1. CHAPTER 7: The Process of Family Therapy
Family Therapy: History, Theory, and Practice
6th Edition
Samuel T. Gladding
Developed by Nathaniel N. Ivers, Wake Forest University
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved

2. Overview Common Factors in Therapy
Impact of Stressors and Enhancers on the Therapist
Battle for Structure vs. Initiative
Problems of Overemphasis and Underemphasis
Treatment Interventions in the Initial, Middle, and Termination Stages of Family therapy

3. Common Factors in Therapy
Extratherapeutic factors
Therapy relationship factors
Expectancy, hope, and placebo
Model and technique

4. Stressors Depression Less time for one’s own family
Unrealistic expectation of one’s family
Psychological distancing from one’s family due to professional status

5. Enhancers Increased ability to solve one’s family problems
Acceptance of a greater ability and desire to communicate effectively
Synergy between personal and professional life

6. Common Problems of Being a Family Therapist: Overemphasis
Overemphasis on . . .
Details
Process versus Content
Redirection
Making people happy

7. Common Problems of Being a Family Therapist: Overemphasis
Overemphasis on . . .
Verbal expression
Coming to an early or too easy resolution
Dealing with one member of the family (i.e., scapegoat)

8. Common Problems of Being a Family Therapist: Underemphasis
Underemphasis on . . .
Establishing structure
Battle for structure
Professional disclosure statement
Informed consent brochure
Showing care and concern
Therapeutic presence
SOLER

9. Common Problems of Being a Family Therapist: Underemphasis
Underemphasis on . . .
Engaging family members in the therapeutic process
Letting the family work on its problems (i.e., battle for initiative)
Attending to nonverbal family dynamics

10. Appropriate Process: Pre-Session
Pre-Session Planning and Tasks
Obtain certain information
Establish a professional but cordial atmosphere
Evaluate intake information
Form a preliminary diagnosis of what is happening with the family
In doing all this, a family therapist comes up with a case conceptualization

11. Appropriate Process: Initial Session(s)
Join the family: Establishing rapport
Inquire about members’ perceptions of the family
Observe family patterns/assess
Family dance
Subsystems
Triangulation
Enmeshment
Distancing

12. Appropriate Process: Initial Session(s)
Assess what needs to be done
Engender hope for change and overcome resistance
Make a return appointment and give assignments
Record impressions of family session immediately

13. Appropriate Process: Middle Phase of Treatment
Involve peripheral family members
Seek to connect family members
Establish contracts and promote quid pro quo relations
Emphasize some change within the family system
Reinforce family members for trying new behaviors

14. Appropriate Process: Middle Phase of Treatment
Stay active as a therapist
Link family with appropriate outside systems
Focus on process
Interject humor when appropriate
Look for evidence of change in the family

15. Termination Orientation Summarization Discussion of Long-Term Goals
Follow-up and Relapse Prevention