"Marriage and Family Therapy Exam Review" - 5 new articles
MeganAfter completing a biopsychosoicial assessment, and an additional session with Mel and Megan, you begin to formulate assumptions about the personal and interpersonal strengths, resources, and difficulties that brought them to marital counseling. Megan expressed in the initial session with you that she has concerns relating to her relationship with her husband, Mel, and that she would like at least some individual counseling sessions with you to discuss personal issues that she feels uncomfortable discussing with Mel in the room. Mel grimaces and looks at Megan with a disdainful look and tells you that he does not have anything to hide and whatever she has to say she should say in front of him. From what Megan stated in the beginning sessions, you discern that if Megan’s concerns are expressed in front of Mel, this could result in emotionally and/or physically negative repercussions against Megan. In therapy, Mel has openly demonstrated his anger, criticism, resistance, and difficulty relinquishing control over Megan. Megan hinted that Mel and her father bear certain similarities in their behavior, and use of control mechanisms with her. You see through Mel’s covert attempts to keep certain aspects of their relationship secret and his attempts to control Megan through modulating his tone of voice, carefully choosing his words and body language and their effect on Megan. You suspect that there is the possibility of domestic violence in the marriage. You further suspect that from Megan’s comments that she has witnessed or experienced domestic violence in her family of origin, with her father as the perpetrator.
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 Experiential Family Therapy (e.g. Carl Whitaker)
A) Assumptions
1. Based on a pragmatic stance with the belief that theory can hinder clinical work 2. Each family member has the right to be themselves 3. Based on the belief of the family being an integrated whole, not as a collection of discrete individuals 4. Familial togetherness and cohesion is associated with personal growth 5. Emphasis on the importance of involving extended family members in treatment (especially the expressive and lively spontaneity of children) 6. Basis of this bold and inventive approach to family therapy was the result of Whitaker’s spontaneous and creative thinking 7. Stresses the importance of genuineness 8. Techniques are secondary to the therapeutic relationship 9. Whitaker believed in this a theoretical approach based on the assumption that many times, theory is way for therapist to create distance from clients; it also helps to control the anxiety of therapists by allowing them to hide behind their “theory”. 10. Emotional expression is thought to be the medium of shared experience and the means to fulfillment (personal and family). 11. Whitaker suggested that self-fulfillment depended on family cohesiveness. B) Why People Do What they Do? (What Motivates Them?) 1. To be authentic and able to freely express oneself 2. Being autonomous while also feeling they are a part of the family 3. To have intimacy 4. Self-actualization and self-determination C) How Do People Get In Trouble? 1. Symptoms and interpersonal problems stem from the lack of emotional closeness and sharing among family members. 2. The needs of the family may be suppressing the rights of the individual. 3. Keeping family secrets can lead to the dysfunction of family members. 4. The family has infringed upon its individual members’ growth and freedom. 5. Personal choice has been comprised. 6. Families put on a façade which restrains its members from being authentic. D) How To Help People Goals of Experiential Family Therapy • The primary goal of experiential therapy is to reduce defensiveness and unlock deeper levels of experiencing by freeing the clients from their impulses. • Goals for the family o improved communication and reduced conflict o growth, not stability: symptom reduction is secondary to greater freedom of choice o increased personal integrity (congruence between inner experience and outer behavior) o less dependence, o expanded experiencing o emphasis on the feeling side of human nature o improved autonomy for each member o improved agreement about roles o merger of needs for individual growth and strengthening the family unit. 1. The therapist’s active and forceful personal involvement and is the greatest way to bring about changes in families with the goal of promoting flexibility among family members. 2. A goal of therapy is to help family members open up and more fully be themselves by freely expressing what they are thinking and feeling. 3. The therapist conducts a family therapy session with the intent of it being a growth experience for him/herself, thereby inspiring the family to do the same; therefore, the therapist helps family members focus on the here and now by the therapist “being with” the family. 4. Focus on expanding immediate personal experiences and increasing the family’s awareness by achieving a higher level of intimacy. 5. Unmask pretense, create new meaning, and liberate family members to be themselves. 6. Aim for authenticity as there is no right or wrong way to be. 7. Attempt to unmask and tap into family secrets. 8. Guide the family through three specific phases: engagement (the most powerful), involvement (dominant parent figure, adviser) & disentanglement (more personal, less involved). E) What Techniques And Skills Are Used? 1. Whitaker pioneered the use of co-therapists as a way to maintain objectivity. 2. Incorporates highly provocative techniques/interventions intended to create turmoil, turn up the emotional temperature, and intensify what is going on here and now in the family while then coaching the family how to get out of the turmoil. 3. Believed in doing therapy with a “crowd” in the room. 4. The therapist is active and directive to help create an intensified affective encounter for family members which allows for the family’s own healing and self-actualizing processes to take hold. 5. Therapist takes a theoretical stance as a way to intensify what the family members are presently experiencing and encourage them to reach into their unconscious to understand what is really going on in the family. 6. Facilitation of individual autonomy and a sense of belonging in the family. 7. Encourage spontaneity, creativity, the ability to play, and the willingness to be “crazy”. 8. The therapist's role is more of a facilitator. Through the use of reflection, he/she exposes the process of family interaction while joining the family process as a genuine and non-defensive person. F) What Are The Limitations On Those Skills Or Techniques? 1. A great limitation is that this approach de-emphasizes theory and the use of “one-size, fits all” techniques. 2. Therapy follows a subjective focus and centers around the subjective needs of the family members (leaving room for bias or skewed perceptions). 3. This approach relies on a highly involved therapist model where the therapist must be visible, take risks, and get involved with family in the sessions. 4. Since success depends on the collaboration of several people, drop-out rates are high. G) What Are The Professional Implications? 1. Whitaker typically relied on his own personality and wisdom, rather than any fixed therapeutic techniques to stir things up in families, so it is a hard theory to “teach” in terms of technique. 2. Whitaker believed in a confrontative approach which may not work well with fragile families. 3. This method incorporates an intuitive form of therapy which lower-functioning families/family members may not grasp. 4. He also acquired the reputation as the most disrespectful among family theorists since he often attacked or sought to overthrow traditional or popular ideas in family theory. 5. Some families may not appreciate the unrestrictive, intuitive, non-interventionist, and sometimes outrageous nature of this approach. 6. Rather than focusing on alleviating symptoms, this approach focuses on enhancing the quality of life of the family members. Although some focus on changing the family system may develop, it is not the primary goal. Therefore, this method may not be well suited for families who are looking for crisis management.  Individually based theory and therapy models 01Psychoanalysis- Freud/Erikson/Mahler
Role of Therapist ■ Invisible- Blank Screen (detachment) ■ Fosters transference ■ Focus on Resistance Therapeutic Goals ■ Bringing the unconscious to the conscious ■ Strengthen the ego Key Ideas ■ Deterministic- problems are rooted in the first six years of life and trapped in unconscious motivations ■ Reality Principle- maximize gratification minimize punishment ■ Biological Drives- sex and instincts ■ Parts of Personality- Id/Ego/Superego ■ Id- Pleasure principle, “Demanding Child,” deterministic, unconscious, satisfy basic survival ■ Ego- Reality principle, “Traffic Cop,” mediator between Id and Superego ■ Superego- Moral Principle, “The Judge,” strive for perfection Psychosexual Stages of Development ■ Oral Phase- 0-1 years, greedy, mistrust, unable to form intimate relationships ■ Anal Phase- 1-3 years, anal retentive, aggressive ■ Phallic Phase- 3-6 years, identity disturbance (Oedipal/ Electra complex) ■ Latency- 6-12 years, Socialization stage ■ Genital- 12+, Interpersonal relations freedom to love/work Techniques ■ Brief psychodynamic therapy (BPT)- treating selective disorders within an established time. ■ Hypnosis ■ Dream Interpretation ■ Free Association ■ Projective Techniques ■ Freudian Slips  Feminist Family Therapy 01Foundations
■ Feminist movement Emerged in the late 1960’s continuing into the 1970’s. ■ Rachel Hare-Mustin o One of the first women to challenge the family-therapy establishment. o 1978 wrote "A Feminist Approach to Family Therapy" ■ Feminism is a theory that focuses on the recognition of the inferior status of women and the reasons for that inequality. ■ The strategies used in this theory are intended to lead to the recognition and validation of inequality and what changes can be made to end it. ■ It acknowledges that gender roles and socialization affect o each individual in the family system o interpersonal relationships in the system o relationships between the family and society o the client and therapist exchange. ■ Originally family theories simply ignored sexual stereotyping in families. o Complementarity ● systemic concept which suggests an temporary inequality between partners ● The inequality is complementary and serves to stabilize the relationship. ● Does not take into consideration that women are ultimately at a disadvantage living in a society which keeps the women in a disadvantaged position structured by: o Neutrality ● A position recommended that encourages the therapists to maintain a position of neutrality with the couple or family. ● The goal is to have all members of the family feel sided with and not against. ● However the relationship is unequal to begin with so it is maintaining a position of inequality by siding equally o Circularity ● Suggests that responsibility for interactional dyads is equal. ● For example, it would suggest that even in cases of domestic violence, she is equally responsible for the abuse as him. ● The therapist who remains neutral by means of silence in a clinical situation like this is encouraging the unequal distribution of power in the system.  More Recent Articles |
