1. © 2016. Cengage Learning. All rights reserved.  Chapter 6: Family Counseling  Chapter 7: Group Work  Chapter 8: Consultation and Supervision 1 Section III: The Helping Relationship II: The Counselor Working in Systems

2. Chapter 6 Couples and Family Counseling 2 © 2016. Cengage Learning. All rights reserved.

3.  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 A Brief History

4. © 2016. Cengage Learning. All rights reserved. *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 A Brief History (Cont’d)

5. © 2016. Cengage Learning. All rights reserved.  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  1970s: Milan Group  More recently: Narrative family therapy (White and Epston) 5 A Brief History (Cont’d)

6. © 2016. Cengage Learning. All rights reserved. *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 A Brief History (Cont’d)

7. © 2016. Cengage Learning. All rights reserved.  Twelve Assumptions Held by Most Family Counselors  See pp. 187-188 7 View of Human Nature

8. © 2016. Cengage Learning. All rights reserved. *von Bertalanffy (1934, 1968) *Explains the interaction of all types of systems *Suprasystems *Subsystems *Interaction in one system affects all other systems 8 General Systems Theory

9. © 2016. Cengage Learning. All rights reserved. *Control mechanism in systems *Regulatory process; homeostasis *Used to avoid disequilibrium in systems *Positive and negative feedback loops *Acts like thermostat *See Box 6.1, p. 190 9 Cybernetics

10. © 2016. Cengage Learning. All rights reserved. *Healthy system has semi-permeable boundaries *Unhealthy: rigid or diffuse boundaries *See Box 6.2, p. 191 *American culture allows for much variability in boundaries *However, as Box 6.2 shows, too much rigidity or permeability leads to dysfunction 10 Boundaries and Information Flow

11. © 2016. Cengage Learning. All rights reserved.  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. 192 11 Rules and Hierarchy, and Communication Theory

12. © 2016. Cengage Learning. All rights reserved.  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 Scapegoats and Identified Patients

13. © 2016. Cengage Learning. All rights reserved.  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 6.1 13 Stress; Developmental Issues

14. © 2016. Cengage Learning. All rights reserved.  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 Social Constructionism

15. © 2016. Cengage Learning. All rights reserved.  Human Validation Process Model  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 Models of Couples and Family Counseling

16. © 2016. Cengage Learning. All rights reserved.  Salvadore Minuchin  Interactional and Transactional Rules  Boundaries  Structure and Hierarchy  Some Techniques  Joining  Mapping  Restructuring  See Box 6.4, p. 199 16 Structural Family Therapy

17. © 2016. Cengage Learning. All rights reserved.  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 17 Strategic Family Therapy

18. © 2016. Cengage Learning. All rights reserved.  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. 201)  Directives 18 Strategic Family Therapy

19. © 2016. Cengage Learning. All rights reserved. *Boszormenyi-Nagy *Ways of relating passed down *Loyalties, indebtedness, ways of relating, 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. 204) *Family projection system *Individuals get triangulated *Used genograms (see Figure 6.1, p. 204) 19 Multigenerational Family Therapy

20. © 2016. Cengage Learning. All rights reserved.  Whitaker  Says he has no theory, but see basic tenets (p. 205)  I-Thou relationship  Become genuine through interactions in therapy  See quotes top and middle of p. 206  Approach is strongly influenced by humanistic psychology with a touch of psychodynamic theory 20 Experiential Family Therapy

21. © 2016. Cengage Learning. All rights reserved.  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 onto family 21 Psychodynamic Family Therapy

22. © 2016. Cengage Learning. All rights reserved.  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 p. 208) 22 Cognitive-Behavioral Family Counseling

23. © 2016. Cengage Learning. All rights reserved.  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. 209 23 Narrative Family Therapy

24. © 2016. Cengage Learning. All rights reserved.  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. 210  Six Stages that include:  Pre-session change, forming a collaborative relationship, describing the problem, establishing preferred outcomes, problem-to-solution focus, reaching preferred outcomes, and ending therapy 24 Solution Focused Family Therapy

25. © 2016. Cengage Learning. All rights reserved.  Points to consider when working with minority families (couples and families from nondominant groups)  See p. 211  Why are professional associations not being inclusive?  American Association of Marriage and Family Counselors  International Association of Marriage and Family Counselors 25 Multicultural/Social Justice Focus

26. © 2016. Cengage Learning. All rights reserved.  Withholding treatment in order to see “whole” family  Informed consent for “whole” family  Confidentiality –can you assure it?  Multiple (Dual) relationships  Seeing a member individually and in the family?  Professional Issues  Individual or family counseling… which is better? 26 Ethical, Professional, & Legal Issues

27. © 2016. Cengage Learning. All rights reserved.  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 “one” member in family when you actually see whole family 27 Ethical, Professional, & Legal Issues

28. © 2016. Cengage Learning. All rights reserved.  Understanding Our Client’s Family, Understanding Our Family  To understand others, we need to understand self  We need to examine how our family has affected us and how the impact of our families can affect the people with whom we work 28 Counselor in Process