Technique: Token Economy
Behavioral Theory
Technique: Battle for Structure
Symbolic-Experiential
Technique: Reframing
Structural
Technique: Process Questions
Intergenerational
Technique: Psycho-education
Cognitive-Behavioral Therapy (CBT)
What are the key techniques used in psychodynamic therapy?
silence and interpretation
Technique: Reinforcement Schedule
CBT
Technique: Therapeutic Contracts
CBT
What are the core problems in psychodynamic therapy?
conflict
projective identification
fixation and regression
Technique: Systemic Desensitization
CBT
What is the emphasis in psychodynamic therapy?
drives
self objects
internal objects
Technique: Augmenting Despair and Amplifying Deviation
Symbolic-Experiential
Technique: Contracts
CBT
Technique: Modeling
CBT
Technique: Listening
Psychoanalytic
Technique: Creating Confusion and Disorganization
Symbolic-Experiential
Technique: Being Public
Collaborative
Technique: Self-Mondala
Satir's Communication Approach
Technique: Reinforcing Parental Hierarchy
Symbolic-Experiential
Technique: Maintaining Coherence with the Client's Story
Collaborative
Technique: Functional Analysis
CBT
Technique: Stories, Metaphors
Symbolic-Experiential
Technique: Empathy
Psychoanalytic
Technique: "Going Home Again
Intergenerational
Technique: Shaping
CBT
Technique: Not Knowing and Curiosity
Collaborative
Technique: Separating interpersonal from Personal Distress
Symbolic-Experiential
Technique: Analytic Neutrality
Psychoanalytic
Technique: Time Out
CBT
Technique: Interpretations
Psychoanalytic
Technique: Family Sculpting
Satir's Communication Approach
Technique: Affective Confrontation of Rigid Patterns and Roles
Symbolic-Experiential
Technique: Assessing Multiple Voices
Collaborative
Technique: Relabeling
MRI
Technique: Spontaneity, Play, and Craziness
Symbolic-Experiential
Technique: Non-anxious Presence
Intergenerational
Technique: Assessing the "not yet said
Collaborative
Technique: Family Reconstruction
Satir's Communication Approach
Technique: Charting
CBT
Technique: Absurd Fantasy Alternatives
Symbolic-Experiential
Technique: Coaching
Intergenerational
Technique: Addressing the Therapuetic Impasse
Collaborative
Technique: Genogram
Intergenerational
Technique: Paradocical Injunction (4 Types)
Strategic
Technique: Situating Comments
Narrative
Technique: Family Life Fact Chronology
Satir's Communication Approach
Technique: Challenging Family Assumptions
Structural
Technique: "On Track
Solutions-Focused
Technique: Displacement Stories
Intergenerational
Technique: Prescribing the Symptom: More of the Same
MRI
Technique: Reflecting Team
Collaborative
Technique: Exploring Specifications for Personhood
Narrative
Technique: Here-and-now experiencing
Symbolic-Experiential
Technique: Restraining and Going Slow
Strategic
Technique: De-Triangulate
Intergenerational
Technique: Exception Questions
Solutions-Focused
Technique: Transforming Rules
Satir's Communication Approach
Technique: Evocative Responding
EFT
Technique: Directives
Strategic
Technique: Advertising rather than Concealing the Problem
MRI
Technique: Miracle Question
Solutions-Focused
Technique: Ordeal
Strategic
Technique: Preference and Permission Questions
Narrative
Technique: Scaling Questions
Solutions-Focused
Technique: Supporting Differentiation
Intergenerational
Technique: Pretend Techniques
Strategic
Technique: Neutrality
Milan
Technique: Joining
Structural
Technique: Eliciting Strengths and Resources
Solutions-Focused
Technique: Boundary Around Couple
Strategic
Technique: Making Covert Overt
MRI
Technique: Audience/Witness
Narrative
Technique: Metaphoric Tasks
Strategic
Technique: Compliments
Solutions-Focused
Technique: Deconstructive Listening
Narrative
Technique: Creating a Calm Atmosphere
Strategic
Technique: Reflection and Validation
EFT
Technique: Boundary Making
Structural
Technique: Metaphors
Satir's Communication Approach
Technique: Formula First Session Task
Solutions-Focused
Technique: Deconstructive Questions
Narrative
Technique: Empathic Conjecture
EFT
Technique: Inspiring Solutions and Solution Building
Solutions-Focused
Technique: Hightening
EFT
Technique: Letters and Certificates
Narrative
Technique: Counter-Paradox
Milan
Technique: Relative-Influence Questioning
Narrative
Technique: Dangers of Improvements "Go Slow
MRI
Technique: Externalization of the Problem
Narrative
Technique: Bellac Ploy
MRI
Technique: Modeling Communication
Satir's Communication Approach
Technique: Family Mapping
Structural
Technique: Statues of Limitations
Strategic
Technique: Initial Interview Questions
MRI
Technique: Temperature Reading
Satir's Communication Approach
Technique: Enactment
Structural
Technique: Reframing
MRI
Technique: Ingredients Intervention
Satir's Communication Approach
Technique: Spontaneous Behavioral Sequences
Structural
Technique: Positive Connotation
Milan
Technique: Plotting Narratives in the Landscapes of Action and Consciouness
Narrative
Technique: Ritual
Strategic
Technique: Team Approach
Milan
Technique: Parts Party
Satir's Communication Approach
Technique: Positioning
Strategic
Technique: Challenging the Symptom, Structure, and Reality
Structural
Technique: Creating Good Memories
Strategic
Technique: Circular Questioning (4 Types)
Milan
Technique: Planning
Structural
Technique: A Learning Process
Milan
Technique: Unbalancing
Structural
Technique: Fines
Strategic
Technique: Rituals
Milan
Technique: Invariant Prescription
Milan
Technique: Affective Intensity
Structural
Technique: Role of Therapist
Satir's Communication Approach
Technique: Hypothesizing
Milan
Technique: Disputing Irrational Beliefs
CBT
Technique: Shaping Competence
Structural
A family system is...
a living, open entity, that grows, develops and reacts to outside forces and influences
Equifinality is...
The idea that a desired end can be achieved in many different ways, and an idea advanced by biologist Ludwig Von Bertalanffy
First order cybernetics refers to a relationship between the therapist and the family in which the therapist is ...
seen as a separate from the family system, observing it from the oustide
Which of the rolling clients is most likely to receive a DSM-IV_TR diagnosis in assessment?
an individual in individual therpay
A dyad is...
any two people in contact with each other
One of the themes or issues covered in the Family Journal in the last ten years is...
sexual, ethical, and children at risk issues
Which of the following are metaframework?
organization of systems sequences of interaction, and gender perspectives
A consideration of a person's parts and how they work together or in unison with the parts of others is an assessment of...
internal family systems
Which of the following is a question associated with a virtue ethics model?
If I were in the shoes of each of the family members, what might I feel and wish to do in relation to the situation.
Which of the following are commonly discussed ethical issues in family practice?
confidentiality, conceptualizing the clients and implementing HIPPA requirements
A map or diagram of the family across three generations is called
a genogram
Technique: Sensate-Focus Tehcnique
CBT
A sign that a developing Bowen therapist has worked through family of origin issues might be
developing person to person relationships with as many family members as possible and striving to relate to one another rather than to talk about others
A Bowen therapist shows a family the movie Ordinary People and asks them to consider what is going on in that family and what might need to happen for the family in the movie to work more together. This is an example of...
The use of displacement stories in therapy
A five step process in which Phillip Guerin, 1) defines the triangulation in a family interaction 2) delineates the triangle's structure and movement 3) revises the direction of the movement 4) exposes emotional process 5) address emotional process to aug
neutralize symptoms in family process
What question might an Adlerian ask the family to determine what the mistaken goals of children might be?
when was the last time a specific problem occurred, in the midst of the misbehavior, how did the parent feel?what did the child do in response to parental correction/intervention?
Satir considered herself as a
feminist who believed in equality and made very few distinctions in her practices with men and women
Among other things, Satir therapists,
take the family's history and note past achievements, show that pain and the forbidden are acceptable to explore, create a setting in which people can risk looking clearly and objectively at themselves
Staying present and focusing and meaning during this stage in Satir's process of change. The key is not to rush not to encourage big decisions, and stay with the process. This stage of change is
chaos
Satir believed that it was possible for parents to
be a team and go with a child to provide the nuturance needed for growth and development
Satir techniques
touch, psychodramatic experiences, physical sculpting
What would lead the symbolic-experiential therapist to shift to less overt interventions in family therapy?
the expressions and interactions of family members seem more authentic
Many feminist family therapists saw in Whitaker...
a male therapist who recognized the problems with stereotyped roles and expectations and was willing to play with patriarchy to undermine it
Whitaker observes that depression is part of a family process, and in most cases seems to sap the strength out of most. He brings batacas, and soft foam rubber bats and asks the family to fight with them. This is an example of
playing with violence
When Whitaker would hear family members express a position that kept them stuck he was most likely to say something even more outrageous. This is called...
seeding the unconsious
Symbolic experiential therapists rely
authentic use of self in therapy
A symbolic-experiental therapy as its own communication
silence
A multigenerational approach looks for
problem patterns across at least 3 generations and focuses on the difficulties associated with triangulation and failure to achieve a differentiated self.
Bowen thought this was essential in remaining emotionally detached as a family therapist
a well articulated theory
Adlerians believe that human beings are
social, purposeful, subjective, and interpretive in their approaches to life
Adlerian family therapy seeks to
unlock patterns and support more effective leadership and relationships
Satir's human validation process stresses
enhancement and validation for self-esteem, family rules, congruence versus defensive communicating patterns, and sculpting
Negative feedback loops are...
loops within the family system that deter changes or precent them from happening
Positive feedback loops...
initiate or allow change
What is triangulation?
under stressful situations, two people may recruit a third person into the relationship to reduce the anxiety and gain stability
Toman believed that position in family
determines power relationships
Basic assumption in Adlerian therapy is that
both parents and children often become locked in repetitive, negative interactions based on mistaken goals that motivate all parties involved.
When family members pay the price of sacrificing themselves in an attempt to please others. This is called
placating behaviors
This increases family members awareness of how they function and how they are viewed by others in the system.
Family scuplting
Enables clients to explore significant events in three generations of family life.
Family reconstruction
Psychodramatic process that helps individuals acknowledge and integrate multiple aspects of the self.
Parts Parties
This is experienced when one falls in love with another and the other is invested with desired attributes and capacities far beyond what any given person could possibly have
delusion of intimacy
The desire for oneness
illusion of intimacy
This is used to direct clients to continue what they are doing rather than try to give it up
Paradox
These are contradictory messages from which an individual cannot escape
Double message
If a kind of "meta-event" with the power of a psychological orgasm occurs within the therapy session, then stimulating it, to evolve into a full blown crisis is one way to release the family into a great sense of becoming
evolving a crisis
Whitaker's process of taking family members inference far beyond anything the family member normally would consider
Seeding the unconsious
Expose and then alter the dysfunctional relationship process in the family system
relationship experiments
This helps people identify triggers to emotional reactivity, look for alternative responses and anticipate desired outcomes.
coaching
Clear and concise statements of the personal opinion and belief that are offered without emotional reactivity
I-Positions
Usually implemented through the use of film or videotape
Displacement stories
In the US, when did family therapy develop into a field of therapy?
in the 1970's
Who is credited with introducing the concepts of cybernetics to understanding family systems?
Gregory Bateson
If a son uses drugs and is cause and the dad leaves it, this is what kind of loop?
Positive
This is superficial changes through which the family system essentially remains the same
first order change
transformational changes in the family system that endure and make a real difference
second order change
This focuses on the present and would ask therapists to breath in and out and focus on themselves. If we attend to something, we attach meaning to it.
Satir's hanging hats
What are examples of emotional cutoffs
disengagement, enstrangement
Kitchener's approach to applying principle ethics is called
Critical-Evaluation Model
Structural figures
Minuchin and Fishman
Structural assumption
ASSUMPTIONS:
Problems reside within a family structure
(although not necessarily caused by the
structure)
Changing the structure changes the
experience the client has
Don't go from problem to solution, we
just move gradually
Children's problems are often
Structural concepts
CONCEPTS:
Family structure
Boundaries
o Rigid
o Clear
o Diffuse
o Disengaged
o Normal Range
o Enmeshment
o Roles
o Rules of who interacts with whom, how,
when, etc.
Hierarchy
Subsystems
Cross-Generational Coalitions
Parentified Child
Structural goals of therapy
GOALS OF THERAPY:
Structural Change.
- Clarify, realign, mark
boundaries
Individuation of family members.
Infer the boundaries from the patterns of
interaction among family members.
Change the patterns to realign the
boundaries to make them more closed or
Structural Role of the therapist
ROLE OF THE THERAPIST:
Perturb the system because the structure is too rigid
(chaotic or closed) or too diffuse (enmeshed)
Facilitate the restructuring of the system
Directive, expert�the therapist is the choreographer
See change in therapy session; homew
Structural assessment
ASSESSMENT:
Assess the nature of the boundaries, roles
of family members
Enactment to watch family
interaction/patterns
Structural interventions
INTERVENTIONS:
Join and accommodate
o mimesis
Structural mapping
Highlight and modify interactions
Unbalance
Challenge unproductive assumptions
Raise intensity so that system must change
disorganize and reorganize
Shape competence through Enactment
(thera
Structural change
CHANGE:
Raise intensity to upset the system, then
help reorganize the system
Change occurs within session and is
behavioral; insight is not necessary
Emotions change as individuals'
experience of their context changes
Structural termination
TERMINATION:
Problem is gone and the structure
has changed (2nd order change)
Problem is gone and the structure
has NOT changed (1st order change)
Structural self of the therapist
SELF OF THE THERAPIST:
The therapist joins with the system to facilitate the
unbalancing of the system
Caution with induction�don't get sucked in to the content
areas, usually related to personal hot spots
Structural evaluation
EVALUATION:
Strong support for working with psychosomatic children, adult drug addicts, and anorexia nervosa.
S
Strategic
John
Weakland
Don Jackson
Paul
Watzlawick
Richard Fisch
Strategic assumptions
ASSUMPTIONS:
Family members often perpetuate problems by their own actions (attempted
solutions) --the problem is the problem maintenance (positive feedback
escalations)
Directives tailored to the specific needs of a particular family can sometimes bring
Strategic concepts
CONCEPTS:
Symptoms are messages
Family homeostasis
Family rules -- unspoken
Cybernetics
o Feedback Loops
o Positive Feedback
o Negative Feedback
First order change
Second order change
Reframing
Content & Process
Report & Command
Paradox
Paradoxical Injunc
Strategic goals of therapy
GOALS OF THERAPY:
Help the family define clear, reachable goals
Break the pattern; perturb the system
First and second order change- ideally second
order change (we cannot make this happen-- it is
spontaneous)
Strategic role of therapist
ROLE OF THE THERAPIST:
Expert position
Responsible for creating conditions for change
Work with resistance of clients to change
Work with the process, not the content
Directive
Strategic assessment
ASSESSMENT:
Define the problem clearly and find out what
people have done to try to resolve it
Elicit goals from each family member and
then reframe into one, agreed-upon goal
Assess sequence patterns
Strategic intervention
Interventions
Skeptical of change
Take a lot of credit and responsibility for change;
however, therapist tells clients that they are
responsible for change
Active
Paradox
Directives
o Assignments ("homework") that interrupt
sequences
Interrupt unhelpful s
Strategic change
CHANGE:
Interrupting the pattern in any way
Difference that makes a difference
Change occurs outside of session; insession
change is in viewing; homework changes
doing
Change in viewing (reframe) and/or doing
(directives)
Emotions change and are important
Strategic termination
TERMINATION:
Client decides when to terminate with the help of the
therapist
When pattern is broken and the client reports that the
problem no longer exists
Therapist decides
Strategic self of the therapist
SELF OF THE THERAPIST:
Therapist needs to be VERY careful with
ethics in this model; it can be very
manipulative (paradox) and a lot of
responsibility is on the therapist as an expert
Strategic evaluation
EVALUATION:
Very little research done
Do clients report change? If so, then it is effective
Strategic - H & M
Jay Haley & Cloe Madanes & Influenced by
Minuchin
Strategic - H & M - assumptions
ASSUMPTIONS:
Family members often perpetuate problems by their own actions (attempted
solutions) --the problem is the problem maintenance (positive feedback
escalations)
Directives tailored to the specific needs of a particular family can sometimes bring
Strategic - H & M - concepts
CONCEPTS:
Symptoms are messages
Family homeostasis
Family rules - unspoken
Intergenerational collusions
First and second order change
Metaphors
Reframing
Symptoms serve functions
Content & Process
Report & Command
Incongruous Hierarchies
Ordeals (prescrib
Strategic - H & M - goals of therapy
GOALS OF THERAPY:
Help the family define clear, reachable goals
Break the pattern; perturb the system
First and second order change- ideally second order change
(we cannot make this happen-- it is spontaneous)
Realign hierarchy (Madanes)
Strategic - H & M - role of therapist
ROLE OF THE THERAPIST:
Expert position
Responsible for creating conditions for change
Work with resistance of clients to change
Work with the process, not the content
Directive
Skeptical of change
Take a lot of credit and responsibility for change;
howeve
Strategic - H & M - assessment
ASSESSMENT:
Define the problem clearly and find out what
people have done to try to resolve it
Hypothesize metaphorical nature of the
problem
Elicit goals from each family member and
then reframe into one, agreed-upon goal
Assess sequence patterns
Strategic - H & M - intervention
INTERVENTIONS:
Paradox
Directives
o Assignments ("homework") that interrupt
sequences
Interrupt unhelpful sequences of interaction
Metaphors, stories
Ordeals (Haley)
"Go slow" messages
Prescribe the symptoms (Haley)
"Pretend" techniques (Madanes)
Strategic - H & M - change
CHANGE:
Breaking the pattern in any way
Difference that makes a difference
Change occurs outside of session; insession
change is in viewing; homework changes
doing
Change in viewing (reframe) and/or doing
(directives)
Strategic - H & M - termination
TERMINATION:
Client decides when to terminate with the help of
the therapist
When pattern is broken and the client reports that
the problem no longer exists
Therapist decides
Strategic - H & M - self of the therapist
SELF OF THE THERAPIST:
Therapist needs to be VERY careful with
ethics in this model; it can be very
manipulative (paradox) and a lot of
responsibility is on the therapist as an expert
Strategic - H & M - evaluation
EVALUATION:
Very little research done
Do clients report change? If so, then it is effective
Milan - figures
Boscolo
Palazzoli
Prata
Cecchin
Milan - assumptions
ASSUMPTIONS:
problem is maintained by family's attempts to fix it
therapy can be brief o
Milan - concepts
CONCEPTS:
family games (family's patterns that maintain the
problem)
o dirty games
o psychotic games
there is a nodal point of pathology
invariant prescriptions
rituals
positive connotation
difference that makes a difference
neutrality
hypothesizing
thera
Milan - goal of therapy
GOALS OF THERAPY:
disrupt family games
Milan - role of therapist
ROLE OF THERAPIST:
therapist as expert
neutral to each family member - don't get sucked into
the family game
curious
Milan - assessment
ASSESSMENT:
Family game
Dysfunctional patterns (patterns that
maintain the problem)
Milan - interventions
INTERVENTIONS:
Ritualized prescriptions
Rituals
Circular questions
Counter paradox
Odd/even day
Positive connotation
"Date"
Reflecting team
Letters
Prescribe the system
Milan - change
CHANGE:
Family develops a different game
that does not include the symptom
(system change)
Requires incubation period
Milan - termination
TERMINATION:
Therapist decides, fewer than 10-12 sessions
Milan - evaluation
EVALUATION:
Not practiced much, therefore not
researched
Follow up contraindicated
Solution Foc Brief Therapy - figures
Steve de
Shazer
Insoo Kim
Berg
Yvonne
Dolan
Eve Lipchik
Solution Foc Brief Therapy - assumptions
ASSUMPTIONS:
Clients want to change
There's no such thing as resistance (clients are telling us how they cooperate)
Focus on present and future except for the past in terms of exceptions; not focused on
the past in terms of cause of changing the past
Chan
Solution Foc Brief Therapy - concepts
CONCEPTS:
Problem talk/ Solution talk
Exceptions
Smallest difference that makes a
difference
Well-formed goals (small, concrete,
measurable, important to client,
doable, beginning of something, not
end, presence not absence, hard work)
Solution not necess
Solution Foc Brief Therapy - goals of therapy
GOALS OF THERAPY:
Help clients to think or do things differently in order to
increase their satisfaction with their lives
Reach clients' goals; "good enough"
Shift the client's language from problem talk to solution talk
Modest goals (clear and specific)
Solution Foc Brief Therapy - role of therapist
GOALS OF THERAPY:
Help clients to think or do things differently in order to
increase their satisfaction with their lives
Reach clients' goals; "good enough"
Shift the client's language from problem talk to solution talk
Modest goals (clear and specific)
Solution Foc Brief Therapy - assessment
ASSESSMENT:
Assess exceptions�times when problem isn't there
Assess what has worked in the past, not necessarily related to the
problem; client strengths
Assess what will be different when the problems is gone (becomes
goal that might not be clearly relat
Solution Foc Brief Therapy - intervention
INTERVENTIONS:
Help set clear and achievable goals (clarify)
Help client think about the future and what they
want to be different
Exceptions: Amplify the times they did things that
"worked" when they didn't have the problem or it
was less severe
Formula
Solution Foc Brief Therapy - termination
TERMINATION:
Client decides
Solution Foc Brief Therapy - self of therapist
SELF OF THE THERAPIST:
Accept responsibility for client/therapist relationship
Expert on therapy conversation, not on client's life or experience of the
difficulty
Solution Foc Brief Therapy - evaluation
EVALUATION:
Therapy/Research:
Simple (not necessarily easy)
Can be perceived that therapist as insensitive- "Solution
Forced Therapy"
Crucial that clients are allowed to fully express
struggles and have their own experiences validated,
BEFORE shifting the
Narrative - figures
Michael
White
David Epston
Jill Freedman
Gene Combs
Narrative - assumptions
ASSUMPTIONS:
Personal experience is ambiguous
Reality is shaped by the language used to describe it - language and experience
(meaning) are recursive
Reality is socially constructed
Truth may not match historic or another person's truth, but it is true to
Narrative - concepts
CONCEPTS:
Dominant Narrative - Beliefs, values, and practices
based on dominant social culture
Subjugated Narrative - a person's own story that is
suppressed by dominant story
Alternative Story: the story that's there but not
noticed
Deconstruction: Take
Narrative - goals of therapy
GOALS OF THERAPY:
Change the way the clients view themselves
and assist them in re-authoring their story in
a positive light; find the alternative but
preferred story that is not problem-saturated
Give options to more/different stories that
don't include
Narrative - role of therapist
ROLE OF THERAPIST:
Genuine curious listener
Question their assumptions
Open space to make room for possibilities
Narrative - assessment
ASSESSMENT:
Getting the family's story, their experiences
with their problems, and presumptions about
those problems.
Assess alternative stories and unique outcomes
during deconstruction
Narrative - intervention
INTERVENTIONS:
Ask questions
o Landscape of action & landscape of
meaning
o Meaning questions
o Opening space
o Preference
o Story development
o Deconstruction
o To extend the story into the future
Externalize problems
Effects of problem on family; effect
Narrative - change
CHANGE:
Occurs by opening space; cognitive
Client can see that there are numerous
possibilities
Expanded sense of self
Narrative - termination
TERMINATION:
Client determines
Narrative -
SELF OF THE THERAPIST:
Therapist's ideas, values,
prejudices, etc. need to be
open to client,
"transparent"
Expert on conversation
Narrative - evaluation
EVALUATION:
No formal studies
CBT - figures
Ivan Pavlov
Watson
Thorndike
B. F. Skinner
Bandura
Dattilio
CBT - assumptions
ASSUMPTIONS:
Family relationships, cognitions, emotions, and behavior mutually influence one
another
Cognitive inferences evoke emotion and behavior
Emotion and behavior influence cognition
CBT - concepts
CONCEPTS:
Schemas- core beliefs about the world, the
acquisition and organization of knowledge
Cognitions- selective attention, perception,
memories, self-talk, beliefs, and expectations
Reinforcement - an event that increases the future
probability of a
CBT - goals of therapy
GOALS OF THERAPY:
To modify specific patterns of thinking and/or
behavior to alleviate the presenting symptom
CBT - role of therapist
ROLE OF THERAPIST:
Ask a series of question about assumptions, rather
than challenge them directly
Teach the family that emotional problems are
caused by unrealistic beliefs
CBT - assessment
ASSESSMENT:
Cognitive: distorted thoughts, thought processes
Behavioral: antecedents, consequences, etc.
CBT - intervention
INTERVENTIONS:
Questions aimed at distorted assumptions (family
members interpret and evaluate one another
unrealistically)
Behavioral assignments
Parent training
Communication skill building
Training in the model
CBT - change
CHANGE:
Behavior will change when the contingencies of
reinforcement are altered
Changed cognitions lead to changed affect and
behaviors
CBT - termination
TERMINATION:
When therapist and client determine
CBT - evaluation
EVALUATION:
Many studies, particularly in terms of marital therapy and parenting
Contextual - figure
Ivan
Boszormenyi
-Nagy
Contextual - assumptions
ASSUMPTIONS:
Values and ethics are transmitted across generations
Dimensions: (All are intertwined and drive people's behaviors and relationships)
o Facts
o Psychological
o Relational
o Ethical
Trustworthiness of a relationship (relational ethics): when r
Contextual - concepts
CONCEPTS:
Loyalty: split, invisible
Entitlement (amount of merit a person has based on
trustworthiness)
Ledger (accounting)
Legacy (we behave in ways that we have been programmed
to behave)
Relational ethics
Destructive entitlement (you were given a bad l
Contextual - goals of therapy
GOALS OF THERAPY:
Balanced ledger
Contextual - role of therapist
ROLE OF THE THERAPIST:
Directive
Expert in terms of assessment
Contextual - assessment
ASSESSMENT:
Debts
Entitlements
Invisible loyalties
Contextual - intervention
INTERVENTIONS:
Process and relational questions
Multi-directional impartiality: Everybody and nobody feel
special�all are attended to but none are more special
Exoneration: Help people understand how they have been
living out legacies and debts-ledgers�ex
Contextual - change
CHANGE:
Cognitive: Awareness of legacies, debts
and entitlements
Behavioral: Very action oriented�
actions must change
Contextual - termination
TERMINATION:
Never- totally up to
the client
Contextual - self of the therapist
SELF OF THE THERAPIST:
Must understand own legacies,
entitlements, process of
balancing ledgers, exoneration
Contextual - evaluation
EVALUATION:
No empirical evaluation
Bowen - figures
LEADERS:
Murray
Bowen
Michael Kerr
(works with
natural
systems)
Edwin
Friedman
Bowen - assumptions
ASSUMPTIONS:
The past is currently influencing the present
Change can happen�individuals can move along in the process of differentiation
Differentiation: ability to maintain self in the face of high anxiety (remain autonomous
in a highly emotional situat
Bowen - concepts
CONCEPTS:
Intimacy
Autonomy
Differentiation of Self
Cutoff
Triangulation
Sibling position
Fusion (within individual and within relationships)
Family projection process
Multigenerational transmission process
Nuclear family
Emotional process
4 sub-concepts
Bowen - goals of therapy
GOALS OF THERAPY:
Ultimate�increase differentiation of self
(thoughts/emotions; self/others)
Intermediate�detriangulation, lowering
anxiety to respond instead of react
Decrease emotional reactivity�increase
thoughtful responses
Increased intimacy one-on-o
Bowen - roles of therapist
ROLE OF THERAPIST:
Coach (objective)
Educator
Therapist is part of the system (non-anxious and
differentiated)
Expert�not a collaborator
Bowen - assumption
ASSESSMENT:
Emotional reactivity
Degree of differentiation of self
Ways that people manage anxiety/ family
themes
Triangles
Repeating intergenerational p
Bowen - intervention
INTERVENTIONS:
Genogram (both assessment and change tool)
Plan for intense situations (when things get hot, what
are we going to do - thinking; process questions)
Process questions-- thinking questions: "What do you
think about this?" "How does that work?
Bowen - change
CHANGE:
Reduced anxiety through separation of
thoughts and emotions - cognitive
Reduced anxiety leads to responsive
thoughts and actions, changed affect,
changed relationships
When we think (respond), change occurs
(planning thinking) -- when you know
how
Bowen - termination
TERMINATION:
Ongoing�we are never fully
differentiated
Bowen - self of the therapist
SELF OF THE THERAPIST:
Important with this
model; differentiated,
calm therapist is main
tool
We don't need to join the
system
We must be highly
differentiated so we can
recognize and reduce
reactivity
Our clients can only
become as differentiated
as we a
Bowen - evaluation
EVALUATION:
Research suggesting validity: not much,
not a lot of outcome
Did not specify symptom reduction
Client report of different thoughts, actions,
responses from others, affect is evidence
of change
Object relations - figures
LEADERS:
Freud
Erik Erikson
Nathan Ackerman
Several others who were
trained, but their models
were not primarily
psychodynamic: Bowen,
Whitaker, etc.
Object relations: Scharff
& Scharff
Attachment theory:
Bowlby
Object relations - assumptions
ASSUMPTIONS:
Sexual and aggressive drives are at the heart of human nature
Every human being wants to be appreciated
Symptoms are attempts to cope with unconscious conflicts over sex and
aggression
Internalized objects become projected onto important othe
Object relations - concepts
CONCEPTS:
Internal objects- mental images of self and others built from
experience and expectation
Attachment- connection with important others
Separation-individuation- the gradual process of a child
separating from the mother
Mirroring- When parents sho
Object relations - goals of therapy
GOALS OF THERAPY:
To free family members of
unconscious constraints so that they
can interact as healthy individuals
Separation-Individuation
Differentiation
Object relations - role of therapist
ROLE OF THERAPIST:
Listener
Expert position
Interpret
Object relations - AAWAAMWNR
ASSESSMENT:
Attachment bonds
Projections (unrealistic attributions)
Object relations - interventions
INTERVENTIONS:
Listening
Showing empathy
Interpretations
(especially projections)
Family of origin
sessions (Framo)
Make a safe holding
environment
Object relations - change
CHANGE:
Change occurs when family members expand their insight to realize that
psychological lives are larger than conscious experience and coming to
accept repressed parts of their personalities
Change also occurs when more, full, real aspects of others
Object relations - termination
TERMINATION:
Not sure how therapy is terminated
Symbolic Experiential - figures
LEADERS:
Carl Whitaker
Virginia Satir
Symbolic Experiential - assumptions
ASSUMPTIONS:
Family problems are rooted in suppression of feelings, rigidity, denial of impulses,
lack of awareness, emotional deadness, and overuse of defense mechanisms
Families must get in touch with their REAL feelings
Therapy works from the Inside (e
Symbolic Experiential - concepts
CONCEPTS:
Honest emotion
Suppress repression
Family myths
Mystification
Blaming
Placating
Being irrelevant/irreverent
Being super reasonable
Battle for structure
Battle for initiative
Symbolic Experiential - goals of therapy
GOALS OF THERAPY:
Promote growth, change, creativity, flexibility, spontaneity,
and playfulness
Make the covert overt
Increase the emotional closeness of spouses and disrupt
rigidity
Unlock defenses, enhance self-esteem, and recover potential
for experien
Symbolic Experiential - role of therapist
ROLE OF THE THERAPIST:
Uses their own personality
Must be open and spontaneous,
empathic, sensitive, and demonstrate
caring and acceptance
Be willing to share and risk, be
genuine, and increase stress within
the family
Teach family effective
communication
Symbolic Experiential - assessment
ASSESSMENT:
Assess individual self-expression and levels of defensiveness
Assess family interactions that promote or stifle individuation
and healthy interaction
Symbolic Experiential - interventions
INTERVENTIONS:
Sculpting
Choreography
Conjoint family drawing
Role playing
Use of humor
Puppet interviews
Reconstruction
Sharing feelings and creating an
emotionally intense atmosphere
Modeling and teaching clear
communication skills (Use of "I" messages)
Symbolic Experiential - change
CHANGE:
Increasing stress among the family members leads to
increased emotional expression and honest, open
communication
Changing experience changes affect; need to get out of
head into emotions; active interventions change
experience, emotions
Symbolic Experiential - termination
TERMINATION:
Defenses of family members are broken
down
Family communicating openly
Family members more in touch with their
feelings
Members relate to each other in a more
honest way
Openness for individuation of family
members
Symbolic Experiential - self of therapist
SELF OF THE THERAPIST:
Through the use of humor, spontaneity, and personality,
the therapist is able to unbalance the family and bring
about change
The personality of the therapist is key to bringing about change
Symbolic Experiential - evaluation
EVALUATION:
This model fell out of favor in the 80s and 90s due to its focus on the emotional experience of the individual
while ignoring the role of family structure and communication in the regulation of emotion
Emotionally Focused Couples Therapy (Sue
Sym Exp - EFCT - figures
LEADERS:
Susan
Johnson
Les
Greenburg
Sym Exp - EFCT - assumptions
ASSUMPTIONS:
"The inner construction of experience evokes interactional responses that
organize the world in a particular way. These patterns of interaction then reflect,
and in turn, shape inner experience" (Johnson, 2008, p. 109)
Individual identity can
Sym Exp - EFCT - concepts
CONCEPTS:
Attachment needs exist
throughout the life span.
Negative interactional
patterns
Primary and secondary
emotions
Empathic attunement
Cycle de-escalation
Blamer softening
Withdrawer re-engagement
Sym Exp - EFCT - goals of therapy
GOALS OF THERAPY:
Identify and break negative interactional patterns
Increase emotional engagement between couple
Identify primary and secondary emotions in the context of
negative interactional pattern
Access, expand, and reorganize key emotional respons
Sym Exp - EFCT - role of therapist
ROLE OF THERAPIST:
Client-centered, collaborative
Process consultant
Choreographer of relationship
dance
Sym Exp - EFCT - assessment
ASSESSMENT:
Assess relationship factors such as:
o Their cycle
o Action tendencies (behaviors)
o Perceptions
o Secondary emotions
o Primary emotions
o Attachment needs
Relationship history, key events
Brief personal attachment history
Interaction style
Vi
Sym Exp - EFCT - interventions
INTERVENTIONS
Reflection
Validation
Evocative questions and empathic conjecture
Self-disclosure
Tracking, reflecting, and replaying interactions
Reframe in an attachment frame
Enactments
Softening
Heightening and expanding emotional
experiences
Sym Exp - EFCT - termination
TERMINATION:
Therapy ends when the therapist and clients
collaboratively decide that the following changes
have occurred:
Negative affect has lessened and is regulated
differently
Partners are more accessible and responsive
to each other
Partners perceive
Sym Exp - EFCT - self of the therapist
SELF OF THE THERAPIST:
Accept responsibility for client/therapist
relationship
Expert on process of therapy, not on client's
life or experience of the difficulty
Collaborator who must sometimes lead and
sometimes follow
Sym Exp - EFCT - evaluation
EVALUATION:
Therapy/Research:
Difficult model to learn
When using the EFT model, it is
important to move slowly down the
process of therapy. This can be difficult
to do.
Learning to stay with deepened emotions
can sometimes be overwhelming, but the
therap
Sym Exp - EFCT - change
CHANGE:
Change happens as couples have a new corrective
emotional experience with one another.
When couples are able to experience their own
emotions, needs, and fears and express them to
one another and experience the other partner
responding to those em
Gottman Couples Therapy - figures
LEADERS:
John Gottman
Julie Gottman
Gottman Couples Therapy - assumptions
ASSUMPTIONS:
Therapy is primarily dyadic
Couples need to be in emotional states to learn how to cope with and
change them
Therapy should be primarily a positive affective experience
Positive sentiment override and friendship base are needed for
communicat
Gottman Couples Therapy - concepts
CONCEPTS:
Negative interactions (four horsemen)
decrease acceptance of repair attempts
Most couples present in therapy with low
positive affect
Sound marital house
Softened startup
Love maps
Gottman Couples Therapy - goals of therapy
GOALS OF THERAPY:
Empower the couple
Problem solving skills
Positive affect
Creating shared meaning
Gottman Couples Therapy - role of therapist
ROLE OF THE THERAPIST:
Coach
Provide the tools that the couple can use with
one another and make their own
Gottman Couples Therapy - research
Gottman's research showed that it wasn't only how couples fought that mattered, but how they made up. Marriages became stable over time if couples learned to reconcile successfully after a fight.
Gottman Couples Therapy - assessment
ASSESSMENT:
Four horsemen are present and repair is ineffective
Four horsemen=Contempt, Defensiveness,
Stonewalling & Withdrawal
Absence of positive affect
Sound marital house
Gottman Couples Therapy - interventions
INTERVENTIONS:
Sound Marital House
Dreams-within-conflict
Label destructive patterns
Enhancing the Marital friendship
Sentiment override
Gottman Couples Therapy - change
CHANGE:
Accepting influence
Decrease negative interactions
Increase positive affect
Gottman Couples Therapy - termination
TERMINATION:
When couples can consistently develop their
own interventions that work reasonably well
Gottman Couples Therapy - self of therapist
SELF OF THE THERAPIST:
Not discussed
Gottman Couples Therapy -evaluation
EVALUATION:
Theory is based on Gottman's research
Trust vs Mistrust
Major Question: "Can I trust the people around me?"
Basic Virtue: Hope
Important Event(s): Feeding
0-2
Autonomy vs Shame
Major Question: "Can I do things myself or am I reliant on the help of others?"
Basic Virtue: Will
Important Event(s): Toilet Training
2-4
Initiative vs Guilt
Major Question: "Am I good or bad?"
Basic Virtue: Purpose
Important Event(s): Exploration, Play
4-7
Industry vs Inferiority
Major Question: "How can I be good?"
Basic Virtue: Competence
Important Event(s): School
7-11
Identity vs Identity Role Confusion
Major Question: "Who am I?"
Basic Virtue: Fidelity
Important Event(s): Social Relationships
12+
Intimacy vs Isolation
Major Question: "Will I be loved or will I be alone?"
Basic Virtue: Love
Important Event(s): Romantic Relationships
19-40
Generativity vs Stagnation
Major Question: "How can I contribute to the world?"
Basic Virtue: Care
Important Event(s): Parenthood and Work
40-65
Integrity vs Despair
Major Question: "Did I live a meaningful life?"
Basic Virtue: Wisdom
Important Event(s): Reflecting back on life
65+