Ch 14: Family Systems Therapy

In assessing families, what question(s) might a structural-strategic therapist ask? "What rules and boundaries were set around each subsystem?" "What were common interactional sequences in your family?" "Who was aligned with whom, and what did they use that alignment to achieve?" "What were the routines that made up your neighbourhood's lifestyle, and what rules were created?"

"What rules and boundaries were set around each subsystem?"

Treatment Goals of Strategic Family Therapy

1. Resolve presenting problems by focusing on behavioral sequences 2. Get people to behave differently 3. Shift the family organization so that the presenting problem is no longer functional 4. Move the family toward the appropriate stage of family development

coalition

An alliance between two people against a third.

__________ is based on the subjective descriptions that family members use to define themselves and the interactions that occur in everyday life. Therapeutic techniques. Interventions. Diagnosis. Assessment.

Assessment

Treatment goals of Structural Family Therapy

1. Reduce symptoms of dysfunction and bring about structural change by: -Modifying the family's transactional rules -Developing more appropriate boundaries -Creating an effective hierarchial structure.

Families are multilayered systems that both affect and are affected by the larger systems in which they are embedded. T/F?

True

Families are multilayered systems that both affect and are affected by the larger systems in which they are embedded.​ T/F?

True

Family systems therapy represents a paradigm shift that is sometimes called "the fourth force."​ T/F?

True

Feminist, multicultural, and postmodern therapists are extremely aware of the power they have entering into already established systems, and they work to promote understanding through curiosity and interest rather than through formal assessments.​ T/F?

True

Structural-strategic family therapy deals with boundaries.​ T/F?

True

The cornerstone of Bowen's theory is differentiation of self.​ T/F?

True

The role of the family therapist involves being in charge of the session.​ T/F?

True

A Multilayered Process of Family Therapy

Families are multilayered systems that both affect and are affected by the larger system in which they are embedded. 2. Both members and the system can be assessed based on power, alignment, organization, structure, development, culture, and gender.

A family therapist poses the following question: "who seems to be most upset when mom comes home late from work?" She is asking _____ question.

a circular or relational

Strategic Family Therapy

1. Jay Haley developed this approach, which is often used in combination with Structural Family Therapy 2. Presenting problems are accepted as "real" and not a symptom of system dysfunction 3. Therapy is brief, process-focused, and solution-oriented 4. Change results when the family follows the therapist's directions and change transactions

Strengths from a Diversity Perspective

1. Many ethnic and cultural groups place great value on the extended family 2. Monica McGoldrick has been the most influential leader in the development of gender and cultural perspectives in family practice 3. The individual culture of the family, the larger cultures to which the family members belong, and host culture that dominates the family's life are explored

Multigenerational Family Therapy (MFT)

1. A theoretical and clinical model developed by Murray Bowen that evolved from psychoanalytic principles and practices 2. The family is viewed as an emotional unit 3. Unresolved emotional reactivity to one's family must be addressed if one hopes to achieve a mature personality 4. Differentiation of the self -A psychological separation from others -Triangulation -A third party is recruited to reduce anxiety and stabilize a couples relationship

Limitations of the Family Systems Approach

1. An overemphasis on the system may result in the unique characteristics and needs of individuals being overlooked 2. Practitioners must not assume that Western models of family are universal and must be culturally competent

Structural Family Therapy

1. Created by Salvador Minuchin, this approach focuses on family interactions to understand the structure, or organization of the family. 2. Symptoms are a byproduct of structural failings 3. Structural changes must occur in a family before an individual's symptoms can be reduced. 4. Techniques are active, directive, and well thought out.

Adlerian Family Therapy

1. Developed by Alfred Adler, AFT is based on an educational model that emphasizes family atmosphere and family constellation 2. Therapists are collaborators who seek to join the family 3. Parent interviews yield hunches about the purposes underlying children's misbehavior

Contributions of the Family Systems Approach

1. In most systemic approaches, neither the individual nor the family is blamed for a particular dysfunction 2. An individual is not scapegoated as the "bad person" in the family 3. Identifying and exploring internal, developmental, and purposeful interactional patterns empowers the family

Recent Innovations in Family Therapy

1. In recent times, feminism, multiculturalism, and postmodern social constructionism have all entered the family therapy field 2. These models are more collaborative, treating clients—individuals, couples, or families—as experts in their own lives 3. These models represent a real paradigm shift in the field of family therapy

Family Systems Perspective

1. Individuals are best understood through assessing the interactions within an entire family 2. A family is an interactional unit and a change in one member effects all members 3. A systems orientation broadens the traditional emphasis on individual internal dynamics

View of Symptoms

1. Symptoms are viewed as an expression of a dysfunction within a family. 2. Problematic behaviors: -serve a purpose for the family -are unintentionally maintained by family processes -reflect the family's inability to operate productively -Are symptomatic patterns handed down across generations.

Limitations from a Diversity Perspective

1. The process of differentiation occurs in most cultures, but it takes on a different shape due to cultural norms 2. Some practitioners may erroneously assume Western models of family are universal 3. Some family therapists focus primarily on the nuclear family, which is based on Western notions

MFT Treatment Goals

1. To change the individuals within the context of the system 2. To end generation-to-generation transmission of problems by resolving emotional attachments 3. To lessen anxiety and relieve symptoms 4. To increase the individual member's level of differentiation

A couple directs the focus of their energy toward a problematic son as a way to avoid facing or dealing with their own conflicts. This is an example of:​ a. ​triangulation. b. ​enmeshment. c. ​normal love. d. ​displacement.

1. Triangulation

experiential therapy

A therapeutic approach that emphasizes the value of the therapist's realness in interacting with a family.

Which approach from family therapy stresses unlocking mistaken goals, investigating birth order and family constellation, and reeducation?

Adlerian family therapy

Adlerian Family Therapy

An approach that is based on the premise that parents and children often become locked in repetitive, negative interactions based on mistaken goals that motivate all parties involved.

conjoint family therapy

An early human validation process model developed by Virginia Satir that emphasizes communication and emotional experiencing.

coaching

Bowen's and Whitaker's view of the role of the therapist in assisting clients in the process of differentiating the self.

differentiation of self

Bowen's concept of psychological separation of intellect and emotions and of independence of the self from others. The greater one's differentiation, the better one's ability to keep from being drawn into dysfunctional patterns with other family members.

Differentiation of the self is the cornerstone of which theory?

Bowenian family therapy

Which approach to family therapy stresses the importance of returning to one's family of origin to extricate oneself from triangular relationships?

Bowenian family therapy

Which of the following therapy models makes the most use to genograms, dealing with family of origin issues, and detriangulating relationships?

Bowenian multigenerational and family therapy

Which of the following is not a key general movement of the multilayered approach to family systems therapy? Forming a relationship. Hypothesising and sharing meaning. Conducting empirical research to evaluate outcomes. Conducting an assessment.

Conducting empirical research to evaluate outcomes.

Assessment is not considered useful in the family systems perspective. T/F?

False

Because Bowen's multigenerational approach looks at families from a three-generational perspective, the therapist is mainly interested in past happenings and does not pay much attention to present issues.​ T/F?

False

Bowen's multigenerational approach stresses techniques more than it does theory.​ T/F?

False

Minuchin and other structural family therapists initiated their work with wealthy suburban clients. T/F?

False

Structural-strategic family therapists do not generally deal with the presenting problem; rather, they focus on the underlying symptom of a dysfunctional system.​ T/F?

False

Structural-strategic family therapy has its foundation in behavioral theory.​ T/F?

False

The focus of family therapy includes all of the following except? Family therapy is not generally action-oriented. Most of the family therapies tend to be brief. Family therapy tends to be solution-focused. The focus is on here-and-now interactions in the family system.

Family therapy is not generally action-oriented.

The systemic therapist may do all of the following except: Explore the system for family process and rules, perhaps using a genogram. Focus on the cause, purposes, and cognitive, emotional, and behavioral processes involved in the client's problems. Invite family members into therapy with the client. Focus on the family relationships within which the continuation of the client's problem "makes sense."

Focus on the cause, purposes, and cognitive, emotional, and behavioral processes involved in the client's problems.

Which of the following roles and functions would be most atypical for a structural family therapist? Mapping the underlying structure of a family. Joining the family in a position of leadership. Intervening in ways designed to transform an ineffective structure of a family. Giving voice to the therapist's own impulses and fantasies.

Giving voice to the therapist's own impulses and fantasies.

Which model emphasises communication and emotional experiencing? Multigenerational family therapy. Human validation process model. Structural-strategic therapy. Structural family therapy.

Human validation process model.

To __________ is to form a set of ideas about people, systems, and situations that focus meaning in a useful way. be super reasonable. Hypothesise. placate. be irrelevant.

Hypothesise.

boundary

In structural family therapy, an emotional barrier that protects individuals within a system.

enactment

In structural family therapy, an intervention consisting of a family playing out its relationship patterns during a therapy session so that the therapist can observe and then change transactions that make up the family structure.

disengagement

Minuchin's term for a family organization characterized by psychological isolation that results from rigid boundaries.

enmeshment

Minuchin's term referring to a family structure in which there is a blurring of psychological boundaries, making autonomy very difficult to achieve.

Within the field of family therapy, ____ has been the most influential leader in the development of both gender and cultural perspectives and frameworks in family practice.

Monica McGodlrick

Within the field of family therapy, ________________has been the most influential leader in the development of both gender and cultural perspectives and frameworks in family practice. Jay Haley. Michele Weiner-Davis. John Gottman. Monica McGoldrick.

Monica McGoldrick

1. The concept of triangulation is most associated with:

Murray Bowen

__________ is/are determined by the practitioner's orientation or by a collaborative process between family and therapist. Specific goals. Interventions. Treatment. Techniques.

Specific goals.

A family therapist poses the following question: "Who seems to be most upset when mum comes home late from work?" She is asking _________________ question. an exception. an intrusive. a thought-provoking. a circular or relational.

a circular or relational.

Which of the following theorists emphasized the development of a nurturing triad?​ a. ​Satir b. ​Minuchin c. ​Bowen d. ​Haley

a. Satir

Techniques are more important to models that see the therapist-as-expert and in charge of making change happen. Collaborative approaches require:​ a. ​planning. b. ​individual interventions. c. ​isolation. d. ​individual techniques.

a. planning

Family therapy perspectives call for a conceptual shift from evaluating individuals to focusing on:​ a. ​system dynamics. b. ​individual symptoms. c. ​the identified client only. d. ​an individual's reactions.

a. system dynamics

Chun Hei is a Korean immigrant who has been separated from her family and friends for over a year since she came to the U.S. with her husband. She spends her days taking care of their two young children while he goes to work, and feels increasingly depressed without her support system. It is likely that a family therapist who meets Chun Hei would:​ a. ​be very interested in how her depression affects others in the family and how it influences family process. b. ​abandon using a systems approach, and treat her with cognitive behavioral methods. c. ​be directive and tell her to convince her husband to go back to Korea so she will once again have family support. d. ​prescribe her antidepressant medication.

a. ​be very interested in how her depression affects others in the family and how it influences family process.

In assessing families, what question might a structural-strategic therapist ask?

all of the above

What best defines the focus of family therapy?

all of the above

A basic assumption within the family system is that_____________. an individual's problematic behaviour only grows out of the interaction with the larger community. an individual's problematic behaviour grows out of the interactional unit of the family and not societal systems. an individual's problematic behaviour only grows out of the interactional unit of the family. an individual's problematic behaviour grows out of the interactional unit of the family as well as the larger community and societal systems.

an individual's problematic behaviour grows out of the interactional unit of the family as well as the larger community and societal systems.

When __________ occurs, a ripple effect flows throughout the family system.​ a. ​a negative behavior b. ​change c. ​an argument d. ​tradition

b. change

A major contribution of Bowen's theory is the notion of:​ a. ​birth order as a determinant of personality. b. ​differentiation of the self. c. ​family rules and communication patterns. d. ​spontaneity, creativity, and play as therapeutic factors in family therapy.

b. differentiation of the self

An integrative approach to the practice of family therapy includes guiding principles that help the therapist organize all of the following, except:​ a. ​interactions. b. ​medications. c. ​goals. d. ​observations.

b. medications

Adler introduced __________ to our understanding of the family system (or family constellation).​ a. ​cultural context b. ​the power structure c. ​phenomenology d. ​balance of leadership

c .Phenomenology

In the assessment process, questions a family therapist might ask include all of the following, except:​ a. ​What does each family member bring to the session? b. ​Are the parents effective leaders of the family, and is the process of leadership balanced or imbalanced? c. ​How can I give voice to my own impulses and fantasies? d. ​Who makes decisions? How are conflicts resolved or problems handled?

c.

A tool for collecting and organizing key relationships in a three-generational extended family is a:​ a. ​projective test. b. ​family sketch. c. ​genogram. d. ​lifestyle assessment.

c. genogram

Alfred Adler and Rudolf Dreikurs and their associates were the first known practitioners of family therapy, often using a model now called:​ a. ​closed-forum individual counseling. b. ​closed-forum family counseling. c. ​open-forum family counseling. d. ​open-forum individual counseling.

c. open-forum family counseling.

Roger and his wife are experiencing tension in their relationship because he believes she is far too lenient with their children when they misbehave. This forces him to play the role of "bad cop" as a parent, which makes him angry. A family therapist working with Roger and his family might:​ a. ​take Roger's side and educate his wife about appropriate disciplinary practices. b. ​focus on getting the children to stop misbehaving so that Roger and his wife won't experience this tension. c. ​help to modify the family's transactional rules and develop more appropriate boundaries. d. refer Roger to individual therapy since he clearly needs to work through his unresolved issues that are causing him to feel so angry.

c. ​help to modify the family's transactional rules and develop more appropriate boundaries.

Which of the following is NOT a key general movement of the multilayered approach to family systems therapy?

conducting empirical research to evaluate outcomes

The antidote to stress communications, according to Satir, is _____, in which family members are emotionally honest, speak for themselves, stay grounded, and are able to share their feelings and ask for what is needed.

congruence

The core of __________ model relied on the power of congruence to help family members communicate with emotional honesty.​ a. ​social constructionist therapy b. ​strategic family therapy c. ​multigenerational family therapy d. ​human validation process

d. human validation process

By the late 1970s, the most used models in family systems therapy are:​ a. ​behavioral approaches. b. ​existential approaches. c. ​the family process approach. d. ​structural-strategic approaches.

d. structural-strategic approaches.

Feminism, multiculturalism, and postmodern social constructionism have all entered the family therapy field. These models are more collaborative, treating clients as:​ a. ​an individual without the ability to make decisions. b. ​needing an expert. c. ​passive participants in their journey. d. the experts in their own lives.​

d. the experts in their own lives.​

The therapy goals self-esteem and connection, and helping family members achieve congruent communication and interaction are most associated with which theory of family therapy?​ a. ​Minuchin's structural family therapy b. ​Dreikurs's experiential/symbolic family therapy c. ​Bowen's multigenerational family therapy d. ​Satir's human validation process model

d. ​Satir's human validation process model

From the family systems perspective, symptoms are often viewed as:​ a. ​evidence of psychopathology. b. ​a result of cognitive distortions. c. ​a sign of weakness. d. ​an expression of a set of habits and patterns within a family.

d. ​an expression of a set of habits and patterns within a family.

Structural family therapy includes all of the following goals except for bringing about structural change by:​ a. ​developing more appropriate boundaries. b. ​modifying the family's transactional rules. c. ​reducing symptoms of dysfunction. d. ​the therapist taking a not-knowing stance with a family.

d. ​the therapist taking a not-knowing stance with a family.

Structural family therapy includes all of the following goals except for bringing about structural change by:​ a. ​modifying the family's transactional rules. b. ​reducing symptoms of dysfunction. c. ​developing more appropriate boundaries. d. ​the therapist taking a not-knowing stance with a family.

d. ​the therapist taking a not-knowing stance with a family.

Which of the following approaches most often employs a co-therapist model, makes use of self-disclosure, uses the therapist's self as change agent, and frequently uses confrontation?

experiential family therapy

Experiential family therapy relies on the expert use of directives aimed at changing dysfunctional patterns.

false

The trend today is toward reliance on a single theory of family therapy rather than using an integrative approach

false

____ views the counselor and therapist as an observer who is outside of the system, can assess what is going on, and can promote change--all without ever becoming part of the system.

first-order cybernetics

Which of the following roles and functions would be most atypical for a structural family therapist?

giving voice to the therapist's own impulses and fantasies

Virginia Satir outlined four communication stances that people tend to adopt under stress. They include all of the following stance except for

sabotaging

Directives and paradoxical procedures are most likely to be used in which approach to family therapy?

strategic family therapy

By the late 1970s, the most used models in family systems therapy were: structural-strategic approaches. Adlerian family approaches. structural family therapy. strategic therapy.

structural-strategic approaches.

One of the strengths of the systemic perspective in working from a multicultural framework is: that many ethnic and cultural groups place great value on the extended family. that all cultural groups place minimal value on extended family. that ethnic and cultural groups do not place any value on the extended family. that all ethnic groups place minimal value on extended family.

that many ethnic and cultural groups place great value on the extended family.

The central principle agreed upon by family therapy practitioners, regardless of their approach, is ___________. that the client must understand differences in the living system in order to create healthy relationships. that the client is at fault for the problems. that the client is connected to living systems. that the client is not connected to living systems.

that the client is connected to living systems.

A multilayered process of family therapy is best supported by a collaborative therapist-client relationship in which mutual respect, caring, empathy, and a genuine interest in others is primary.

true

All change in human systems starts with understand and accepting things as they are.

true

Conducting an assessment is one of the phases of the mutlilayered perspective in family therapy.

true

In terms of assessment, it is useful to inquire about family perspective on issues inherent in each of the lenses.

true

Reframing is the art of putting what is known in a new, more useful perspective.

true

The emergence of feminist and post-modern perspectives has moved the field of family therapy toward more egalitarian, collaborative, and constructing relationships

true

The family therapist's skill is communicating understanding and empathy through active listen lays the foundation for an effective working relationship.

true

Understanding family process is almost always facilitated by "how" questions.

true