© 2007 thomson brooks/cole, a division of thomson learning chapter 6: family counseling chapter 7:...

© 2007 Thomson Brooks/Cole, a division of Thomson Learning

Chapter 6: Family CounselingChapter 7: Group WorkChapter 8: Consultation and Supervision

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Couples and Family Counseling

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1800s: Charity Organization Societies and “Friendly Visitors” worked with poor family Led to “social casework” –first time people were

viewed systemically Also, around same time, Alfred Adler began to see

families and believed education could help alleviate problems in children

Until 1940s, families were generally not seen together due to pressure placed on therapist from the developing “individual approaches” to counseling

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A number of approaches developed around the 1950s: Psychodyanmic: Ackerman; Boszormeyi-Nagy Multigenerational: Bowen Palo Alto: Bateson hired Haley, Weakland, Jackson, & Fry

Looked at communication in systems Double-bind theory Applied principles of systems and cybernetics

Out of Palo Alto came MRI Jackson, Haley, Satir, Madanes Focused on communication and family process

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Soon, people developed own theories Satir: Human validation process model Haley and Madanes: Strategic therapy Whitaker: Experiential approach Minuchin: Structural family therapy 1966: within MRI: Brief Family Therapy Center

Eventually led to solution-focused family therapy 1970s: Milan Group More recently: Narrative family therapy (White and

Epston)

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Today Over 50 states have marriage and family

licensure Two main associations: AAMT and IAMFC (a

division of ACA) Accreditation Bodies

▪ COAMFTE▪ CACREP

Efficacy of family therapy now shown

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Twelve Assumptions Held by Most Family Counselors (see pp. 192-193)

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Bertalanffy Explains the interaction of all types of systems

Suprasystems Subsystems Interaction in one system affects all other

systems

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Cybernetics Control mechanism in systems Regulatory process Used to avoid disequilibrium in systems Acts like thermostat See Box 6.1, p. 195

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Boundaries and Information Flow in Family Systems Healthy system has semi-permeable

boundaries Unhealthy: rigid or diffuse boundaries

(See Box 6.2, p. 196) American culture allows for much variability in

boundaries However, as Box 6.2 shows, too much rigidity

or permeability leads to dysfunction

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Rules and Hierarchy Universal rules Idiosyncratic rules Rules can be overt or covert Rules often related to hierarchical structure

Communication theory Watzlawick and others researched

communication theory See 10 communication tenets, p. 197

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All couples bring unfinished business to relationship Unfinished business can lead to discontent as

couples blame each other for their projected problems

Family members will sometimes focus on one member (rather than own problems)

This takes focus off of self or relationship Families will often bring in the “scapegoat” or IP

and state they “have” the problem

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Stress Stressful contact of one member with extrafamilial forces

(e.g., difficulty at work) Stressful contact of the whole family with extrafamilial

forces (e.g., a natural disaster such as a hurricane) Stress at transitional or developmental points in the

family (e.g., puberty, midlife crises, retirement, aging) Idiosyncratic (situational) stress (e.g., unexpected illness) See Box 6.3

Developmental Issues: See Table 6.1

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Believes that systems theory and cybernetics places too much emphasis on causal factors

Social constructionists believe that couples and families “co-construct” their understanding of who they are

Construction of self occurs through ongoing dialogue and nonverbal interactions among people and broader culture

Change, therefore occurs through conversation with counselor

Together, counselor and clients co-construct a new meaning-making system

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Virginia Satir Humanist, one of the major theorists of 20th century Primary survival triad Four universal communication patterns: placater,

blamer, computer, distracter Congruent, respectful, and caring parents yield healthy

children Two well-known techniques

Complete a family life facto chronology Family Sculpting

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Salvadore Minuchin Interactional and Transactional Rules Boundaries Structure and Hierarchy Some Techniques

Joining Mapping Restructuring

See Box 6.4, p. 203

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Arose out of Palo Alto Group and work of Milton Erickson Theorists: Jay Haley, Cloe Madanes, Milan group Focused on changing communication sequences No focus on feelings (except to help people feel better) Concerned with how power is dispersed in families Focuses mostly on presenting problem Haley's Stages: social, problem, interaction, goal-setting Some techniques

Telling client what to do when (when client will do it) Telling them what to do when knowing client will rebel Giving a metaphor (see quote, bottom of p. 205)

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Boszormenyi-Nagy• Ways of relating passed down• Loyalties, Ledger of indebtedness and

entitlements Murray Bowen

• Differentiation of self• Nuclear family emotional system• Undifferentiated ego mass (we pick people of

same psychological health –see Box 6.5, p. 209)• Family projection system• Individuals get triangulated• Used genograms (see Figure 6.1, p. 208)

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Whitaker Says he has no theory, but see basic tenets (p.

209) I-Thou relationship Become genuine through interactions in therapy See quotes top and middle of page 210

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Robin Skynner and Nathan Ackerman Emphasis: How parents assist children through

developmental stages Problems in each parent reflected through

unconscious Couple explores how behaviors related to their

own childhood Unfinished, unconscious problems become

projected on family

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Focused on symptom relief Highly structured Focus on behaviors and cognitions

Operant conditioning Classical conditioning Social learning (modeling) Changing negative automatic thoughts Integrates how problems get infused in family through the

system A number of common elements in all that do this approach

(see pp. 212)

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Michael White and David Epston Goal: To recreate how family comes to understand

itself Based on postmodernism, social constructivism,

and narrative reasoning Deconstruct past narrative and construct new

ones General guidelines, see p. 213

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Insoo Kim Bert and Steve de Shazer A pragmatic and future-oriented approach Based on social constructionism and post-

modernism Assumes that clients can change quickly Focuses on solutions and use of problem free

language See underlying assumptions, p. 214

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Points to consider when working with couples and families from nondominant groups—see p. 215

Why are professional associations not being inclusive? American Association of Marriage and Family

Counselors International Association of Marriage and Family

Counselors

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Withholding treatment in order to see “whole” family Informed for “whole” family Confidentiality –can you assure it? Multiple (Dual) relationships—seeing a member

individually and in the family? Individual or family counseling—which is better? Professional Associations: AAMFT, IAMFC Accreditation: CACREP; COAMFTE Credentialing: LMFT; NCA Knowing the law: child, spousal, family abuse; custody Insurance fraud: e.g., saying you’re seeing “1” member

in family when you actually see whole family

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Understanding Our Client’s Family, Understanding Our Family To understand others, we need to understand

self We need to examine how our family affected us

and how the impact of our families can affect the people with whom we work

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© 2007 thomson brooks/cole, a division of thomson learning chapter 6: family counseling chapter 7:...

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