Chapter 7: Group Work

geographertonguesAI and Robotics

Nov 30, 2013 (3 years and 11 months ago)

128 views

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Chapter 6: Family Counseling

Chapter 7: Group Work

Chapter 8: Consultation and Supervision



1

© 2007 Thomson Brooks/Cole, a division of Thomson Learning

Couples and Family Counseling



2

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


1800s: Charity Organization Societies and “Friendly Visitors”
worked with poor family


Led to “social casework”

first time people were viewed
systemically


Also, around same time, Alfred Adler began to see families
and believed education could help alleviate problems in
children


Until 1940s, families were generally not seen together due
to pressure placed on therapist from the developing
“individual approaches” to counseling

3

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


A number of approaches developed around the 1950s:


Psychodyanmic: Ackerman; Boszormeyi
-
Nagy


Multigenerational: Bowen


Palo Alto: Bateson hired Haley, Weakland, Jackson, & Fry


Looked at communication in systems


Double
-
bind theory


Applied principles of systems and cybernetics


Out of Palo Alto came MRI


Jackson, Haley, Satir, Madanes


Focused on communication and family process

4

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Soon, people developed own theories


Satir: Human validation process model


Haley and Madanes: Strategic therapy


Whitaker: Experiential approach


Minuchin: Structural family therapy


1966: within MRI: Brief Family Therapy Center


Eventually led to solution
-
focused family therapy


1970s: Milan Group


More recently: Narrative family therapy (White and Epston)


5

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Today


Over 50 states have marriage and family licensure


Two main associations: AAMT and IAMFC (a division of
ACA)


Accreditation Bodies


COAMFTE


CACREP


Efficacy of family therapy now shown

6

© 2007 Thomson Brooks/Cole, a division of Thomson Learning




Twelve Assumptions Held by Most Family
Counselors (see pp. 192
-
193)

7

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Bertalanffy


Explains the interaction of all types of systems


Suprasystems


Subsystems


Interaction in one system affects all other systems

8

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Cybernetics


Control mechanism in systems


Regulatory process


Used to avoid disequilibrium in systems


Acts like thermostat


See Box 6.1, p. 195

9

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Boundaries and Information Flow in Family Systems


Healthy system has semi
-
permeable boundaries


Unhealthy: rigid or diffuse boundaries


(See Box 6.2, p. 196)


American culture allows for much variability in boundaries


However, as Box 6.2 shows, too much rigidity or
permeability leads to dysfunction

10

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Rules and Hierarchy


Universal rules


Idiosyncratic rules


Rules can be overt or covert


Rules often related to hierarchical structure



Communication theory


Watzlawick

and others researched communication theory


See 10 communication tenets, p. 197


11

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


All couples bring unfinished business to relationship


Unfinished business can lead to discontent as couples blame
each other for their projected problems


Family members will sometimes focus on one member
(rather than own problems)


This takes focus off of self or relationship


Families will often bring in the “scapegoat” or IP and state
they “have” the problem

12

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Stress


Stressful contact of one member with extrafamilial forces
(e.g., difficulty at work)


Stressful contact of the whole family with extrafamilial
forces (e.g., a natural disaster such as a hurricane)


Stress at transitional or developmental points in the family
(e.g., puberty, midlife crises, retirement, aging)


Idiosyncratic (situational) stress (e.g., unexpected illness)


See Box 6.3


Developmental Issues: See Table 6.1


13

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Believes that systems theory and cybernetics places too
much emphasis on causal factors


Social constructionists believe that couples and families “co
-
construct” their understanding of who they are


Construction of self occurs through ongoing dialogue and
nonverbal interactions among people and broader culture


Change, therefore occurs through conversation with
counselor


Together, counselor and clients co
-
construct a new meaning
-
making system

14

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Virginia Satir


Humanist, one of the major theorists of 20
th

century


Primary survival triad


Four universal communication patterns: placater, blamer,
computer, distracter


Congruent, respectful, and caring parents yield healthy
children


Two well
-
known techniques


Complete a family life facto chronology


Family Sculpting



15

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Salvadore Minuchin


Interactional and Transactional Rules


Boundaries


Structure and Hierarchy


Some Techniques


Joining


Mapping


Restructuring


See Box 6.4, p. 203

16

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Arose out of Palo Alto Group and work of Milton Erickson


Theorists
:
Jay Haley
,
Cloé
Madanes, Milan group


Focused on changing communication sequences


No focus on feelings (except to help people feel better)


Concerned with how power is dispersed in families


Focuses mostly on presenting problem


Haley's Stages: social, problem, interaction, goal
-
setting


Some techniques


Telling client what to do when (when client will do it)


Telling them what to do when knowing client will rebel


Giving a metaphor (see quote, bottom of p.
205
)

17

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Boszormenyi
-
Nagy


Ways of relating passed down


Loyalties, Ledger of indebtedness and entitlements


Murray Bowen


Differentiation of self


Nuclear family emotional system


Undifferentiated ego mass (we pick people of same
psychological health

see Box 6.5, p. 209)


Family projection system


Individuals get triangulated


Used genograms (see Figure 6.1, p. 208)

18

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Whitaker


Says he has no theory, but see basic tenets (p. 209)


I
-
Thou relationship


Become genuine through interactions in therapy


See quotes top and middle of page 210

19

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Robin Skynner and Nathan Ackerman


Emphasis: How parents assist children through
developmental stages


Problems in each parent reflected through unconscious


Couple explores how behaviors related to their own
childhood


Unfinished, unconscious problems become projected on
family

20

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Focused on symptom relief


Highly structured


Focus on behaviors and cognitions


Operant conditioning


Classical conditioning


Social learning (modeling)


Changing negative automatic thoughts


Integrates how problems get infused in family through the
system


A number of common elements in all that do this approach
(see pp. 212)

21

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Michael White and David Epston


Goal: To recreate how family comes to understand itself


Based on postmodernism, social constructivism, and
narrative reasoning


Deconstruct past narrative and construct new ones


General guidelines, see p. 213

22

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Insoo Kim Bert and Steve de Shazer


A pragmatic and future
-
oriented approach


Based on social constructionism and post
-
modernism


Assumes that clients can change quickly


Focuses on solutions and use of problem free language


See underlying assumptions, p. 214


23

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Points to consider when working with couples and families
from nondominant groups

see p.
215



Why are professional associations not being inclusive?


American Association of
Marriage

and Family Counselors


International Association of
Marriage

and Family
Counselors

24

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Withholding treatment in order to see “whole” family


Informed for “whole” family


Confidentiality

can you assure it?


Multiple (Dual) relationships

seeing a member individually
and in the family?


Individual or family counseling

which is better?


Professional Associations: AAMFT, IAMFC


Accreditation: CACREP; COAMFTE


Credentialing: LMFT; NCA


Knowing the law: child, spousal, family abuse; custody


Insurance fraud: e.g., saying you’re seeing “1” member in
family when you actually see whole family

25

© 2007 Thomson Brooks/Cole, a division of Thomson Learning


Understanding Our Client’s Family, Understanding Our
Family


To understand others, we need to understand self


We need to examine how our family affected us and how
the impact of our families can affect the people with whom
we work

26