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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Chapter 6: Family CounselingChapter 7: Group WorkChapter 8: Consultation and Supervision
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Twelve Assumptions Held by Most Family Counselors (see pp. 192-193)
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Bertalanffy Explains the interaction of all types of systems
Suprasystems Subsystems Interaction in one system affects all other
systems
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Cybernetics Control mechanism in systems Regulatory process Used to avoid disequilibrium in systems Acts like thermostat See Box 6.1, p. 195
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Salvadore Minuchin Interactional and Transactional Rules Boundaries Structure and Hierarchy Some Techniques
Joining Mapping Restructuring
See Box 6.4, p. 203
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
Arose out of Palo Alto Group and work of Milton Erickson Theorists: Jay Haley, Cloe 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)
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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)
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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© 2007 Thomson Brooks/Cole, a division of Thomson Learning
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
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