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Symbolic-experiential Family therapy

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Joe B Wright

on 15 June 2014

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Transcript of Symbolic-experiential Family therapy

Late Phase
Symbolic-experiential Family therapy
6 Core Stages of
Symbolic-Experiential Therapy
Core Techniques of
Symbolic-Experiential Therapy
Early Phase
Middle Phase
From Roots
to Results


Carl Whitaker
The non-theoretical
theory
The therapist's own life experiences are important to their response to the client
The ideas behind the Approach
The therapist's own emotional responses to the client guide the therapist's intervention
Therapists should be spontaneous and real people with their clients
Gehart & Tuttle, 2003
When therapists are truly engaged with the family in therapy, they do not use predetermined techniques or interventions
Augustus Napier
Influenced by:
Humanistic Psychology
Gestalt Therapy
Gehart & Tuttle, 2003
Generating an Interpersonal Set
Creating a Supra-system
Stimulating a Symbolic Context
Activating Stress within the System
Creating Symbolic Experience
Moving out of the System
-Mitten & Connell, 2004
roots
References
Gehart, D.R. & Tuttle, A. R. (2003).
Theory-based treatment planning for marriage and family therapists
. Belmont, CA. Brooks/Cole.
Mitten, T.J. & Connell, G.M. (2004). The core variables of symbolic-experiential therapy: A qualitative study. Journal of Marital and Family Therapy. 30(4), 467-478.
"Gestalt therapy focuses on here-and-now experience and personal responsibility."

"The objective, in addition to overcoming symptoms, is to become more alive, creative, and free from the blocks of unfinished issues which may diminish optimum satisfaction, fulfillment, and growth."

"Gestalt therapy relies heavily on the interpersonal relationship between client and therapist that is developed and nurtured over the course of therapy. "
-goodtherapy.org
Anonymous (2013, June 5).
Gestalt therapy
. Retrieved March 25, 2014 from http://www.goodtherapy.org/Gestalt_Therapy.html
"Humanistic psychology acknowledges that the mind is strongly influenced by determining forces in society and in the unconscious, and that some of these are negative and destructive."

"Humanistic psychology emphasizes the independent dignity and worth of human beings and their conscious capacity to develop personal competence and self respect."
-The Association for Humanistic Psychology
Association for Humanistic Psychology (2013). Humanistic views & methods. Retrieved March 25, 2014 from http://www.ahpweb.org/index.php?option=com_k2&view=item&id=33:humanistic-view--methods&Itemid=24
Activating Anxiety
- using positive anxiety to motivate the family to change. Symptoms may be reframed as opportunities to learn and grow.
Battle for Initiative
- the family must take the lead for initiative after the therapist has established the rules and structure of therapy. The therapist may have to withstand long periods of silence until the family takes initiative.
Fantasy Alternatives-
the therapist, or family, share a "what if . . ." scenario to speak about uncomfortable topics or to introduce alternatives that are absurd.
Expanding Distress
- the therapist finds natural ways to expand the distress and the problem to include all members of the family. This helps to avoid blame and works toward a whole group solution.
Affective Confrontation-
the therapist uses very emotional and subjective questions or statements to stimulate the family to be more open as well. This leads to more intimate sharing and examination.
Co-Therapist-
many SET therapists use a second person to ensure balance. The emotional involvement of the therapist can lead to a narrow perspective. A co-therapist can help therapists maintain objectivity.
Gehart & Tuttle, 2003
Malorie and Doug Banks have been married for 20 years. Malorie reports that 17 year old Kristin is highly disruptive at home and at school and she suspects that Kristin is using drugs and alcohol. 15 year old Julia and 12 year old Brad have become more withdrawn from the family by staying in their rooms and spending time with friends due to Kristen's behaviors.
Scenario:
(scenario and planning outline taken from Gehart & Tuttle, 2003)
Goal 1- Establish a safe environment & join the Banks' system.
Interventions:
-Be open and real with the Banks family to model communication
-Require that the entire Banks family attend therapy sessions
-Involve humor and spontaneity in discussions
Goal 2- Identify Banks' systemic boundaries, coalitions, roles, and anxiety levels.
Interventions:
-Involve all the Banks' in discussions
(Especially encourage Julia and Brad to participate)
-Use affective confrontation for assessment
-Explore each family member's ideas of the symptoms
-Explore Kristen's role as scapegoat
-Identify role rigidity in the Banks family
Goal 3- Establish therapy goals & require the Banks' initiative.
Interventions:
-Require that the family demonstrate initiative
-Challenge the family to decide the topic of discussion
-Use "what if ..." fantasies with the family
Goal 1- Develop cohesion with the Banks family with clear boundaries that do not support Kristin's symptoms.
Interventions:
-Use affective confrontation to expand positive anxiety of Julia and Brad's symptoms
-Use affective confrontation to highlight Doug & Malorie's coalition of denial about marital problems
-Present fantasies of the family without Kristin's behavior
-Increase parental empathy to ensure Kristin's needs are met
-Assign Kristin, Julia, and Brad to rotate the assignment of being scapegoat
Goal 2- Create and maintain generational and parental boundaries to reduce marital conflict and the need for Kristin's symptoms.
Interventions:
-Use humor to expose Doug & Malorie's avoidance of acknowledging marital conflict
-Use affective confrontation to point out role rigidity and role delegations
-Seize moments to expose and address inappropriate generational and parental boundaries
-Use couples therapy to address marital conflict and intimacy challenges
Goal 1- Promote the growth of all the Banks family members and the new family structure
Interventions:
-Continue to be a real person authentically engaged with the Banks family
-Define stressers, highlighting that conflict between Doug & Malorie does not have to include Kristin or other children
-Encourage individuation and growth with crazy "what if..." fantasies
Goal 2- Highlight accomplishment of goals, growth, and relief of symptoms.
Interventions:
-Allow each member to express feelings about therapy and its effects
-Reframe Kristin's original symptoms as opportunity for growth and change
-Identify possible blocks to continued development
-Share therapist's personal responses to the Banks
"Like spring,
the changes came slowly, a leaf at a time."
-Augustus Napier
in
The Family Crucible
Napier, A. Y. & Whitaker, C. (1978).
The family crucible: The intense experience of family therapy
. New York, NY. HarperCollins.
"Whatever happens to any of us will touch all of us."
-Augustus Napier
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