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Symbolic-Experiential Family Therapy: A brief Introduction

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Mark Smith

on 4 November 2013

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Transcript of Symbolic-Experiential Family Therapy: A brief Introduction

Symbolic-Experiential Family Therapy: A brief Introduction
Description of Model
Approach initiated by Carl Whitaker in 1953 and focuses on changing interactions and patterns through the growth process, rather than utilizing medications to create change as in psychiatric approaches
Not your typical theoretical approach to therapy; therapists encouraged to be authentic and spontaneous (Gehart & Tuttle, 2003)
Description of Model (cont.)
Focus of treatment is growth of a client family, not resolution of a presenting problem
Often performed by 2 co-therapists: one providing support and one being confrontational (Gehart & Tuttle, 2003)
Typical duration of therapy: 6 months-2 years
Description of Model (cont.)
Therapy includes entire client family of origin, not subsets of family subsystems or individual family members
Typical Symbolic-Experiential Treatment Plan (Gehart & Tuttle, 2003)
Early Phase Goals
1. Provide safe environment, join family system, discuss presenting problems.

Likely interventions include:
Engaging family as "real" person
Battle for structure
Encourage participation and attendance of all family members
Use spontaneity and humor
Invite co-therapist when appropriate
Symbolic-Experiential Treatment Plan (cont.)
2. Gain info about family system's level of conflict, roles, boundaries, coalitions, and empathy- "trial of labor" (Whitaker & Keith, 1981)

Likely interventions include:
Actively listen and involve all family members
Utilize affective confrontation
Assess shells of context
Explore competencies
Identify levels of conflict
Identify role rigidity
Symbolic-Experiential Treatment Plan (cont.)
Assess level of parental empathy and pseudomutuality (Roberto, 1991)
Assess for disorganized boundaries

3. Establish goals and further strengthen the family initiative

Likely interventions include:
Family needs to win battle for initiative, allowing family system to determine pace and course of therapy (Napier & Whitaker, 1978)
Challenging family to determine session's agenda
Symbolic-Experiential Treatment Plan (cont.)
Engage family in fantasy alternatives to potentially identify "what if ..." situations (Whitaker & Malone, 1953)
Middle-Phase Goals
Mark N. Smith
1. Develop sense of cohesion with nuclear family, family of origin, and extended family (shells of context) in order to assist in relieving presenting symptoms.
Symbolic-Experiential treatment plan (cont.)
Likely Interventions include:

Redefine symptoms as steps toward potential growth
Use affective confrontation and encourage positive anxiety
Interact spontaneously with the family and use "craziness" (Roberto, 1991)
Address unacknowledged issues and feelings by utilizing affective intensity
Present fantasy alternatives to problems (Whitaker & Malone, 1953)
Expand distress and fights to include all family members (Whitaker & Keith, 1981)
Role-play a problem issue to call the family's "bluff"
Symbolic-Experiential treatment plan (cont.)
Dialogue with absent family members using empty chair
2. Create and maintain appropriate boundaries between generations in the family.
Likely Interventions include:

Highlight coalitions by presenting affective confrontation statements (Gehart & Tuttle, 2003)
Point out delegated child roles and role rigidity
Encourage parents to communicate with each other directly
Help the family see the absurdity of their interactional patterns by using humor, metaphors, and craziness
Symbolic-Experiential treatment plan (cont.)
Seize the moments in a session to highlight inappropriate boundaries
Late-Phase Goals
1. Promote individual growth through the achievement of developmental tasks

Likely interventions include:

Maintain total/real person in order to encourage each of the family members to do so
Use fantasy alternatives to explore "what if ..." situations to identify new options for feeling, thinking, and responding
Symbolic-Experiential treatment plan (cont.)
Seperate intrapersonal and interpersonal stress to promote an increase in individuation
Activate constructive (positive) anxiety in order to encourage addressing developmental tasks
2. Highlight the accomplishment of goals and completion of developmental tasks while addressing the relief of symptoms
Likely interventions include:

Allow each member of the family to express their feelings about their individual experience in the therapy
Symbolic-Experiential treatment plan (cont.)
Encourage each member of the family to acknowledge family and self growth
Role-play current and future scenarios with the family and discuss the potential implications
Discuss and redefine the problem in the family to reflect growth and potential change
Attempt to identify possible blocks to future growth potential of the family and its members
Potential advantages of symbolic-experiential family therapy as an alternative to psychiatry and drug therapy
Working with a family in group therapy versus psychiatric therapy with an identified patient alone provides the opportunity for therapists to affect real change to the family system, in turn, affecting change to presenting symptoms and problems
While psychiatric therapy can continue indeterminably for a client's entire lifetime potentially, this approach to therapy typically lasts in duration from 6 months to 2 years in duration of sessions
Family therapy provides an alternative to drug therapies, which focus on changing neurological patterns within the brain
Potential advantages of symbolic-experiential family therapy as an alternative to psychiatry and drug therapy (cont.)
More cost effective for both client and clinic
This approach to therapy would accommodate all diversified families and clients presenting at the clinic for any number of presenting symptoms and problems
References
Gehart, D. R., & Tuttle, A. R. (2003) Theory-based treatment planning for marriage and family therapists: Integrating theory and practice. Pacific Grove, CA: Brooks/Cole/Thomson. ISBN: 9780534536169
Whitaker, C. A., & Keith, D.V. (1981). Symbolic-experiential family therapy. In A. S. Gurman, & D. P. Kniskern (Eds.), Handbook of Family Therapy (pp. 187-224). New York: Brunner/Mazel.
Roberto, L.G. (1991). Symbolic-experiential family therapy. In A. S. Gurman, & D. P. Kniskern (Eds.), Handbook of Family Therapy, volume 2 (pp. 444-476). New York: Brunner/Mazel.
Napier, A. Y., & Whitaker, C. (1978). The family crucible: The intense experience of family therapy. New York: Harper.
Whitaker, C. A., & Malone, T. P. (1953). The roots of psychotherapy. New York: Blakiston.
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