Interventions
Name and Explain 2 Interventions of Bowenian Family Therapy
Genogram - encourages clients to think systematically and help understand family patterns
Process Questions - encourage focus on thinking (over feeling). Helps own contribution to conflict. Ex: “How do the struggles you are experiencing with your partner compare with your parents?”
Relationship Experiments - Designed to illuminate and disrupt destructive patterns. Observe dinner table interactions over holiday, encourage something different.
“I” Positions - Taking a personal stance, stating what you think/feel rather than what “others are doing”
Neutralizing Triangles - The therapist should try to remain free of emotional entanglements in order to avoid feeling stuck or stalemated
What Are Schemas and Name 2 Common Schema Types.
Schemas are core beliefs through which people filter their perceptions. They are learned in the process of growing up and we develop schemas about ourselves. Some common schema types include:
Abandonment, Mistrust, Defectiveness, Vulnerable to harm/illness, Entitlement, Unrelenting Standards/Hypercritical, Dependence
Cognitive Behavioral Therapy
Define Boundaries and What the Difference is Between Rigid and Diffuse Boundaries.
Boundaries: The rules we set in a family system; rigid means fam is very separated/ diffused (enmeshed) means family lacks independence
How Does the Experiential Family Therapist Describe Healthy and Dysfunctional Families?
Healthy families have flexible roles that are supportive of family members' change and growth.
Dysfunctional families avoid change and risk, and may also be rigid and avoid confrontation.
Circular Causality Definition
Circular causality is the idea that A affects B, just as B effects A. In other words, relationships are reciprocal and each party mutually influences the other, there is no one person to blame.
Name and Explain 2 Interventions of Cognitive Behavioral Therapy
Behavioral exchange/contingency contracts
Contingency Contracts → outlining rewards and consequences for behavior
Behavioral Contracts
Quid pro quo → one person gives something & gets something in return
(non-contingent)
Tracking problematic cognitions → thought record
Systematic desensitization
Token Economy → Give reward, token, or prize for good behavior
Positive Feedback Loop and Who Do I Belong To?
When a family's response exacerbates a problem (keeps doing more of the problematic thing, it can be destructive. The response is what is continuing to make the problem worse.
Strategic Family Therapy
What Does a Strategic Therapist Do to Try and Facilitate Change?
They intervene in the cycle and make sure everyone knows what is being worked on. Change also occurs by:
Challenge the logic of the cycle (MRI)
• Identify positive feedback loop, rules that govern it, and then change rules to
interrupt cycle
• OR...you can take a 1 down position and ask them to explain cycle to you
• Get them to explain it to you so they must give a rationale for what they are
doing
• This can sometimes alleviate the problem
Alter malfunctioning triangles and faulty hierarchies (HM)
Reorganize family rules of interaction (Milan, MRI)
• Find out what underlying rules govern why family does what they do
• Make rules overt and push family to do things differently
When families perceive their problems differently (Milan)
• The problem stops being defined as a problem
When new information is brought into the system (Milan)
• Spontaneous change
• Not necessarily through overt attempts to change behaviors
How Are Problems Developed and Maintained According to Strategic Therapy?
Families' continuous use of ineffective solutions. Difficulties are turned into chronic problems by misguided solutions.
Hierarchy governed by faulty rules. Inadequate parental hierarchies behind most problems.
Family members attempt to protect or control one another (covertly or overtly).
When a family's old beliefs do not fit current patterns of interaction (families are constantly evolving).
Differences between MFT and traditional/individual psychology
MFT’s focus on circular causality rather than linear causality (individual psychology).
Linear causality is cause and effect thinking, circular causality there is no one to blame.
Individual psychology focuses on the why, and their explanations for behavior are typically internal causes.
MFT believes that there is more to understanding a person than what occurs inside them. MFT’s also ask “how” or “what” instead of “why”. Context is also viewed as very important for MFT’s because members of a system mutually influence one another.
Name and Explain 2 Interventions of Experiential Family Therapy
Family Drawing: technique used for children mainly where they draw out what their family looks like
Role Playing: helps individuals take a different perspective, can use puppets as well
Letter Writing: individuals can use this as a way to express emotions through writing; can be written to self or others
Empty Chair: using a physical empty chair as a way for clients to visualize a family member either alive or deceased who is not present in the session. It is a way for the client to express themselves without the other person physically being present
Sand Tray: using a tray with figurines to represent the individual and their current family situation. This is a great way for the client to express what they are experiencing while having a barrier to protect them from what they may perceive as judgment
Emotion Wheel: a wheel presenting various emotions in the human experience. The wheel provides a detailed emotions and helps clients identify secondary emotions and the primary emotion behind it
Family Projection Process vs. Nuclear Family Emotional Process
Family Projection Process- Process by which parents transmit their level of differentiation onto their children. It is what strongly determines how children manage stress and how they behave in relationships. Bowen- children bare anxiety from all previous generations.
Nuclear Family Emotional Process- What is the family’s way of managing relational anxiety. How big is the family system? Family level of differentiation.
How Do You Treat Problems According to Cognitive Behavioral Therapy?
Modify distorted and extreme cognitions, and help clients identify and change them.
Restructuring maladaptive schemas
Improve communication and problem-solving skills: sharing emotions appropriately, not only through anger. Improve communication first, then focus on problem-solving.
How Does a Bowenian Family Therapist Define Healthy vs. Dysfunctional Families?
Healthy- High differentiation of self. In order to be healthy you must be independent, but also connected to others. Finding a good balance is key.
Dysfunctional- results from unsuccessful management of relational anxiety. Low differentiation of self can also be seen as unhealthy/dysfunctional.
Positive vs Negative Feedback
Negative feedback - When change is not happening/ change is rejected by the system, and homeostasis is maintained. Ex: negative pregnancy test
Positive feedback - When a change is accepted by the system and homeostasis is disrupted. Ex: positive pregnancy test
Name and Explain 2 Interventions of Structural Family Therapy
Enactment: picking a given family issue and have the family discuss it this helps show the family structure and allows the therapist to observe all of this
Manipulation of physical space: observing the family to see who talks to who and who sits where. Noticing where the parents sit in relation to the kids. The therapist might have solely parent sessions.
Structural Mapping: a way to draw the family system
Boundary Making: therapist helps client draw out what boundaries clients want and how to set them into their family system
Interruption/ Blocking: A way to stop families attempts at arguing
Cross-Generational Coalition and Who Do I Belong To?
Two family members allying against another.
Structural Family Therapy
What are the Goals of Cognitive Therapy and What are the Goals of Behavioral Therapy
Cognitive:
Get rid of undesired behaviors
Reinforce positive alternatives
Teaching communication, problem solving, negotiation skills
Reexamine distorted thoughts and beliefs
Behavioral Therapy
Increase positive and negative behaviors (modify interactions)
Modify consequences of problem behavior (rather than ground child, add extra chores)
Teach communication and problem solving skills
Structural Family Therapy Conceptualizing Problems
imbalance of power within the family system
problems can arise is if there are unclear boundaries
if the family is in a constant state of homeostasis. In order for a family to grow, it must be adaptive to change. When a family is not receptive to change, problems will arise.
First Order vs. Second Order Change
First order change- Occurs on the behavioral level without impacting the operating rules of the system. Considered more superficial and less sustainable than second order changes.
Second order change- Involves not just behavior, but changes, or “violations”, of the rules of the system itself. Family systems therapy usually seeks second order change.
Name and Explain 2 Interventions of Strategic Family Therapy
Reframing- Changing the interpretation of someone's behavior.
Sequence Questions- Trace the entire sequence of behaviors that constitute the problem.
Paradoxical Interventions - Ask family to do something that seems in opposition of the goal.
Ordeals - Make the symptom too costly to keep up.
Circular Questioning - Asking family members about perspective on other family member's behaviors.
Battle for Structure vs. Battle for Initiative
Battle for Structure: therapist must win this battle of creating structure/ safe atmosphere within the therapy room
As a therapist you have to make sure that you are able to hold space for client
Battle for Initiative: client must win this battle/ realize that change must come from the work they are doing
Once therapist sets up the structure, clients job is to open up and share their life experiences
Experiential Family Therapy
Describe Circular Questioning and What is its Purpose?
Ask each family member their perspective on other family member's behaviors. It allows everyone in the family to see perspectives on how the other family members see them.
Strategic Family Therapy
How are Marital and Family Problems Conceptualized in Terms of Cognitive Behavioral Therapy?
Problems occur when:
Too much negative interactions/ not enough positive
Problematic schemas
Cognitive distortions
Destructive automatic thoughts
Ineffective communication and problem solving skills
Double Bind Hypothesis Definition and Example
Double bind- 2 messages are sent (one verbal, one nonverbal), each message denies or negates the other, the receiver of the message is unable to avoid or comment on the paradoxical nature of the messages and through repetition, thee receiver learns to see reality in double-bind patterns.
Ex: “ A mother telling her child that she loves them, while at the same time turning away in disgust, or inflicting corporal punishment as discipline.”