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FAMILY AND GROUP THERAPIES 2 - Coggle Diagram
FAMILY AND GROUP THERAPIES
2
Conjoint Family Therapy (Satir)
AKA
Human Validation Process Model
Influenced by Humanistic, Communication, and Experiential approaches
Satir believed fam systems
seek a state of balance
; fam probs arise when balance is maintained by
unrealistic expectations, inappropriate rules / roles, and dysfunctional communication
Dysfunctional Comm Styles
Placating
agreeing with / capitulating to others due to fear, dependency, and desire to be loved / accepted
Blaming
Accusing, judging, and bullying others to avoid taking responsibility and to hide feelings of vulnerability and worthlessness
Computing
taking overly intellectual and rational (super-reasonable) approach to avoid becoming emotionally engaged with others
Distracting
changing subject / making inappropriate jokes to distract attention and avoid conflict
Congruent (leveling) Style
functional style characterized by congruence between verbal and nonverbal messages, directness and authenticity, and emotional engagement with others
Primary Goal
Enhance growht potential of members by incr
self-esteem,
strengthening prob solv skills, and helping them communicate congruently
Therapist's "Use of the self" is best tool; apply
multiple roles
(facilitator, mediator, advocate, educator, and role model)
Techniques:
Sculpting
each memb take turn positioning other members in ways that depict their view of family relationships
Family Reconstruction
psychodrama involving role-playing 3 generations of the family to explore unresolved family issues / events
Narrative Family Therapy (White and Epston)
Core basis
Practitioners consider person's problems as arising from / maintained by, oppressive (socially constructed) stories that dominate their life
AKA: the problem is not internal but external (e.g., instead of saying a memb is depressed; depression sometimes causes problems for the memb)
Primary Goal
replace
prob-saturated stories w/ alternative ones that
support more satisfying / preferred outcomes
General Stages
Meeting:
getting to know fam separate from problems (interests / every-day activities)
Listening:
paying attn to what fam membs say to ID dominant discourses and unique outcomes (Sparkling Moments); which are experiences that aren't consistent with prob-sat stories
Separating
membs from problems by
externalizing
the problems
Enacting
preferred narratives; ID alt stories that lead to more satisfying realities and IDs
Solidifying
strengthening alt stories (e.g., writing letters of support to membs and expanding social netwrk to incl ppl who support its stories
Therapist
COLLABORATOR
Uses questions to ID current stories and construct alt / healthier one
Externalizing Questions
help them view probs as outside of themselves (e.g., asking a memb what their anger tells them to do)
Opening Space Questions
help membs ID unique outcomes (e.g., asking membs if there ever have been times when conflicts didn't control their lives)
Other Interventions
Therapeutic Letters
letters from therpist to emembers to reinf their emerging alt stories
Therapeutic Certificates
given to membs near end of therapy to acknowledge accomplishments
Definitional Ceremonies
provide opps to tell others how they overcame their problems and celebrate changes they've made
Emotionally Focused Therapy (EFT)
CORE:
Attachment, Humanistic-Experiential approaches and Systems Theory
Initially for couples, but also applied to fam / indv
As couples intervention:
help emo distressed partners who want to strengthen relatp and stay together
contraindicated when
partners have diff agendas for relatp / therapy
therapist belives emo vulnerability isn't safe / advisable (e.g., ongoing physical abuse) or when one has untreated subst use disorder
Assumptions
a.) emos are essential to organization of attachment behaviors and infl how ppl experience themselves / partners
b.) attachment needs of partners are essentially healthy / adaptive BUT problems arise when needs are enacted in context of attachment-related insecurities
c.) Relatp distress maintained by ways interactions btwn partners are organized and by the dominant emotional experiences of each partner
helping express / deal with emos is fastest / effective way to solve probs
Primary Goal:
expand / restructure emo experiences they have with each other --> devel new interactional patterns and experience
attachment security
Stages
Assessment and cycle de-escalation
Changing interactional positions and creating new bonding events
Consolidating and integration
Research involving
EMDR
(eye movement desensitization) - Shapiro
combo for couples affected by war trauma (greatest marital satisfaction and attachment security
EMDR alone had greatest reduction in posttraumatic symptoms
Functional Family Therapy (FFT)
-- like FBA
Primary Goal
replace problmatic beh w/ nonproblmatic ones that fulfill same relational functions
CORE:
tailored for
at-risk youth
and their fams
Structural, Strategic, and Behavioral Family Therapy
Assumptions:
prob behaviors serve important functions (i.e., regulate interpersonal connections and relational heirarchies)
Structure
ordinarily 8-30 sessions over 3- to 6-month period
3 stages
Engagement and motivation stage
emphasis on forming therapeutic alliance w/ members and helping them reduce hopelessness and negativity
incr positive expectations for change and develop family-focused understanding of probs
Behavior Change Stage
immediate and long-term goals IDd, individualized treatment plan is implemented
techniques: training in parenting, communication, prob-solving, and coping skills
Generalization Stage
linking membs to community resources; generalize acquired skills to new probs and situations; ID ways to avoid relapse
Multisystemic Therapy (MST)
CORE:
fam and adolescent offenders at-risk for out-of-home placement
adapted for adolescents with other serious clinical psychiatric problems, sub abuse, and childhood maltreatment
Based on
Bronfenbrenner's Ecological Model
focuses on variables that contribute to youth's presenting problems and the interactions btwn them
9 treatment principles applied using analytic process ("MST Do-Loop") --> structures develep, implemen, and eval of treatment plan
Provided in family's home / community settings where problems occur
interventions derived from Structural, Behavioral, and CBT
targets factors that are
driving
problem behaivors
e.g., when assessment indicates drivers of a teen's pot use are low parental monitoring and ineffective discipline, the teen's poor social skills and friendships with using teens, and availability in neighborhood, these factors addressed in therapy
delivered by Multidiscinlinary team (e.g., case worker, fam therapist, sub abuse counselor, and others who work with school / neighborhood.
Quality assurance system used to promote fidelity
prgm implementation review every 6m
Group Therapy
Yalom
3 overlapping formative stages
1.) Intial orientation, hesitation participation, search for meaning, and dependency
interactions often describe symptoms previous treatments and involve giving / seeking advice
Clarify nature / purpose of group; depend on leader
2.) Conflict, Dominance, and Rebellion Stage
compete for power / pecking order; critical, maybe hostile; resentful toward therapist when not "favorite"
3.) Development of Cohesion Stage
conflict decreases
more trust in each other and therapist; reveal reason they've come to therapy; concern when member drops out / is absent
Therapeutic Factors
11 total but Cohesiveness is the "analogue" of "therapeutic alliance" --> strong predictor of postiive group outcomes