{"id":4258,"date":"2018-09-18T18:26:38","date_gmt":"2018-09-18T22:26:38","guid":{"rendered":"https:\/\/www.amyork.ca\/academic\/zz\/?p=4258"},"modified":"2019-05-25T23:58:51","modified_gmt":"2019-05-26T03:58:51","slug":"family-group-therapy","status":"publish","type":"post","link":"https:\/\/www.amyork.ca\/academic\/zz\/psychological-counseling\/family-group-therapy\/","title":{"rendered":"Family\/Group Therapy"},"content":{"rendered":"<p>The family systems perspective<\/p>\n<ul>\n<li>During the 1950s the systemic family therapy began to take root<\/li>\n<li>Individuals are best understood through assessing the <strong>interactions within an entire family.<\/strong><\/li>\n<li>The development and behaviour of one family member is <strong>inextricably interconnected <\/strong>with others in the family.<\/li>\n<li>A family is an <strong>interactional unit <\/strong>and a change in one member affects all members.<\/li>\n<li>A systems orientation does not preclude dealing with the dynamics within the individual, but this approach broadens the traditional emphasis on individual internal dynamics &#8211; Working with and considering the family as a whole best facilitate change.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>View of symptoms<\/p>\n<ul>\n<li><strong><em>Symptoms <\/em><\/strong>are viewed as an expression of a dysfunction within a family \u00e0\u00e0 in a set of <strong>habits and patterns<\/strong> within a family.<\/li>\n<li>There are two types of behaviours that people present to family therapy: the individual (problematic child) or general difficulties (problems with communication or organization)<\/li>\n<li>This perspective is grounded on the assumptions that a client\u2019s problematic behaviour may:\n<ul>\n<li><strong>Serve a purpose<\/strong> for the family (e.g. scapegoating- focus is on one child rather than problems of someone else)<\/li>\n<li>Are <strong>unintentionally maintained<\/strong> by family processes o Are a function of the family\u2019s <strong>inability to operate productively<\/strong> o Are symptomatic patterns <strong>handed down across generations <\/strong>(e.g. eating disorders\/depression)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Systemic vs. Individual approaches\u00a0 &#8211; The systemic therapist may:<\/p>\n<ul>\n<li>Explore the system for family process and rules, perhaps using a genogram o Invite family members into therapy with the problematic individual o Be concerned with trans-generational meanings, rules, cultural and gender perspectives within the system, and even the community and larger systems affecting the family<\/li>\n<li>Intervene in way design to help change the individual\u2019s context &#8211; The individual therapist may:<\/li>\n<li>Focus on obtaining an accurate diagnosis, may use DSM<\/li>\n<li>Begin therapy with the individual immediately<\/li>\n<li>Focus on the causes, purposes, and cognitive, emotional and behavioural processes involving<\/li>\n<li>Be concerned with the individual experiences and perspectives o Intervene in ways design to help the individual cope<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Adlerian family therapy<\/p>\n<ul>\n<li>Developed by <strong>Alfred Adler, <\/strong>this approach is based on an educational model.<\/li>\n<li>Emphasis is on <strong>family atmosphere<\/strong> and <strong>family constellation<\/strong><\/li>\n<li>Therapists function as <strong>collaborators who seek to join the family<\/strong><\/li>\n<li>Parents interviews yield hunches about the purposes underlying children\u2019s misbehaviour\u00e0\u00e0 <em>all behaviour is purposeful.<\/em><\/li>\n<li>Children act in a pattern motivated by a desire to belong.<\/li>\n<li>Help recognize why the child is acting a certain way<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Treatment goals of AFT<\/p>\n<ul>\n<li>Unlock mistaken goals and interactional patterns<\/li>\n<li>Engage parents in a learning experience and a collaborative assessment\u00e0\u00e0 their role in the repetitive and negative interactions- can be particularly difficult if the child has been seen as the problem and scapegoated<\/li>\n<li>Emphasis is on the family\u2019s motivation patterns-<em>what is the problematic behaviour aiming to achieve? What do others do when I behave this way?<\/em> &#8211; Main aim is to initiate a reorientation of the family<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Multigenerational family therapy<\/p>\n<ul>\n<li>A theoretical and clinical model developed by <strong>Murray Bowen <\/strong>that evolved from psychoanalytic principles and practices\u00e0\u00e0 problems in one\u2019s family need to be understood by considering one\u2019s family of origin and their patterns of behaviour<\/li>\n<li>The family is viewed as an <strong>emotional unit<\/strong>\u00e0\u00e0<strong> each member has their own patterns.<\/strong><\/li>\n<li>Within the family unit, unresolved emotional reactivity to one\u2019s family unit- family of origin must be addressed if one hopes to achieve a mature and unique personality &#8211; Applicable to both individual and family therapy<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>MFT treatment goals<\/p>\n<ul>\n<li><strong><em>Differentiation of the self<\/em><\/strong><em>: <\/em>a psychological separation from others- separation of intellect and emotion and independence of the self- as in the process of individuation and development of self<\/li>\n<li><strong><em>Triangulation<\/em><\/strong><em>:<\/em> a third party- the therapist \u2013 is recruited to reduce anxiety and stabilize a couples\u2019 relationship.<\/li>\n<li>To change the individuals within the context of the system<\/li>\n<li>To end generation-to-generation transmission of problems by resolving difficult emotional attachments<\/li>\n<li>To lessen anxiety and relieve symptoms<\/li>\n<li>To increase the individual member\u2019s level of differentiation or self-identity<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Human validation process model<\/p>\n<ul>\n<li>Key concepts of <strong>Virginia Satir\u2019s<\/strong> model of family therapy include:\n<ul>\n<li>Enhancement and validation self-esteem o Family rules- understanding these rules o Congruence- emotional honesty and openness in communications.<\/li>\n<li>Sculpting their verbal\/non-verbal interactions with one another- family members design their relationship to one another using posture, facial and other gestures to create distance or closeness to one another- <strong>body language<\/strong><\/li>\n<li>Nurturing triads- establishing trust and gaining acceptance of the family \u2013 mother father child<\/li>\n<li>Family mapping (<strong>family of origin<\/strong>) and family-life chronologies<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Goals of Satir\u2019s HVPM<\/p>\n<ul>\n<li>Open communications\n<ul>\n<li>Individuals are allowed to honestly report their perceptions o Reduce communication stances used in times of stress.<\/li>\n<li>What are the responses to stress<\/li>\n<li>The four communication stances are blaming, placating, super reasonable and irrelevance<\/li>\n<li>\u00a7 <strong>Blaming<\/strong> \u2013 Shift responsibility to someone else<\/li>\n<li>\u00a7 <strong>Placating <\/strong>\u2013 Taking the blame to protect someone else from being held responsible<\/li>\n<li>\u00a7 <strong>Super Reasonable<\/strong> \u2013 Responding to a situation with facts and maintaining emotional control<\/li>\n<li>\u00a7 <strong>Irrelevance<\/strong> \u2013 Using distracting communication to avoid the situation<\/li>\n<\/ul>\n<\/li>\n<li>Enhancement of self-esteem\u00e0\u00e0 family decisions are based on individual needs<\/li>\n<li>Encouragement of growth\u00e0\u00e0 differences are acknowledged and seen as opportunities for growth<\/li>\n<li>Transform extreme rules into useful and function rules\u00e0\u00e0 families have many spoken and unspoken (implied) rules \u2013 can cause problems too<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Experiential Family Therapy<\/p>\n<ul>\n<li>Confrontational method<\/li>\n<li>A freewheeling, intuitive, sometimes outrageous approach developed by <strong><em>Carl Whitaker <\/em><\/strong>that aims to unmask pretense, create new meaning, and liberate family members to be themselves<\/li>\n<li>Whitaker stressed <strong>choice, freedom, self-determination, growth and actualization and used co-therapists. <\/strong><\/li>\n<li><strong>Techniques are secondary<\/strong> to the therapeutic relationship. As a therapist, intuition is important as an approach<\/li>\n<li><strong>Pragmatic and atheoretical<\/strong> \u2013 more <em>confrontational <\/em>in approach<\/li>\n<li><strong>Interventions create turmoil<\/strong> and intensify what is going on in the family as a motivation for change<\/li>\n<li>Speeds up the process<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Goals of EFT<\/p>\n<ul>\n<li>Facilitate individual autonomy and a sense of belonging in the family<\/li>\n<li>Help individuals achieve more intimacy by increasing their awareness and their experiencing<\/li>\n<li>Encourage members to be themselves by freely expressing what they are thinking and feeling- identify where this has been restricted<\/li>\n<li>Support spontaneity, creativity, the ability to play, and the willingness to be crazy<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Structural-strategic family therapy<\/p>\n<ul>\n<li>Origins can be traced back to the early 1960s<\/li>\n<li>Minuchin\u2019s (1974) central idea was that an individual\u2019s symptoms are best understand from the <strong>vantage point of interactional patterns within a family <\/strong>and that structural changes must occur in a family because symptoms can be reduced or eliminated.<\/li>\n<li>Goals:\n<ul>\n<li>Reduce symptoms of dysfunction<\/li>\n<li>Bring about structural change within the system by modifying the family\u2019s <strong>transactional rules and developing more appropriate boundaries.<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Recent innovations in family therapy<\/p>\n<ul>\n<li>In recent times, <strong>feminism, multiculturalism and postmodern social constructionism<\/strong> have all entered the family therapy field.<\/li>\n<li>These models are collaborative, <em>treating clients as experts in their own lives. <\/em><\/li>\n<li>These new approaches challenge <strong>first-order cybernetics- <\/strong>the view that counsellor and therapist as an observer outside of the system<\/li>\n<li>Feminist and postmodern models of family therapy are based on the perspective of <strong>second-order cybernetics<\/strong>\u00e0\u00e0 the family practitioner becomes part of the system and by being present with the family, changes it.<\/li>\n<li>How the family interact with the therapist can be commented upon and worked with<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>A multi-layered process<\/p>\n<ul>\n<li>Families are multilayered systems that both affect and are affected by the larger systems in which they are embedded<\/li>\n<li>Both the members and the system can be assessed based on <strong>power, <\/strong><strong>alignment, organization, structure, development, culture and gender<\/strong>.<\/li>\n<li>How the family has progressed developmentally<\/li>\n<li>The process of family therapy has movements\u00e0\u00e0 these can be described as separate experiences embedded in the larger flow of therapy.<\/li>\n<li>Four general movements:\n<ul>\n<li>Forming a relationship \u00e0\u00e0 understanding family process is almost always facilitated by <em>how questions. <\/em><\/li>\n<li>Conducting an assessment \u00e0\u00e0 may construct a <em>genogram<\/em> o Hypothesizing and sharing meaning<\/li>\n<li>Facilitating change\u00e0\u00e0 two common forms for facilitating change are <em>enactments and assignment of tasks.<\/em><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Strengths from a diversity perspective<\/p>\n<ul>\n<li>Many ethnic and cultural groups place great value on the <strong>extended family.<\/strong><\/li>\n<li><em>Monica McGoldrick <\/em>has been the most influential leader in the development of gender and cultural perspectives and frameworks in family practice<\/li>\n<li>Family therapist explore the individual culture of the family, the larger cultures to which the family members belong and the host culture that dominates the family\u2019s life.<\/li>\n<\/ul>\n<p>Limitations from a diversity perspective<\/p>\n<ul>\n<li>The process of differentiation occurs in most cultures, but it takes on a different shape due to cultural norms<\/li>\n<li>A possible shortcoming involves practitioners who assume <strong>western models of family are universal<\/strong><\/li>\n<li>Some family therapists focus primarily on the <strong>nuclear family, <\/strong>which is based on western notions, and this could be a shortcoming in working with clients in extended families.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Contributions of the family systems approach<\/p>\n<ul>\n<li>In most systemic approaches, neither the individual nor the family is blamed for a particular dysfunction<\/li>\n<li>An advantage to this approach is that an individual is not scapegoated as the \u201cbad person\u201d in the family although the family may have scapegoated one of the family members. This individual may be the reason that the family enters therapy.<\/li>\n<li>The family is empowered through the process of identifying and exploring internal, developmental, and purposeful interactional patterns.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Limitations of the family systems approach<\/p>\n<ul>\n<li>An overemphasis on the system may result in the unique characteristics of individual family members being overlooked. The individual may need personal therapy as well as benefit from family therapy.<\/li>\n<li>The reality is that it is not individual therapy.<\/li>\n<li>Concern with the well-being and function of the system may overshadow the therapist\u2019s view of the needs and functioning of individuals in the system<\/li>\n<li>Practitioners must <strong><em>not <\/em><\/strong>assume that Western models of family are universal and <strong>must be culturally competent.<\/strong><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Group therapy<\/p>\n<ul>\n<li>Why are groups important?\n<ul>\n<li>Provide the structure upon which families, communities and societies are built o Enable relationships to occur o Provide connection with others<\/li>\n<li>Facilitate learning of social norms, form identity and achieve personal goals<\/li>\n<\/ul>\n<\/li>\n<li>Group dynamics\n<ul>\n<li>Patterns of interactions that develop within groups over time<\/li>\n<li>How members behave in the group o How people think and feel in the group o The continuing responses and changes that occur &#8211; \u00a0 With positive group dynamics:<\/li>\n<li>The group\u2019s <strong>purpose is achieved<\/strong><\/li>\n<li>Individual members\u2019 <strong>socio-emotional needs are met<\/strong><\/li>\n<\/ul>\n<\/li>\n<li>Group dynamics\u00e0\u00e0 which can be observed o <strong>Resistance<\/strong>&#8211; silence, argumentative, lateness o <strong>Conflict<\/strong> against leader, against another member o C<strong>ohesion<\/strong>&#8211; developing a sense of \u2018<strong>we\u2019re in this together\u2019<\/strong>\n<ul>\n<li><strong>Unhelpful behaviours identified<\/strong>&#8211; attention seeking, splitting o <strong>Emergence of task\/work focus <\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Interaction patterns<\/p>\n<ul>\n<li>The interactional patterns we look at:\n<ul>\n<li>Communication\u00e0\u00e0 verbal\/non-verbal, who speaks to whom? Who is silent? Who speaks? Who listens? Who is disengaged\/bored? Who encourages other\/ is enthusiastic? o Group cohesion<\/li>\n<li>Group culture\u00e0\u00e0 Values, beliefs, traditions, rules<\/li>\n<li>Facilitator\u2019s role in identifying these patterns and working with them &#8211; How can these patterns be influenced?<\/li>\n<li>Leadership\/facilitation<\/li>\n<li>Importance of leadership in developing and maintaining a group<\/li>\n<li>Group leadership: <em>skills, knowledge, emotional resources, personality, ideas, vision, imagination, style of interaction<\/em><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Yalom and group psychotherapy<\/p>\n<ul>\n<li>The therapeutic factors<\/li>\n<\/ul>\n<p>o <u>Installation of Hope<\/u> \u2013Faith in the treatment method can be therapeutically effective o <u>Universality<\/u> \u2013 Most clients think they are alone or unique in their problems\u00a0\u00a0 o <u>Imparting Information<\/u> \u2013 Psycho-education and direct advice<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li><u>Altruism-<\/u> Clients receive through giving as part of the reciprocal giving-receiving sequence. Helping others has given me more self-respect<\/li>\n<li><u>The corrective recapitulations of the primary family group<\/u>&#8211; most who enter groups have a background of stress from their family of origin or primary family. Group<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>Therapy resembles a family. \u201cThis group is like my family.\u201d<\/p>\n<p>o <u>Development of socializing techniques<\/u> \u2013 Social learning which may be explicit. E.g. a group for Asperger\u2019s. In other groups it is indirect.<\/p>\n<ul>\n<li><u>Imitative behaviour<\/u> \u2013 Modelling of behaviours. Effective in a group for Asperger\u2019s<\/li>\n<\/ul>\n<p>Syndrome\u00a0\u00a0 o <u>Interpersonal Learning <\/u>\u2013 The Group as a Social Microcosm<u>\u00a0 <\/u>\u00a0o <u>Group Cohesiveness<\/u> \u2013 Belonging and acceptance by others<\/p>\n<ul>\n<li><u>Catharsis<\/u> \u2013 An opportunity to vent negative and positive feelings about the group leader or other members. The therapist makes sure something comes out from this.<\/li>\n<\/ul>\n<p><u>Existential Factors<\/u>&#8211; \u201cLife is not fair.\u201d \u201cTaking responsibility\u00a0 for my decisions.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The family systems perspective During the 1950s the systemic family therapy began to take root Individuals are best understood through assessing the interactions within an entire family. The development&hellip; <a class=\"continue\" href=\"https:\/\/www.amyork.ca\/academic\/zz\/psychological-counseling\/family-group-therapy\/\">Continue Reading<span> Family\/Group Therapy<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[98],"tags":[],"_links":{"self":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4258"}],"collection":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/comments?post=4258"}],"version-history":[{"count":1,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4258\/revisions"}],"predecessor-version":[{"id":4879,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/posts\/4258\/revisions\/4879"}],"wp:attachment":[{"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/media?parent=4258"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/categories?post=4258"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amyork.ca\/academic\/zz\/wp-json\/wp\/v2\/tags?post=4258"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}