Bowenian
Goals of Bowenian Therapy
Increase differentiation
Decrease anxiety
Increase ability between thinking and feeling within self and others
Using skill of differentiation to direct one’s life and solve problems. Requires opening closed family ties and detriangulation
Goals of MRI Therapy
Minimalistic, one presenting problem is resolved, if the family does not have any other complaints, the therapy is terminated.
Goal of MRI therapist is to help families define clear and reachable goals.
Goals of Milan Strategic Therapy
Similar to MRI, Milan expanded the network of people involved in maintaining problems but still concentrated on interrupting destructive family games.
Less problem-focused than other strategic schools, interested more in changing family members' beliefs about covert collusions and the motives for strange behavior. (pg. 95)
Goal to alter family rules, games, and myths and change the role of the symptom in the family
Goals of Haley Strategic Therapy
Haley's ultimate goal is often the structural reorganization of the family, particularly its hierarchy and generational boundaries.
Goals of Behavioral Therapy and/or Cognitive Behavioral Therapy.
Behavioral Therapy Goals: Limited to modifying the current pattern of behavior. Goals are determined by the client. Want clients to gain knowledge and skills to monitor their own behavior.
Cognitive Behavioral Therapy Goals:
To extinguish behavior that is undesirable and reinforce positive alternatives
Decrease use of aversive exchanges and coercion
Teach communication and problem solving skills
Modify interpretations and distortions
Increase the rewarding interactions between family members
As a Bowenian Therapist, what is my role in the therapy room?
Bowenian therapists are neutral, objective, and coaching. They ask a lot of questions and refrain from taking sides.
As an MRI Therapist, what is my role in the therapy room?
Very brief therapeutic relationship, once presenting problem is resolved, therapy is terminated.
Assessment goals of MRI include defining a resolvable complaint, identifying attempted solutions that maintain the complaint, and understanding the client's unique language for describing problems.
As a Milan Strategic Therapist, what is my role in the therapy room?
Co-therapists with one being female and the other one male. They are very compassionate, non-critical, and neutral.
Standard format consisted of 5 parts:
Pre-session(getting to know each other)
Session (presenting problems and hypothesis)
Intersession (meeting between the team of therapists)
Intervention (therapists deliver their techniques)
Post-session discussion. (pg. 104)
As a Haley Strategic Therapist, what is my role in the therapy room?
Structural and Strategic.
Interested in cybernetic (misguided solutions), structural (triangles & hierarchies), and functional (protective nature of problems) explanation of how problems develop.
As a Behavior and/or CBT Therapist, what is my role in the therapy room?
Behavioral Therapists have a reductionistic approach, they are non-pathological and ahistorical.
CBT Therapists take a directive approach. They coach, teach, model behaviors, and act as a reinforcer.
As a Bowen Systems Therapist, what is my stance on dysfunction? (aka "normal" family development)
Bowenian therapists believe that healthy family development happens when family members are differentiated, anxiety is low, and partners are in good emotional contact with their families of origin.
Bowenian therapists also believe that symptoms result from stress exceeding a person's ability to manage it. The more differentiation between family members results in more resilient systems.
As an MRI Therapist, what is my stance on dysfunction? (aka "Normal Family Development")
MRI Therapists take a non-normative stance, avoiding taking a stance on how families should behave.
Cybernetic view of how problems develop - difficulties are turned into chronic problems by misguided solutions, forming positive feedback escalations.
As a Milan Strategic Therapist, what is my stance on dysfunction? (aka "Normal" family development)
Strove to maintain an attitude of neutrality. They didn't apply preconceived notions or normative models. Instead, raising questions that helped families examine themselves and exposed hidden power games, they trusted families to recognize their own. (pg. 93)
Milan Therapists believe that family members engaged in unacknowledged, destructive, repetitive sequences of interaction. When rules governing the system are too rigid, dysfunction occurs.
As a Haley Strategic Therapist, what is my stance on dysfunction? (aka "Normal" family development)
Haley had a structural approach, and believed that healthy functioning families had clear boundaries and generational hierarchy.
As a CBT Therapist, what is my stance on dysfunction? (aka "normal" family development")
Adaptability, flexibility, and change are central to a healthy family. Problem-solving skills and coping mechanisms are integral to successful families.
CBT Therapists believe problems arise from learned responses from beliefs or attributions that have come about as a result of growing up in their particular family system.
Understanding, not action, is the vehicle of cure.
Two most important elements of Bowenian therapy is the atmosphere of the session designed to minimize emotionality and asking questions that foster self reflection. (pg. 77)
Directed at individuals one at a time, rather than encourage family dialogues, which can get heated (pg. 77)
How do problems develop and persist, according to an MRI Therapist?
Believe problems arise when difficulties are turned into problems by misguided solutions to the problems. They believe every family has difficulties in their lives, but these difficulties only become problems depending on how they deal with them.
As a Milan Strategic Therapist, how do I help facilitate change?
Milan Therapists turn behaviorism on its head. More interested in getting families to see things differently than in getting family members to behave differently. (pg. 95)
Often their goal was to alter family rules and games, in order to change the role of the symptom in the family.
As a Haley Strategic Therapist, how do I help facilitate change?
Haley believed telling people what they're doing wrong only causes resistance. He believed changes in behavior alter perceptions rather than the other way around. (pg. 95)
As a CBT Therapist, how do I help facilitate change?
By teaching communication skills and problem-solving skills, modifying interpretations and distortions, and extinguishing undesirable behavior and reinforce positive alternatives.
Name & Describe at least 1 Technique associated with Bowenian Therapy.
Process Questions -
Detriangulation - where a person removes themselves from the emotions of two others
Geneogram - diagram of the family going back multiple generations, showing the relationships, triangles, and cutoffs within the system
The "I" Position - a statement made by the client in a calm and clear way that states their personal opinion without placing blame or speaking in absolutes.
Coaching - less emotionally involved role of the therapist in order to help the family solve their own problems.
Relationship Experiments - experiments between individuals to help increase awareness of the processes of their interactions as well as their role in them.
Name & Describe at least 1 Techniques associated with the MRI model
AND/OR
Name the steps of the MRI Approach
Reframing - a technique to shift a client's view of a particular problem, event, or person.
Paradoxical - therapist instructs family members to do something that runs counter to common sense. (symptom prescription)
MRI Approach:
1. Introduction to treatment setup
2. Inquiry and definition of the problem
3. Estimation of the behavior maintaining the problem
4. Setting goals for treatment
5. Selecting and making behavioral interventions
6. Termination
Name & Describe at least 1 Technique associated with the Milan Strategic Model.
Positive connotation - reframing symptoms as serving a protective function
Rituals - getting families go engage in a series of actions that run counter to or exaggerated rigid family rules and myths.
Invariant prescriptions - a specific ritual where the goal is to strengthen an alliance and reinforce boundaries between generations
Circular Questions - questions to shift clients from thinking about individuals and linear causality towards reciprocity and interdependence.
Name & Describe at least 1 Technique associated with the Haley Strategic Model.
Directives- Straightforward (homework) or Indirect (paradoxical)
Pretend Techniques- having a client pretend a certain behavior, framed as play.
Ordeals- system where therapist attaches an aversive, yet constructive, activity to the presenting problem. Designed to make symptoms more trouble than they're worth
Metaphors- symbolizing a family problem using facts relevant to client's daily life. Helps to indirectly facilitate change.
Name & Describe 1 or more Technique associated with CBT or Behavioral Therapy.
CBT Techniques:
1. Downward Arrow - a succession of questions to uncover core beliefs.
2. ABCs of CBT (Antecedent, Behavior, Consequence)
3. Systemic desensitization
4. Exposure Therapy
5. Assertiveness training
6. Mindfulness
7. Meditation
8. Problem Solving Training
9. Communication Training
10. Homework Assignments
Behavioral Techniques (Operant Techniques)
1. Shaping
2. Contingency Management
3. Time Out
4. Token Economies