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Family Systems Theory

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Cassandra Grieve

on 7 October 2016

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Transcript of Family Systems Theory

By Steph & Cass
Family Systems Theory:
A Brief Outline

Agenda:
Salvador Minuchin's
Structured Family Therapy
Ice Breaker Exercise- Chalkboard Sentences
Video Clip: "A Family is a Family"
Notes
Video Clip: "Dr. Kenneth Hardy"
Notes
Video Clip: "Virginia Satir"
Notes
Sculpting Activity
Notes
Video Clip: "Carl Whitaker"
Notes
Discussion
Qualities of a Healthy Family
In the 1940s to the beginning of the 1950s, therapy was considered most successful when focusing on the individual client apart from the client’s environment and family dynamics. For this reason, clients were treated in isolation, as it was believed that fixing the individual would consequently fix the family system.

The overall shift from this toward a family therapy approach, was prompted by several developments: Alfred Adler’s child guidance movement, small-group dynamics, research on family dynamics, and understanding schizophrenia, and social work practices. This is a key contrast between Psychotherapy and the Family Systems Approach.
The History of Family Systems Theory
Following WW1, Alfred Adler established multiple child guidance clinics, which are considered the earliest forms of family therapy. In these clinics, therapy was approached as an open-forum style discussion with the participation of parents, teachers, and community members.
Postmodernism
Healthy families are on a continuous journey of evolution and adaptation. Healthy families are able to support the family system with resiliency, positivity, appropriate conflict resolution, and realistic planning and goal setting.

Healthy families model:
commitment to the family system and its members, appreciation of one another and of the family system, willingness for regular interactions, good routine and regular communication skills, strong religious or spiritual orientation, effective coping skills and strategies, mutual encouragement, and clearly defined boundaries and roles.
1. The whole rather than the individual parts.

2. Family system context helps to understand the individual, and the social system defines and influences human behavior.

3. Multidirectional cause and effect. Individual changes within a family system will subsequently alter the whole.

4. Nonfunctional family systems are counterintuitively maintained, as homeostasis and stability are naturally sought.

5. Family therapists work at the level of the family system, rather than at the level of the individual to make positive change.
Principles of Family Therapy
"That therapists must examine the family as a system" (Jones-Smith, 2012, pp. 509). Family therapists emphasizes interpersonal relationships, and changing the family system operations and organization to support the evolving needs of the family and its individual members. This view also expands to include the interactions between, and the influences of, the community and the bigger social system.
Major Contributions of Family Therapy
Alfred Adler's Child Guidance Movement:
In 1951, Kurt Lewin concluded, through research on the dynamics within groups, that “a group is more than the sum of its parts” (Jones-Smith, 2012, pp. 509). From this conclusion, therapists began to shift toward understanding the function of the family system, including all of its dynamics, to successfully help the client.
Small Group Dynamics
In the 1950s the Bowen Theory was developed by Murray Bowen, who established a project through the National Institute of Mental Health (NIMH) that utilized the family therapy approach. The focus of this project was to study family systems in which there was an individual with a schizophrenia diagnosis.

Bowen's NIMH project further prompted the Bateson Project, initiated by Gregory Bateson, Don Jackson, and Jay Haley in the 1960s, which narrowed this family systems approach by studying specifically the mother’s role and influence on the development of schizophrenia.
Family Dynamics and Schizophrenia research:
In the 1970s, Salvador Minuchin (1921 -)began using a structured family therapy approach in schools, subsequently becoming one of the leaders of family therapy. Minuchin applied the general systems theory developed by Ludwig von Bertalanffy to his work that emphasized any change in one part of the family system would ultimately change everything else.

Through this theory, Minuchin applied family therapy by deconstructing the homeostasis of a disorganized family structure that he believed to be supporting a particular dysfunction, so that a new and more functional family system that operated upon open communication and appropriate conflict resolution management may be implemented.
Postmodern family therapists generally follow the idea of numerous family system realities within the perceptions of one family, of encouraging objective versus subjective thinking, of regular and habitual communication to create meaning, and attention to contextual influences on issues.

Postmodern approaches also take into consideration the social, economical, and political functions that affect the operation of the family system.

Postmodern family therapists move into a role of collaborator, rather than director, of the family system changes and adaptations that improve function. In this way, all family members provide input, while the therapist acts "primarily from a solution-focused or a narrative therapy perspective" (Jones-Smith, 2012, pp. 512).
To increase function within family of origin systems by reducing anxieties and unresolved issues, which will halt emotional projections and triangulation. This, according to the Family Therapy approach, will cease multigenerational transmissions of dysfunctional emotional patterns.

To improve individual levels of differentiation, which increases emotional stability while also decreasing emotional dependency. Having even one individual improve differential, according to the Family Therapy approach, will have a trickle-down affect of influencing other family members to also improve.

Step-by-step, these goals can be achieved by first, utilizing a genogram to identify the pattern of the issue; second, by working to improve the emotional reactiveness and strategies of key individuals within the issue; and third, by identifying and creating awareness around central and subsequent triangles, that may be a result of intergenerational patterns.

Bowen Theory approaches family dysfunctions with the idea that a lack of differentiation results in an inability to effectively manage stresses and anxieties. By helping individuals in separating the thinking processes from the feeling processes, resolutions can be applied in a logical manner.
The therapist remains neutral to the family system’s emotional issues while prompting self-reflection, and encourages the individuals to resolve issues amongst one another by guiding, demonstrating, and educating key individuals toward:

Accepting personal responsibility for their own role.Detriangulating relationships.Increasing personal differentiation from the family system.Nurturing a broader spectrum of family relationships.Defining spousal relationships.Resolving emotional cutoffs.
Genograms: “a visual representation of a person’s family tree using geometric figures, lines, and words” (Jones-Smith, 2012, pp. 525). Genograms aid in clearly identifying specific influential demographic factors within family systems, as well as identifying patterns, coinciding occurrences, or off-schedule life events.

Going Home Again: by returning to the family of origin, an individual may gain an increase in understanding of the other family members, which may improve individual differentiation and overall emotional reactivity and health. Over time and with practice, the individual may decrease emotional dependency or level of emotional cutoff, thus healing the individual, and potentially facilitating the healing of the family system.

Detriangulation: encourages members of a family system to remain neutral, rather than being pulled into the conflicts between others. Where a triangle already exists, the therapist will aid the individuals in extracting themselves. It is also crucial during therapy that the therapist not become entangled in a triangle within the family.

Talk to the Therapist, Not to Each Other: in this way, emotional reactivity is kept at a minimum and triangulation is prevented.

Person-to-Person Relationships: encourages family members to identify
ways they relate to one another, to share common experiences and promote bonding. This includes multigenerational relating, as between parents and their children.

Asking Questions: the therapist will ask numerous questions that help to trace the source of the conflict. These questions include identifying significant life events, and prompting self-reflection of cause-and-effect relationships from emotional reactiveness and multigenerational patterns. This may include “the displacement story technique”, wherein the therapist relates a similar conflict in another family, and suggests similar solutions or courses of action for resolution (Jones-Smith, 2012, pp. 526-527).
Emotional cutoff: a coping strategy for emotional issues within the family of origin. This may result in an individual moving away from the family, ceasing communication with the family, or self-segregating in another room in the house. While immediate anxiety may be reduced, the conflict remains unresolved and may spread.

An open relationship: maintaining open relationships within family systems reduces anxiety. This is more challenging when emotional cutoffs are high, and therefore, a reduction of these is sought that will facilitate the decrease of intensity surrounding issues.

Societal emotional process: refers to the transmission of societal anxieties on individual family systems. Negative social constructions are said to be societal emotional processes that consequently influence family systems and the individuals within them.
Additional Bowenian Key Concepts
Bowen's Multigenerational Therapy Goals
Role of the Bowenian Therapist
Bowenian Therapy Techniques
Bowen's Multigenerational Theory Core Concepts
Murray Bowen (1913-1990)
Bowen Theory Limitations
•Alfred Adler wanted to offer encouragement to children and to reduce feelings of inferiority that children had. He believed that treating the child would prevent adult mental disorders. Therefore, he created child guidance clinics in Vienna where children, along with their families and teachers could be counselled.
•Adler and his fellow Adlerians, believed that, “all human problems are inevitably of a social nature” (Jones-Smith, 2012, p.512). If a person is not able to “fit” well into social groups then they will experience maladjustment
•Each person creates their own subjective meaning because of social and familial experiences. “We develop our meaning of life and our conceptions of appropriate roles and responsibilities from being in our families” (Jones-Smith, 2012, p.513).
•Within a family each member is entitled to a level of respect from the other members. The family works together to accomplish goals (with each member contributing)
•If a relationship within a family is built on competition rather than cooperation, disharmony will occur. This is because one member feels inferior.
•Each family member establishes his or her own rules or “private logic” within the family system. When working with a family, a therapist must work to understand what each family members personal rules are.
More on Alfred Adler...

History & Key Points
Goals of Adlerian Family Therapy:
Adlerian family therapists work to re-educate the family from a position of mutual respect. Furthermore, the therapist must strive to understand the various behaviours and motivations of each member. “In contrast to behaviour therapies, Adlerian family therapists describe their approach as motivation modification rather than behavior modification” (Jones-Smith, 2012, p. 513).
Role of the Therapist
in Adlerian Therapy:
There are 4 treatment phases in Adlerian therapy:

Phase 1: The therapist works to gain the trust of the family and works to understand the concerns of each family member.

Phase 2: The therapist gathers as much information as is possible and tentatively assesses the family dynamics.

Phase 3: The “reorientation” phase- this is when the therapist gives insight into the family members behaviours and motivations and encourages change.

Phase 4: The therapist begins the process of disengaging from the family system. The therapist also works with the family to prepare a “relapse prevention” program and meets with the family for a follow-up interview.
Phases of Family Counselling:
•Obtaining information about family relationships, birth order etc.
•Understanding the “family constellation” (how different members relate to each other)
•Asking for personal stories or descriptions of a “typical” day in the household
•Teaching family members how to encourage each other
•Asking each member to agree to a set of guidelines during therapy sessions (ie, no speaking for others, blaming of others etc.)
Techniques Used in
Adlerian Therapy:
Sometimes in Adlerian Therapy, a technique is used in which a therapist interviews a family while other families view and ask questions- this is called an "open forum". The objective of this is to educate the families as well as to identify common struggles. The therapist gains a knowledge of what behaviours the family would like to change and they work on this goal together.
Use of the
Open Forum
Adlerians believe that family members often have mistaken goals within their relationships with other members. Children and adults alike can succumb to these mistaken goals.

Children’s Mistaken Goals:

1.Attention-getting goal
2.Power struggles
3.Revenge goal
4.Assumed inadequacy

Parent’s Mistaken Goals:

1.Demonstration of parental adequacy
2.Power and control over children
3.Revenge
4.Demonstration of inadequacy as an adult with children
(Jones-Smith, 2012, p. 516-517)
Mistaken Goals:
There are two parenting skills training approaches in Adlerian therapy: the “STEP” program (created by Don Dinkmeyer Sr., Don Dinkmeyer Jr. and Gary McKay) and the “positive discipline” approach (developed by Jane Nelson). These two approaches outline the following concepts:

1.Understanding that you cannot change someone else’s feelings or beliefs

2.Listening attentively and without judgment, to children

3.Identifying which family member a problem belongs to

4.Learning the difference between praise and encouragement

5.Disciplining children through natural and logical consequences rather than punishment
1. To promote change and growth within the family system and within each family member. These changes include:

•The change of the family’s perceptions, values, goals and beliefs
•A change within the family’s structure and overall organization (including play)
•Change of the family’s skills and behaviours
•An alteration of the way that the family members use power

2. To increase each family members positive connections with others and social interests

3. To ensure that family members are committed to growth within the family

4. To encourage each member to analyze their own motivations and behaviours
Adlerian Parenting
Skills Training
Differentiation of self: the level of emotional maturity of an individual (gauged between 0-100, with 100 the ideal), that enables them to separate their own emotions and thoughts from those of the family system, to avoid being reactive to the emotional issues of others, and to be self-confident rather than emotionally dependent on the other family members.

Triangles: refers to the relationship between, in the simplest form, three people. In the case of two people in the family having a conflict, one of those people will often draw a third person into the issue, creating a triangle. In this way, anxieties are redirected, though the conflict is not resolved. Instead, one of the first two will become deliberately excluded outside of the triangle, while the other two remain inside and strengthen their bond.

Nuclear family emotional process: when a family system has a history of low differentiation, or a couple with similarly low levels of differentiation marry and have children, their children will often carry the same emotional dependencies. These instabilities are thought to produce “one or more of the following situations: (1) reactive emotional distance between the spouses, (2) physical or emotional dysfunction in one spouse, (3) overt marital conflict, and (3) projection of the problem onto one or more children” (Nichols & Schwartz, 2007, as cited by Jones-Smith, 2012, pp. 522).
This therapy focuses more on the previous family patterns rather than present conflicts.
This therapy involves a significant amount of time and money.
This therapy may not be conducive to collectivist societies, where differentiation is not supported.


From the 1960s humanistic-existential era emerged a new perspective on family systems therapy – experiential family therapy. This approach places emphasis on the present and “…is characterized by such terms and concepts as awareness and expression of feelings, growth, and spontaneity” (Jones-Smith, 2012, p. 529). Two leaders in experiential family therapy are Virginia Satir and Carl Whitaker.

Satir established the communication/validation model and forged the use of family exercises within and out of therapy. She believes that ineffective family communication or non-functional family communication is the result of deliberate evasion of personal awareness. This hinders emotion expression.

Carl Whitaker is known for his unorthodox approach to family therapy. He put an emphasis on authenticity of self and within the family system. Whitaker also pioneered the co-therapy technique wherein a therapy twosome would ensure the integrity of the session. “From his perspective, family togetherness and cohesion were synonymous with personal growth (Jones-Smith, 2012, p. 532).
Experiential Family Therapy:
Satir’s main objective for therapy is the improvement of self-esteem for each family member. This in turn provides more functional interpersonal communication within the family unit. This was achieved through the use of 5 treatment stages:

1. Develop trust

2. Establish an understanding of the roles of each family member

3. Provide new perspectives for family members

4. Presentation of individual’s new perspectives and personal responsibilities to the family

5. Integration of family therapy techniques into everyday life
Virginia Satir's Goals &
Treatment Process
1.“I” Statements- encouraging a position of responsibility for personal feelings by the use of non-accusatory language

2.Sculpting- a non-verbal role-playing/charades like activity in which family members are moved into positions that demonstrates personal perspectives on specific family relationships

3.Choreography- a verbal re-enactment of typical family patterns from the perspective of individual family members

4.Touch- a less frequently used technique in which the therapist uses casual physical contact with the clients in an effort to establish a bond

5.Props- the use of representative objects (such as ropes or blindfolds) to demonstrate the impacts of individual family dynamics on the family system
Satir's Techniques:
Whitaker’s main goal objective is for family members to be open and genuine; through this clients learn to improve self-awareness and self-expression. Other goals include the creation of intimacy, strengthening of family, increased autonomy of and within the family system, enhancement of individual experiences and expanding emotional awareness.

In Whitaker’s approach, a therapist is highly and dynamically involved in the therapeutic process. There are three phases that a therapist leads the family through: engagement, involvement and disentanglement.
Carl Whitaker's Goals & Role of Therapist
Whitaker's Treatment
& Techniques
•therapists must have an awareness of multicultural influences and perspectives when working with families

•this type of therapy may inadvertently reinforce socially constructed roles related to such things as gender or age
Issues & Limitations of
Family Therapy
Minuchin's Key Concepts
Coalitions: natural alliances that occur between family members. Stable coalitions are constant and healthy, as between a parent and a child, while detouring coalitions involve the deliberate exclusion of another family member.

Subsystems: within a family structure are three primary subsystems that define individual roles and influence the overall function of the family system. These subsystems are spousal, parental, and sibling.

Boundaries and family mapping: similar in structure to Bowen's genogram, boundary diagrams outline the health of intergenerational patterns within a family system. Each relationship is connected with either a broken, solid, or dotted line representative, respectively, of either a clear, rigid, or diffused boundary.

Roles, rules, and power: individual responsibilities and expectations should be clearly defined, and some power should be allocated to all members of the family, though there are usually one or two people that hold the majority and make most of the decisions.
Family projection process: typically occurs when one parent transmits their own low level of differentiation to one of their children. The child, consequently, becomes emotionally dependent on the parent and tend to take on the parents anxiety as their own.

Multigenerational transmission process: the projection of emotional tendencies or pathologies throughout many generations in a family system. It is believed that depression and alcoholism are a result of the multigenerational transmission process, and therefore, previous generations also require treatment to stop the projection.

Sibling position: the sibling position of each parent is thought to influence individual parenting strategies. How each parent, as children themselves, competed for security within their childhood family systems will dictate how they establish relationships with their own children.
The goals of structural therapy involves redefining nonfunctional aspects of the family system. The therapist actively engages in alliances with each individual while determining the family's structural diagnosis and then developing a way to restructure the family system to promote positive change.
Minuchin's
Therapy Goals & Therapist's Role
Structural Therapy Techniques
Punctuation: therapist acknowledges and emphasizes positive interactions during therapy sessions.

Unbalancing a system: therapist allies with a 'weaker' family member during a session to balance power and redefine roles.

Enactment: therapist encourages a genuine negative interaction during therapy, which increases clients' awareness of typical behavior.

Boundary making: therapist demonstrates natural adaptation and evolution of family boundaries in correlation to appropriateness..

Restructuring: changing the composition of a family system, and introducing techniques to facilitate positive change.

Diagnosing: therapist formulates a family system diagnosis during the first session, then refines and reformulates this diagnosis throughout the therapy process.
Strategic Family Therapy
•Therapy should be short term (about 10 sessions)

•Symptoms are encouraged in therapy (ie, arguing) because they have a purpose

•Main emphasis is on solving current issues

•Children act out in order to protect the family system (ie, often times the parents will share in the agony of having a misbehaving child and grow closer)

•The main goal is not to understand the problem but to fix it (similar to behaviour therapy)
Key Concept & Goals of
Strategic Family Therapy
Jay Haley outlined these 5 stages of therapy that are repeated until the presenting problem is resolved: 1.Social stage- the therapist gets to know each family member and begins an initial hypothesis of the family dynamics

2.Problem Stage- the therapist asks the family members about the issue that they are having

3.Interaction Stage- the therapist observes the family members as they talks about the problem at hand. He/she makes notes based on who speaks, who doesn’t etc.

4.Goal-setting Stage- together, the family and the therapist decide on goals to be achieved

5.Task-setting- the therapist asks the family to complete a certain task outside of the therapy session
Treatment Process in
Strategic Family Therapy
Activity
Whitaker’s treatment process was considered to be dynamic, unstructured and spontaneous to encourage emotional intensity for the sake of healing. Though not structured, Whitaker did use a variety of intervention methods.

“These include: (1) redefine symptoms as efforts for growth, (2) model fantasy alternatives to real-life stress, (3) separate interpersonal and intrapersonal stress, (4) add practical bits of intervention, (5) magnify the despair of a family member so that other members understand them better, (6) promote affective confrontation, and (7) treat children like children and not like peers" (Jones-Smith, 2012, p. 534).
References:
Jones-Smith, E. (2012). Theories of Counseling and Psychotherapy: An Integrative Approach. United States: Sage Publications, Inc.
Discussion
•Jay Haley is considered to be the creator of “Strategic Family Therapy”

•Ironically, Haley did not believe that what he did was a theory so much as “provocative instructions to which clients are to respond” (Jones-Smith, 2012, p. 543)

•Many of the concepts are similar to Minuchin’s Structural Family Therapy
Full transcript