Is a branch of psychiatry which sees an individual’s psychiatric symptoms as inseparably related to the family in which he lives

1. FAMILY AND MARITAL THERAPY

2. DEFINITION
Is a branch of psychiatry which sees an
individual’s psychiatric symptoms as
inseparably related to the family in
which he lives.

3. Goals of family therapy
Establishing empathetic / supportive connection
Evaluating the family’s current needs
Explore the expectation of the relatives & experiences by all the
members of the family
Orienting the relatives to the current situation
Developing an initial plan for family service/ involvement

4. Components of family therapy
 Assessment of family structure, roles, boundaries, resources,
communication patterns & problem solving skills
 Teaching communication skills & problem solving skills, writing a
behaviour marital contract.
 Home work assignments.

5. Patient selection
 Families referred by private physicians & agencies such as the school systems,
welfare board, parole officers & judges from emergency room psychiatric
services after a visits caused by a crisis in the family such as drug over dose
 Some families are
 F.T is a treatment of choice when there is a marital problems/siblings conflict,
when using one child as scape goat.
 Situation crisis such as the sudden death of the family members & maturational
crisis such as the birth of the first child

6. Types of family therapy
Individual family
therapy
Conjoint family
therapy
Couple’s therapy
Multiple family
group therapy
Multiple impact
therapy
Network therapy

7. 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 ae
relating to one another and work out specific issues that
have been defined by the individual members.

8. CONJOINT FAMILY THERAPY
 The most common type of family therapy is the single-family group, or
conjoint family therapy.
 The nuclear family is seen, and the issues and problems raised by the
family are the ones 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
they arise and are defined.
Virginia Satir (26 June 1916 – 10 September 1988) was an American author and social
worker, known especially for her approach to family therapy and her work with family
reconstruction. She is widely regarded as the "Mother of Family Therapy"Her most well-
known books are Conjoint Family Therapy, 1964

9. COUPLES 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, and 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.

10. MULTIPLE FAMILY GROUP THERAPY
 In multiple family group 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.
 The multiple family group become the support for all the
families.
 The network also encourages each person to reach out form
new relationships outside the group.

11. MULTIPLE IMPACT THERAPY
 In 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.

12. NETWORK THERAPY
 Network therapy 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.
 This gathering includes family, friends, neighbors, professional
groups or persons, and anyone in the community who has an
investment in the outcome of the current crisis.
 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.

13. Nurse’s roles in family work
 To coordinate treatment
 To pay connection to the social & clinical needs of the patients & family
 To provide optimum medication management
 To listen to families & treat them as equal partners
 To provide clear communication & active listening
 To provide structured problem solving techniques
 To encourage family to expand to adjust their expectations

14. GROUP THERAPY

15. INTRODUCTION
 Human beings are complex creatures who share their
activities of daily living with various groups of people.
 Human beings are
Biological
organism
Psychological
organism
Social
organism

16. GROUP FUNCTIONS
Sampson and marthas (1990) , have outlined eight
functions that group serve for their members.
Socialization
Support
Task completion
Camaraderie
Informational
Normative
Empowerment
Governance
GROUPS TYPES
Sampson and marthas (1990) , have outlined eight
functions that group serve for their members.
 Socialization
Support
Task completion
Camaraderie
Informational
Normative
Empowerment
Governance

17. DEFINITION
Is a treatment in which carefully selected peoples who are
emotionally ill meet in a group guided by a trained therapists, for the
purpose of changing the maladaptive behaviour of the individual
member

18. SELECTION
Homogenous groups
Adolescents and patients with
personality disorder
Families and couples where the system
needs change
CONTRAINDICATIONS
Antisocial Patients.
Actively suicidal or severely depressed
patients.
Patients who are delusional.

19. PHYSICAL CONDITIONS
SEATING
 There should not be any barriers between the members.
 A circle of chair is better than chairs around a table.
 Members should be encouraged to sit in different chairs for each
meeting.
SIZE
 7 – 8 members in a group favors the therapeutic environment
 larger the size, less time is available to devote to individual
members.

20. MEMBERSHIP
 Open ended groups:
 are those in which members leave and others join at any time while the
group exists.
Open ended groups are commonly used in short – term in – patients.
 Close ended groups:
 are usually pre – determined and have fixed time frame.
All members join at the time the group is organized and terminate at the
end of the designate time period.

21. Purpose
 To intervene in
psychopathology
 To reveal, examine & resolve
distortion in IPRS
 To improve the skill of relating
to others
 To learn coping styles
Therapeutic factors involved
in group psychotherapy
Sharing experience
Support to & from group
members
Socialization
Imitation
Interpersonal learning

22. Types of group therapy
According to the size
of the group:-
• Small group
• Large group
According to the
diagnosis of the
clients:-
• Homogenous group
• Heterogeneous group.
According to the
nature of the group:
-
• Primary group
• Secondary group.
According to the
purpose: -
•Psychoanalytical group psychotherapy,
•Transactional analysis,
•Rational-emotive therapy,
•Inter personal group therapy,
•Psychodrama,
• Encounter groups,
•T- groups ,
•Community support groups
•Marathon groups

23. Stages of G.T
Initial stage:
Involvement with other
members superficially,
becoming acquainted with
other, searching for
similarities & differences b/w
the group members&
structuring of group norms,
roles, and responsibilities
Working stage:
Members get in to work
accomplishment, freely
approaching & discussing
their problems & conflict and
cooperation surface during
the group work
Termination stage:
Evaluating & summarizing the
group experiences and
exploring positive and
negative feelings about the
group experiences

24. Criteria of patients to be included in G.T
 Ability to communicate
 Willingness to share his problems with others
 Motivation to change
 Patient with authority anxiety
 Patient using defence mechanism of projections,
repression, denial, suppression, Transference
reaction

25. APPROACHES
1. Therapist role – Facilitator (Provides safe and comfortable environment).
2. Focus on “Here and Now”.
3. Protect members from any verbal abuse or scapegoating.
4. Provide positive reinforcement.
5. Therapist should approach the clients in a group in a gentle, supportive and non threatening
manner.
6. Able to preserve the self – esteem of hallucinatory and delusional patients.
7. Must able to set limits for the undesired behaviours of the clients.
8. Use Silence. Encourage Introspection and Facilitate Insight.
9. Laughter and Moderate Joking contributes to group cohesiveness.
10. Role – playing helps members to develop insight.

26. TECHNIQUES
1. Reflecting or rewarding comments of group members.
2. Asking for group reaction to one member's statement.
3. Pointing out any shared feelings within the group.
4. Summarizing various points at the end of the session.

27. Advantages of G.T
Cost effectiveness
Members profited by hearing other members problem
Opportunity to explore specific styles of communication in a
safe atmosphere
Learn multiple way of solving problem from other group
members
Learn socialization skills

28. Nurse’s role in G.T
Group
task
role:
• To identify the group
problems & select methods to
solve those problems
• Suggest new ideas
• Seeks clarification
• Gives information
• Elaborates the meaning of
suggestions
• Coordinates shows / clarifies
how ideas can work
Group
building
and
mainantance
role:
• To strengthen, regulate &
perpetuate the group
members to function as whole
group
• Encourages & accepts the
contribution of others
• Reconciles differences b/w the
group members
• Admits his/ other error to
maintain group harmony
• Keeps communication opens
& provides encouraging
remarks
• Sets group goals & evaluate
the functioning of the group
Individual
roles:
•To meet the needs of the group
members & not the group . this
hampers group functioning
•Expresses aggressions which
deflates the status of individual &
group accomplishment
•Resists progress by arguing / dis
aggressing beyond reason
•Calls attention to himself/ herself
through boasty & points out his
achievement
•Gives self confession by
expressing his/her feelings &
ideology not r/t to groups
•Uses group as audiences

29. CONCLUSION
Group Therapy plays a major role in rehabilitation of mentally ill
patient. It gives an opportunity for immediate feedback. It
facilitates chance for therapist to observe the patients emotional
and behavioral response towards variety of people. Enhances
patients IPR, Communication, decision making and assertive
skills.