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Section III: The Helping Relationship II: The Counselor Working in Systems

Chapter 6: Family Counseling Chapter 7: Group Work Chapter 8: Consultation and Supervision. Section III: The Helping Relationship II: The Counselor Working in Systems. Couples and Family Counseling. Chapter 6:. A Brief History.

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Section III: The Helping Relationship II: The Counselor Working in Systems

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  1. Chapter 6: Family Counseling Chapter 7: Group Work Chapter 8: Consultation and Supervision Section III:The Helping Relationship II: The Counselor Working in Systems

  2. Couples and Family Counseling Chapter 6:

  3. A Brief History • 1800s: Charity Organization Societies and “Friendly Visitors” worked with poor family • Led to “social casework” –first time people were viewed systemically • Also, around same time, Alfred Adler began to see families and believed education could help alleviate problems in children • Until 1940s, families were generally not seen together due to pressure placed on therapist from the developing “individual approaches” to counseling

  4. A Brief History (Cont’d) • A number of approaches developed around the 1950s: • Psychodyanmic: Ackerman; Boszormeyi-Nagy • Multigenerational: Bowen • Palo Alto: Bateson hired Haley, Weakland, Jackson, & Fry • Looked at communication in systems • Double-bind theory • Applied principles of systems and cybernetics • Out of Palo Alto came MRI • Jackson, Haley, Satir, Madanes • Focused on communication and family process

  5. A Brief History (Cont’d) • Soon, people developed own theories • Satir: Human validation process model • Haley and Madanes: Strategic therapy • Whitaker: Experiential approach • Minuchin: Structural family therapy • 1966: within MRI: Brief Family Therapy Center • Eventually led to solution-focused family therapy • 1970s: Milan Group • More recently: Narrative family therapy (White and Epston)

  6. A Brief History (Cont’d) • Today • Over 50 states have marriage and family licensure • Two main associations: AAMT and IAMFC (a division of ACA) • Accreditation Bodies • COAMFTE • CACREP • Efficacy of family therapy now shown

  7. View of Human Nature • Twelve Assumptions Held by Most Family Counselors (see pp. 192-193)

  8. Key Concepts(General Systems Theory) • Bertalanffy • Explains the interaction of all types of systems • Suprasystems • Subsystems • Interaction in one system affects all other systems

  9. Key Concepts(Cybernetics) • Cybernetics • Control mechanism in systems • Regulatory process • Used to avoid disequilibrium in systems • Acts like thermostat • See Box 6.1, p. 195

  10. Key Concepts(General Systems Theory) • Boundaries and Information Flow in Family Systems • Healthy system has semi-permeable boundaries • Unhealthy: rigid or diffuse boundaries • (See Box 6.2, p. 196) • American culture allows for much variability in boundaries • However, as Box 6.2 shows, too much rigidity or permeability leads to dysfunction

  11. Key Concepts(Rules & Hierarchy; Communication Theory) • Rules and Hierarchy • Universal rules • Idiosyncratic rules • Rules can be overt or covert • Rules often related to hierarchical structure • Communication theory • Watzlawick and others researched communication theory • See 10 communication tenets, p. 197

  12. Key Concepts(Scapegoats and Identified Patients) • All couples bring unfinished business to relationship • Unfinished business can lead to discontent as couples blame each other for their projected problems • Family members will sometimes focus on one member (rather than own problems) • This takes focus off of self or relationship • Families will often bring in the “scapegoat” or IP and state they “have” the problem

  13. Key Concepts(Stress; Developmental Issues) • Stress • Stressful contact of one member with extrafamilial forces (e.g., difficulty at work) • Stressful contact of the whole family with extrafamilial forces (e.g., a natural disaster such as a hurricane) • Stress at transitional or developmental points in the family (e.g., puberty, midlife crises, retirement, aging) • Idiosyncratic (situational) stress (e.g., unexpected illness) • See Box 6.3 • Developmental Issues: See Table 6.1

  14. Key Concepts(Social Constructionism) • Believes that systems theory and cybernetics places too much emphasis on causal factors • Social constructionists believe that couples and families “co-construct” their understanding of who they are • Construction of self occurs through ongoing dialogue and nonverbal interactions among people and broader culture • Change, therefore occurs through conversation with counselor • Together, counselor and clients co-construct a new meaning-making system

  15. Models of Couples and Family Counseling(Human Validation Process Model) • Virginia Satir • Humanist, one of the major theorists of 20th century • Primary survival triad • Four universal communication patterns: placater, blamer, computer, distracter • Congruent, respectful, and caring parents yield healthy children • Two well-known techniques • Complete a family life facto chronology • Family Sculpting

  16. Models of Couples and Family Counseling(Structural Family Therapy) • Salvadore Minuchin • Interactional and Transactional Rules • Boundaries • Structure and Hierarchy • Some Techniques • Joining • Mapping • Restructuring • See Box 6.4, p. 203

  17. Models of Couples and Family Counseling(Strategic Family Therapy) • Arose out of Palo Alto Group and work of Milton Erickson • Theorists: Jay Haley, Cloé Madanes, Milan group • Focused on changing communication sequences • No focus on feelings (except to help people feel better) • Concerned with how power is dispersed in families • Focuses mostly on presenting problem • Haley's Stages: social, problem, interaction, goal-setting • Some techniques • Telling client what to do when (when client will do it) • Telling them what to do when knowing client will rebel • Giving a metaphor (see quote, bottom of p. 205)

  18. Models of Couples and Family Counseling (Multigenerational Family Therapy) • Boszormenyi-Nagy • Ways of relating passed down • Loyalties, Ledger of indebtedness and entitlements • Murray Bowen • Differentiation of self • Nuclear family emotional system • Undifferentiated ego mass (we pick people of same psychological health –see Box 6.5, p. 209) • Family projection system • Individuals get triangulated • Used genograms (see Figure 6.1, p. 208)

  19. Models of Couples and Family Counseling(Experiential Family Therapy) • Whitaker • Says he has no theory, but see basic tenets (p. 209) • I-Thou relationship • Become genuine through interactions in therapy • See quotes top and middle of page 210

  20. Models of Couples and Family Counseling (Psychodynamic Family Therapy) • Robin Skynner and Nathan Ackerman • Emphasis: How parents assist children through developmental stages • Problems in each parent reflected through unconscious • Couple explores how behaviors related to their own childhood • Unfinished, unconscious problems become projected on family

  21. Models of Couples and Family Counseling (Cognitive-Behavioral Family Therapy) • Focused on symptom relief • Highly structured • Focus on behaviors and cognitions • Operant conditioning • Classical conditioning • Social learning (modeling) • Changing negative automatic thoughts • Integrates how problems get infused in family through the system • A number of common elements in all that do this approach (see pp. 212)

  22. Models of Couples and Family Counseling (Narrative Family Therapy) • Michael White and David Epston • Goal: To recreate how family comes to understand itself • Based on postmodernism, social constructivism, and narrative reasoning • Deconstruct past narrative and construct new ones • General guidelines, see p. 213

  23. Models of Couple and Family Counseling(Solution Focused Family Therapy) • Insoo Kim Bert and Steve de Shazer • A pragmatic and future-oriented approach • Based on social constructionism and post-modernism • Assumes that clients can change quickly • Focuses on solutions and use of problem free language • See underlying assumptions, p. 214

  24. Multicultural/Social Justice Focus • Points to consider when working with couples and families from nondominant groups—see p. 215 • Why are professional associations not being inclusive? • American Association of Marriage and Family Counselors • International Association of Marriage and Family Counselors

  25. Ethical, Professional, & Legal Issues in Family Counseling • Withholding treatment in order to see “whole” family • Informed for “whole” family • Confidentiality –can you assure it? • Multiple (Dual) relationships—seeing a member individually and in the family? • Individual or family counseling—which is better? • Professional Associations: AAMFT, IAMFC • Accreditation: CACREP; COAMFTE • Credentialing: LMFT; NCA • Knowing the law: child, spousal, family abuse; custody • Insurance fraud: e.g., saying you’re seeing “1” member in family when you actually see whole family

  26. Counselor in Process • Understanding Our Client’s Family, Understanding Our Family • To understand others, we need to understand self • We need to examine how our family affected us and how the impact of our families can affect the people with whom we work

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