Quiz 3• Enactment

Therapeutic contract

As used by behavioral family therapists, written negotiated agreements between family members to make specific behavior changes in the future.

Alignments

Clusters of alliances between family members within the overall family group; affiliations and splits from one another, temporary or permanent, occur in pursuit of homeostasis.

ARBITRARY INFERENCES

Conclusions drawn in the absence of supporting substantiating evidence. ("She's late returning from work. She must be having an affair.")

Coalition

Covert alliances or affiliations, temporary or long term, between certain family members against others in the family.

Sequences

Strategic therapists also track interactional sequences of events, which are likely to be circular.Rather than treating the individual offender, strategists change the relevant interactional sequence of the presenting problem, helping the family replace painful or escalating sequences between members with a calmer and more conciliating sequence.

Direct communication

Surface level or content level communication. Problems may arise when a message at the first level ("Nice to see you") is contradicted by a facial expression or voice tone that communicates another message ("How can I get away from this boring person?") at the second level.

First-Order Changes

Temporary or superficial changes within a system that do not alter the basic organization of the system itself.

Developing Therapeutic Strategies

The focus throughout is alleviating the presenting problem, and not exploring its roots or buried meanings. Likely to be short term, limited to specific problems and tailored to solutions. Therapists intervene when they see the need to do so (rather than when family requests input from the therapist), comment openly about the family's efforts to influence or control them, give directions and assign tasks and assume temporary leadership with the family group. Strategic tactic- emphasize the positive by relabeling previously defined dysfunctional behavior as reasonable and understandable.

Social learning theory

The theory that a person's behavior is best understood when the conditions under which the behavior is learned are taken into account.

Joining

The therapeutic tactic of entering a family system by engaging its separate members and subsystems, gaining access in order to explore and ultimately

Double binds

The view that an individual who receives important contradictory injunctions at different levels of abstraction—about which he or she is unable to comment or escape—is in a no-win, conflict-producing situation.

Functional model

fosters both cognitive and behavioral changes in individuals and their families. The model, which purports to integrate learning theory, systems theory, and cognitive theory, goes beyond most behavioral models by attempting to do more than change overt behavior. This posits that clients need help first in understanding the function the behavior plays in regulating relationships. This has emerged as a clinically relevant, evidence-based intervention used widely to treat adolescent behavioral problems, especially underserved youth with problems with violence, delinquency, and substance abuse.

Family Subsystems

have appropriate tasks and functions. Example: parents, their function is to care for the family

The Initial Interview

insists the whole family attend, sets the stage for the entire course of therapy. strategists negotiate with the family to decide what specific problem requires attention, then formulate a plan of action to change the family's dysfunctional sequences or faulty hierarchy in order to eliminate the problem. The stages are: brief social stage, problem stage, problem stage, the goal-setting stage, and task-setting stage. If the initial interview is successful, family members feel comfortable with the therapist and committed to working together for change.

Family Structure

invisible set of rules governing family transactions

Enactment

is a staged effort by the therapist to bring an outside family conflict into the session so that family members can demonstrate how they deal with it. The therapist can observe the conflict sequence and begin mapping a way to modify the members' interaction and create structural changes. Using this technique, the therapist has the players act out their dysfunctional transactions rather than simply describe them

What are the two strengths of strategic family therapy?

its insistent attention to removing the disturbing symptom or dysfunctional behavioral sequence by continuously tracking the family's patterns of interpersonal exchanges and its use of assignments of tasks to achieve therapeutic ends

Structural model

use of spatial and organizational metaphors, both in describing problems and identifying solutions and in its insistence on active therapist direction

Clearly defined boundaries

between subsystems help maintain separateness and at the same time emphasize belongingness to the overall family system. In an ideal arrangement, the clarity enhances the family's overall well-being by providing support and easy access for communication and negotiation between subsystems while simultaneously encouraging independence and the freedom to experiment by the members of the separate subsystems.

Family mapping

An assessment technique used by structural family therapists to graphically describe a family's overall organizational structure and determine which subsystem is involved in dysfunctional transactions.

OVERGENERALIZATION

An isolated incident or two is allowed to serve as representative of all similar situations, related or not. ("She turned me down for a date Saturday night. I'll always be rejected.")

MAGNIFICATION AND MINIMIZATION

A case or circumstance is perceived in a greater or lesser light than is appropriate. ("Our checkbook is out of balance. We're financially ruined.")

Meta communication

A message about a message, typically nonverbal (a smile, a shrug, a nod, a wink), offered simultaneously with a verbal message, structuring, qualifying, or adding meaning to that message.

Prescribing the symptom

A paradoxical technique in which the client is directed to voluntarily engage in the symptomatic behavior; as a result, the client is put in the position of rebelling and abandoning the symptom or obeying, thereby admitting it is under voluntary control.

The Meaning of Symptoms

A strategy that is active to a current social situation for controlling a relationship when all other strategies have failed

BIASED EXPLANATIONS

A suspicious type of thinking about a partner, especially during times of interpersonal stress, assuming his or her negative intent. ("He's acting real 'lovey-dovey' because later he'll ask me to do something he knows I hate to do.")

What does strategic therapy rely on?

A therapeutic approach in which the therapist develops a specific plan or strategy and designs interventions aimed at solving the presenting problem.

Tracking

A therapeutic tactic associated with structural family therapy in which the therapist deliberately attends to the symbols, style, language, and values of the family, using them to influence the family's transactional patterns.

Accommodating

A therapeutic tactic, used primarily by structural family therapists, whereby the therapist attempts to make personal adjustments in adapting to the family style in an effort to build a therapeutic alliance with the family.

Therapeutic Assumptions

Emphasizes irony in the solution people use in attempting to alleviate a problem often contributes to the problems maintenance even worsening. Problems can arise from anything. A pragmatic, therapist-directed approach breaks into the family's repetitive and negative cycle. The MRI therapist wants to know what makes the behavior persist and what he or she must do to change it. The therapist must carefully delineate the problem in clear and concrete terms.

DICHOTOMOUS THINKING

Experiences are codified as complete successes or complete failures. (A husband asks his wife how his paperhanging job is going. She questions the smoothness of one seam, to which he replies, "I can't do anything right in your eyes.")

Second-Order Changes

Fundamental changes in a system's organization, function, and frame of reference, leading to permanent change in its interactive patterns.

Unbalancing

In structural family therapy, a technique for altering the hierarchical relationship between members of a system or subsystem by supporting one member and thus upsetting family homeostasis.

What are the 3 major thesis of the structural model?

Individual symptoms are rooted in the context of family transaction patterns. Family organization or structure must change before symptoms are relieved. The therapist must provide a directive leadership role in changing the structure or context in which the symptom is embedded.

Power

Influence, authority, and control over an outcome.

SELECTIVE ABSTRACTIONS

Information taken out of context, highlighting certain details and ignoring others. ("He didn't say good morning when we woke up. He must be angry.")

MIND READING

Knowing what the other is thinking without asking and, as a consequence, ascribing unworthy intentions to the other. ("I know what's going on in her mind. She's trying to figure out a way to dump me.")

What are the 3 major steps in designing a paradox?

Redefining, Prescribing, and Restraining

Schema

Relatively stable cognitive structures involving underlying core beliefs a person develops about the world.

Hierarchies

Without viewing a client family's hierarchical structure as functional or dysfunctional, strategists want to know what roles each member plays and whether problems arise because people are unhappy with their roles. Strategic therapists are especially attuned to oppositional behavior that may develop in a family when assigned or ascribed roles are uncomfortable or no longer fit and conflictual communication and behavioral sequences follow.

Diffuse boundaries

are excessively blurred and indistinct, so easily intruded upon by other family members. Here, parents are too accessible, and contact with their children may take the form of hovering and the invasion of privacy. Children run the risk of becoming too involved with their parents, in the process failing to develop independence or to learn the skills for developing relationships outside the family. Because there is no clear generational hierarchy, adults and children may exchange roles easily, and a member's sense of self or personal identity becomes hard to establish for later adulthood. Here children may feel supported and cared for by parents, but it is often at the expense of feeling free to take independent (and possibly disapproved-of) actions.

Mental Research Institute: MRI Interactional Family Therapy: Developing a Communication Paradigm

based largely on general systems theory, cybernetics, and information theory. It encourages the simultaneous study of semantics (the clarity of meaning between what is said and received), syntax (the pattern as well as manner or style in which information is transmitted), and pragmatics (the behavioral effects or consequences of communication),

Reframing

changes the original meaning of an event or situation by placing it in a new context in which an equally plausible explanation is possible. The idea is to relabel what occurs in order to provide a more constructive perspective, thereby altering the way the event or situation is viewed. As used by structuralists, this relabels the problem as a function of the family structure.

Excessively rigid or inflexible boundaries

lead to impermeable barriers between subsystems. In this case, the parents and children—the generational hierarchy—are separate and distinct; the members of neither subsystem are willing or able to enter into the other's world. With parents and children unable to alter or cross subsystem boundaries when necessary, autonomy may be maintained, but nurturance, involvement, and the easy exchange of affection with one another are typically missing. While the child in such a family may gain a sense of independence, it may come at the price of feeling isolated from others and unsupported during critical times.

Strategic model

offer active and straightforward therapeutic interventions aimed at reducing or eliminating the presenting family problems or behavioral symptoms. Less focused on the meaning of the symptom or its origins, strategists typically issue a series of directives or tasks to the family. These aim to change repetitive interactive sequences that lead to crossgenerational conflict, sometimes without the cooperation of family members or their awareness that they are being manipulated into doing so.

The Use of Directives

play a role in strategic family therapy by getting people to behave differently so they will have different subjective experiences, to intensify the therapeutic relationship by involving the therapist in the family's actions between sessions, and to gather information by their reactions as to how the family members respond to the suggested changes

Triangles

problems involve the interaction of at least three parties (with a coalition of a minimum of two against at least one other). While larger numbers may exist in a family, they argue that the triangle is the preferred way of describing family interaction

Restructuring Transactional Patterns

realign family boundaries and roles to be more adaptive to the entire family

Enmeshment

refers to an extreme form of proximity and intensity in family interactions in which members are overconcerned and overinvolved in each other's lives. The family's lack of differentiation between subsystems makes separation from the family an act of betrayal. Belonging to the family dominates all experiences at the expense of each member's self-development. Whatever is happening to one family member reverberates throughout the system.

Paradoxical Intervention

represent a particularly ingenious way of maneuvering a person or family into abandoning dysfunctional behavior. Similar to "prescribing the symptom," this technique is particularly appropriate for strategists because they assume that families who come for help are also frightened and therefore resistant to the help being offered. If not careful, the therapist can easily get entangled in the family's contradictory logic of "help me change, but without changing anything."

Boundary permeability

that degree of accessibility helps determine the nature and frequency of contact between family members.

What do functional family therapists believe about behavior?

that it is adaptive. Rather than being thought of as "good" or "bad," it is viewed as serving a function, representing an effort to create a specific outcome in relationships.

The Communications Outlook

the manner in which information is exchanged within a family; the precision, clarity, or ambiguity of the transmission; and the behavioral or pragmatic effect of the communication, as much as the content of what is communicated—help determine those relationships. In shifting the locus of pathology from the individual to the social context. Communication theorists argue that a circular interaction continues between people because each participant imposes her or his own punctuation on what is being communicated; that is, each believes that what she or he says is caused by what the other person says. Also, the early view of the therapist as an authoritative expert strategically directing— manipulating—families to change has largely been replaced by a collaborating therapist or coach without fixed ideas of how the family should change.