Alignments

structural family therapy term developed by Minuchin

ways in which family members join together or oppose one another in carrying out a family activity

Forming alignment can be source of power for those who formed it

affiliations and splits, temporary or permanent, are usually formed in pursuit of homeostasis w/i family system

Ex:

Bowen’s Family System Theory (tenets of)

Bowen conceptualized family as emotional unit w/  network of interlocking relationships, best understood when analyzed within multigenerational framework

always trying to balance two life forces–family togetherness & individual autonomy

8 interlocking concepts: differentiation of self (individual should differentiate from family),

triangles (when 2-person system moves 3rd individual btw to decrease anxiety),

nuclear family emotional system (individuals attracted to mates w/ similar differentiation levels),

family projection process (parents project emotional problems onto at least 1 child),

emotional cutoff (extreme emotional distancing from family of origin),

multigenerational transmission process (chronic anxiety is transmitted down generations),

sibling position, and

societal emotional process.

Ex:

Brief Solution-Focused Therapy (tenets of)

work of social constructionist Steve de Shazer 

family therapy which focuses on change & solutions over current problems and pathology

Based on premise that dysfunction develops from failed attempts at problem-solving

focuses on changing the family’s cognitions, or how they view the problem

Clients not naturally resistant to change but become “stuck” in problem-solving process

Language is used to imply change will take place, which make’s client’s expectant of change & therefore more willing to actually change

Ex:

Circular Questioning

interviewing technique in family therapy

involves asking each family member questions that help discover their perception of events and relationships within their family

allows therapist & family to hear multiple perspectives of different members, & serves to expose family patterns

Ex:

Coalitions

structural family therapy term coined by Minuchin

Occur when 2 or more individuals (the insiders) join together against another member of the family (the outsider). 

May be stable, in which case they become dominant part of family’s everyday functioning, or detouring, in which coalition holds a third member of the family responsible for their difficulties &/or conflicts with one another

Ex:

Deconstruction in Narrative Therapy

Term coined by Derrida

Literary works have no single meaning, & appropriated to narrative therapy to remind clients there is no one meaning or one set of assumptions that is “correct” for same event or experience

multitude of meanings or assumptions may be derived from same event

Deconstruction empowers clients to deal more competently with new views of reality and lead more satisfying lives; offers perspective

Ex: The therapist encouraged the client to see themselves from a variety of view points so that they could understand that they have control over their definition of self.

Differentiation

Bowen’s family systems theory

separation between an individual's thoughts and feelings

ability to differentiate thoughts and feelings helps an individual differentiate themselves from their family’s emotions and thoughts with their own

Better differentiated individuals are less prone to dysfunction

Ex:

Disengagement

structural family therapy developed by Minuchin 

Occurs when boundaries in family system are too rigid

Rigid boundaries & subsequent disengagement occur when there is over-differentiation & individuation between family members, resulting in loss of “we” of family

Disengagement results in feelings of isolation and disconnectedness from each other

(Counterpart to enmeshment)

Ex:

Double Bind

family therapy term

Individual receives two conflicting orders from person w/ whom they have an ongoing important relationship

Individual feels that they cannot win no matter which order they obey, & not allowed to comment on situation in which they've been placed

Bateson and others hypothesized that this could cause severe pathology, like schizophrenia

Ex: Observing a family’s interaction, the therapist noticed that the mother put the son in a double-bind by telling him that she was open to him hugger her, when her body language clearly communicated he did not wish to be touched.

Enactment

family therapy

Facilitating intervention in which family is asked by  therapist to spontaneously enact their relationship patterns during therapy session

Allows therapist to observe family structure & ultimately develop a plan or new set of rules for restructuring family’s future interactions

Ex:

Enmeshment

Structural family therapy, developed by Minuchin 

Boundaries btw members in family system are too diffuse

Diffuse boundaries & subsequent enmeshment occurs when there is no differentiation or individuation between family members, resulting in the loss of “I” for each member

Family members are over-involved & over-concerned w/ each other’s lives

(Counterpart to disengagement)

Ex:

Entropy

Systems theory

State of disorganization & disorder to which closed systems may gradually regress bc they lack

Family system whose boundaries are not easily crossed & who is not receiving feedback outside family may be ineffective, fearful, or confused during crises

Ex:

Experiential Family Therapy (tenets of)

Family therapy pioneered by Carl Whitaker

Emphasizes non-rational therapeutic experience as only thing that can effect change in family

Pragmatic, non-theoretical approach to psychotherapy seeking to depathologize human behavior & replace preplanned therapeutic techniques w/ therapist’s spontaneous activity

Therapist uses their self as a tool in order to effectively engage the families

Ex:

Externalization Technique

Michael White, Part of Narrative therapy

Therapist helps family recognize problem as separate from their selves

Deconstructs problem as internal deficiency or pathological condition & redefines as objectified external deficiency

Family is then encouraged to unite against the externalized Problem

Ex: A family came to therapy because the mother was depressed and the family was blaming her for not fulfilling her motherly/wifely duties. In an effort to externalize the problem, the therapist asked the mother, “What do you think Depression’s purpose is in invading your life like this?”.

Fusion

Family systems theory, Bowen

Family member or members are not differentiated from each other & are therefore drawn to each other’s emotions & anxiety

Individuals fused w/ families have trouble differentiating thoughts/feelings from their family's 

Ex:

Genogram

Bowen & his followers, Family Systems therapy

Schematic diagram of family’s relationship system

In the form of a generic tree and usually includes at least three generations

Therapists may use to trace recurring patterns within the family

Ex:

Homeostasis

Family therapy

Dynamic state of balance or equillibrium in the family

Homeostatic mechanisms within family work to self-regulate family to maintain stability and resist change

Therapist may find themselves fighting against homeostatic mechanisms to change the family system

Ex:

Joining

Minuchin’s structural family therapy

Therapeutic tactic in which therapist joins family as kind of “distant relative” by engaging it’s separate members & subsystems

Becoming a nonpermanent but concerned member of the family allows therapist to gain access to family system & to help identify & modify dysfunctional aspects of system

In order to join, therapist may mimic family’s manner & style (i.e., language) in order to solidify their status as a member of the family

 Avoids attacking defensive mechanisms, while simultaneously helping family to engage in progressive communication

Ex: (therapist joins & uses confirmation, validating realities of members, to points out positives)

Multigenerational Transmission Process

Bowen

1 of 8 interlocking concepts in family systems theory

Process, occurring over multiple generations, in which poorly differentiated individuals marry similarly differentiated mates, ultimately resulting in offspring suffering from severe mental disorders

Bowen believed severe dysfunction is the result of chronic anxiety transmitted over several generations

Ex:

Narrative Therapy (tenets of)

Michael White, family therapy

Based on the premise that our sense of reality is organized & maintained by stories we tell ourselves about who we are & the world we live in

Family’s problems develop as result of negative, self-defeating, dead-ended narratives that they tell themselves about their lives

Help the family construct alternative stories that offer new options & possibilities for future

Reject notion therapist is “expert”, believing  clients have skills needed to construct more positive stories about themselves

Ex:

Paradoxical Intervention

Therapeutic technique, Strategic model of Family Therapy

Clients are put in double bind by therapist who gives family/client a firm directive which they actually want resisted; through resisting the therapist, change is accomplished

Intervention typically used w/ families or clients resistant to change or defiant of the therapist 

(Another term for“reverse psychology”)

Ex: A client is afraid to disappoint others around them and always puts others first, even though this is hurting the client financially and about to have to file for bankruptcy. The therapist uses the paradoxical intervention technique, telling the client to always put others’ needs before their own, even if this means financial failure. 

Process Questions

Bowen’s Family Systems therapy

Questions designed to help family members think about their own reactions to what others are doing & saying

Help family differentiate–to think logically & not emotionally

Redirects family members away from blaming each other & focuses them on thinking about their part in contributing to family’s problems

Ex: Therapist: "When your husband doesn't return your calls, what goes on inside you?" 

Wife: "I get scared. And then I feel disrespected." 
Therapist: "And how does that manifest?" 
Wife: "I withdraw from him." 
Therapist: "What are you trying to tell him when you do that?" 
Wife: "That I'm hurt." 
Therapist: "Does it work?" 

Reframing

Therapeutic technique

Therapist changes original meaning of situation or event by offering equally plausible explanation

Alters context in which situation or event is perceived & invites new responses to the same behavior

May put more positive spin on a negative interpretation, or it may simply provide the client(s) with an alternative way of viewing something/further perspective

Ex: A client comes to therapy complaining about their mother, who they say is intrusive and always setting them up on dates and giving them advice. The clinician reframed the situation by offering the explanation that perhaps the mother was trying to be helpful instead of just annoying, as a loving, rather than harmful, gesture.

Scapegoat

Ackerman, Psychodynamic model of Family Therapy

Individual in family who is blamed & punished for all of the family’s problems in attempt to resolve

Scapegoat is typically the identified patient, or  reason family initially comes to therapy

Ex: (Brother committed suicide because of sister's allegations of molestation–family's story/blaming–helps them to relieve anxiety & grief associated with mother & other brother being actually there with him, using the drug that killed him.)

Scaling Questions

Solution-Focused Brief Therapy

Questions that ask client to quantify perception of a situation, often by rating on scale from 0 to 10

Repeatedly using scaling questions can allow therapist & client to measure change & set goals that seem manageable

Help clients develop positive outlook & move toward achievement of goals

Ex:

Structural Family Therapy (tenets of)

Minuchin

Change in family structure or organization is necessary for an individual’s symptoms to be relieved (as the symptoms are best understood in the context of family transaction patterns)

Therapist must provide direct leadership in changing  structure or context in which symptom is embedded

To achieve change in a family, structuralists believe there must be clearly defined generational boundaries, alignments btw parental subsystem about key issues, & rules related to power and authority

Ex:

Triangulation

Minuchin, Structural Family Therapy

Process in which child becomes caught between their two parents, w/ both parents demanding the child ally w/ them against the other parent. 

Typically occurs when parents are having trouble resolving things between themselves

Produces “no-win” situation for child, as siding w/ one parent leads to other parent feeling attacked

(Triangulation is similar to Bowen’s concept of triangles)

Ex:

Unbalancing Technique

Structural Family Therapy

Therapist attempts to change hierarchical relationship between members of system or subsystem by appearing to support one member of family

Upsets family’s homeostasis & makes an initial move toward changing pre-existing family patterns, now made less rigid 

Ex:(therapist points to son's good behavior in looking out so well for his father in his old age & much of the rest of the family at that. Father is patriarch & dominant, but therapist upset the hierarchy with the unbalancing technique in order to be able to really begin effecting change.)