© 2007 Thomson Brooks/Cole, a division of Thomson Learning Chapter 6: Family Counseling Chapter 7: Group Work Chapter 8: Consultation and Supervision 1

© 2007 Thomson Brooks/Cole, a division of Thomson Learning Couples and Family Counseling 2

© 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 3

© 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 4

© 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) 5

© 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 6

© 2007 Thomson Brooks/Cole, a division of Thomson Learning  Twelve Assumptions Held by Most Family Counselors (see pp ) 7

© 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 8

© 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

© 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 10

© 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

© 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 12

© 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

© 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 14

© 2007 Thomson Brooks/Cole, a division of Thomson Learning  Virginia Satir  Humanist, one of the major theorists of 20 th 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 15

© 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

© 2007 Thomson Brooks/Cole, a division of Thomson Learning  Arose out of Palo Alto Group and work of Milton Erickson  Theorists: Jay Haley, Cloé 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) 17

© 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) 18

© 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

© 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 20

© 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) 21

© 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

© 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

© 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 24

© 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 25

© 2007 Thomson Brooks/Cole, a division of Thomson Learning  Understanding Our Client’s Family, Understanding Our Family  To understand others, we need to understand self  We need to examine how our family affected us and how the impact of our families can affect the people with whom we work 26