This document outlines several schools of family therapy, including psychodynamic, behavioral, strategic, Milan's systemic, and solution-focused approaches. It describes key concepts and therapeutic techniques for each approach. For example, behavioral family therapy applies principles of behaviorism to change family interactions, while strategic family therapy uses indirect techniques like reframing and paradoxical interventions. The document also discusses integrative approaches that combine concepts and strategies from different schools of family therapy.

1. Schools of Family Therapy

2. Schools of family therapy
 Psychodynamic
 Behavioural
 Psycho education
 Structural family therapy
 Strategic family therapy
 Milan’s systemic therapy
 Solution focused
therapy
 Emotion focused
therapy
 Experiential approach
 Narrative approach
 Integrative approach

3. Psychodynamic Family Therapy
 Ackerman, Boszormenyi-Nagy, Framo, & Sager
 To help the family members obtain insight into
themselves and the way they interact with each
other
 Unconscious mental processes are important.
 Early experience has an influence on later
behaviour and experience.

4.  The refinement of object relations concept has
led to the emergence of several family therapies
 Emphasized on the processes that occur within
individuals
 The frame of treatment, the formal arrangements
such as frequency, time, and length of sessions
 ‘free associate’
 Transference and counter transference

5.  Different from other schools: therapists make
fewer comments, ask fewer questions, intervene
less actively, refrain from giving advices and
from manipulating the families they treat
 The concepts have contributed to our
understanding of families, but there is no well
defined psycho dynamic school of family therapy
 Research studies are rare.

6. Behavioural Family Therapy
• Applies the principles of behaviour therapy
• Change in families is conceptualized in terms of
respondent conditioning, operant conditioning,
modeling or cognitive change
• Primary objective is to increase the positive
behaviours at the expense of the negative or
undesired ones
• Operant conditioning has great importance:
central to OC is reinforcement

7. • Widely used in marital therapy
• not deal primarily with whole family systems
• Intervene in families by working out and
implementing plans to change the interactions
between certain members, in fairly specific ways

8. • According to the behaviour exchange model,
‘marital distress is viewed largely as a function of
the rate of reinforcement/ punishment directed
by marital partners toward one another, and the
relationship between each person’s delivery of
reinforcement and punishment’ (Jacobson &
Margolin, 1979)

9. • Problem behaviour is the product of skill deficits
that stem from lack of knowledge, or from the
establishment of coercive exchange
• Techniques are:
 Skill training-
 Positive exchange- awareness about patterns of
exchange

10. Cognitive behavioural approaches
 Extend behavioural principles to the treatment of
family systems
 Primarily for work with children and marital
dissatisfaction
 Thoughts & behaviour are central to all aspects
of functioning
 Directly address dysfunctional thoughts and
behavioural patterns

11. Psycho education
• Syndromes that seriously impair functioning
have a biopsychosocial basis
• It is developed in the context of schizophrenia

12. Structural Approaches
• Salvador Minuchin, 1974
• The three primary dimensions of structure are
boundary, alliance, and power
• Focused on the balance between stability &
change, openness & closed ness

13. Strategic Family Therapy
 Purely systemic approach
 Brief focused intervention
 From a strategic view point, change is a
discontinuous process. The goal is to intervene,
find a new way of functioning, and promptly end
the treatment
 Use of team approach: offer commentary and
directives to the therapist and family

14. • They see families with problems as having got
themselves into a repetitive but dysfunctional
pattern of interaction, developed at some critical
point in the family’s development
• Eg: when a family presents with a symptomatic
member, the strategic therapist is interested in
their organization around the symptom, their
pattern of interaction, and the focus is on the
process not content

15. Strategic methods are -
• Indirect
• required when direct methods prove ineffective
It centers on altering feedback cycles within the
family, but do not seek to enable insight within
the family about such cycles
Change, not learning about the change process, is
clearly the center of attention

16.  Reframing: Process whereby new meaning is given
to a behaviour, a sequence of interactions, a
relationship or some other feature of the current
situation.
context reframing content reframing
A bhvr is redefined as useful Reframing the meaning of
in certain circumstances not some event, behaviour or
in the current sitn-identifying stimulus. Eg;-
where a bhvr is useful

17.  Paradox- effective when the family and the therapist
become locked in a symmetrical relationship. Directives
are offered which if acted one would move the family in
the opposite direction from that which is desired
 Changing the sequence of their interactions-
Prescribing the sequence in which things are to be done
 Metaphor- Greek mythology, biblical parables and
children’s fairy tales
 Rituals- another way in which ideas can be
communicated, points made and sequence of behaviour
changed

18. Strategic Family Therapy:
Therapeutic Techniques
There are two major models of
strategic therapy
• Brief communication model-
Mental Research Institute
• Haley’s problem Solving
therapy

19. Brief communication model- Mental
Research Institute Model
 Jackson, Watzlawick, & Weakland
 Mix of systems theory, cybernetics, and the
study of communication process
 Problems are viewed as natural part of family life
and families deal with their problems
 “first order change”- Families become stuck in
systemic patterns and in efforts to solve the
problems, changes in behaviour, and makes the
problem even worse

20. Therapy focuses on “second order change”- an
alteration in the rules of the system that govern
interactions
Treatment consists of identifying the maintaining
factors and rules lie beneath these behaviours &
then changing the behavior

21. Haley’s problem-solving therapy
• Haley & Madanes (1980)
• Each person’s perspective about the problem is
elicited
• Observation of therapist focus on triangles and
hierarchy, but these ideas are not directly
shared with clients
• Aim is to engage family in new and different
behaviours

22. Systemic Family therapy
Milan
In the classic Milan therapy, sessions are held
approximately once per month. The team forms a
hypothesis about the family, to be modified over
the course of treatment.
Intervention techniques are:
Positive connotation Prescription of a ritual
Reframing behaviour in Therapy move to exaggerate
a positive light- suggesting or move against rigid patterns
how the behaviour serves in the family
the goals of the system

23. Milan’s approach stressed the importance of
therapist’s neutrality
Bosccolo and Cecchin (1987) introduced the term
“circular questions”
Aim is to move the family toward a specific goal, but
to initiate thought and conversation in order to
create greater understanding of the problem and
to elicit productive pathways towards change
Collaborative approach
Very little empirical testing of the Milan approaches

24. Solution-focused therapy
 DeShazer (1985), Berg (1993), O’Hanlon and
Weiner- Davis (1989)
 Attempts to move discussion fully to think in terms
of solutions rather than problems
 Assumes that clients wants to change and reject
the notion of deeply ingrained pathology
 Seeks to introduce ways of thinking about and
facing and resolving difficulties

25.  Techniques-
 Look for exceptions: times when problems have
not been present or overcome
 To nurture and help clients notice small changes
from which they can build larger ones
 Miracle question: “Suppose one night, while you
were asleep there was a miracle and this
problem was solved. How would you know?
What would be different? ”
 Aim- To help the clients to think in terms of
solution

26. Narrative Approaches
• Michael White (1990)
• Roots in social constructivism- Knowing is socially
constructed through language and discourse, &
depends on the context of the observer
• Difficulties are the products of stories that have been
socially created and can be reconstructed
• De-emphasizes the therapist’s role as an expert
• Therapist & clients as equal partners in conversation
• Focus on the individual than family

27. Experiential Approaches
• Whitaker(1981), Satir(1983), & Greenberg and
Johnson(1988)
• Emphasis on the felt experience
• Primary instrument is the therapist who uses self
as an instrument toward change
• Techniques:
Direct commentary to wrestling, aimed to fight
emotional deadness- Whitaker
Focused interaction btw couples- Greenberg &
Johnson

28. • Relatively few family therapist trained in this
area
Influential in highlighting
• Importance of the person of the therapist
• Need to maintain liveliness and authenticity in
family work

29. Emotion-Focused Therapy
• Les Greenberg and Sue Johnson (1980)
• EFT is an integration of an interactional / family
systems approach with an affective/experiential
approach that also draws upon attachment
theory.
• Attempts to shift the cognitive/affective balance
by emphasizing the crucial role of the
experience of adaptive emotion

30. • Emotions themselves have an innately adaptive
potential that, if activated, can help clients
change problematic emotional states or
unwanted self-experiences

31. Emotion in Marriage and Marital Therapy
• Intimate relationships are at the core of our
emotional lives.
• No other context is so infused with, and
responsive to, the ebb and flow of human
emotion
• The majority of communication is emotional
communication involving minute signals about
closeness/ distance and dominance/submission
• Affect is the soil in which attachment grows

32. • EFT is carried out in nine steps:
1. Delineate the conflict issues between the partners
2. Identify the negative interaction cycle
3. Access unacknowledged feelings underlying
interactional positions
4. Reframe the problem(s) in terms of underlying feelings
5. Promote identification with disowned needs and aspects
of self
6. Promote acceptance by each partner of the other
partner’s experience
7. Facilitate the expression of needs and wants to
restructure the interaction based on the new
understandings
8. Establish the emergence of new solutions (cycles)
9. Consolidate new positions
( Johnson & Denton, 2002)

33. Integrative Approaches
 Common in couple & family therapy
 Integrative models merge the raw material of
various approaches, at three distinct levels:
theory, strategy and intervention
 Some integrative approaches accent each
therapist’s building of a personal method, while
others offer a specific map for when to do what

34.  Most of them combine behavioural notion of
learning, with a systemic understanding of the
family process and the individual psychodynamics
 Highly effective for dealing with a wide range of
problems

35. Conclusion
Approaches to couple and family therapy are
 increasingly integrative
 incorporates a range of concepts & intervention
strategies
 focus on the individuals with in the family as well
as on the broader social system in which the
family subsides

36. Thank you