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Family-System Therapy Theories and Practices An Introduction Copyright © 1997-2002 Melvin W. Wong, Ph.D. All Rights PowerPoint Presentation
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Family-System Therapy Theories and Practices An Introduction Copyright © 1997-2002 Melvin W. Wong, Ph.D. All Rights Reserved. Melvin W. Wong, Ph.D. 黃偉康博士 Licensed Clinical Psychologist ChristianMentalHealth .com 220 Montgomery St., Suite 1098, San Francisco , CA 94104

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Family-System Therapy Theories and Practices An IntroductionCopyright © 1997-2002 Melvin W. Wong, Ph.D. All Rights Reserved

Melvin W. Wong, Ph.D.

黃偉康博士

Licensed Clinical Psychologist ChristianMentalHealth.com

220 Montgomery St., Suite 1098, San Francisco, CA 94104

1357 Mowry Avenue, Fremont, CA 94538

Tel (510) 794-8898 Fax (510) 475-1473

course requirements
Course Requirements

Class Attendance & Finish the Reader

Each student is expected to complete one paper assignments A written report (about 10 pages) to be submitted to the office, entitled:

“If I were a master Family Systems Theorist”

if i were a master family systems theorist
“If I were a master Family Systems Theorist”

When you become a master family systems theorist, how would you describe your system theory?

  • Include your use of common terms: enmeshment, triangulation, etc.
  • Include any new terms that you have invented?
  • What about the relationship between husband & wife?
  • What are your constructs?
  • How do you do assessments?
  • What are your therapy goals?
  • How do you do interventions?
if i were a master family systems theorist7
“If I were a master Family Systems Theorist”

How would your theory be different from the four theories we have discussed in class?

In what way is your theory similar to the four theories we have discussed in class?

What makes your theory relevant for Hong Kong Chinese families?

What makes your theory relevant for Christians?

How would you implement your theory in prevention efforts at church?

  • How would you prevent divorces?
  • What ministry can you provide for children of divorce?
term paper due
Term Paper Due

Friday, July 26, 2002

Handed in at Kay Wong’s office

If you need your grade to graduate,

Please say so on the front page of your paper!

(If you need more time to finish your work, please make an application for extension at the registrar’s office or through Kay Wong)

class time
Class Time

09:00 to 10:30 AM Instruction session 1

10:30 to 10:45 AM Break 1

10:45 to 12:00 PM Instruction session 2

12:00 to 01:00 PM Lunch

01:00 to 02:30 PM Instruction 3 (or film)

02:30 to 02:45 PM Break 2

02:45 to 05:00 PM Instruction session 4

05:00 to 05:30 PM Q/A Individual Time

course description and outline
Course Description and Outline
  • This graduate marriage and family studies course provides fundamental introduction to the study of common marriage and family systems theories.
  • Theories and techniques of family therapy will be reviewed and practical application discussed.
  • The structural family therapy approach is studied in depth.
  • Theoretical perspectives are presented through readings, lectures, and videotapes by the masters; classroom PowerPoint presentations and student demonstrations.
course objectives and outcomes
Course Objectives and Outcomes
  • Upon completion of this course, students will be able to understand and use the four predominant theories:
  • The Structural Model, the Bowenian Model, the Satir model and the Strategic School.
  • Students will be shown how to assess their counseling cases from a system's perspective using the theoretical framework from the above approaches, and to apply, to some extent, some of the intervention techniques covered.
  • Cultural and theological and other relevant issues will also be addressed to assist students in this course to enhance their ability to minister through the local church.
course objectives and outcomes12
Course Objectives and Outcomes
  • Students will establish a working knowledge of the historical developments central to Marriage and Family Therapy standards as well as marital and family counseling in general.
  • They will have a working understanding of general systems theory, as well as a working knowledge of the major models of family therapy; they will understand family assessment, treatment planning and intervention techniques, from the perspectives of the various models discussed.
assessment criteria or course requirements
Assessment Criteria or Course Requirements
  • Students are expected to attend class minimum of 100%.
  • There are assigned reading for the course based on the required textbook below.
  • There will be either an examination at the end of the course or a term paper due.
  • Students are expected to participate in classroom discussion as well as a short presentation of their papers if one is assigned.
textbook
Textbook

Nichols, M.; Schwartz, R.,

Family Therapy: Concepts and Methods. Boston: Allyn & Bacon, 2001

(fifth edition).

reference books
Reference Books
  • Goldenberg, I, & Goldenberg, H. (2000). Family Therapy: An overview. Needham Heights, MA: Allyn & Bacon, 5th ed.
  • Haley, J. (1977). Problem-solving Therapy. San Francisco, CA: Jossey-Bass.
  • Minuchin, S. (1974). Families and Family Therapy. Cambridge, MA: Harvard University Press.
  • Satir, V. (1993). Conjoint Family Therapy. Palo Alto, CA: Science Behavior Books.
acknowledgments credits
Acknowledgments & Credits

Michael P. Nichols,The Essentials of Family Therapy

Curricula (English) References From:

C. R. Barké, Ph.D.; Tamara L. Kaiser, Ph.D.; Michael I. Vickers, Ph.D.

Curricula (Chinese) References From:

關何少芳 (香港家庭治療協進會主席)

黃張淑英 (香港家庭治療協進會學術秘書)

楊陳素端 (1990)

videos by the masters
Videos by the Masters
  • Key videos will be shown as direct illustrations from the masters of a particular theory.
    • “Marriage: Just a Piece of Paper?”
    • “Minuchin Interview”
  • Other videos will be included on a time-permitting basis.
    • "Unfolding the laundry," Salvador Minuchin
the family is the context of most human problems
The family is the context of most human problems

The whole is greater than the sum of its parts

Like all human groups, the family has emergent properties -fall into two categories

  • Structure and
  • Process
family therapy is new
Family Therapy is New
  • Psychiatry: Medical Model
    • Schizophrenia was not believed to be biological
    • Family is not included in hospital treatment
    • Family is believed to be the cause of illness
    • Psychiatrists are not trained to treat families
  • Change the Family to change the Person
    • Change the Person and change the Family
  • Theorists were smart researchers
    • Studied different parts to improve the whole
triangle triangles triangulation
Triangle-Triangles-Triangulation

A Three-Person system; according to Bowen, the smallest stable unit of human relationship. “Diverting conflict between two people by involving a third.”

“The unhappy mother uses her last born son to triangulate against his father”

She is unhappy with her marriage and to find stability and significance in her identity as a woman, she chose her youngest son to be a husband replacement: He is young and compliant

system family system
System (Family System)

Mary Richmond, 1917

Families are not isolated wholes (closed systems), but exist in a particular social context, which interactively influences and is influenced by their functioning (they are open).

Her approach to practice was to consider the potential effect of all interventions on every systemic level, and to understand and to use the reciprocal interaction of the systemic hierarchy for therapeutic purposes.

boundary
Boundary

Emotional and physical barriers that protect and enhance the integrity of individuals, subsystems, and families

the family is the context of most human problems23
The family is the context of most human problems
  • The structure of families includes triangles, subsystems, and boundaries.
  • The processes that describe family interactions-emotional reactivity, dysfunctional communication, etc.-the most central is circularity.

Rather than worrying about who started what, family therapists understand and treat human problems as a series of moves and countermoves, in repeating cycles.

family systems secret
Family Systems Secret

What is the Family Systems Secret?

Fix the Marriage

Then

The Family is Fixed

bad marriage is the context of most of human problems
Bad Marriage is the Context of Most of Human Problems

Family is Bad: Father & Mother are Bad

Like all human groups, the family has emergent properties – Parental Happiness determines family happiness

  • How to be Happily Married? and
  • How to keep Children Happy?
marriage just a piece of paper discussion
Marriage: Just a Piece of Paper?Discussion
  • Cohabitation: No Marriage = No divorce
    • No commitment, no security (Maturity issue)
  • Consumerism in Marriage Relationships:
    • “If I don’t like it, I move on” (Fear-reduction based)
  • Divorce’s victims: Children (No advocate, no defense)
    • Abandonment fear: “If mom & dad can split up, they can leave me too!” (limited cognitive abilities as children)
    • Daughters of divorce: “Boy crazy, need a dad” (Intimacy)
    • Sons of divorce: “What is the role of man in a family, none?”
  • Covenant Marriage vs. Contract Marriage
    • Premarital Counseling & Prove Fault before divorce
important resource
Important Resource

Marriage Clinic

John Gottman

(available at the Baptist Seminary library)

616.89156

G686m c.2

the four models of family therapy
The Four Models of Family Therapy

Structural Model

(Salvador Minuchin)

Intergenerational Model

(Murray Bowen, Boszormonyi-Nagy, James Framo)

Humanistic-Experiential Model

(Virginia Satir, Carl Whitaker)

Strategic (Communication) Model

(Jay Haley)

complementary relationship
Complementary Relationship

Relationship based on differences that fit together in which qualities of one make up for lacks in the other

Therefore, in marriages, there will always be differences because each spouse is different: This is the perpetual tension that exists in a marriage

family homeostasis
Family Homeostasis

Tendency of families to resist change in order to maintain a steady state

group dynamics
Group Dynamics

Interactions among group members that emerge as a result of properties of the group rather than merely of their individual qualities

identified patient ip
Identified Patient (IP)

The symptom-bearer or official patient as identified by the family

videos by the masters35
Videos by the Masters

Salvador Minuchin

Interview

masters series videos salvador minuchin
Masters Series VideosSalvador Minuchin
  • First-born son from an Argentinean-Jewish family
  • Complex, closed-extended family community: Gossips
  • Defended Jewish identity & Argentinean freedom
    • Imprisoned for political struggle against dictatorship: Peron
  • Studied to be a pediatrician to be a child psychologist
  • Worked with delinquent youths multi-culturally
  • Dated & married “Pat”: “Capitalist” Spent 3 months: 1st date
  • Visited other family therapy research groups ’70’s
  • “Not a good team psychiatrist” “Not sexist” “Convinced”
  • Empirical observations of families: Psychosomatic families
subsystems boundaries
Subsystems & Boundaries

Families are structured in Subsystems as determined by

Generation, gender, common interests and function

which are demarcated by interpersonal

Boundaries

The invisible barriers that regulate the amount of contact with others

Boundaries safeguard the separateness and autonomy of the family and its subsystem

structural family therapy minuchin
Structural Family Therapy (Minuchin)

Constructs

Structure

  • The invisible set of functional demands (rules, roles, etc.) that organize the ways in which family members interact.
  • These form repeated transactions or patterns of how, when, and who to interact with, which underpin the system and its functioning.
structural family therapy minuchin39
Structural Family Therapy (Minuchin)

Subsystems

  • The family system differentiates and carries out its functions through subsystems, which include each individual as a subsystem, and other combinations, including generational, gender, interest, or function/role subsystems.
  • Families typically include a marital subsystem, a parental subsystem, and a sibling subsystem.
structural family therapy minuchin40
Structural Family Therapy (Minuchin)

Boundaries

  • To ensure proper family functioning, the boundaries of subsystems must be clear.
  • A boundary is described as the rules that define who participates and how.
  • It functions to protect the differentiation and separateness of subsystems and facilitate transactions among subsystems.
structural family therapy minuchin41
Structural Family Therapy (Minuchin)

Boundaries are described on a continuum

  • From Diffuse 混雜邊界 (Enmeshment)
    • Forming an enmeshed style of transactions in the system, to
  • Rigid 分離邊界 (Disengaged Boundary)
    • Forming a disengaged style of transactions in the system
structural family therapy minuchin42
Structural Family Therapy (Minuchin)

Healthy Family Functioning

  • In healthy families, there is a clear hierarchy,
  • with parents functioning as executive subsystem with effective power,
  • children in a sibling subsystem, less power, though this changes developmentally over time.
structural family therapy minuchin43
Structural Family Therapy (Minuchin)
  • Boundaries are clear, flexible and permeable among all members, and between subsystems, meaning members can communicate with one another, can access others' time, attention and energy.
  • Parents are aligned and function jointly, marital relationship is open internally, but clearly separate from children.
structural family therapy minuchin44
Structural Family Therapy (Minuchin)
  • Rules and roles are clearly and explicitly defined, yet with some flexibility across circumstances, and changing over time as children develop.
structural family therapy minuchin45
Structural Family Therapy (Minuchin)

Unhealthy Family Functioning

  • In unhealthy families, any or all of these are missing or distorted.
  • There may be overly rigid or diffuse boundaries between persons or subsystems,
  • reversed hierarchy with children having too much power influence,
structural family therapy minuchin46
Structural Family Therapy (Minuchin)
  • coalitions across subsystems,
  • conflict within subsystems,
  • cross-subsystem alignments,
  • rules and roles are ambiguous or conflicting,
  • or remain fixed as children grow older,
  • system may be disengaged or enmeshed.
structural family therapy minuchin47
Structural Family Therapy (Minuchin)

Therapy Goals

Structural family therapy goals focus on restructuring, altering any or all of the structural components, thereby promoting changes in symptoms and symptom-maintaining behaviors of members.

structural family therapy minuchin48
Structural Family Therapy (Minuchin)
  • Examples of restructuring goals would be establishing an effective hierarchy,
  • making boundaries more flexible or less diffuse,
  • deconstructing coalitions,
  • establishing healthy alignments,
  • improving within subsystem communication,
structural family therapy minuchin49
Structural Family Therapy (Minuchin)
  • clarifying or establishing clear rules and roles, changing these to reflect developmental processes.
structural family therapy minuchin50
Structural Family Therapy (Minuchin)

Assessment

  • Assessment is accomplished through a combination of inquiry, using circular questions as a tracking method, joining, with the therapist interacting with the family members, and observation using enactments in which the family interacts around a topic or issue.
  • Family maps may be constructed by the therapist and/or members, depicting structural components.
structural family therapy minuchin51
Structural Family Therapy (Minuchin)

Interventions

  • The therapy employs brief, direct, active restructuring interventions.
  • The sequence of these may include joining, enactments, diagnosing, highlighting and modifying interactions, boundary making, unbalancing and challenging family assumptions (rules and roles).
structural family therapy minuchin52
Structural Family Therapy (Minuchin)
  • Others include shaping competence,
  • emphasizing positive and effective behaviors;
  • and reframing behaviors from negative to positive.
virginia satir humanistic experiential model
Virginia SatirHumanistic-Experiential Model
  • “If people are left alone, they tend to flourish!” (Carl Rogers)
  • “Self-actualization” (Abraham Maslow)
  • “Family myths” Mystification: Control to achieve peace and quiet
  • Counter-Transference: Emotional reactivity on the part of the therapist
  • Family Sculpting: Nonverbal experiential technique; family members position themselves in settings that reveal significant aspects of perceptions and feelings
  • Role playing: Acting out the parts of important characters to dramatize feelings to practice new ways of relating
virginia satir humanistic experiential model54
Virginia SatirHumanistic-Experiential Model

HUMANISTIC FAMILY THERAPY

Constructs

Open/Closed Family systems

  • Satir views families as either
  • open (functional) or
  • closed (dysfunctional).
virginia satir humanistic experiential model55
Virginia SatirHumanistic-Experiential Model
  • In closed families every individual must be very cautious about what he or she says;
  • everyone is supposed to have the same feelings, thoughts, beliefs, and desires.
  • Honest self-expression is impossible; differences are dangerous;
  • members must become "dead to themselves."
virginia satir humanistic experiential model56
Virginia SatirHumanistic-Experiential Model
  • An open system permits honest self-expression,
  • differences are viewed as natural,
  • members can say what they feel or think and can
  • negotiate for personal growth and reality without threatening the system.
virginia satir humanistic experiential model57
Virginia SatirHumanistic-Experiential Model

Family Roles

Satir identified four family roles, which represent patterned ways that individuals may behave.

  • blamer,
  • placator,
  • irrelevant distracter,
  • super-reasonable computer.
virginia satir humanistic experiential model58
Virginia SatirHumanistic-Experiential Model
  • As roles, each of these restricts or constrains open communication, though in different ways, and thereby limit growth and functioning of the system.
virginia satir humanistic experiential model59
Virginia SatirHumanistic-Experiential Model

Family Functioning

  • Satir's approach is considered a "growth" model of functioning and therapy.
  • In healthy families, the system nurtures its members, facilitating their growth and natural development, members listen and are considerate, value one another, and are open about themselves ("Anything can be talked about").
virginia satir humanistic experiential model60
Virginia SatirHumanistic-Experiential Model
  • This promotes both the healthy self-actualization of individuals and the accomplishment of family goals and tasks.
  • In unhealthy families, there are rules, roles and communication patterns which limit or prevent open, honest and expressive interactions among members.
virginia satir humanistic experiential model61
Virginia SatirHumanistic-Experiential Model

Therapy Goals

  • Satir's family therapy goals focus on the identification and habilitation of "process," rather than on symptom or problem reduction.
  • The symptom is a signal of dysfunction in the family, and "the illness goes away when the individual is either removed from the maladaptive system,
virginia satir humanistic experiential model62
Virginia SatirHumanistic-Experiential Model
  • or the system is changed to permit healthy response and communication" (Satir, 1967).
  • Process is more a matter of "how" than "what,"
  • and she will focus on process rather than content.
virginia satir humanistic experiential model63
Virginia SatirHumanistic-Experiential Model

Assessment

  • Assessment is accomplished by Satir through the use of a "family life chronology,"
  • which is an interview process, that may span several sessions, or be interspersed across session.
virginia satir humanistic experiential model64
Virginia SatirHumanistic-Experiential Model
  • It begins with the meeting of the couple, moves to their families of origin, returns to the planning of children, and then focuses on the routine facts of a typical day.
  • Each member is involved in the process, and discuss feelings, hopes and disappointments as well as facts.
virginia satir humanistic experiential model65
Virginia SatirHumanistic-Experiential Model

Diagnostically, Satir uses several tools,

  • an analysis of the family's handling of differences;
  • role function analysis;
  • model analysis;
  • communication analysis; and
  • rule analysis.
virginia satir humanistic experiential model66
Virginia SatirHumanistic-Experiential Model

Interventions

  • Satir's interventions are a combination of her own responses and directives in session (encouraging the use of "I" statements, reframing), in session exercises, such as role-playing and sculpting, and games (rescue game, lethal game, communication game), and homework assignments.
strategic family therapy haley madanes
Strategic Family Therapy (Haley, Madanes)

Constructs

  • More interested in changing behaviors and patterns than in understanding them, more focus on technique than theory.
  • Behavior in families is patterned and rule governed, often by the labels or interpretations placed on behavior.
  • In families, hierarchy is crucial, and needs to be top-down and functional.
strategic family therapy haley madanes68
Strategic Family Therapy (Haley, Madanes)

Family Functioning

  • Decline to identify "normal" functioning in any absolute sense – if it is working for the family it is healthy, if not, it is dysfunctional ("Non-normative").
  • Generally, though, in healthy families, there are functional rules that govern behavior, but also flexibility to attempt different solutions to problems that the rules do not work for.
strategic family therapy haley madanes69
Strategic Family Therapy (Haley, Madanes)
  • Families make misguided attempts to solve difficulties, when these fail they are termed "problems" and they repeat unsuccessful solutions, which makes the problem seem worse, an develops into a vicious circle.
  • "Symptoms" are unsuccessful solutions. In unhealthy families,
strategic family therapy haley madanes70
Strategic Family Therapy (Haley, Madanes)

Therapy Goals

  • Strategic family therapy goals focus on the presenting problem, or symptom.
  • The goals are to eliminate the symptomatic behaviors or patterns of interaction which are experienced as distressing or prevent successful completion of individual or family tasks and development.
strategic family therapy haley madanes71
Strategic Family Therapy (Haley, Madanes)
  • Also to develop alternative behaviors or solutions which facilitate accomplishment.
  • Let go of utopian, broad sweeping goals.
  • Once presenting problem is eliminated, therapy is concluded.
strategic family therapy haley madanes72
Strategic Family Therapy (Haley, Madanes)

Assessment

  • Assessment is accomplished through observation and inquiry about actual behaviors between and among members of the family, and of the ways behaviors are defined, labeled and interpreted.
strategic family therapy haley madanes73
Strategic Family Therapy (Haley, Madanes)

Three common types of unsuccessful solutions (symptoms)

  • Solution is to deny that there is a problem; action is needed but not taken;
  • Solution is an effort to solve something that is not really a problem; action is not needed but is taken;
  • Solution is an effort to solve problem within a framework that makes it impossible for it to work; action is taken but at the wrong level.
strategic family therapy haley madanes74
Strategic Family Therapy (Haley, Madanes)

Interventions

  • Approach to problems is to first identify the feedback loops that are maintaining the behaviors,
  • then identify the frames (rules) that support these interactions, then change the rules.
strategic family therapy haley madanes75
Strategic Family Therapy (Haley, Madanes)
  • Interventions are strategies that are planned and implemented by the therapist, using directives, which may be straightforward or indirect or paradoxical.
  • Process is one of interrupting, even reversing, unsuccessful feedback loops.
  • Specific interventions include prescribing the symptom, restraining, prescribing ordeals, pretending, and rituals.