Family Systems Therapy



Picture 1

What is Family Centered Therapy?

Family therapy is a type of psychological counseling (psychotherapy) done to help family members improve communication and resolve conflicts. Family therapy is usually provided by a psychologist, clinical social worker or licensed therapist. These therapists have graduate or postgraduate degrees and may be credentialed by the American Association for Marriage and Family Therapy (AAMFT).

Family therapy is often short term. It may include all family members or just those most able to participate. Your specific treatment plan will depend on your family's situation. Family therapy sessions can teach you skills to deepen family connections and get through stressful times, even after you're done going to therapy sessions.

Major Contributors to Family Systems Therapy:
 

Picture 2

Alfred Adler (1870-1937)

                                                     

Picture 3

                                                          Murray Bowen (1913-1990)

Key Concepts:

·         Systemic therapists:
Explore the system for family process and rules, perhaps using a genogram

·         Invite the clients' family to therapy with them

·         Focus on the family relationships

·         Be concerned with transgenerational meanings, rules, cultural, and gender prespectives within the system, and even the community and larger systems affecting the family

·         Intervene in ways designed to help change the client's context

·         Differentiation of self- Involves the psychological separation of intellect and emotion and independence of the self from others

·         Structural family therapy-"Minuchin's central idea was that an individual's symptoms are best understood from the vantage point of interactional patterns, or sequences, within a family, and further, structural changes must occur in a family before an individual's symptoms can be reduced or eliminated" (Corey p. 440). 

Therapeutic Goals:

·         Specific goals are determined by the practitioner's orientation or by a collaborative process between family and therapist" (Corey p. 456).

·         Interventions are used to enable the client and their family to change and reduce their distress.

·         Ultimately, every intervention a therapist makes is an expression of a value judgment (Corey p. 456).

Techniques:



Picture 4



·         Personal characteristics such as respect for clients, compassion, empathy, and sensitivity are human qualities that influence the manner in which techniques are delivered" (Corey p. 456).  Central consideration is what is in the best interests of the family..



Picture 5

Why Family Therapy?

Family relationships are an important component of any child’s psychological health. Therapy, and improving the parent-child relationship, can be a vital part of the solution to a variety of teen dysfunctional behavior (such as discipline issues, problems at school, depression, eating disorders, self-mutilation, and drug and alcohol abuse). What I do is attempt to uncover the emotional dynamics fueling your child’s behavior, improve family communication, and teach parents how to guide their children more effectively. Family therapy can also greatly benefit families struggling with divorce, grief, and other difficult life transitions.

Research indicates that marriage and family therapy is as, or more, effective than standard and/or individual treatments for many mental health problems, such as: depression, adult/adolescent drug and alcohol abuse, children’s conduct disorders, eating disorders, chronic physical illness, and marital distress.  Marriage and family therapy:

• improves communication
• focuses on workable solutions
• enhances emotional attachment
• produces quick results

 

Picture 6

References:

 

Corey, G. (2013). Theory and practice of counseling and psychotherapy. Belmont, CA: Brooks/Cole

Picture 1

(nd) Retrieved from:  http://mainstreetcounselinggroup.com/services/

Picture 2

(nd) Retrieved from:  http://johnnyb93.blogspot.com/2011/04/rowboats-john-bonanno-photograph.html

Picture 3

(nd) Retrieved from:  http://www.socalbowentheory.com/bowen-theory.html

Picture 4

(nd) Retrieved from:  http://www.counselor.org/wp-content/uploads/2012/01/christian2.jpg

Picture 5

(nd) Retrieved from:  http://prehealthfig2008.wikispaces.com/file/view/family_therapy.jpg/49317163/family_therapy.jpg

Picture 6

(nd) Retrieved from:  http://robertdterris.files.wordpress.com/2010/10/familytree.jpg

Post Modern Therapy

What is Post Modern Therapy?

Postmodern psychotherapists believe that it is difficult at best, and often impossible, for a mental health “expert” to be able to determine what is “psychologically healthy,” since there is no truly objective measurement of mental health. As in postmodern philosophy, art, architecture, and music, “deconstruction” is a dominant theme in postmodern psychotherapy. In psychological terms, “deconstructing” means to regard the “givens” we take for granted as true (for example, “adolescence is a time for teens to separate from their parents,” or “if you don’t earn a good living you’re not successful”) and carefully examine their usefulness/appropriateness from the client’s point of view.

Practitioners of postmodern therapy even question the “givens” of their own profession (e.g. the concept of transference and its relevance to working with clients), and try to pay particular attention to minimizing the unavoidable power of authority granted to the therapist by the client who comes seeking “expert” advice. This is done through working hard to be as collaborative with the client as possible.

The are three main types of postmodern therapies:

• Narrative Therapy rests on two underlying principles: a) all human thought and behavior exist in cultural contexts that give them particular meaning and significance, and b) people’s view of the world is shaped through a complex, generally unconscious process of sifting through experiences and selecting those that are most consistent with the story one holds of oneself.
• Solution-Focused Therapy emphasizes the construction of solutions to problems, rather than an examination of their causes or how they are maintained. This approach is inherently brief compared with “traditional” psychotherapy, and rests on the belief that clients can solve their problems by doing more of what has been successful for them in the past.
• Collaborative Language Systems is a type of postmodern therapy that “dis-solves” problems through conversation and emphasizes a collaborative conversational partnership between therapist and client.

Picture 2

Founders of Post Modern Therapy:



Picture 3

                       Steven de Shazer (1940 - 2005) and Insoo Kim Berg (1964 - 2007)

 



Picture 5



                                             MICHAEL WHITE 1948-2008

                                              



Michael White, a social worker and family therapist of Adelaide, Australia and David Epston of Auckland, New Zealand, began collaborating in the 1980’s to creation of what is now called Narrative Therapy. 

“The narrative metaphor has enable us to conceive of this process ( therapy) as one that establishes the opportunity for people to re-author their lives and their relationships according to alternative stories that have preferred outcomes.” 

                                                                                                          Michael White 1990



Picture 5(2)

                                                 DAVID EPSTON 1944-PRESENT

 

Key Concepts:

·         Social constructionism is a psychological expression of this postmodern worldview; it values the client's reality without disputing whether it is accurate or rational (Corey p. 397).

·         Solution-focused brief therapy (SFBT) is a future-focused, goal-oriented therapeutic approach to brief therapy developed initially by Steve de Shazer and Insoo Kim Berg. (Corey p. 400).
SFBT differs from other therapies because it is interested in the present and the future but not the past.
Solution-focused brief therapy is grounded on the optimistic assumption that people are healthy and competent and have the ability to construct solutions that can enhance their lives" (Corey p. 400).

·         Positive psychology concentrates on what is right and working instead of what is a problem or weakness.  The emphasis of SFBT is to focus on what is working in clients' lives, which stands in stark contrast to the traditional models of therapy that tend to be problem-focused" (Corey p. 401).

SFBT explains how people change and how they can reach their goals.  Of all the social constructionists, Michael White and David Epston are best known for their use of narrative in therapy (Corey p. 410).

Therapists are encouraged to establish a collaborative approach with a special interest in listening respectfully to clients' stories; to search for times in clients' lives when they were resourceful; to use questions as a way to engage clients and facilitate their exploration; to avoid diagnosing and labeling clients or accepting a totalizing description based on a problem; to assist clients in mapping the influence a problem has had on their lives; and to assist clients in separating themselves from the dominant stories they have internalized so that space can be opened for the creation of alternative life stories" (Corey p. 410).

Therapeutic Goals:

·         SFBT reflects some basic notions about change, about interaction, and about reaching goals (Corey p. 403).

·         Goals are unique to each client.

·         Client expresses what they want from therapy and what concerns they want to explore.

·         Solution-focused therapists concentrate on small, realistic, achievable changes that can lead to additional positive outcomes (Corey p. 403).

·         Change viewing of a situation or frame of reference.

·         Change the doing of the problematic situation.

·         Tap into the client's strengths and resources. 

·         A general goal of narrative therapy is to invite people to describe their experience in new and fresh language(Corey p. 412).

Techniques:

·         Pretherapy change-Scheduled an appointment which initiates positive change.

·         Exception questions-Client is directed to times when the problem did not exist or was not as intense; exceptions are times when the problem should have occurred in the client's life but somehow did not.

·         Miracle question-If the problem was solved overnight what would happen? What would it look like?

·         Scaling questions- Rate feelings, moods, etc. on scale for example 1-10.

·         Formula First Session Task-Homework the client is given to complete between first and second therapy sessions.

·         Therapist feedback to clients

·         Terminating- "Once clients are able to construct a satisfactory solution, the therapeutic relationship can be terminated" (Corey p. 408).

·         Questions and more questions- The questions asked in narrative therapy are circular or relational and seek to empower clients.

·         Externalization and deconstruction- The person is not the problem the problem is the problem.

·         In the narrative approach, externalizing questions are followed by questions searching for unique outcomes" (Corey p. 416). Constructing new stories goes along with the process of deconstruction.

Picture 6

References

Corey, G. (2013). Theory and practice of counseling and psychotherapy. Belmont, CA: Brooks/Cole.

Picture 1

(nd) Image Retrieved from:  http://www.livingwellfeelinggood.com/2012/01/solution-focused-therapy-introduction/

Picture 2

(nd) Image Retrieved from:  http://creativesideofdiana.blog.com/2012/05/02/post-modernism/

Picture 3

(nd) Image Retrieved from:  http://pdjtherapie.blogspot.com/

Picture 4

(nd) Image Retrieved from:  http://www.azerinstitute.com/wp-content/uploads/2011/12/white.jpg

Picture 5 and 5(2)

(nd) Image Retrieved from: http://oreillyjnarrativetherapy.com/Julia_OReillys_Site/Founders_Of_Narrative_Therapy.html

Picture 6

(nd) Image Retrieved from:  http://www.cartoonstock.com/newscartoons/cartoonists/bro/lowres/bron1453l.jpg

Reality Therapy

Picture 1

What is Reality Therapy?

Reality therapy (RT) is an approach to psychotherapy and counseling. Developed by William Glasser in the 1960s, it is considered a form of cognitive behavioral therapy.  RT differs from conventional psychiatry, psychoanalysis and medical model schools of psychotherapy in that it focuses on what Glasser calls psychiatry's three R's: realism, responsibility, and right-and-wrong, rather than symptoms of mental disorders. Reality therapy maintains that the individual is suffering from a socially universal human condition rather than a mental illness. It is in the unsuccessful attainment of basic needs that a person's behavior moves away from the norm. Since fulfilling essential needs is part of a person's present life, reality therapy does not concern itself with a client's past. Neither does this type of therapy deal with unconscious mental processes. In these ways reality therapy is very different from other forms of psychotherapy.

Who is the Founder of Reality Therapy?

Picture 2

William Glasser (May 11, 1925)

William Glasser was born on May 11, 1925 in Ohio. He attended Case Western Reserve University, from where he earned both his BA and his MA. He continued his education in California and received his MD from UCLA. Glasser worked as a psychiatrist for the VA in the beginning of his professional career. It was during this time that he met his mentor, Dr. G.L. Harrington. Glasser spent much of his lifetime focusing on the development of his theories, specifically his Choice Theory. He studied the effects of control and how it related to psychology and observed this dynamic in his own clients over decades of private practice. He examined how the choices each individual made affected the other, and focused on the fact that each had the power to made their own, unique, personal choices, independent of the other. In 1967, Glasser opened the Institute for Reality Therapy.

 

Picture 3



Techniques of Reality Therapy

Reality therapy is a cycle of counseling (counseling environment & procedures for behavior change)

W= wants, explore wants, needs and perceptions

D= direction and doing, focus on what clients are doing and the direction they are headed

E= evaluation, challenge clients to evaluate their total behavior (continual basis)

P= planning and commitment, assist in the formulation of realistic plans and making commitment to carry out plans

Goals of Reality Therapy

·         Overall goal- assist clients to better meet their needs for love, belonging, survival, power, freedom, and fun.

·         Help clients gain psychological strength, accept personal responsibility, regain control of lives

·         Challenge clients to examine what they are doing, thinking, and feeling

·         Teach client to self-evaluate behaviors and determine what they want to change

·         Personal growth, Improvement, Enhanced lifestyle, Decision making

Picture 4

Picture 1)

(nd) Retrieved from:  http://newcounselor.blogspot.com/2012/04/reality-therapy.html

Picture 2

 (nd) Retrieved from: http://wgiwestregion.com/

Picture 3

(nd) Retrieved from:  http://brentonrussell.com/2010/12/20/design-your-lifestyle-for-happiness-and-fulfillment/

Picture 4
(nd) Retrieved from:  https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_0RiNMxMXbA1n7N__I3qbgrijp0Mu4oXJTqyPgAMNFFYEmrOQwcRf2FBDtmXwomPPoSuCy37hzcS274yd4effT9SehI8e8PVMh57Vxn-nT8TlzF41xOl_EMatJsvRsK9adc1jm24iAiW5/s1600/happiness20hands.jpg

Cognitive-behavioral Therapy



Picture 1





What is Cognitive behavior therapy?

Cognitive behavior therapy is one of the few forms of psychotherapy that has been scientifically tested and found to be effective in hundreds of clinical trials for many different disorders. In contrast to other forms of psychotherapy, cognitive therapy is usually more focused on the present, more time-limited, and more problem-solving oriented. In addition, patients learn specific skills that they can use for the rest of their lives. These skills involve identifying distorted thinking, modifying beliefs, relating to others in different ways, and changing behaviors.


Who is the Founder of Cognitive Behavioral Therapy?

Albert Ellis (1913-2007)

American psychologist who in 1955 developed Rational Emotive Behavior Therapy (REBT). He held M.A. and Ph.D. degrees in clinical psychology from Columbia University and American Board of Professional Psychology (ABPP). He also founded and was the President of the New York City-based Albert Ellis Institute for decades.^[1] He is generally considered to be one of the originators of the cognitive revolutionary paradigm shift in psychotherapy and the founder of cognitive-behavioral therapies.



Picture 3

CBT Techniques

Cognitive Behavioral Therapists use a wide variety of techniques to help patients change their cognitions, behavior, mood, and physiology. Techniques may be cognitive, behavioral, environmental, biological, supportive, interpersonal, or experiential. Therapists select techniques based on their ongoing conceptualization of the patient and his or her problems and their specific goals for the session. They continually ask themselves, “How can I help this patient feel better by the end of the session and how can I help the patient have a better week?” These questions also guide clinicians in planning strategy.

 What are the Goals of Behavior Therapy?

The focus and method of cognitive behavioral therapy sets it apart from other, more traditional therapies:

·         CBT is based on two specific tasks: cognitive restructuring, in which the therapist and patient work together to change thinking patterns, and behavioral activation -- in which patients learn to overcome obstacles to participating in enjoyable activities. CBT focuses on the immediate present: what and how a person thinks more than why a person thinks that way.

·         CBT focuses on specific problems. In individual or group sessions, problem behaviors and problem thinking are identified, prioritized, and specifically addressed.

·         CBT is goal oriented. Patients working with their therapists are asked to define goals for each session as well as longer-term goals. Longer-term goals may take several weeks or months to achieve. Some goals may even be targeted for completion after the sessions come to an end.

·         The approach of CBT is educational. The therapist uses structured learning experiences that teach patients to monitor and write down their negative thoughts and mental images. The goal is to recognize how those ideas affect their mood, behavior, and physical condition. Therapists also teach important coping skills, such as problem solving and scheduling pleasurable experiences.

·         CBT patients are expected to take an active role in their learning, in the session and between sessions. They are given homework assignments at each session -- some of them graded in the beginning -- and the assignment tasks are reviewed at the start of the next session.

·         CBT employs multiple strategies, including Socratic questioning, role playing, imagery, guided discovery, and behavioral experiments.

·         CBT is time limited. Typically, treatment with CBT lasts 14 to 16 weeks.

Who Can Benefit From CBT?

Anyone with mild or moderate depression can potentially benefit from cognitive behavioral therapy, even without taking medication. A number of studies have shown CBT to be at least as effective as antidepressants in treating mild and moderate depression. Studies also show that a combination of antidepressants and CBT can be effective in treating major depression.



Picture 4



Picture 1

(nb) Retrieved from:  https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjp43qExnC9XsKsamkhgqvEMeqcFKKWuc3fuJOwZnXCXyqVEsaMCiyQxGgUxFkS8wv2nseqntGWt7YyqYk8xpC8QDXLyhouTZ1B6jfcp4MS7sl_u-lrXIRS3LoQrShVVQQUP7HynA9KIuSc/s400/CBT_logo.jpg

Picture 2

(nb) Retrieved from:  http://thisaintevenfunny.files.wordpress.com/2012/11/cbt-bigchart.gif

Picture 3

(nb) Retrieved from:  http://www.drcarnazzo.com/uploads/1/3/4/3/13437686/1089509.jpg?1349886772

Picture 4

(nb) Retrieved from:  http://breathenews.files.wordpress.com/2011/05/life.jpg?w=300&h=295