Family Therapy

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Information about Family Therapy
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Published on October 5, 2010

Author: slubaguio

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Family Life Cycle : Family Life Cycle DR.A.ANAND, PhD www.eisrjc.com www.peerc.com www.aerassociation.com Seven stages of family life cycle : Seven stages of family life cycle 1. Pairing/Marriage Fusion Leaving family of origin (emotionally and physically) Readiness for intimacy (psychological and sexual) Agreeing roles, goals and values Complementarities /symmetry of marital relationship 2. Childbearing : 2. Childbearing Sharing each other Role ambiguity - wife, woman or mother? Two's company, three's a crowd Pairing off 3. School-age-Children : 3. School-age-Children Providing security (emotional and environmental) How to be a parent Separation anxiety Involvement with community Mother with more time again Differences between children 4. Family with adolescent children : 4. Family with adolescent children Control versus freedom Power struggle and rebellion Individuation Social and sexual exploration 5. Family as a launching ground : 5. Family as a launching ground Changing roles of children still at home The empty nest - loss or opportunity? Parents rediscover each other Latent marital conflict 6. Middle Years : 6. Middle Years Mid-life crisis Fulfillment /disappointment Accepting limitations Changing self-image Anticipating retirement ? Death of parents 7. Old Age : 7. Old Age Aging, illness and death Closing-in of boundaries Achieving serenity Religion and philosophy Isolation/dependency Bereavement Family Dynamics : Family Dynamics DR.A.ANAND, PhD www.eisrjc.com www.peerc.com www.aerassociation.com Defining family dynamics : Defining family dynamics Family dynamics refers to the ways in which family members relate to one another. Because humans are capable of change, and family members take part in different experiences, the dynamics within a family never remain the same. People often look at family dynamics in the context of what makes a family dysfunctional Assessing Family Dynamics : Assessing Family Dynamics 1. Leadership Functional leadership Nominal leadership Stop gap leadership Clarity of authority Assessing Family dynamics : Assessing Family dynamics 2. Role: Role play of the family members, clarity of roles 3. Communication: Adequate, appropriate communication, Double bind communication Communication should be open and positively oriented Assessing Family dynamics : Assessing Family dynamics 4. Social support: Inter-personal and intra-personal relationship Adequate and inadequate 5. Cohesiveness: Cohesive family within and outside Family Therapy : Family Therapy DR.A.ANAND, PhD www.eisrjc.com www.peerc.com www.aerassociation.com Family Therapy : Family Therapy Family therapy, also referred to as couple and family therapy and family systems therapy, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. It tends to view change in terms of the systems of interaction between family members. It emphasizes family relationships as an important factor in psychological health. Psychologists who contributed to the history of family therapy. : Psychologists who contributed to the history of family therapy. Family therapy did not become a popular mode of treatment until the late 1950s and early 1960s. However, when researching the history of family therapy, there are several psychologists in the early part of the 20th century that had an influence on how family therapy developed. These early pioneers came to the understanding that a patient’s progress in therapy often was influenced by the relationship within the family unit. Patients with good family dynamics faired much better than those that were in less stable families Psychologists who contributed to the history of family therapy : Psychologists who contributed to the history of family therapy In the early 1920’s, social psychologists studying group dynamics, realized the behaviors of individual members within the group influenced how the group functioned as a whole. Psychologists began to understand that this same group process could be applied to a family unit. Psychologists who contributed to the history of family therapy : Psychologists who contributed to the history of family therapy One of the early psychologists that greatly influenced the history of family therapy is Virginia Satir. She began working with families in 1951, and she held the belief that families need to share their feelings and affections to have a healthy family life. Ms. Satir also strongly believed love and nurturing were of the highest importance to heal the family unit. Psychologists who contributed to the history of family therapy : Psychologists who contributed to the history of family therapy Other psychologists whose influence contributed to the history of family therapy include, John Elderkin Bell. Although not as well known as other therapists, Edward Bell’s approach to family therapy was to develop a step-by-step plan to treat problems within the family. He believed these steps would help families improve communications and aid in resolving family issues. Psychologists who contributed to the history of family therapy : Psychologists who contributed to the history of family therapy Nathan Ackerman strongly advocated for all members of a family to be included in treatment, not just the member having difficulties, and said this was the best form of treatment for children. He also founded the Family Mental Health Clinic in New York City in 1957 and the Family Institute in 1960, which was later renamed the Ackerman Institute Psychologists who contributed to the history of family therapy : Psychologists who contributed to the history of family therapy Paul Watzlawick believed communication was the key to the well being of the family unit; Edward Sapir, an anthropologist, also thought communication in the family unit was important, and Gregory Bateson added to the history of family therapy by coining the term “system thinking”, referring to a system of interacting within a family. Psychologists who contributed to the history of family therapy : Psychologists who contributed to the history of family therapy Over time, due to the major impact of the above therapists and many others as well, The family therapy focused not only on the affected individual but also the whole family Eventually the combination of family therapy and medications evolved as an effective mode of treatment. Tenets of Family Therapy : Tenets of Family Therapy DR.A.ANAND, PhD www.eisrjc.com www.peerc.com www.aerassociation.com Tenets of Family Therapy : Tenets of Family Therapy Individual psychotherapy is sought for a number of reasons, one of which is family problems. Families can have a powerful effect on an individual's behavior. As such, seeking individual treatment may not be sufficient. Changes may need to be made in one's family for progress to occur. Family therapy allows the patient and the patient's family to address specific issues or events that may be causing the tension or hindering the patient's recovery. 1. Features : 1. Features Family therapy is a form of psychotherapy that includes members of the patient's immediate, and sometimes extended, family. Weekly therapy sessions generally last 45 to 50 minutes and may be conducted by one or more therapists. These sessions are focused on specific issues and tend to require several months of treatment to be resolved. 2. Considerations : 2. Considerations Family therapy is only beneficial if members are willing to participate. The purpose is to help families adjust to a change in the family. Helping families adjust to a new baby or a divorce could result from family therapy. It is not recommended for families with long-term dysfunction. 3. History : 3. History Initially, the treatment of psychological conditions was provided through the relationship between a patient and doctor. In the 1950s, this treatment was extended to include the patient's family as well. This occurred as the influence of the patient's family came to be recognized as a significant contributor to the progress of the patient. For example, social workers were able to obtain a wealth of information by visiting homes and interviewing each family member. Family therapy came to be provided by social workers as well as psychologists, psychiatrists and even pastors. 4. Function : 4. Function Family therapy allows a therapist to examine the behavior and role of the patient in the family and vice versa. A major benefit of observing this interaction is the opportunity to form an objective assessment of the family as opposed to the purely subjective opinion provided by a patient during individual sessions. Patients may misinterpret what a family member said or how it was said. Family members may be oblivious to the effect of their words or actions on the patient. The therapist's role is to facilitate the interaction while maintaining a safe environment to do so. 5. Effects : 5. Effects The goal of family therapy is to establish and strengthen healthy relationships among within families. This leads to many people obtaining therapy who may not have otherwise on an individual basis. It also promotes prevention of future dysfunction. From a managed care point of view, family therapy is cost efficient, since treatment is provided to a number of individuals in one session as opposed to several individual sessions. It also tends to require fewer weekly sessions overall than individual psychotherapy. Family Therapy Techniques : Family Therapy Techniques DR.A.ANAND, PhD www.eisrjc.com www.peerc.com www.aerassociation.com Family Therapy Techniques : Family Therapy Techniques 1. Family Systems Approach What affects one family member will effect the others. Effective family therapy techniques are based in the family systems approach. The family systems approach sees the individual as an extension of the family unit and that one cannot be treated to the exclusion of the other. Psychologists trained in marriage and family therapy recognize that an individual's emotional, mental and physical well-being is embedded in the myriad of relationships that make up the individual's life. 1. Family Systems Approach : 1. Family Systems Approach A husband's depression can affect the wife and children just as a child's eating disorder can be both a result of familial expectations and a pressure on the family dynamic. Effective family therapy techniques involve the entire family in the diagnosis of problems as well as the short-term and long-term treatment options. 2. Observation : 2. Observation Family units establish equilibriums to protect the family unit, but that equilibrium can cause an imbalance for individual parts of the family. A clinical psychologist is trained to observe the family dynamic and monitor both verbal and non-verbal cues. During the assessment phase and initial interviews, the family systems psychologist will monitor how the parents interact with each other and how their children react to them. He or she will compare his or her observations with testing data offered in both subjective and objective forms. The subjective test data is gathered during the interview while the objective test data is gathered via clinical tests that family members are requested to fill out and return to the psychologist. 2. Observation : 2. Observation Observation is an effective family therapy technique because it offers the psychologist the first real window into the family dynamic. Family therapy may be recommended for any number of causes, but for the psychologist to make a fair and accurate assessment, he or she must get a base measurement of the family's interactions, emotional balance and initial dysfunction. During observation, for example, it may be revealed that a mother's depression and need for anti-anxiety medication is due in part to her husband's unemployment and the economic pressure she is overcompensating to fulfill. To create an effective treatment plan for the family, the therapist needs as much data as possible. 3. Effective Communication : 3. Effective Communication Lessons in Effective CommunicationIf each member of the family is interdependent on other members of the family it stands to reason that dysfunction with one will affect the whole. Effective communication is an important lessons that family systems psychologist incorporate into group and individual family therapy sessions. To create an effective solution to any dysfunction or problem in the group dynamic requires effective communication so that all members of the group or family are in touch with each other 3. Effective Communication : 3. Effective Communication For example, the mother who commits to more and more tasks in order to compensate for her family's overextending commitments may stretch herself to the limits because she lacks the ability to communicate how stretched thin she is. Instead, she promises to do more and more, exerting increasing emotional and mental stress upon herself when she cannot meet all the commitments she is making. This leads to disappointment and disagreement in the family.. 3. Effective Communication : 3. Effective Communication When other members of the family express their disappointment, this impacts her already damaged sense of self-worth leading to a vicious cycle that may result in depression, generalized anxiety disorder, substance abuse and more. In every way, however, the family is not happy. Therapists teach effective communication skills and the importance for mom to let the family know she is overextended and that she either needs help or they need to rearrange priorities in order to break out of the circular causality of this family's problems 3. Effective Communication : 3. Effective Communication Effective communication allows a family to dialogue on their problems, concerns and feelings without lashing out or feeling obligated to resolve the problems being shared. A large portion of effective communication resides in active listening, a skill that must be learned. 4. Problem Solving : 4. Problem Solving Problem solving is an effective therapy technique not because it teaches the family how to resolve the issue that brought them to see the family systems psychologist, but it teaches them how to identify, develop plans and create resolutions for future problems. Problem solving may seem like a common sense resolution, but it requires a willingness on the parts of all parties to contribute to the solution 4. Problem Solving : 4. Problem Solving Problem solving is a family therapy technique that requires effective communication and often comes later in therapy sessions as the therapist challenges family members to role-play situations previously deemed irresolvable. Family members may also be required to play the part of other family members, parents playing the part of the children or dad taking on the role of mom to a child's dad and a mom's child. By actively role playing other members of the family, each member is required to see that person's point of view. This leads to learning how to disagree in positive and respectful manner and to not allow those disagreements to impede problem solving efforts. 5. Family Contracts : 5. Family Contracts The family contract is a therapeutic tool that allows families to negotiate terms and come to an agreement on how they want to handle future family problems and to commit to positive change. A family contract, for example, may detail that a child who copes with an eating disorder commits to talking about her feelings on weight, eating and social perception. Her parents will then commit to listening and not dismissing her feelings. All parties commit to working together to build self-esteem and a healthy lifestyle. 5. Family Contracts : 5. Family Contracts Family contracts are a positive tool in the arsenal of a family systems psychologist because they are facilitated agreement that a family makes to avoid future dysfunction. The family contract also helps family members recognize when problems are occurring, particularly if elements of the contract are not being upheld. Effective family therapy techniques treat the entire family as an emotional unit of which each family member is a part of and acknowledges that what affects one member of the family affects the whole family. By treating the whole family as a unit, the family also becomes a part of the solution. 6. Reality Therapy : 6. Reality Therapy Reality therapy is an approach to psychotherapy and counseling. It was developed by the psychiatrist Dr. William Glasser in 1965. Reality therapy is a considered a cognitive-behavioural approach to treatment . The reality therapy approach to counseling and problem-solving focuses on the here-and-now of the client and how to create a better future. Typically, clients seek to discover what they really want and whether what they are currently doing (how they are choosing to behave) is actually bringing them nearer to, or further away from, that goal. 6. Reality Therapy : 6. Reality Therapy Reality therapy is more than a counseling technique. Reality therapy is a problem solving method that works well with people who are experiencing problems they want help solving, as well as those who are having problems and appear to not want any assistance. Reality therapy also provides an excellent model for helping individuals solve their own problems objectively and serves as the ideal questioning series during coaching sessions. 7. Psychoeducation : 7. Psychoeducation Psychoeducation refers to the education offered to people who live with a psychological disturbance. Frequently psychoeducational training involves patients with schizophrenia, clinical depression, anxiety disorders, psychotic illnesses, eating disorders, and personality disorders, as well as patient training courses in the context of the treatment of physical illnesses. Family members are also included. 7. Psychoeducation : 7. Psychoeducation A goal is for the patient to understand and be better able to deal with the presented illness. Also, the patient's own strengths, resources and coping skills are reinforced, in order to avoid relapse and contribute to their own health and wellness on a long-term basis. The theory is, with better knowledge the patient has of their illness, the better the patient can live with their condition 7. Psychoeducation : 7. Psychoeducation Since it is often difficult for the patient and their family members to accept the patient's diagnosis, psychoeducation also has the function of contributing to the destigmatization of psychological disturbances and to diminish barriers to treatment. Through an improved view of the causes and the effects of the illness, psychoeducation frequently broadens the patient's view of their illness and this increased understanding can positively affect the patient. The relapse risk is in this way lowered; patients and family members, who are more well-informed about the disease, feel less helpless. 7. Psychoeducation : 7. Psychoeducation Important elements in psychoeducation are: Information transfer (symptomatology of the disturbance, causes, treatment concepts, etc.) Emotional discharge (understanding to promote, exchange of experiences with others concerning, contacts, etc.) Support of a medication or psychotherapeutic treatment, as cooperation is promoted between the mental health professional and patient (compliance, adherence). Assistance to self-help (e.g. training, as crisis situations are promptly recognized and what steps should be taken to be able to help the patient). Plan a Family Therapy Intervention : Plan a Family Therapy Intervention DR.A.ANAND, PhD www.eisrjc.com www.peerc.com www.aerassociation.com Exercise : Exercise Draw a Genogram Assess the family dynamics Assess the functions and dysfunctions of the family Plan a family therapy intervention

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