2 KEY THEORETICAL APPROACHES IN SW PRACTICE:
1) Virginia Satir's Conjoint Family Therapy
2) Salvador Minuchin's Structural Family therapy
Satir's Conjoint Family Therapy
-emphasizes open communication
-see's marital problems resulting from low self-esteem which leads to a fear of rejection, which then leads to dysfunctional communication-->
-when communication involve suppresion of taboo subjects, avoidance, denial, projection and other reality distortions, then a child or anyone in the family can manifest a sx.
-GOAL: to develop clear and functional communication patterns
-THERAPIST ROLE: to objectively govern communication during sessions and teach and model functional communication.
-emphasis in the HERE & NOW interaction in sessions
Minuchin's Sturctural Family Therapy
-problem bx viewed as result of a dysfunctional family structure (relatively stable patterns of relationship between people)
-2 kinds of problems:
*Problems of inflexible structure: family that is unable to change its patterns of relationship according to changs in their situation
*Problems of resonance: how enmeshed or disengaged family members are with one another
(aka: how senstive or reactive is the system to each member's actions?)
GOAL: a well-balanced, flexible family structure
THERAPIST ROLE: "joins the family"= goes along w/ the family's existing structure comunication patterns. Uses comments to challenge / draw attention to existing structure via behavioral prescriptions, suggestions, and "homework" assignments, to actively work to change that structure
5 MODELS OF FAMILY THERAPY
2) Open Communication / Growth Approaches
3) Bowenian Theory (Intergenerational Theory)
4) Structural Family Therapy
5) Strategic Therapy
Psychodynamic Family Theory
VIEW OF PROBLEM: function of past interpersonal experiences and transferences resulting from them; current focus is on the way in which members counterbalance one another's pathology
TX GOALS: work through unconscious distortions to permit more adaptive reality responses; have each members accept his/her ambivalences and wishes in order to decrease projections w/in the family and decrease rigid defenses
THERAPIST ROLE: looks for transferences from past family relations to the therapist, and works through them; session involves 1:1 interactions between family members and the therapist; therapist offers: understanding- acts as a safe parent figure - provides acceptance - clarifies relationship patterns - teaches and encourages new patterns
Psychodynamic family therapy can be "free-passive-interprative-blank screen" similar to psychoanalysis but may also be structured as done for ex: w/ an "aggressive, anti-social" teen
Ex. tx: -
take an authoritative stance
identify what his parents' concerns are
discuss his rights and self-determination
Open Communication / Growth Approaches
- draws from Virginia Satir and Jay Haley
VIEW OF THE PROBLEM: low self-esteem leads to fear of rejection which leads to dysfunctional communication involving mixed messages and hidden messages
TX GOALS: develop clear and functional communication patterns. Make hidden meanings known in order to defuse them.
THERAPIST GOAL: serve as an objective governor of communication as it emerges during sessions and teach functional communication skills. The therapist models clear and functional communication, oftern working w/ a co-therapist for this purpose
Bowenian Intergenerational Theory
-by Murray Bowen
VIEW OF THE PROBLEM: Sx result from a LACK OF DIFFERENTIATION between THINKING & FEELING and SELF & OTHERS in the family.
A family's degree of differentiation is established over multiple generatios of family life. Bowen assumes that people choose partner from families with similar levels of differentiation
TX GOALS: increase level of differentiation, which will enable family members to withstand greater degrees of anxiety in life.
Increase the solid-self = clear convictions and internal consistecy (Roger's self-congruence); it's reponsible, autonomous and non-dogmatic
Decrease the pseudo-self= convictions that change w/ social pressure; lives in a predominantly feeling world where major life decisions are based on "getting comfortable."
THERAPIST ROLE: seen as teacher and coach; homework assignments used as a way of demonstrating patterns of bx.
Therapist works w/ the "leader, " = person most influential in the family system.
Structural Family Therapy
by Salvado Minuchin
-focuses less on insight (as done in Psychodynamic and Bowenian approaches) and looks at more concrete bx patterns.
VIEW OF THE PROBLEM: problem bx viewed as fx of dysfunctional fam. structure (established patterns of interactions). Focus on problems of inflexible structure and problems of resonance
TX GOALS: develop a well-balanced, flexible structure w/ a stong parental coalition
-determined the nature of the family's structure as part of the assessment phase
-determined the nature of the family's communication patterns
-homework assignments used as probes to illustrate family relationship patterns
-help the clients better understand their family's structure
clarify all family members' symptoms, not just Eddie's
clarify the family members' reality circumstances
actively make suggestions and "behavioral prescriptions" to change dysfunctional aspects of structure
THERAPIST ROLE: eval structure, flexibility, and resonance; eval how sx are serving to maintain existing structure; contract for specific goals; homework assignments to test bx patterns then to teach and practicie changes in bx
Strategic Family Therapy
by Haley and Satir
-a brief, sx oriented therapy w/ present focus and little attention to insight development
VIEW OF THE PROBLEM: sx are dysfunctional attempts to regulate family relationships and resolve problems in the family.
A family system is a pattern of rules (norms, expectations) and families become dysfunctional b/c of ambiguity and covert communications.
The emphasis is on the family as a whole.
TX GOALS: clarify communications patternsand work to make them functional. Make the implicit explicit. Change repetitive, dysfunctional communication sequences.
THERAPIST'S ROLE: therapist is DIRECTIVE and ACTIVE. Reframe the family's view of the problem. Use paradoxical instruction to prescribe sx as a way of interfering with repetitive communication sequences.