Family systems theories

Family systems theories

1. SYSTEMATIC FAMILY THERAPY Muhammad Musawar Ali MPHIL, ICAP [email protected] 1

2. Family Traditionally, family has been defined as a unit made up of two or more people who are related by blood, marriage, or adoption; live together; form an economic unit; and bear and raise children. 2

3. Family and it types Nuclear Family that is made up of married parents and their biological or adopted children. Extended Family , which consists of parents and children as well as other kin, such as uncles and aunts, nieces and nephews, cousins, and grandparents Single parents family Dual Career family ( both partners work) Childless family Aging family gay/Lesbian family Multicultural family ( belong to different cultural background) Blended family ( one of the couple previously married and has children) 3

4. Defining Historical Event After world war II in united state three trends originate this High divorce rate Changing role of Women Expansion of life span In the 1950s a number of researchers who were working independently began to look at schizophrenia as an area where family influences might be connected to the development of psychotic symptoms.  4

5. Difference between Structural & Strategic therapy Structural Family Therapy Structural family therapists believe that by changing the structure within the system that relational styles will change as a natural  consequence. Look family context, process of change, presenting problem, subsystems. Strategic Family Therapy Strategic family therapists believe that by changing the relational strategies that the structure will change as a natural consequence Look at the problem solution 5

6. System Theory 6 System theory is a generic term for conceptualizing a group of related elements (people) that interact as a whole entity (e.g family or group). According to the theory, any living organism is composed of interacting component mutually affecting one another Change in any part affects all other parts

7. Three basic assumptions distinguish system theory from other counseling approaches: Causality is interpersonal Psychosocial system are best understood as repeated patterns of interpersonal interaction, and Symptomatic behaviors must be understood from an interactional viewpoint. 7

8. Main concepts introduced by this theory are: Circular causality The idea that events are related through a series of interacting feedback loops. Scapegoating ( in which one person is singled out as the cause of the problem) And Linear causality (one action is seen a the cause of other) are eliminated. 8

9. 9 Bowen’s Family System Theory System = organized unit made up of interdependent parts Whole unit is greater than the sum of its parts Change in any part affects all other parts Family is system in which each member has a significant influence on all other members Families may struggle to find a healthy balance between two extremes: Enmeshment = over involvement in each others’ lives Disengagement = too much detachment from one another

10. View of Human Nature Chronic anxiety in all life that is both emotional and physical. Some individual are more affected than other “because of way previous generation in their families have channeled the transmission” If anxiety is low = problem exist for family If anxiety is high= people prone to illness 10

11. Bowen’s Family Systems Theory Central Constructs Differentiation of self Chronic anxiety Triangles Emotional distance 11

12. 12 Differentiation of Self Occurs when an individual is able to distinguish between intellectual processes and the feeling process he or she is experiencing. Greater fusion between individuals, poorer functioning ( Can’t differentiate b/w thoughts and feelings and have trouble differentiating themselves from others ). Highly differentiated = better at handling stress/anxiety Increased differentiation by one family member is likely to lead other members to become more differentiated Self-differentiation is principal goal of family therapy

13. Differentiation of self scale 13 Fusion Lowest levels Emotionally fused to the family Feelings dominate Differentiation of self Differentiation of self Highest levels Separate thinking from feelings

14. Chronic anxiety Bowen believed that there is chronic anxiety in all life that is both emotional and physical. Multigenerational transmission process Transmission of anxiety from generation to generation Patterns, themes and roles are passed through generations Less anxiety focused on children = more likely they’ll grow up w/ greater differentiation Child most involved in family’s fusion has lower differentiation 14

15. De-triangulation of Self from Family Emotional System Triangulation refers to the practice of two family members bringing a third into their conflict Triangles Smallest stable relationship system A major influence on the activity of a triangle is anxiety More anxiety = more distance, or closeness Less anxiety = comfortable back and forth discussion of feelings 15

16. Why Families Enter Therapy Stressors -- environmental and developmental -- arise in the normal course of a family’s life. The failure of its members to accommodate to stressors leads members to disengage from some members, and become enmeshed with others Indirectness of communication and anxiety ensues, with triangular relationships substituting for direct encounter and the pursuit of intimacy. Identified patient is usually reason for entering therapy, but often only the symptom of family distress.. 16

17. A distressed family Is often unwilling to take responsibility Interprets problems from a linear causality perspective , rather than a circula r perspective. Suffers a confusion of levels (children and parents) Forms coalitions (a parent and a child against another parent) 17

18. Counselor’s Role During the first interview, the therapist looks for the family’s motivations and encourages them to avoid resistances. He keeps away the risk of blames, in order to get the best participation possible. It should be avoided to the patient to be seen as a “scapegoat”. careful/sensitive attention 18

19. Goals Goals: if counseling is successful, clients will understand and modify the coping strategies and patterns of coping with stress that have been passed on from generation to generation. They will display a non-anxious presence in their daily lives and will be able to separate their thoughts from their feelings and themselves from others. 19

20. Sessions Family therapy tends to be a solution-focused and short-term approach, and generally around six to 20 sessions are needed for families to realize their strengths and find ways forward . For families and loved ones who are experiencing more complex difficulties however, further sessions may be needed. Sessions can last from between 50 and 90 minutes, and intervals between each one could be several weeks at a time depending on various factors, such as the problems being addressed, the stage of treatment and the needs of family members. Ultimately all elements of family therapy, including the setting, family therapy techniques and length of sessions will result from a collaboration and mutual agreement between the therapist and family. 20

21. Goals of Initial Sessions 1 . Outline Therapy Boundaries & Structure (introduction, teamwork, video, confidentiality, structure of the session & therapy, Questions). 2 . Engage and Involve all family members (supportive environment, hear from everyone, neutrality) 3 . Gather and Clarify Information (the context of therapy, the systems, presenting difficulties/issues, solution & success to date) 4 . Establish Goals and Objectives of Therapy 21

22. Middle Sessions Goals Develop and Monitor Engagement (Creating and offering choices about the process of therapy & Resolving issues in the family-therapist-team system as they arise) Gather Information and Focus Discussion (presenting difficulties, family system, solution & success) Identify & Explore Beliefs (presenting difficulties, relationship b/w family and wider system, solution & success, therapy process, family behavior) Work towards change at the level of beliefs and behaviors ( challenge existing patterns & assumptions, provide distance b/w family & problem, reframe, elicit solution, amplify change, enhance mastery, introduce therapist/team ideas) Return to Objectives and Goals of Therapy 22

23. End Sessions Goals Gather Information and Focus Discussion ( the presenting issues, solution & success, the system/wider system) Continue to work towards change at the level of behaviors and beliefs (amplifying change, enhance mastery, reframe, open up new stories & explanations , challenging new patterns & assumptions) Develop family understanding about behaviors and beliefs Secure Collaborative Decision re: Ending (positive feedback from the family, negative feedback from the therapy, therapist notice changes) Review the process of therapy 23

24. Techniques Techniques in this approach focus on ways to create an individuated person with a healthy self-concept who can interact with others and not experience anxiety every time the relationship becomes stressful . Ways of achieving this goal include assessment of self and family in a number of ways. 24

25. Multigenerational Genogram It’s a visual representation of a person’s family tree , depicted in geometric figure, lines and words. Genograms include information related to family and it’s member relationships with each other over at least three generations. A genogram helps people gather information, hypothesize and track relationship changes in the context of historic and contemporary events. 25

26. Genogram Tree 26

27. Content Based Questions The focus of this technique is on cognitive process. Ask questions of one’s family. The objective is to understand what happened in one’s family without any emotional overlay. A client may also go home again and visit with his or her family in order to get know them better. Such a procedure promotes person- to- person relationship on dyadic level and asking questions about pivotal events that had an impact on the family such as death, births and marriages. Asking questions is an important tool in Bowen’s work. 27

28. Detriangulation Focus on Detriangulation involves “the process of being in contact and emotionally separate with others. Detriangulation operates on two levels: One is to resolve anxiety over family situation and not project feelings onto others. The second is to avoid becoming a target or scapegoat for people who may be overcome with anxiety. 28

29. Differentiation of Self The ability of a person to distinguished between subjective feelings and objective thinking. Confrontation between client and the counselor is involves in becoming differentiated. 29

30. Proscribed Practices Advise Un-transparent/closed practices Therapist monologue (not give lecture) Consistently siding with one person Inattention to use of language 30

31. Reflections Sticking in one time frame (but past, present, future) Agreeing/not challenging ideas Ignoring information that contradict hypothesis Dismissing ideas Inappropriate affect Ignoring family affect Ignoring differences 31

32. Strengths and Contributions Cognitive emphasis of this approach and its focus on differentiation of self and Detriangulation are unique . Comprehensive process in assisting families Looks at many aspects of the family (i.e., atmosphere, constellation, goals) Respect is given to both children and adults Interventions are suggested to children and adults Focus on multigenerational family history Uses genograms in plotting historical links, which is specific tools that was originated with the Bowen approach. 32

33. Limitations This approach may required considerable investment on multiple levels, which some clients may not be willing or able to do . Parents feigning or embellishing Provides much insight into behavior, interactions, and motivation, but not many explicit interventions Client who benefit most from Bowen work are those who are severely dysfunctional or have a low differentiation of self. 33