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FAMILY THERAPY Hayley Golledge & Amanda Cran Child & Youth Mental Health Service PowerPoint PPT Presentation


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FAMILY THERAPY Hayley Golledge & Amanda Cran Child & Youth Mental Health Service. WHAT IS A FAMILY?. Families come in lots of different shapes and sizes including: 2 parent families (“intact family”) single parent families (“solo parent family”)

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FAMILY THERAPY Hayley Golledge & Amanda Cran Child & Youth Mental Health Service

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Family therapy hayley golledge amanda cran child youth mental health service l.jpg

FAMILY THERAPYHayley Golledge & Amanda Cran Child & Youth Mental Health Service

Kindly provided by Occupational Therapy - Townsville MHS


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WHAT IS A FAMILY?

Families come in lots of different shapes and sizes including:

  • 2 parent families (“intact family”)

  • single parent families (“solo parent family”)

  • families which bring together children from different relationships (“blended family”)

  • families where childcare is shared between different people

  • families with same sex partners

  • fosters families

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WHAT IS A WELL-FUNCTIONING FAMILY?

  • Generally the people in the family like and support one another

  • Parents’ marriage has the strongest emotional bond. The main axis in which everyone revolves around.

  • When presented with a problem the family deals with it co-operatively.

  • Efficient communication without necessarily using a lot of words

  • Family members can be dependent when they need to be, but can grow up and be autonomous without someone (usually parent) resisting that maturation, or making its acceptance conditional upon conforming to a whole system of regulations about everything from religion to how they do their hair.

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It is from the observation of the parents’

marriage that the child learns how:

  • Affection and anger are expressed

  • Power distributed

  • Communication is managed

  • Roles allocated

  • From which notions of marital justice and fairness are derived

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Unattached young adult

Joining of families through marriage

Launching children and moving on

Family with young children

Family with Adolescents

FAMILY CYCLE

The family in later life

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FAMILY CYCLE

“family stress is often greatest at transition points from one stage of the family developmental process, and symptoms are most likely to appear when there is an interruption or dislocation in the unfolding family life cycle”

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EVENTS IMPACTING ON THE FAMILY CYCLE

  • Additions to the family

  • Chronic illness

  • Financial setbacks

  • Divorce

  • Abuse/neglect

  • Domestic violence

  • Grief/loss

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WHAT IS FAMILY THERAPY

  • A way of working with people with problems. Often these problems are affected by other things that are going on in their family. All sorts of things affect a family and the relationships between family members.

  • Family therapy is an alternative to working with individual members of the family

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People in families are intimately connected, and focusing on those connections may be a more valid way to understand and promote change in problem-related behaviour than focusing on the perspective of any one individual.

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INDICATIONS FOR FAMILY THERAPY

  • Symptoms are imbedded in a dysfunctional system of family relationships

  • Problems presented in terms of a relationship rather than as the problem of and individual family member

  • Separation difficulties (adolescent)

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AIMS OF THERAPY

Therapy requires the family to change either:

  • Their usual ways of coping with problems

  • Their relationship with one another

  • Their modes of communicating

  • Their discipline, rules, and power hierarchy

  • Their over-or-under involvement with one another

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GENERAL TREATMENT GOALS

1.To facilitate communication of thoughts and feelings

2.To shift disturbed, inflexible roles and coalitions

3. To increase options and demythologize

  • To teach ways of dealing with change; and coming to terms with uncertainties of working out their own answers

  • To promote Clarity of communication and negotiating of differences to cope with ambiguity, change and loss.

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WHAT DO FAMILY THERAPISTS WANT TO KNOW?

  • FT’s talk to families about their strengths and successes as well as problems that they are facing

  • They will ask lots of questions and will want to hear from all members of the family who attend

  • No one is forced to answer any of the therapist’s questions

  • Discover the families goals and reasons for attendance

  • May ask about parents family of origin

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Lineal Questions

Strategic Questions

Leading questions

Problem explanation questions

Confronting questions

Problem definition questions

Behavioural effect questions

Hypothetical future questions

Difference questions

Observer perspective questions

Circular Questions

Reflexive Questions

CIRCULAR ASSUMPTIONS

TYPES OF QUESTIONING

LINEAL ASSUMPTIONS

ORIENTING INTENT

INFLUENCING INTENT

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Linear Questions

  • Orientates the therapist to the client’s situation

  • Intent behind these is predominately investigative

  • Usually has a beginning and an end

  • Examples: Who did what?, where?, when?, Why?

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Strategic Questions

  • These are asked in order to influence the family in a specific manner

  • Based on linear assumptions about the nature of the therapeutic process

  • Questions predominately corrective

  • Therapist behaves like a teacher / instructor / judge, telling family members how they should and shouldn’t behave.

  • Example: “why don’t you talk to him about your worries instead of the kids?”, “wouldn’t you like to stop worrying rather than being so preoccupied with them?”, “What would happen for the next week at 8am every morning you suggested that he takes some responsibility?”

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Reflexive Questions

  • Intended to influence the family in an indirect or general manner

  • Intent behind this is predominately facilitative

  • Example: “In 6 months time how do you see things in your family?”, “If this depression suddenly disappeared how would your lives be different?”

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Circular Questions

  • The therapist behaves more like an explorer / researcher /scientist who is out to make a new discovery.

  • It is assumed that everything is somehow connected to everything else.

  • The intent behind these are predominately exploratory

  • Example: “How is it that we find ourselves together today?”, “Who else worries?”, “Who do you think worries the most?”, “Who do you imagine worries the least?”, “What do you think about what mum said?”

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FAMILY THERAPY

  • At CYMHS

    - Team discussion to prepare for family

    - 2 therapists and observing team

    - Sessions run for approximately 45minutes

    - Therapists seek feedback from observing team

    - Brief feedback given to family

    - Fortnightly appointments

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GIVING FEEDBACK

  • Metaphors

  • Strengths

  • Observed behaviour

  • Observed processes

  • Avoid being the expert

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CONTRAINDICATIONS FOR FAMILY THERAPY

  • Inability to attend appointments

  • Poor motivation for change

  • Unavailability of competent family therapists

  • Malignant, irreversible trend to break up of the family

  • Destructive motivation

  • Dishonesty in one or both parents

  • Family secret

  • Rigid differences

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REFERENCES

  • Barker, P. (1998) Basic Family Therapy. Blackwell Publishing. Oxford.

  • Geldard K. & Geldard D. (n.d.) Family Counselling Workshop: “Looking through Different Lenses” notes

  • Nothling M. M. (1980) Indications and Contraindications for Family Therapy. Patient Management.

  • Zuckerman, E. L. (n.d.) Clinician’s Thesaurus: The Guidebook for Writing Psychological Reports. Guilford Press.

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