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Actions by any individual family member will influence all the others in the family,
and their reactions will have a reciprocal effect on the individual.
Alfred Adler was the fi rst psychologist of the modern era to do family
therapy (Christensen, 2004).
Adler was a phenomenologist, and even though birth order appeared to
have some constancy to each position, he believed it was the
interpretations children assigned to their birth positions that counted. Adler
noted that all behavior was purposefuland that children often acted in
patterns motivated by a desire to belong, even when these patterns were
useless or mistaken.
Adlerians also use an educational model to counsel families in open
forums in schools, community agencies, and specially designated family
education centers.
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Multigenerational Family Therapy
At about the same time that Bowen was developing his approach, Virginia
Satir (1983) began emphasizing family connection.
Her therapeutic work had already led her to believe in the value of a
strong, nurturing relationship based on interest and fascination with those
in her care.
Satir discovered the power of family therapy, the importance of
communication and metacommunication in family interaction, and the
value of therapeutic validation in the process of change (Satir & Bitter,
2000).
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Whitaker did not propose a set of methods; rather, it is the personal
involvement of the therapist with a family that makes a difference.
When techniques are employed, they arise from the therapists intuitive
and spontaneous reactions to the present situation and are designed
to increase clients awareness of their inner potential and to open
channels of family interaction.
Whitaker saw his role as creating with the family a context in which
change can occur through a process of reorganization and
reintegration (Becvar & Becvar, 2006).
The origins of structural family therapy can be traced to the early 1960s
when Salvador Minuchin was conducting therapy, training, and research
with delinquent boys from poor families at the Wiltwyck School in New
York.
Minuchins (1974) central idea was that an individuals symptoms are best
understood from the vantage point of interactional patterns within a family
and that structural changes must occur in a family before an individuals
symptoms can be reduced or eliminated.
The goals of structural family therapy are twofold:
o Reduce symptoms of dysfunction and
o Bbring about structural change within the system by modifying the
familys transactional rules and developing more appropriate
boundaries.
In the late 1960s Jay Haley joined Minuchin at the Philadelphia Child
Guidance Clinic. The work of Haley and Minuchin shared so many
similarities in goals and process that many clinicians in the 1980s and
1990s would question whether the two models were distinct schools of
thought. Indeed, by the late 1970s, structural-strategic approaches
were the most used models in family systems therapy. Both models seek
to reorganize dysfunctional or problematic structures in the families;
boundary setting, unbalancing, reframing, ordeals, and enactments all
became part of the family therapeutic process
Strategic Family Therapy
In 1974, Haley and Clo Madanes started the Family Therapy Institute of
Washington, D.C.
Haley (1984) and Madanes (1981) have been more interested in the
practical applications of strategic interventions to ameliorate a familys
problems than in formulating a theory of therapy distinct from the structural
model.
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Emphasis is given to power, control, and hierarchies in families and in the
therapy sessions.
Madanes brought a humanistic perspective to strategic therapy by
addressing the need to be loved and by emphasizing the nurturing
aspects of therapy.
Recent Innovations
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Eight Lenses in Family Systems Therapy
The original six metaframeworks are internal family systems;
sequences; organization; developmental; multicultural; and gender.
To these have been added teleological and process metaframeworks.
The value of this approach is that it allows the therapist to draw on
multiple perspectives rather than being locked into a single viewpoint.
The lenses can be used for assessment as well as to tailor therapeutic
interventions to the specific needs of the family.
These eight lenses provide a foundation for integrating the various models
of family systems therapy.
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Reframing begins by asking:
o What purposes does this symptom, interaction, or process
serve?
o How does the individuals behavior protect the self?
o What are the social consequences of an action or
interaction?
o How are the goals of family members at cross-purposes
with each other?
o Are the goals of the family at odds with the goals of
therapy?
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Family therapy is often about developing more useful sequences at any or
all of these four levels.
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In assessing different levels, family therapists look for constraints and seek to
remove them so that natural growth and transitions become possible once again
(Breunlin et al., 1997).
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Process is also about our movement through significant events in life. Clarity of
process tells us where we are and delineates where we are likely to go. It
allows the therapist and the family to examine where they are in the flow of life,
the process of change, and the experience of therapy.
When essential routines are interfered with, the result is a disruption that throws
a system out of balance. In the face of disruption, families may initially seek to
retreat, but they generally fall into a state of chaos. Because chaos is
experienced as crisis, family members often want to make huge decisions even
though everything seems out of balance. Therapists immediately become one of
the familys external resources with a primary responsibility to help individuals
reconnect with their internal resources and strengths, which are often not
recognized.
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Many ethnic and cultural groups place great value on the extended family.
Allows the therapist and families to appreciate diversity and to
contextualize family experiences in relation to larger cultures.
Shortcomings from a Diversity Perspective
A possible shortcoming of family therapy involves practitioners who
assume Western models of family is universal.
Some family therapists focus primarily on the nuclear family, which is
based on Western notions.
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Contributions of Family Systems
Approaches
One key contributions of systemic approaches in that neither the individual
nor the family is blamed for a particular dysfunction.
A systems perspective recognizes that individuals and families are
affected by external forces and systems, among them illness, shifting
gender patterns, culture and socioeconomic considerations.
Redefines the individual as a system embedded within other systems,
which brings an entirely different perspective to assessment and
treatment.
An individual is not scapegoated as the bad person in the family.
The entire family has an opportunity to:
o Examine the multiple perspectives and interactional patters that
characterize the unit.
o Participate in finding solutions.
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