Conference on family and couple therapy

1. FAMILY THERAPY
PRESENTATION
ON
By Priyanshi

2. INTRODUCTION
• Family therapy is the branch of psychiatry which sees
an individual’s psychiatric symptoms as inseparably
related to the family in which he/she lives, thus the
focus of treatment is not on the individual, but the
family as whole.
• Family therapy is essentially about changing
relationship through changing interaction among
people who make up the family.
• The basic principle of family therapy evaluate the
complex web of relationship pattern of transaction
taking place within a family system.

4. DEFINITION
• “A psychotherapeutic approach that focuses on
interaction between a couple within a nuclear family
or its members in extended family or between the
family and other interpersonal systems with the goal of
alleviating problems initially presented by individual
family members, family subsystem, the family as a
whole or other referral sources.”

5. AIMS/GOALS
• To reduce dysfunctional behaviour of individual family
members.
• To reduce conflicts in family relations.
• To improve family communication skills.
• To heighten awareness and sensitivity to other family
members to meet their needs.

6. • To strengthen family’s ability to cope with major life
stressors and traumatic events.
• To improve integration of family system into social
system.
• To improve autonomy for each member.
• To reduce distress in the patient.

7. INDICATION
1. Problem in relationship within the
family
2. Interdependence of symptoms
3. Failure of individual therapy
4. Psychosis
5. Schizophrenia
6. Childhood psychiatric disorder
7. Anxiety disorder
8. Bipolar disorder

8. CONTRAINDICATION
1. Family in the process of breaking up.
2. Family in which tense, dysfunctional equilibrium is
present.
3. Families staying apart.
4. Non-availability of key family members.
5. Families in which members are unwilling to take
therapy.

9. FUNCTIONS OF
FAMILY THERAPY

10. 1. MANAGEMENT FUNCTIONS: Decision-making, rule-making,
provision of financial support. In a healthy family, usually adults
take these decisions and they see that children learn decision
making skills as they mature and prefer to make choices on their
own lives.
2. BOUNDARY FUNCTIONS: Boundary maintain distinction between
individuals in family, They may be
• Clear Boundaries :are usually well understand by all members,
helps define their roles in family.
• Diffuse Boundaries :refers to blending together of roles, thoughts
and feelings. Clear distinctions may fail to emerge.
• Rigid Boundaries :in families where this predominates, isolation
may be marked. The family can often get cut-off from
community.

11. 3. COMMUNICATION FUNCTION: Extremely important in family life,
encourages members to express their feelings and prevent
conflicts.
4. EMOTIONAL-SUPPORTIVE FUNCTION: Healthy family is concerned
with each others need and provide emotional support to the
family members at the time of crisis. Gives freedom to grow,
explore new roles within family members.
5. SOCIALISATION FUNCTION: It is within the family that each
member learns socialisation skills, learn how to interact,
negotiate and plan. They also adopt coping skills. Promotes
safety, security and lays emphasis on kinship patterns. Decreases
the chances of social tension and conflicts with society.

12. TYPES OF FAMILY THERAPY
1. INDIVIDUAL FAMILY THERAPY: In individual family
therapy, each family member has a single therapist.
The whole family may meet occasionally with one or
two of the therapists to see how the member’s are
relating to one another and work out specific issues that
have been defined by the individual members.

13. 2. CONJOINED FAMILY THERAPY: The most common type
of family therapy is the single-family or nuclear family
therapy. The family is seen, and the issues and problems
raised by the family are addressed by the therapist. The
way in which the family interacts is observed and
becomes the focus of therapy. The therapist helps the
family deal more effectively with problems as defined.

14. 3. MULTIPLE FAMILY GROUP THERAPY: In this therapy, four or
five families meet weekly to confront and deal with the
problems or issues they have in common. Ability or inability to
function well in the home and community fearing of talking
to or relating to others, abuse, anger, neglect, the
development of social skills, and responsibility for oneself are
some of the issues on which these group focus and become
the support for all the families.

15. 4. MULTIPLE IMPACT THERAPY: Several therapists come together
with families in a community setting. They live together and
deal with pertinent issues for each family member within the
context of the group. Multiple impact therapy is similar to
multiple family group therapy except that it is more intense
and time limited. Like multiple family group therapy, it focuses
on developing skills or working together as a family and with
other families.

16. 5. NETWORK THERAPY: It is conducted in people’s homes. All
individuals interested or invested in a problem or crisis that
particular person or persons in a family are experiencing take
part in therapy. This gathering includes family, friends,
neighbours, professional groups or persons. People who form
the network generally know each other and interact on a
regular basis in each other’s lives. Thus a network may include
as many as 40 to 60 people.

17. 6. MARITAL/COUPLE THERAPY: Couples are often seen by the
therapist together. The couple may be experiencing difficulties
in their marriage, and in therapy, they are helped to work
together to seek a resolution for their problems, family patterns,
interaction and the communication styles, each partner’s goals,
hopes and expectations are examined in therapy. This
examination enables the couple to find a common ground for
resolving conflicts by recognizing and respecting each other’s
similarities and differences.

18. OBJECTIVE OF MARITAL
THERAPY
• A support of marriage/couple in identifying sources of
conflict.
• A help to each partner in determining their
participation in conflicts.
• A help in deciding whether to continue the
relationship or not.
• An improvement in natural verbal communication
and non-verbal communication.

19. INDICATIONS OF MARITAL
THERAPY
• Overprotection of one partner co-existing with
emotional dependence of others.
• Jealousy combined with controlled suspicion and
restriction.
• Dominance of one partner with lowering self esteem
of other.
• Mutual antagonism blaming an emotional
interdependence.

20. CONTRAINDICATIONS OF
MARITAL THERAPY
• Physical violence between partners.
• Mental illness or addiction problem of one or both
partners.
• Staying of partners in other relationship and lack of
motivation to give up on them.
• Undertaking the decision of divorce.

21. NURSING
DIAGNOSIS AND
INTERVENTIONS

22. 1. Impaired parenting related to ineffective role-
modelling as evidenced by lack of parental
attachment behaviour.
• Asses parents of developmental task of self and
understanding of child’s growth and development.
• Provide an opportunity for parents to express their
feelings needs and goals.
• Praise the parents for their participation in child’s care.
• Include the parents in planning and care and setting
goals.

23. 2. Ineffective therapeutic regimen management
complexity of healthcare as evidenced by verbalised
difficulty with prescribed regimen.
• Assess for related circumstances that may negatively
influence resolution.
• Evaluate the parents conviction on his/her ability to
perform desired behaviour.
• Inform patient of benefits of adherence to prescribed
regimen.
• Include the patient in planning the treatment
regimen.

24. 3. Ineffective coping related confusion in pattern of
appraisal of threat or tension release as evidenced by
inability to meet role expectation.
• Assess for influence of cultural beliefs, norms and
values on the patient’s perception of effective
coping.
• Observe the causes for ineffective coping such as
poor self concept, grief, lack of problem solving skills,
etc.
• Observe for strength such as ability to relate to the
facts and acknowledge source of stressors.
• Monitor risk for harming self or others and work
appropriately.

25. 4. Knowledge deficit related to emotional state
affecting learning as evidenced by verbalization
inaccurate information / incorrect task performance.
• Assess the ability to perform desired health related
care.
• Identify priority of learning needs within the overall
plan of care.
• Allow learner to identify what is most important to
him/her.
• Explore attitudes and feelings about change.
• Allow for self support ,self directed and self designed
learning.

26. NURSING RESPONSIBILITIES
1. Create a therapeutic environment that foster
trust and make member fully safe and
comfortable.
2. Promote effective communication by seeking
clarification or vague statements.
3. Identifying patterns of interaction that interfere
with successful problem solving.
4. Help the family to identify problems that
demand change.
5. Encourage all members to express honest feeling
without judgement .

27. 6. Avoid being triangled in family’s emotional
system. Remain natural and objective.
7. Reframe problems into their resolutions.
8. Discuss present coping strategies encourage
each member to describe how they cope with
stress.
9. Identify community resources that may assist
members to adapt coping mechanisms.
10.Assist family members in planning leisure time
activities together and encourage ‘we-feeling’.

28. RESEARCH

29. • An analysis of available evidence published in 2005 concluded
that family therapy is now an empirically supported therapy . It
clearly works both in general and for a variety of specific
problems.
• 2019 review of research listed the following circumstances in
which family therapy has proven to be effective, these are:
⮚Problem in infancy like sleep, feeding and attachment.
⮚Child abuse and neglect, conduct problems and delinquency.
⮚Emotional problem including anxiety, depression, grief, bipolar
disorder, suicidal tendencies.
⮚Drug abuse/ Substance abuse.
⮚Eating disorders including anorexia nervosa, bulimia nervosa and
obesity.
⮚Adjustment to chronic physical illness.