THEORY IN BRIEF: FAMILY SYSTEMS

NAME OF THEORY:  Family Systems 

 

BASIC PREMISES AND PHILOSOPHY:  This modality is a holistic shift from an individualistic to a family context perspective and how the systemic perspective affects the conceptualization of healthy human development, a presumed disorder, and appropriate therapeutic intervention. The systemic worldview sees the family as the primary unit and holds that all members of the family are important contributors to clients’ psychological functioning and development. Every family is significantly impacted by the relationships, rules, and roles that are engendered within the larger social systems of which they are a part. Therefore, human interactions are seen as cyclical rather than linear.   

Focus is on the rules of relationships within family systems. A variety of approaches can be used in promoting the family systems style of therapy. Problems are understood in the context of their family systems rather than in terms individual experience alone. Individual problems represent larger family dysfunctions. If any one part of the system is changes it will affect others who are interconnected. 

All therapy is family therapy. Families pass through predictable stages. What the client experiences growing up in their family of origin shapes the way the family evolves in the present. Families organize themselves in order to maintain stability and exist in a cultural context, and human behavior is often triangular. Families get stuck in repetitive patterns. Symptoms that emerge in families are often useful and functional in maintaining their stability.

FOUNDERS OR IMPORTANT CONTRIBUTORS:  Alfred Adler, Lewis Thomas, Norbert Wiener, James Gleick, Edward Lorenz, quantum physicists, Von Bertalanffy, Gregory Bateson, Murray Bowen, Nathan Ackerman, James Framo, Carl Whitaker, Virginia Satir, Salvador Minuchin, Milton Erickson, Jay Haley, Cloe Madanes, Gerald Sue, Paul Pedersen, Allen Ivey Kenneth Gergen, Michael Mahoney, Michael White

COUNSELING GOALS:  Uncover the cyclical influence of the family on clients and understand family dynamics and how these factors play into clients’ issues. Then help clients understand and adapt their reactions to promote healthier interactions with others.

ROLE OF COUNSELOR:  To consider client’s family context when conceptualizing their healthy human development, devising an appropriate therapeutic intervention by examining, and discussing relationship, rules and roles in the family. Establish trusting relationship and explore concerns of clients, formulate assessment and treatment/action plans.

ROLE OF CLIENT:  Be open to exploring relationship of self to own family and exploring how family systems and dynamics affect clients’ issues. 

USEFUL WITH WHAT POPULATIONS AND TYPES OF PROBLEMS:  Families, multicultural clients, for most issues

EXAMPLES OF TECHNIQUES:  Various approaches:  psychoanalytic, humanistic/existential, structural, strategic and multicultural, narrative therapy (externalizing conversations, mapping the influence, unique outcome questions, unique possibilities, restorying), making genograms. Establishing trust seen as fair and objective, maintain control, redefine or reframe the problem, be highly active and directive and assess interactive patterns, keep things moving

TERMS: Continued reciprocal influence, circular causality, rules of relationships, enmeshment, coalitions, life cycle, metaphors, genograms, restorying, psychoanalytic, humanistic/existential, structural approach, strategic and multicultural, structural, strategic, multicultural, constructivist, narrative theory, externalizing conversations, mapping the influence, unique outcome questions, unique possibilities.

SEE POSTS:  THEORIES IN BRIEF

WORTH 1000 WORDS

CREDIT:  A FELLOW BLOGGER

WHAT IS PERFECTION?

GEORGE ORWELL QUOTE

A tragic situation exists precisely when virtue does not triumph but when it is still felt that man is nobler than the forces which destroy him.

~ George Orwell

THEORY IN BRIEF: Self-Psychology

I wrote this series--Theory in Brief--for students and practitioners of psychology/therapy; however, I believe it contains much interesting information for the layperson, especially those interested in psychology and/or philosophy.

NAME OF THEORY:  Self Psychology   

BASIC PREMISES AND PHILOSOPHY:  Empathically obtained knowledge strengthens the capacity to live both with truth and illusion and the fundamental, radical and unavoidable uniqueness and infinity of the eternal and internal self.   

Focus on fundamental needs for healthy development, particularly idealizing, mirroring and twin-ship (or alter ego) needs.  Peoples’ self-cohesion, self-esteem and vitality derive from and are maintained by empathic responsiveness of others to their needs.   

Subjective experience is at the center of clinical and theoretical concerns.  How and why we change and how and why in certain ways we predictably stay the same are considered.  The return of the repressed is relative.

FOUNDERS OR IMPORTANT CONTRIBUTORS:  Harold Kohut, Bowlby, F. Ornstein, F. Alexander

COUNSELING GOALS:  Facilitate clients’ understanding of relationship needs and personal deficits.  Help empower clients’ abilities and ways of making positive changes/transformations in their relationships, thereby facilitating positive change in themselves and their lives.

ROLE OF COUNSELOR:  Establish trusting relationship with client.  Sustain empathic emergence into the subjective perspectives and experiences of clients.  Place self-object transferences at center of analytical approach with empathic immersion to guide understanding and explanation.

EXAMPLES OF TECHNIQUES:  Acceptance: use reflective responses and active listening; Understanding:  therapeutic dialog, empathic or optimal responsiveness; therapeutic regression; vicarious introspection; empathy with therapists’ own experiences to explore and discover subjective “I” of clients

TERMS:  self-object experiences and transferences, healthy narcissism, empathic ambiances/failures, disruption/restorative process, fragmentation, self cohesion.

SEE POSTS:  THEORIES IN BRIEF

MY OPINIONS OF NLP

The following is my response to anyone promoting or considering Neurolinguistic Programming (NLP), a relatively recent and controversial technique used in counseling and psychology.  NLP has become a popular style of dealing with issues through the efforts of Tony Robbins, as well as other advocates.  NLP is the child of the old EST of the 70's (now known as the Landmark Forum).

Having had experience with NLP, I believe that it is neither neurological, linguistic, nor programming.  The leader of my first practicum site is a fan (despite being a bright, competent woman working on her doctorate in psychology). I look to this example when reminding myself how insidious NLP is in deceiving even intelligent and trained professionals.

NLP has co-opted methods and theories from many other sources in the field of psychology and succeeded at making it a phenomena that is especially focused on business, sales, and other money goals. 

Though based on other sound theories, NLP is overly  manipulative.  Their theory may sound good but is not substantial.  Training in NLP is also suspect as it encourages an undercurrent of cult-like admiration for its teachers or, as they like to call themselves, "motivators".

Even though therapy generally employs manipulation (in the best sense) to help clients, NLP crosses the line in efforts to control outcomes.  I found the practices of NLP to be deceptive and unethical.  In addition, the hype and promises of NLP are based on fluff that is self-activating. (In other words:  You want to believe it; you then believe it and it becomes true for you--for a while. Later, your old issues plague you once again.)

The foundation of NLP is weak, with its "use whatever works" and "reality is your perception" approach.  It can be destructive, especially to clients who are unstable. This phenomena is exacerbated by clients trusting NLP counselors and motivators who are insufficiently trained, yet often pumped up by ego-boosting false positivity.

I believe the training in NLP is cult-like and most attractive to people with control issues.  Perhaps some people have benefited from some aspects of the NLP process, training, and counseling; however, I cannot condone a preference for a counseling modality that is based on such high levels of control and methods of manipulation (by trainers and, eventually and inadvertently, by the self).

NLP claims they have studied the voice inflections and choice of vocabulary of such noteworthy pioneers as Virginia Satir (pioneer of the family approach to therapy), Fritz Perls (gestalt), and Milton Friedman (hynotist and psychiatrist) in order to reach the client.

That alone seems benign enough.  Words do have power. However, too much emphasis seems to be placed on the superficial for the "quick fix" rather than on the gradual and often painstaking work of genuine therapy.

NLP falls within the area of manufacturing authority by inadvertent consent.  In my opinion, NLP, taken as a whole, is generally unethical. This becomes especially evident when employing "pop" techniques to reach the unconscious.

Furthermore, I find it offensive that the NLP movement passes off their program as being new, unique, and innovative when, in essence, they have stolen theories and techniques from so many other modalities (e.g., those based on strategic, brief, gestalt, cognitive and behavioral theories) without giving them due credit.  In addition, they conveniently leave out NLP's history which is based on the brainwashing techniques of EST--a method that is blamed for many harmful results with their clients.  Deception is the main source of NLP's power.  Could YOU trust it?

To better understand NLP and issues I have with this technique, I have listed three sites that give you exposure to NLP.  There are many more sites to explore.  Tell me what you think.  I would appreciate your feedback!

http://www.landmarkeducation.com/
(notice the slick marketing and overblown promises of this organization)

http://www.worldofnlp.com/nlp-practitioner-training-singapore-submodality-protocols/

http://www.tranceformingnlp.com/nlp_improve_visual_sensory_acuity_training_leeds_uk.php
 

INDIVIDUAL THERAPY, THEORETICAL ORIENTATION AND GROUPS

I wrote this post for students and practitioners of psychology/therapy; however, I believe it contains much interesting information for the layperson, especially those interested in psychology and/or philosophy.

INTRODUCTION

The choice of theoretical approach practitioners use in their efforts to conduct the most effective groups raises many questions. How can individual needs be best served? How deep do therapists need to delve into the psyche of clients? What are clients’ level of cognitive functioning? How well can both therapists and clients conceive of and discuss life’s issues and meanings? How important is the need for immediate relief of psychiatric symptoms? What are clients’ and therapists’ strengths and weaknesses? How flexible and integrative are therapists? What length of time are both clients and therapists willing to devote to treatment? What are the resources for treatment? What are the money, social support, education, and development factors? What are clients’ and therapists’ biases?

One of the most important questions, however, is: What are the sources of clients’ problems? Deciding on a group theoretical approach is one of the first steps in the discovery process because focusing on methods of getting at the root causes of clients’ issues can better serve their mental health needs.

THEORETICAL METHODS

To find underlying sources of clients’ dysfunctions clinicians need to look at methods of eliciting information on sources of dysfunction. In focusing on what appears to be the obvious—that clients are people, not pigeons (that is, just laboratory subjects)—it appears imperative clinicians approach clients with those attributes that historically appeal to humans.

Warmth, kindness, caring, and respect all increase the likelihood of engendering positive and productive responses from clients. A humanistic approach needs to be the starting, middle, and ending points in assessment. Combining this general approach with other theoretical approaches can help mental health practitioners elicit more accurate information.

Humanism maintains that clients know the answers to their problems within themselves. However, it is up to therapists to open the door to this cache of knowledge. By encouraging client cooperation and participation, a humanistic approach helps open the door to client-understanding and problem treatment, and helps close it by bringing closure, thereby completing the phases of effective treatment. The humanistic approach is especially valuable because it seems to be effective in building positive relationships with most people, regardless of their differences. Whatever theory is employed in making assessments, it would seem that the method of approaching and implementing those theories depends heavily on incorporating a humanistic approach when conducting groups.

The next layer of discovery appears to lie in examining client behaviors. Behavioral learning theory focuses on what is observable in clients. Behavior is the crust of clients’ psyches. Clinicians can see behavior and measure it—it helps them gain a foothold in understanding clients’ dysfunction. Based on the concept of rewards and punishment, behavioral theory promotes the belief that what can be learned, can be unlearned. But by addressing outward manifestations of dysfunction, can we adequately address the underlying issues? Behavioral theory gives therapists a concrete starting point for effective assessment of individuals’ suitable for groups. However, because outward manifestations are the most superficial aspect of clients’ issues, therapists need to dig deeper to find out what causes these behaviors.

In agreement with social learning theory, mental health practitioners can assess societal and relationally conditioned behaviors that contribute to clients’ dysfunction. By combining both behavioral and social learning theories, practitioners can further enhance their ability to understand clients’ issues and, thereby, their suitability for a particular group. Exploring added dimensions of clients’ worldviews, belief systems, and how they interact resulting in decisions a greater understanding of behavior emerges.

But what is the next step? Do clinicians focus on understanding and changing client behaviors based on their social context or clients’ personal habits or can comprehensive positive change be facilitated by revising clients’ external behaviors alone? Which comes first—the chicken or the egg? In order to understand clients’ outer manifestations, it seems more effective for therapists to focus on clients’ inner world. Part of clients’ inner world consists of the way clients’ think. Therefore, to promote more effective individual suitability for groups, clients’ cognitive functions need to be examined.

Approaching assessment from a cognitive view focuses on thoughts that set up behavior, which in turn helps determine social learning. Cognitive assessment also helps clinicians understand clients’ thoughts that lead to the distressing emotions that usually bring them to therapy in the first place. Therefore, tailoring questions to elicit clients’ thoughts and beliefs leads to more readily available conscious information that facilitates group determination.

According to cognitive theory, therapists can then focus on fostering change in clients’ faulty thinking to facilitate behavioral change. Although many studies seem to indicate that changing thought processes can lead to changes in behaviors, it begs the question: From where do clients’ dysfunctional thinking stem? Are not behaviors external symptoms of deeper issues? Examining sources of cognitive deficits and, therefore, resultant dysfunctional behaviors, takes therapists another step deeper into clients’ psyche.

Once therapists are able to elicit disclosure from clients, they can then apply clients’ thoughts and beliefs to understanding reasons for their behaviors, and help them arrive at a possible diagnosis. Ascertaining a basic understanding of individual client’s issues then promotes better decision-making as to whether or not a particular group will be appropriate for the client.

http://www.mind-mapping.co.uk/make-mind-map.htm

Exploring clients’ philosophies provides a roadmap for challenging faulty thinking. Psychologist and philosopher William James described philosophy as “an unusually stubborn effort to think clearly. (Fulford, et al., 2001, p. 130)” However, clients’ philosophies are often not products of clear thinking. If helping clients think clearly improves clients’ functioning, then the next step in assessment requires understanding their muddy thinking.

An effective understanding of clients’ cognitions requires putting those cognitions into concepts. To help clients answer questions such as, “What does it all mean?”, and “Why did I do that?” practitioners must also be clear about their personal beliefs, philosophies and thinking. Critical thinking is key to paving the way to client-understanding.

An existential approach to individual client assessment can help clinicians sort out how clients’ philosophies affect and motivate them and learn more about their cognitive capabilities. If a penchant for philosophizing and an above average intellect is determined, it may be helpful for that client to participate in a group with an existential framework.

Existentialism is useful for tying environmental, behavioral, cognitive, and affective aspects of clients’ issues together into a cohesive and coherent picture. Without assessing the totality of who clients are, including their philosophies, therapists’ subsequent efforts at effective diagnosis and treatment are significantly hampered.

References by request.