Family Therapy


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Crisis Intervention- Course

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  • These psychotherapies included Murray Bowen, Nathan Ackerman, Salvador Minuchin, Jay Haley and Virginia Satir.They begin to change their approach from treating and to include family to help increase therapeutic effectivenessThese changes was on the belief that until the pattern of the family was changed, the individual behaviour would remain fixed.So this approach correspond with another method that viewing family as a system of relationships such as that between brother and sister or mother and daughter.Each member of the family must able to communicate in a productive and healthy way with others in the system.
  • Additionally, families in crisis experience impaired or ineffectual interactional patterns, which generates disruptive coping responses.
  • This is useful when the family system does not perform its basic functions adequately.Issues such as Dysfunction or the acting out as a child Marital conflict or intergenerational relationship problems that can be improved through family therapy
  • The therapist must function as a role model, demonstrating how to deal with conflictsThe therapist also helps family members take a realistic view of their relationships with one another and overall effect of their behavior on each other.
  • An understanding of these stages provides the nurse with guidelines for analyzing family growth and health promotion needs and the ability to provide therapeutic intervention when conflict arises.
  • Family Therapy

    1. 1. Family and Life Cycle Presented by Joy Christie P. Suresca
    2. 2. Objectives After one and half hour of discussion my colleageus will be able to: • Differentiate the family therapy from individual psychotherapy • Know the kinds of intervention in family crisis • Enumerate and define different approaches of family therapy
    3. 3. Family • Are groups of individual that interact, support, and influence each other in performing basic functions. • They are an integral part of the society, bound together by intense and long- lasting ties of past experience, social roles, mutual support, and expectations.
    4. 4. System is a set of interacting or interdependent components forming an integrated whole
    5. 5. Family as a System In the early 1950’s , the psychotherapist began to look not only at the individual with problems, but also at the pattern of relationships that correspond with the family problems.
    6. 6. Family Crisis A crisis occurs when individuals or families encounter stressful situations and normal coping mechanisms fail to resolve the disruption (Caplan, 1964)
    7. 7. 5 Interpersonal Requisite For Maintenance of Well Being or Health in Individuals and Families • Love • Support • Impulse control • Feel part of the group • Personal achievemnt and recognition
    8. 8. Healthy families take care of the needs of their members and support each other during crisis (Caplan, 1964)
    9. 9. Adaptive Qualities of Healthy Family • Strong parental leadership qualities • Effective communication patterns • Clear boundaries and roles • Flexibility
    10. 10. Healthy Functioning Families • No single member dominates or control another • Family members participates in activites together • Children are allowed to express opinions • Family members adapt to the changes ( Goldenberg & Goldenberg, 1995)
    11. 11. In a culturally diverse families functioning may have different ways. Culture and traditions give families a sense of stability and support from which members draw comfort. Guidance and a means of coping with the problems of life (Andrews & Boyle, 2002)
    12. 12. Crisis intervention is a useful strategy in which families and children can find relief from overwhelming circumstances
    13. 13. Family Crisis Intervention Advantages • Enhances self-awareness • Clarifies the roles of members in sustaining it • Develops fresh coping skills • Gains a sense of competency to manage the situation. Langsley & Kaplan (1968)
    14. 14. Family therapy is a method of treatment in which family members gain insight into problems, improve communication, improve functioning of individual members as well as the family as a whole .
    15. 15. Family therapy • Major goal is to facilitate positive change in the family • Other goals are – fostering open communication of thoughts and feeling – promoting optimal functioning interdependent roles
    16. 16. Family therapy VS individual therapy Family therapy Individual therapy Assumes that outside or external influences play a major role in personality development and regulation of member’s lives Internal or intrapsychic thoughts, feelings, and conflicts are the major components of personality development
    17. 17. Approaches to Family therapy Jones (1980) describes seven orientations or approaches to family therapy • Integrative Approach • Psychoanalytic Approach • Bowen Approach • Structural Approach • Interactional or Strategic Approach* • Social Network or Systematic Approach* • Behaviorist Approach*
    18. 18. Integrative Approach • Nathan Ackerman • Grandfather of family therapy • Focused on family values • A problem arises when interpersonal conflict is internalized by the client and it becomes an Overall goal: Remove pathogenic or intrapersonal conflict and promote more healthy relationships within the family (Jones, 1980)
    19. 19. Psychoanalytic Approach • Family members are affected by each member’s psychological make-up • Problem arises when there is an internalization or introjection of parental figures Goal: Guide the family members who exhibit pathology into clarifying old misunderstandings and misinterpretations between themselves and parent s and members of the family of origin and establishing an adult to adult relationship(Jones, 1980)
    20. 20. Bowen Approach • Consist of both emotional and relational systems. • Individuals behavior is a response to the functioning of the family system as a whole (Bowen, 1978) • Differentiation of self-concept • Focuses on guiding one or more family members to become a more solid, defined self in the face of emotional forces created by marriage, children, or the family of origin Goal: To gain the clarity and conviction to carry through one’s own positions, such as a parent, spouse, or dependent child (Titleman, 1998)
    21. 21. Structural Approach • Salvador Munuchin • Family as a system of individuals • problem arises if family boundaries become enmeshed or disengaged and can’t cope with change • The therapy is short term and action oriented with the focus on changing family organization and social context Goal: Develop clear boundaries for individual members and changing the family’s structural pattern
    22. 22. Interactional or Strategic Approach • Virginia Satir & Jay Haley • Communication theory • The therapist studies the interactions between and among family members, recognizing that change in one family member occurs in relation to change in another family member. • Deals with interpersonal relationships among all family members and focuses on why the family is in therapy and what changes each member expects Goal: Homeostasis among family members
    23. 23. Social Network or Systematic Approach • Healing comes from social relationship • Problem arises when the family loses its ability to recover quickly from change • This used but is not clearly defined • Bringing several people together as a social network who have similar ideals and goals Emphasizes the natural healing powers of the family
    24. 24. Behaviorist Approach • Individual learns that she or he obtain satisfaction or rewards from certain responses of other individuals. • Problem arises when maladaptive behavior is learned and reinforced by the family • TO GAIN ATTENTION!! • This approach is direct and clearly stated in bringing change Goal: Behavorial change by positive reinforcement
    25. 25. Stages of Family Therapy • The Initial Interview • The intervention or working phase • Termination phase
    26. 26. The Initial Interview • Engagement stage • Assessment stage • Exploration stage • Good setting stage • Termination stage
    27. 27. Family Assessment Guide I. Construct of a family genogram II. Description of the family in relation to the community, focusingon ethnicity, socioeconomic class, educational level and religion III. Description of presenting problems, focusing on each family member’s perception of the identified problem
    28. 28. IV. Identification of communication patterns focusing on who speaks to whom, tone of voice, emotional climate and manner by which emotions are expressed Family Assessment Guide
    29. 29. V.Identification of roles of family members as supportive, antagonistic, critical scapegoat, rescuer, or victim.Are there family coalitions, pairings,triangles, splits? VI. Developmental history of the family in general and of presenting problems VII.Family’s expectations of therapy Family Assessment Guide
    30. 30. The Intervention or Working Phase • The goal of the intervention phase is to help the family accept and adjust to change • Occurs once a week • The therapist role is to clarify and interpret communication as well as to offer suggestion and guidance
    31. 31. 12 family strengths by Otto (1963) 1. Provide for the physical, emotional and spiritual needs of each family members 2. Be sensitive to the needs of family members 3. Communicate feelings, emotions, beliefs and value effectively 4. Provide support, security and encouragement to enhance creativity and independence
    32. 32. 12 family strengths by Otto (1963) 5. Initiate and maintain growth- producing relationships within and without family system 6. Maintain and create constructive and responsible community relationships in the neighborhood, school, town, and local and state governments. 7. Grow with and through children
    33. 33. 12 family strengths by Otto (1963) 8. Help one’s self and accept help when appropriate 9. Perform family roles flexible 10. Show mutual respect for the individuation and independence of each family member 11. Uses crisis as a means of growth 12. Have aconcern for family unity and loyalty and for cooperation among
    34. 34. The Termination Phase • If the family has achieved the goals and identified specific problems have been resolved then its time to initiate the termination phase
    35. 35. The Family Life Cycle • Duvall’s theory, 1977 • The family is a developing system that must progress in the proper manner for healthy child development • These family developmental tasks refer to growth and reponsibilities achieved by a family and by individual developmental requisites
    36. 36. Duvall’s 8 stages of family cycle Stage Description of Family task 1. Beginning families Satisfying to live together by learning and provide personality’s needs to each other Relating harmoniously to the three families Family planning Develop a sexual and marital role adjustment 2. Early Childbearing New parent role Reconciling conflicting developmental task of various family member Jointly facilitating developmental needs of family members to strengthen each other and the family unit Accepting the new child's personality
    37. 37. • Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Vivamus et magna. Fusce sed sem sed magna suscipit egestas. • Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Vivamus et magna. Fusce sed sem sed magna suscipit egestas. Stage Description of Family task 3. Families with pre- school children Exploring the environment by children Establishing privacy, housing and adequate space Husband-father involved in household responsibilities Pre-schoolers assume responsibilities of self care Socializing of children Integrating of new family member Separating from children as they enter school 4. Families with school- aged children Promoting school achievement Maintaining a satisfying marital relationship Promoting open communication Accepting adolescence Duvall’s 8 stages of family cycle
    38. 38. • Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Vivamus et magna. Fusce sed sem sed magna suscipit egestas. • Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Vivamus et magna. Fusce sed sem sed magna suscipit egestas. Stage Description of Family task 5. Families with teenagers Maintaining a satisfying marital relationship Maintaining open communication Maintaining family ethical and moral standards by the parents Allows independence 6.Launching center families Expanding the family circle Accepting the new couple lifestyle and values Devoting time to other activities and relationship Re-establishing the wife and husband roles Assisting aging and ill parents Duvall’s 8 stages of family cycle
    39. 39. • Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Vivamus et magna. Fusce sed sem sed magna suscipit egestas. • Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Vivamus et magna. Fusce sed sem sed magna suscipit egestas. Stage Description of Family task 7. Families of middle year Maintaining a sense of ell being psychologically and physiologically by living in a healthy environment Attaining and enjoying a career or other accomplishment by cultivating leisure time activities and interests Sustaining satisfying and meaningful relationships with aging parents and children Strengthening the marital relationship 8. Families in retirement and old age Maintaining satisfying living arrangement Maintaining marital relationships Adjusting a reduced income Adjusting to the loss of a spouse Duvall’s 8 stages of family cycle
    40. 40. TYPES OF FAMILY THERAPY 1. Conjoint Family Therapy The entire family is seen at the same time by one therapist. The therapist is passive. 2. Concurrent Family Therapy One therapist see all family members but in individual session. 3. Collaborative Family Therapy Each family member sees a different therapist.
    41. 41. TYPES OF FAMILY THERAPY 3. Multisystematic Therapy Was developed for juvenile offenders and their families. a) Treatment is delivered in the person’s home, school, or other community locations b) Therapist are available for consultation 24 hours a day 7 days a week c) Caseloads of therapist are kept intentionally low