Couples and Family CounselingCPS-508 Instructor: Sarah SpiegelhoffAdam SchwartzSusan Brockway

Defining The FamilyThose persons who are Biologically

and/or Psychologically related through historical, emotional, or economical bonds and who perceive themselves to be part of a household.

-Gladding, 2007

Key Characteristics of The Family

Nonsummativity- Is greater than the sum of it’s parts.

IndividualMembers

Patterns between members

NonsummativeWhole

Key Characteristics (Cont.) Equifinality- Similar Family patterns can

arise from varying origins just as similar origins can result in differing family patterns.

Family Pattern

x

Origin A

Origin B

Origin C Origin

A

Family Pattern

Z

Family Pattern

W

Family Pattern

X

Family Pattern

Y

Key Characteristic (Cont.) Communication- All behavior is the

result of interpersonal messages Content- Factual information Relationship- How the information is delivered

Content Delivery

Value of Communication

Key Characteristic (Cont.) Family Rules

Rules Structures- Explicit and implicit rules governing action of family members.

Roles Sub-systems- Expectations regarding individual behavior and responsibilities of members

Boundaries- Invisible barriers that regulate amount and type of contact between individual members.

Key Characteristics (Cont.) Morphogenesis- The ability a system to

remain self-directed and modify it’s patterns to under new circumstances in order to remain stable. (positive feedback loop) Ex. If a father returned to school then certain

adjustments are allowed for such as giving him uninterrupted study time and functioning on less disposable income in order to maintain family stability.

Key Characteristic (Cont.)

Homeostasis- The tendency of a family to remain stable unless forced to change. When a member upsets the balance of homeostasis, the other members react in order to maintain balance. (negative feedback loop) Ex. Staging an intervention for a family

member abusing substances.

1.Unattached Adult- Differentiation from family of origin/Initiation of Career/ Development of peer relations

2.Newly Married Adults- Making room for spouse with family and friends/ Adjusting Career demands/ Formation of marital system

3.Childbearing Adults- Adjusting marriage to make room for child/ Taking on parental roles/ Making room for grandparents

Gladding & Newsome 2010

Gladding & Newsome 2010

4. Preschool-age Child- Adjusting family to the need of specific child(ren)/ Taking time as a couple/ Coping with energy drain and lack of energy

5. School-age Child- Extending family/society interaction/ Encouraging the child’s educational progress/ Dealing with increased activities and time demands

6. Teenage Child-Shifting the balance in the parent-child relationship/Refocusing on midlife career and marital issues/ Dealing with increased concerns for older generation

Gladding& Newsome 2010

7. Launching Center-Releasing adult children into work , college, marriage/ Maintaining supportive home base/ Accepting occasional returns of adult children

8. Middle-aged Adults- Rebuilding the marriage/ Welcoming children’s spouses, grandchildren into family/ Dealing with aging of one’s own parents

9. Retired Adults-Supporting middle generation/Maintaining individual and couple functioning/Closing or adapting family home

Varieties of Family Formations

Type Minority Ethnic

Dual-Career

Single-Parent

Childless

Particular Stressors

Biases, Misunderstandings, Stereotyping

Conflict and stress between work and family responsibilities, Gender-typing

Financial hardships, underemployment, Availability of social support

Fertility issues, Stigmatization, Mourning of children never had

Varieties of Family FormationsType

Remarried

Gay & Lesbian

Aging

Multigenerational

Military

Particular Stressors

Developing new roles and new rules

Traditional Concerns, Internalized Homophobia, Lack of Societal Validation

Health concerns, Relaunching of adult children, Aging parents moving in with adult children

Space restrictions, Economic restrictions, Stress on parent subunit

Frequent uprooting, Dangerous deployments, International affairs

Family Structure Rules/Structures-Taken from societal

norms to help form initial interactions and may become modified by resulting emergence of sub-systems’ interaction.

Roles/Sub-systems-Determined by initial interactions and once established shape future interactions.

Boundaries-Determinations of the amount and type of contact between the subsystems.

The Vertical and Horizontal Family Life Stressors

The Family Circumplex Model

Family Imbalance- Cohesion

Enmeshed Vs.

Diffuse sub-system boundaries

High in support at the expense of independence.

Leads to trouble relating to others outside the system.

Disengaged

Results from solid boundaries between sub-systems.

Leaves individuals isolated.

Limits nurturing and affection.

Family Imbalance- Adaptability

Chaotic Vs.

Allows little concern for original parental relationship

Leaves sub-systems’ expectations and boundaries undefined

Can lead to low self-esteem and antisocial behavior in children

Rigid

Can result in emotional distance between parents and children

Leads to an inability to deal with the unexpected

Can stifle curiosity and a sense competence.

J.A.M.R. Counseling Model Joins family-Counselor and Family get to know each

other and rapport is built.

Assessment-What brings them in, Each person presents from their own point of view.

Monitoring-Counselor watches to see how this proceeds and observes sub-system interactions.

Restructuring-A more harmonious set of rules, roles, and boundaries begins to be constructed.

Theoretical Approaches to Family CounselingSocial-learning

Based on the premise that we learn behavior by observing and modeling others.

A deficit or excess of learned behavior is at the core of the problem.

Self-reports, communication-enhancement, contracting, and other homework is used for skill-building.

Emphasis on the present and linear thinking.

Theoretical Approaches to Family CounselingBowen Family Systems

Focuses on undifferentiated togetherness (fusion) or physical or psychological avoidance (cutoff)

Often one or both spouses have not clearly defined themselves as separate from their family of origin.

Problems stem from triangulation with marriage itself, a child, or outside influence

Techniques are used to form a healthy concept of self that can couple with less anxiety.

Theoretical Approaches to Family CounselingStructural-Strategic

Active behavioral approach focused towards specific goals.

Symptomology is a result of maladaptive reactions to the progressing family life cycle.

Uses homework assignments such as Relabeling, Paradoxing, & Prescribing The Symptom.

A specific behavior is targeted for change with the expectation that a spillover effect will occur and bring about changed in other behaviors.

Theoretical Approaches to Family CounselingR.E.B.T.

“Double Systems” approach seeking both individual and family systems change.

Uses the ABC’s of REBT to address distorted and irrational thoughts.

Focus is on changing individual distorted cognitions first while working with clients alone.

After individual assessment the couple’s shared irrational beliefs regarding marital issues are addressed.

Theoretical Approaches to Family CounselingPsychoanalytic

Object-related approach. Objects are unconscious preferences

derived from experiences with other generations.(i.e. primary family)

Interpretations, dreams, analysis of resistance, transference, and catharsis are used.

New insights lead to changed behavior.

Rubin Hill’s Crisis Intervention Model

A + B + C = XActivating Event

Beliefs- Assessment of Interpretations

Coping Skills- Assessment of Availability and efficacy

X-Restructuring

Integrative Models Eclecticism Selective

Borrowing Comprehensive

Models that combine two or more distinct approaches

Case Study A 15 year old adolescent girl who is an insulin

diabetic and overweight – binge eats because she has no friends and no social life. Her previous failed attempts to make friends put her in the hospital due to her sugar level instability. Mother and daughter are locked in a battle in which the mother is enmeshed and constantly criticizing the daughter because she is irresponsible with regard to her medical condition. The daughter wants to be independent, she says she is no longer a child and her mother will not allow her to make her own choices. How would you help this family?