Family therapy

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Family therapy , also referred to as spouse and family therapy , marriage and family therapy , family system therapy , and < b> family counseling , is a branch of psychotherapy that works with families and couples in intimate relationships to foster change and development. This tends to see a change in terms of the interaction system between family members. It emphasizes family relationships as an important factor in psychological health.

Different schools of family therapy have in common the belief that, regardless of the origin of the problem, and regardless of whether the client perceives it as an "individual" or "family" issue, involving the family in the solution often benefits the client. This family involvement is generally achieved by their direct participation in the therapy sessions. The skills of family therapists thus include the ability to influence the conversation in a way that catalyzes the strength, wisdom, and support of the wider system.

In the early years of the field, many doctors defined the family in a narrow traditional way, usually including parents and children. As the field has progressed, the concept of family is more commonly defined in terms of roles and long-term relationships that are very supportive among people who may or may not be related to blood or marriage.

The conceptual framework developed by family therapists, especially those of family systems theorists, has been applied to a variety of human behaviors, including organizational dynamics and studies of greatness.

Video Family therapy

History and theoretical framework

Formal interventions with families to help individuals and families who experience a variety of problems have become part of many cultures, perhaps throughout history. These interventions sometimes involve formal or ritual procedures, and often include large families as well as non-relative family members (see eg Ho'oponopono). After the emergence of specialization in various societies, this intervention is often carried out by members of a particular community - for example, heads, priests, doctors, etc. - usually as a support function.

Family therapy as a different professional practice in Western culture can be said to have its origins in the 19th century social movement work in England and the United States. As a branch of psychotherapy, its roots can be traced somewhat later into the early 20th century with the advent of the child counseling movement and marital counseling. The formal development of family therapy dates from the 1940s and early 1950s to the founding in 1942 of the American Marriage Counselor Association (predecessor of AAMFT), and through the work of various physicians and independent groups - in the United Kingdom (John Bowlby at Tavistock Clinic), United States (Donald deAvila Jackson, John Elderkin Bell, Nathan Ackerman, Christian Midelfort, Theodore Lidz, Lyman Wynne, Murray Bowen, Carl Whitaker, Virginia Satir, Ivan Boszormenyi-Nagy), and in Hungary, DLP Liebermann - who began to see family members together for an observation or therapy session. Initially there was a strong influence of psychoanalysis (most of the early founders of the field had a psychoanalytic background) and social psychiatry, and then from the theory of learning and behavioral therapy - and significantly, the doctor began to articulate theories about the nature and function of the family as more entities than just a collection of individuals.

This movement received an important boost beginning in the early 1950s through the work of anthropologist Gregory Bateson and his colleagues - Jay Haley, Donald D. Jackson, John Weakland, William Fry, and later, Virginia Satir, Ivan Boszormenyi-Nagy, Paul Watzlawick, and others - in Palo Alto in the United States, which introduces ideas from cybernetics and general system theory into social psychology and psychotherapy, focusing specifically on the role of communication (see Bateson Project). This approach avoids the traditional focus on individual psychology and historical factors - involving so-called linear causes and content and instead emphasizes feedback and homeostatic mechanisms and "rules" in interaction here-and-now - so-called circular causal > and processes - which are considered to defend or aggravate the problem, regardless of the original cause. (See also systemic psychology and systemic therapy.) This group is also significantly influenced by the work of a US psychiatrist, hypnotherapist and therapist, Milton H. Erickson - especially his innovative use of strategies for change, > paradoxical directions (see also Reverse psychology) . The members of the Bateson Project (such as the founders of a number of other school-family therapies, including Carl Whitaker, Murray Bowen, and Ivan Boszormenyi-Nagy) have a particular interest in the possible causes of psychosocial and schizophrenic treatment, especially in terms of the expected "meaning" and "function" of signs and symptoms in the family system. Psychiatrists and psychoanalyst studies Lyman Wynne and Theodore Lidz on communication and role aberrations (eg, pseudo-mutuality, pseudo-enmity, schism and skew) in the families of people with schizophrenia also become influential with the communication systems. and renowned therapists. A related theme, applicable to dysfunction and psychopathology more commonly, is that of "identified patients" or "i" bringing problems " as embodiments or substitutes for family, or even society, problems. (See also double bonds: family nexus.)

In the mid-1960s, a number of different schools of family therapy had emerged. Of the groups most affected by cybernetics and systems theory came the MRI Brief Therapy, and a little later, strategic therapy, Structural Family Therapy from Salvador Minartin and the Milan system model. In part as a reaction to some aspects of this systemic model, the approach of experience of Virginia Satir and Carl Whitaker, which undermines theoretical constructs, and emphasizes subjective experiences and feelings that are not expressed [ including the subconscious), authentic communication, spontaneity, creativity, therapeutic involvement, and often including large families. Simultaneously and somewhat independently, there emerged intergenerational therapies from Murray Bowen, Ivan Boszormenyi-Nagy, James Framo, and Norman Paul, who presented different theories of health transmission and intergenerational dysfunction, but all dealing normally with at least three family generation (directly or conceptually), either directly in the therapy sessions, or through "homework" , "return trips" , etc. Psychodynamic family therapy - which, more than any other school of family therapy, is directly related to individual psychology and unconsciousness in the context of current relationships - continues to flourish through groups influenced by the ideas and methods of Nathan Ackerman, as well as by British School from Object Relations and John Bowlby's work on attachments. The double family group therapy, the precursor of the psychoeducation family intervention, emerged, in part, as a form of alternative pragmatic intervention - primarily as an adjunct to serious mental medicine. disorders with significant biological basis, such as schizophrenia - and represent something of a conceptual challenge for some "systemic" (and thus potentially "family-blame") implicit paradigms of pathogenesis in many of the dominant models of family therapy. The late-1960s and early 1970s saw the development of tissue therapy (similar to traditional practices such as Ho'oponopono) by Ross Speck and Carolyn Attneave, and the emergence of behavioral therapies marriage (renamed behavior therapy couple in the 1990s; see also relationship counseling ) and behavioral family therapy as a model in they own right.

In the late 1970s, the severity of clinical experience - especially in relation to the treatment of serious mental disorders - has led to several revisions of a number of original models and moderations of some laziness and purity of previous theories. There is a beginning of the general softening of tight demarcation between schools, with a move towards restoration of relationships, integration, and eclecticism - although there are, however, some positioning hardening in some schools. These trends are reflected and influenced by field life debates and criticism from various sources, including feminism and postmodernism, reflected in the cultural and political tenor of the age, and which signify the emergence (in the 1980s and 1990s). ) of the various "post-system" constructivist and social constructionist approaches. While there is still a debate in the field about whether, or to what extent, the systemic-constructivist paradigm and medical-biologically always conflict with each other (see Also Anti- psychiatry; biopsychosocial model), there is a growing willingness and tendency from the family therapist to work in multi-modal clinical partnerships with other members of the assisting and medical profession.

From the mid-1980s to the present, this field has been characterized by a diversity of approaches that reflect some of the original schools, but also uses other theories and methods of individual psychotherapy and elsewhere - these approaches and sources include: short therapy, structural therapy, constructivist approach (eg, Milan, post-Milan/collaborative/conversational , reflective ), solution-focused therapy, narrative therapy, cognitive and behavioral approaches, psychodynamic and objects, attachments and Emotional Focused Therapy, intergenerational approaches , network therapy , and multisystemic therapy (MST). A multicultural, intercultural, and integrative approach is being developed. Many practitioners claim to be "eclectic," using techniques from several areas, depending on their own propensity and/or client needs, and there is a growing movement towards a single "generic" family therapy that seeks to combine the best of accumulated knowledge in the field and which can adapted to various contexts; However, there are still a large number of therapists who adhere more or less strictly to a particular, or limited number, approach (es).

Ideas and methods of family therapy have been influential in general psychotherapy: a survey of more than 2,500 US therapists in 2006 revealed that of the top 10 most influential therapists in the previous quarter century, three were prominent family therapists and that the model of marriage and family systems was the second model the most widely used after cognitive behavioral therapy.

Maps Family therapy

Technique

Family therapy uses a variety of counseling and other techniques including:

• Structural therapy - identifying and reorganizing the family system organization
• Strategic therapy - view patterns of interaction between family members
• Systemic therapy/Milan - focuses on the trust system
• Narrative therapy - restores the saturation-dominated narrative, the emphasis on context, the separation of the problem from that person
• Transgenerational therapy - transgenerational transmission of unwholesome patterns of belief and behavior
• communication theory
• psychoeducation
• psychotherapy
• relationship counseling
• relationship education
• systemic training
• system theory
• reality therapy
• genogram

The number of sessions depends on the situation, but the average is 5-20 sessions. A family therapist usually meets with several family members at the same time. It has the advantage of making a distinction between how family members perceive mutual relationships as well as patterns of interaction in clear sessions for both the therapist and the family. These patterns often reflect patterns of habitual interaction at home, even though the therapist is now incorporated into the family system. Therapeutic interventions typically focus on patterns of relationships rather than analyzing impulses of the subconscious mind or individual childhood traumas as do a Freudian therapist - although some family therapy schools, such as psychodynamic and intergeneration >, taking into account such individual and historical factors (thereby embracing the causes of linear and circles ) and they can use instruments such as genograms to help explain patterns of cross-generational relationships.

The characteristic of family therapy is its perspective and analytical framework rather than the number of people present in the therapy sessions. In particular, family therapists are relational therapists: They are generally more interested in what happens to between individuals than in one or more individuals, although some family therapists - especially those who identify as a psychodynamic, object relation, intergenerational , or family experience therapist (EFT) - tend to be as interested in individuals as in an individual system -individuals and their relationships are. Depending on the conflict in question and the progress of therapy to date, a therapist may focus on analyzing examples of prior conflicts, such as by reviewing previous incidents and suggesting alternative ways family members may have responded to each other during the process, or even continuing directly to address the sources of conflict at a more abstract level, such as by showing patterns of interactions that the family may not be concerned about.

Family therapists tend to be more interested in maintenance and/or problem solving than trying to identify a single cause. Some families may consider causal analysis as an attempt to allocate errors to one or more individuals, with the effect that for many families the focus on the cause is little or no clinical use. It is important to note that a circular way of evaluating a problem is used as opposed to a linear route. Using this method, families can be helped by finding patterns of behavior, what causes them, and what can be done to improve their situation.

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Evidence base

Family therapy has a growing evidence base. Summary of evidence is currently available through the Family Therapy Association in the United Kingdom.

According to a 2004 French government study conducted by the French Institute of Health and Medical Research, family and partner therapy is the second most effective therapy after cognitive behavioral therapy. This study used a meta-analysis of more than a hundred secondary studies to find some level of "proven" or "suspected" effectiveness exists. Of the treatments studied, family therapy is considered or proven effective for treating schizophrenia, bipolar disorder, anorexia, and alcohol dependence.

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Concerns and criticism

The late Frank Pittman, MD, has been practicing marriage and family therapy in Atlanta, Georgia for 33 years when he wrote:

"One of the horrors of psychotherapy is the affirmative clientele may feel from their seemingly neutral therapist that they are 'okay' even when they do terrible things for themselves and their loved ones.Some therapists listen without comment to stories of abuse, abuse substances, infidelity, even incest.They are silent consent Some therapists do worse than silently accept whatever the customer says or does, some actively assert that the customer is always right Therapist, because they take their heart to their customers, can actually provide an 'interpretation' to free the client from the guilt they need to keep them from hurting others and bring disaster to themselves... therapists who do psychotherapy effectively do so because they understand the value conflict and they deliver, without should preach about it, the values ​​of that work. "

In a 1999 lecture for the Marriage Counsel Conference, Family and Educational Couples in Washington, D.C., University of Minnesota Professor William Doherty said:

"I am not grateful to be a whistle blower, but it is time I am a committed marriage and family therapist, having been doing this therapy since 1977. I train wedding and family therapists I believe that wedding therapy can be very helpful in the hands of committed therapists on professions and practice, but there are many problems out there with therapeutic practices - a lot of trouble. "

Doherty suggests questions potential clients should ask the therapist before starting treatment:

1. "Can you describe your background and training in marital therapy?"
2. "What's your attitude in saving a troubled marriage versus helping couples break up?"
3. "What's your approach when one partner is seriously considering ending marriage and the other wants to keep it?"
4. "What percentage of your practice is marital therapy?"
5. "Of the couples you treated, what percentage would you say enough to overcome their problem to stay married with a reasonable amount of satisfaction with the relationship." "What percentage is broken when they see you?" "What percentage does not improve?" "What do you think makes a difference in this result?"

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License and degrees

Family therapy practitioners come from various professional backgrounds, and some are particularly eligible or licensed/enrolled in family therapy (licenses are not required in some jurisdictions and requirements vary from one place to another). In the UK, family therapists will have prior professional training relevant in one of the assisting professions usually psychologists, psychotherapists, or counselors who have conducted further training in family therapy, either diploma or M.Sc. In the United States there are special titles and licenses as marriage and family therapists; However, psychologists, nurses, psychotherapists, social workers, or counselors, and other licensed mental health professionals can practice family therapy. In the UK, family therapists who have completed the four-year qualification (MSc) qualification program are eligible to apply to the professional Family Therapy Association (AFT), and with the UK Council for Psychotherapy (UKCP).

A master's degree is required to work as an MFT in several American states. Most commonly, the first MFT will earn a M.S. or M.A. in marriage and family therapy, counseling, psychology, family studies, or social work. Upon graduation, MFT candidates work as apprentices under the supervision of licensed professionals and are referred to as MFTi.

Prior to 1999 in California, counselors specializing in this field were called Marriage, Family, and Child Counsel. Today, they are known as Marriage and Family Therapists (MFT), and work in various ways in private practice, in clinical settings such as hospitals, institutions, or counseling organizations.

Marital and family therapists in the United States and Canada often seek degrees from an accredited Master or Doctorate program recognized by the Accreditation Commission for Marriage and Family Therapy Education (COAMFTE), a division of the American Association of Marriage and Family Therapy.

Requirements vary, but in most countries approximately 3000 hours of work supervised as internships are required to take the license exam. MFT must be licensed by the state to be trained. Only after completing their education and apprenticeship and passing the state licensing exam can someone call themselves a Marital and Family Therapist and work unattended.

License restrictions may vary from one state to another. Contact information about the license plate in the United States is provided by the Association of Marital and Family Affairs.

There are concerns that arise in the profession about the fact that specialist training in spousal therapy - which differs from family therapy generally - is not required to obtain a license as an MFT or membership of a major professional body , AAMFT.

Value and ethics

Because of the issue of interpersonal conflict, power, control, values, and ethics are often more prominent in relationship therapy than in individual therapy, there is a debate in the profession about the different values ​​implied in the various theoretical models of therapy and the role of the therapist's own values ​​in the process therapeutic, and how prospective clients should go in search of therapists whose values ​​and goals are most consistent with their own. Specific issues that have emerged have included the growing question of long-standing ideas about therapeutic neutrality, attention to questions about justice and self-determination, connectedness and independence, "functioning" versus "authenticity," and questions about "pro-marriage/family" level of therapist versus "pro-individual" therapist.

The American Association for Marriage and Family Therapy requires members to comply with the "Code of Ethics", including a commitment to "continue a therapeutic relationship only as long as it is clear enough that the client is benefiting from that relationship."

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Founder and key influence

Some key developers of family therapy are:

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A summary of theory and techniques

( references: )

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Journals

• Contemporary Family Therapy
• Family Process
• Family Relationships
• Family Relationships , Interdisciplinary Journal of Applied Family Studies, ISSN 0197-6664
• Family Therapy Journal
• Wedding Fitness
• Journal of Marriage and Family Therapy
• Family, System & amp; Health

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See also

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Footnote

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Further reading

• Deborah Weinstein, The Pathological Family: Postwar America and Family Therapy Awakening. Ithaca, NY: Cornell University Press, 2013.

Source of the article : Wikipedia