask all family members to pick their top problem symptoms and toxic seeds that they want to address with rationale; and (d) set the goals of therapy. The chapter provides case example illustrating six key mini-steps in Phase I: the symptom/stress chart; the seed/tree diagram; the top seed and symptom selections; the choice between stabilization and direct trauma work first; setting the goals of therapy; and consolidate gains using ethnographic interviews.
This book provides brief overviews of various models, including their history, views of change, views of the family, and the role of the therapist. The models include: Bowen family systems theory; contextual family therapy and restoration therapy; cognitive behavioral family therapy models; rational emotive behavior therapy; symbolic-experiential family therapy; Satir human validation process model; Milan systemic family therapy; structural family therapy; strategic family therapy; solution-focused therapy with families; solution-focused narrative therapy with families; narrative therapy with families; emotionally focused therapy; and medical family therapy. The book covers each model in a consistent way, so that the reader can better understand the underlying theories and practical distinctions between them. It explains how the cognitive behavioral therapist (CBT) differs from the solution-focused therapist (SFT) in the way of being direct and prescriptive with clients (CBT) rather than letting the client decide the direction of therapy (SFT). The book also explains how restoration therapy simplifies the contextual therapy model yet stays with the premises that clients need to understand the depth and breadth of their pain. Each chapter contains realistic examples of family problems, typical of today's families—many drawn from actual practice, which shows one how that particular model addresses issues that are commonly faced by practicing marriage and family therapists. To encourage the reader further, there are extensive interviews with many of the gurus responsible for creating and honing the theories one will read about in this book. They shared their ideas on how change occurs, how they set goals, and how they actually do therapy. Additionally, a case study is presented to each master therapist within these pages.