4 What is a typical family? Divide into pairs and sketch a picture of a typical U.S. family
5 What is the Definition of Family 2-parent biological family (mono- nuclear family) Single parent family Blended family Extended family Partners without children
6 U.S. Census Definitions Family Group: A family group is any two or more people (not necessarily including a householder) residing together, and related by birth, marriage, or adoption.
7 Family Household: A family household is a household maintained by a householder who is in a family (as defined above), and includes any unrelated people (unrelated subfamily members and/or secondary individuals) who may be residing there.
8 What makes up a family? Cultural influences WASP families (mono-nuclear) African-American families (include kin and community) Italian families (include grandparents and godparents) Chinese and other Asian families (include ancestors and future descendants) Native American families (include tribal group and community)
11 1. Infancy or Oral-Sensory Ages – Birth to 18 months Basic Conflict – Trust vs. Mistrust Important Events - Feeding Important for child to develop trusting relationship with caregiver
12 Infants and Disability Severe disabilities identified prenatally or at birth Abortion? Hospitals will screen for 30 metabolic and genetic diseases Grief cycle How should information be shared with parents?
13 2. Early Childhood or Muscular- Anal Ages – 18 months to 3 years Basic Conflict – Autonomy vs. Shame/Doubt Important Events – Toilet Training Development of control over physical skills
14 Early Childhood and Disability Disabilities are identified as child matures Participation in early intervention programs IDEA (Individuals with Disabilities Education Act) Part C (from birth to age 3) Emphasis on family involvement
15 3. Preschool or Locomotor Ages – 3 to 6 years Basic Conflict – Initiative vs. Guilt Important Events – Exploration/Independence Assertion of control/power over environment
16 4. School Age or Latency Ages – 6 to 12 years Basic Conflict – Industry vs. Inferiority Important Event – School Learning new social and academic skills
17 School Age and Disability Child’s special needs are apparent Parents begin to develop a vision for child’s future Professionals can strongly influence how parents develop this vision Discuss mainstream vs. separate classes
18 RC 631 Family, Disability, and Lifespan Development
19 5. Adolescence or Latency Ages - 12 to 18 Basic Conflict – Identity vs. Role Confusion Important Event – Social Relationships Develop sense of self and personal identity
20 Adolescence and Disability Strongly influenced by cultural context values Increased family stress Increased isolation Sexuality education Expanding self-determination skills
21 6. Young Adulthood Ages – 19 – 40 Basic Conflict – Intimacy vs. Isolation Important Events – Relationships Forming of intimate relationships
22 Young Adulthood and Disability Off-time transitions Issues of independence and dependence Separation issues Relationship issues Identifying appropriate transitions Postsecondary educational programs and support Accessing supported employment options
23 7. Middle Adulthood Ages – 40 to 65 Basic Conflict – Generativity vs. Stagnation Important Events – Work and Parenthood Creation of something that will continue
24 Mid-Life and Disability Employment issues Social support Family support
25 8. Maturity Ages – 65 to death Basic Conflict – Ego Integrity vs. Despair Important Events – Reflection on Life Look back on life and experience feelings of success or failure
26 Old Age and Disability Disability is more common in the elderly Disability is more frequent in lower socioeconomic groups Lifestyle predicts disability (70%) compared with genetics (30%) Cognitive and sensory decline Increase in ADL care (activities of daily living) Eating, bathing, dressing, using the toilet
27 RC 631 Family, Disability, and Lifespan Development
28 FAMILY LIFE CYCLE Independence Coupling or Marriage Parenting: Babies through Adolescents Launching Adult Children Retirement or Senior Years
29 Independence Stage Separation and individuation Identity Develop intimate relationships Establish career
30 Coupling Stage Develop new family system Interdependence Create life-style values Finances Recreational activities/hobbies Friendships
31 Parenting: Babies through Adolescents Deciding to have a baby Develop parenting role Maintain individuality as well as family commitments Allow for individuality with adolescents Mid-life issues Caring for older family members
32 Parenting: Empty Nest Re-define relationship with children Re-define relationship with spouse Establish new relationships with adult children’s families
33 Senior Stage Freedom Physical and mental challenges New roles with family and society Dealing with loss/death Reviewing life
34 Family Life Cycle Summary Families need to be seen from a multigenerational perspective. Changes in one generation complicate adjustments in another. Families often develop problems at transitions in the life cycle. Environmental Developmental
35 Discussion Questions Describe the challenges at the 8 different developmental stages. Give an example of each. What are off-time or off-cycle transitions? Give examples of off-time transitions at the different stages. How has your role in your family changed as you have gone through different developmental stages?
36 Family Structure Family patterns of interaction are predictable. Family subsystems are determined by generation, gender, common interests, and function.
37 Family Subsystems Marital Subsystem Parental Subsystem Sibling Subsystem Extended Family Subsystem
39 RC 631 Family, Disability, and Lifespan Development
40 FAMILY COUNSELING THEORIES Psychoanalytic Family Therapy Bowen Family Systems Therapy Experiential Family Therapy Cognitive-Behavioral Family Therapy Narrative Family Therapy
41 Psychoanalytic Family Therapy Focus on uncovering and interpreting unconscious impulses and defenses Focus on basic wants and fears Sexuality and aggression drives behaviors Couples focused
42 Psychoanalytic Family Therapy Self-Psychology Every human longs to be appreciated Object-Relations We relate to others based on expectations formed by early experiences “Internal objects” form the core of the personality
43 Psychoanalytic Therapy Techniques Listening Attend to clients’ fears and longings Empathy Interpretations Clarify hidden aspects of experience Analytic Neutrality Don’t worry about solving the problem
44 Psychoanalytic Therapy Techniques Focus on: Internal experience The history of that experience How the partner triggers that experience How the context of the session and the counselor’s input contribute to experience between partners
45 Important Names in Psychoanalytic Family Therapy Jill and David Scharff – Object- Relations John Bowlby – Attachment Theory Ivan Boszormenyi-Nagy – Contextual Therapy
46 Bowen Family Systems Therapy Focus on multigenerational family systems Major problem is emotional fusion Major goal is differentiation Focus on subsystems Focus on the triangle Focus not on solving family issues but on learning individual roles in the family and how system operates
47 “A therapist can only progress as far with a family as he/she has progressed with their own family relationships.” Bowen
48 Systems Therapy Techniques Genograms The Therapy Triangle Process Questions Relationship Experiments Coaching “I” Position
49 Important Names in Systems Family Therapy Murray Bowen – Systems Theory Milton Erickson – Strategic Theory Jay Haley – Communication Model Salvador Minuchin – Structural Theory
50 Experiential Family Therapy Developed in reaction to psychoanalysis Freedom and immediacy vs. determinism Focus on fulfillment vs. “accepting” neurosis Focus on emotional well- being/experience of individuals vs. problem solving
51 Experiential Therapy Techniques Family sculpting/choreography Clarify communication Role-play Envision difficult situation Experience your feelings Imagine child’s feelings or other’s feelings Imagine being observer
52 Important Names in Experiential Family Therapy Carl Whitaker – Experiential Theory Virginia Satir – Experiential Theory
53 Cognitive-Behavioral Family Therapy “Behavior is maintained by its consequences.” Family behavior will change when reinforcements change Focus on identifying behavioral goals, learning new techniques, and using social reinforcers
54 Cognitive-Behavioral Family Therapy Techniques Operant conditioning Reinforcers used may be tangible or social (not just money or candy) Shaping (small steps toward goal) Token economy (system which rewards) Contingency (contracts/agreements) Time-out
55 Important Names in Cognitive- Behavioral Family Therapy Gerald Patterson - Parent Training Robert Liberman - Role rehearsal and modeling Richard Stuart - Contigency contracting (focus on increasing positive behavior using reinforcement recriprocity)
56 Narrative Family Therapy Narrative Therapy Assumptions People have good intentions People are profoundly influenced by discourse around them People are not their problems People can develop alternative, empowering stories
57 Narrative Family Therapy Narrative Family Counselors Show strong interest in family’s story Search for times when family was strong or resourceful Use questions to respectfully understand story Never label individuals – see each as unique Support alternative life stories
58 Narrative Family Therapy Techniques Deconstruct unproductive stories Reconstruct new and more productive stories Look for strengths and talents Family problem is separate from individuals Re-author new story Reinforce new story
59 Important Names in Narrative Family Therapy Michael White – Founder of Narrative Movement David Epston – from Auckland, New Zealand
60 RC 631 Family, Disability, and Lifespan Development
61 Discussion Questions When would you recommend individual counseling vs. family counseling? What are the trade offs of focusing on the system vs. focusing on the individual?
62 COMMON PROBLEMS OF BEGINNING FAMILY COUNSELORS I. FAILURE TO ACT Failure to establish structure Failure to show care and concern Failure to engage family members in the therapeutic process Failure to let the family work on its problems Failure to attend to nonverbal family dynamics
63 II. OVER-ACTION Over-emphasis on details Over-emphasis on making everyone happy Over-emphasis on verbal expressions Over-emphasis on coming to too early or too easy resolutions Over-emphasis on dealing with one member of the family
64 What rehab counselor should keep in mind: Family demographic data (SES, ethincity/cultural background, etc.) Family communication patterns Division of labor in the family Extent of family member’s outside socialization and access to social and cultural experiences Family health or illness Characteristics of disability or illness Impact of disability on the family
65 Also, examine the following: Family strengths and weaknesses Family reaction to the disability Information the family has concerning the disability and expectations held by the family member with a disability Services needed to enhance rehabilitation
66 Points to remember… Many families do not openly discuss disability issues with each other Initial meeting with VR counselor may feel threatening Explore impact of disability on each family member Remain neutral toward all family members
67 Carefully examine your own attitudes/biases toward disability to reduce any prejudices in client contacts Implicit and explicit messages by the counselor can convey disapproval or acceptance of particular family members The client should be asked which family members would benefit from a family meeting to discuss rehabilitation
68 Family Boundaries Boundaries are invisible barriers that regulate the amount of contact with others. Rigid boundaries Disengagement Enmeshment
69 What is the impact of a family member with a disability on the marital subsystem? What is the impact of a family member with a disability on the parental subsystem? What is the impact of a family member with a disability on the sibling system? What is the impact of a family member with a disability on the extended family subsystem?
70 Legitimate source of authority, established and supported over time Stable rule system established and consistently acted upon Stable and consistent nurturing behavior Effective and stable childrearing and marriage-maintenance practices Set of goals toward which the family and each individual works QUALITIES OF HEALTHY FAMILIES (Turnbull & Turnbull, 2006)
71 Sufficient flexibility and adaptability to accommodate normal developmental challenges as well as unexpected crises Commitment to the family as well as its individuals Appreciation of each other (i.e., a social connection) Willingness to spend time together Effective communication patterns
72 High degree of spiritual/religious orientation Ability to deal with crisis in a positive manner (i.e., adaptability) Encouragement of individuals Clear roles
73 HEALTHY COPING STRATEGIES OF FAMILIES (Carter & McGoldrick, 2007) Ability to identify the stressor Ability to view the situation as a family problem, rather than a problem of one member Solution-oriented approach rather than blame Tolerance for other family members Clear expression of commitment to and affection for other family members
74 Open and clear communication among members and outside the family Lack of physical violence Lack of substance abuse Recognizing that stress may be positive and lead to change Realizing that stress is usually temporary Focusing on working together to find solutions Realizing that stress is a normal part of life
75 Changing the rules to deal with stress and celebrating victories over events that led to stress Evidence of high family cohesion Evidence of considerable role flexibility
76 OBSERVING FAMILY INTERACTIONS 1. What is the outward appearance of the family? 2. What is the cognitive functioning in the family? 3. What repetitive, non-productive sequences do you notice? 4. What is the basic feeling state in the family and who carries it?
77 5. What individual roles reinforce family resistances and what are the most prevalent family defenses? 6. What subsystem are operative in this family? 7. Who carries the power in the family? 8. How are the family members differentiated from each other and what are the subgroup boundaries?
78 9. What part of the family life cycle is the family experiencing and are the problem-solving methods stage appropriate? 10. What are the counselor’s own reactions to the family?
79 RC 631 Family, Disability, and Lifespan Development