Family Therapy in 21st Century


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Family Therapy in 21st Century

  1. 1. FAMILY THERAPY IN st CENTURY 21 by Sümeyye BALCI
  2. 2. CONTENTS Family Therapy in 21st Century Feminist Family Therapy A Feminist Approach to Illness and Family Family Violence Multiculturalism Race Poverty and Social Class Gay and Lesbian Rights Spirituality Tailoring Treatment to Populations and Problems Single-Parent Families African American Families Gay and Lesbian Families Home-Based Services Medical Family Therapy and Psychoeducation Relationship Enrichment Programs
  3. 3. Family Therapy in st 21 Century combine models and techniques from various family therapy theories specific needs of every client Postmodernism : not knowing the truth for sure. According to Rovelli (2012), stating that some idea or phenomena is a scientifically proved is closing the doors to improving that idea/phenomena
  4. 4. Feminist Critique sharing the responsibility of the problem is another way of accusing the victim and continuing with the remaining system blaming women for causing their own abuse blaming women for their children's psychopathology and even the problem of family the father figure who was the hero and saved the family from dissolution?!
  5. 5. Feminist Family Therapy differences between a feminist family therapist and a therapist who adopted the principles and practices of feminism Feminist therapist is defined as the ones who composed feminism both into their personal lives and to their psychotherapy practice main idea that makes a feminist family therapist is the sensitivity to gender and a nonsexist approach towards the clients those who also put the gender equality in the center of their therapy practice are should be considered as feminist therapists
  6. 6. Feminist Family Therapy feminist family therapist‟s one of the main goal is to extend the assessment to the cultural and social context in order to rescue men and women from narrow and unequal roles that they‟ve been playing for a long time powerful political aspect because what this approach aims to accomplish is to change patriarchy with a feminist consciousness a feminist family therapist should have a feminist sensibility rather than feminist agenda while challenging patriarchy
  7. 7. Feminist Family Therapy The major conflict which is encountered by families is the cultural coding that forces women to nurture and support men while they are seeking success even if it decreases women‟s development challenge this balance by empowering women to feel adequate „power‟ refers to having freedom and resources to accomplish to do things but not domination or control over someone Both men and women should be empowered to free themselves from what taught them to be acceptable and what is best for them
  8. 8. Feminist Family Therapy Therapists are used to working with women as their clients and in family therapy they tend to accept the absence of father because of his work schedule. But in order to resolve the problems that are result of the sexist arrangement of family system, family therapist should insist on having the father come to the therapy with the rest of the family members(Nichols, 2013)
  9. 9. A Feminist Approach to Illness and Family traditional gender roles are accepted unconsciously however in case of a chronic illness of a family member may result the obligatory change in these roles because of the demands of the illness in dysfunctional couples, through health habits and depression, there is an indirect effect on health and health outcomes and direct effects on cardiovascular, immune and endocrine systems Spouses contributions to their course of disease might be helpful or hinder
  10. 10. A Feminist Approach to Illness and Family Behavior patterns of being ill is different for men and women an illness can challenge gender roles For example, a woman might need to built trust first to tell the health psychologist her illness story; and a man might feel difficulty talking about his illness story because this is very much related to exposing vulnerability which is against to most men‟s socialization.
  11. 11. Illness, couples and family life cycle if a couple with young children face a chronic illness, while one of them is mostly focused on childrearing and the other one on working, these differences might cause additional difficulties because it will devastating considering the parent roles and responsibilities In therapy; how each partner can make transition into a new role and what are the possible obstacles towards these changes(Silverstein & Goodrich, 2003)
  12. 12. Medical family therapy has a gender sensitivity to fight with these oppressive experiences caused by gender roles aims to help families and increase agency via psycho-education encouraging all family members to maintain individual and family identities, develop flexible roles for caring illness, and finding resources independent from gender based socializations Medical family therapy counters the traditional medical approach by making sure the patient‟s voice is heard by the health care professional and mutual agreement about a treatment to avoid noncompliance
  13. 13. Family Violence Judith Myers Avis reported that therapist who adapt the systemic approach will keep supporting male power in family and indirectly leading to danger against women and children. Systemic approach believed that family violence was result of a cycle of mutual provocation
  14. 14. Multiculturalism It is important to be familiar with our clients‟ backgrounds and their cultures because some of their behavior due to their culture might be different to us but it is not necessarily wrong
  15. 15. Race In the US, African American therapists such as Nancy Boyd-Franklin and Ken Hardy put families of color into the map by emphasizing white therapists‟ denial and ignorance towards them and the racism they have to live with everyday
  16. 16. Poverty and Social Class People who are low on economic status tend to believe that it was their own fault to become poor because that‟s what is believed by everyone Therapists should familiarize themselves about the conditions that poor people live in A therapist might help the clients see that being poor is not the result of their own making
  17. 17. Gay and Lesbian Rights Therapists should be aware of that a gay/lesbian client might had to deal with pressures from society and accepting their own identity. When working these clients, it is a therapists responsibility to get familiarize about the issues these people face(Nichols, 2013).
  18. 18. Spirituality a debate about whether therapists should explore the spirituality of the family or not people‟s answers about their spirituality also tell a lot about their well-being(Nichols, 2013)
  19. 19. Integrating Spirituality in Family Therapy In therapy, most families wanted to gain deep meaning about their lives and contribute to their spirituality examples of effective faith based health care programs which combines spirituality aspects through clergy with communication skill for a premarital program for couples it is important for therapists to familiarize about their own spirituality and religious view and related biases It is important to acknowledge the client‟s spirituality, religious views and beliefs rather than avoiding it
  20. 20. in Eastern cultures, to treat an illness, they use mind, body and spirit interactions In Chinese medicine, trying to find ways to increase energy for internal resilience and resistance to disease In future, new approach to family, a more holistic approach such as biopsychosocial and spiritual way to approach clients
  21. 21. Spirituality and Health our faiths, rituals and prayers provide positive effects on our health and physical well being by triggering emotions that influence physiological systems elderly who have strong religious beliefs tend to be happier with their lives and to have a lower blood pressure(Walsh, 2009)
  22. 22. There are two ways that therapist could utilize the spirituality of their clients in the sessions; first, is the spirituality of the client contribute to distress of the family; secondly is the spirituality of the family can contribute to solving the problems in the family When families face a conflict, a crisis; they use their strengths and bounds between members and resilience which all these are enhanced by sharing spiritual values and and practices to support one another(Walsh, 2009)
  23. 23. Tailoring Treatment to Populations and Problems Books about family therapy cover families with specific problems such as drug abuse, single parent families, stepparent families, divorcing families, blended families and families who are in a transmission A family therapist might face some difficulties when treating single-parent families, families of minorities and gay and lesbian families(Nichols, 2013)
  24. 24. Single-Parent Families Single parent families have a very similar problem with two parent families: an overburdened mother, who is enmeshed with her children and disconnect from relationships with other adults the goal of therapy is to empower the mother‟s position in the family and in her relationships with her children and provide her some resources to make her life more fulfilling
  25. 25. the therapist should support the parent with already existed resources and empower her to acquire more effective role in her children providing for the children with one pay-check is very hard and sometimes force people to put up with very difficult conditions in workplace just to provide their families Financial difficulties may led to depression and low self-esteem
  26. 26. In therapy, therapist should account for financial state of his/her client and arrange sessions according to the parent‟s work schedule. Further in therapy, single-parent can be presented with options that suggest a more financially stable life such as going back to school Supporting the single-parent can be started with empowering already existing bounds with his/her parents and close friends A very important challenge that a single mother might face is to integrate the father of her children to their lives. Usually the father seems like an outsider and even an enemy however the therapist should understand these negatives feelings of the mother towards the father and help her to involve the father (emergence of two subsystems after divorce)
  27. 27. Ambiguities after divorce ex-spouses have different constructs about each other and these constructs are mostly determined by the reason led them to get a divorce If these complicated views about ex spouses toward each other may lead to feelings of anger and blaming one side; the therapist should help the ex spouses to reconstruct new images about each other so that they can believe the other one will offer something to their children in the future(Barnes, 2004) In children, sadness, failure at school, violence; in parents, increasing hostility towards one another
  28. 28. African American Families African American families are characterized with their extended families and kinship networks which provide support and strength to them Usually an African American family came to therapy when they lost connections of their extended family and kinships
  29. 29. In therapy, therapist should focus on connecting the family again with those extended family members and kinships to provide them support to cope with conflicts. These extended family members and kinship networks might be call to the therapy sessions as well in the assessment process. Religion plays an important role as a source of strength in an African American family, so it is useful to state whether the family is practicing any religion. particular complications in African American families caused by absence of men (fathers: death or in jail), presence of grandparents in the household and so on
  30. 30. Gay and Lesbian Families In gay community, the term family refers to an important reconstruction of a traditional arrangement that was causing difficulties and abusive for LGBT individuals(Silverstein &Goodrich, 2003) specific problems same sex couples face such as homophobia in their families and in society, boundaries, gender related behaviors and developing social support
  31. 31. In working with same sex couples, therapist should pay attention to use a language free from homophobic expressions and biases as much as possible Gender roles in heterosexual couples, are controversial in same sex couples and led some problems for the same sex couple Monogamy is an issue to discuss in therapy with same sex couples to clarify the boundaries of commitment Because there is not a model of family in same sex couples, the issues of couples needed to be handle more cautiously by the therapist
  32. 32. Sex and Internet Internet, is rather a recent technology, is helping people connect with others and not connect with others while keeping them online socializing and having them socialize in a non traditional but a technological way
  33. 33. In the US, many family therapists are facing with the problems in family caused by cybersex incidents excessive consumption of internet pornography and infidelity issues are very common The dangers to internet use for children may involve cyberbullying, cyberharassment and inappropriate sexual contact with people in real world For teenagers, parental control over their behavior might let to rebellion which may not be so obvious if the subject is shame sensitive such as sexuality Pornography might seem rather harmless for adult audience however there are still risks that it can turn into compulsions and their secret nature might cause harm to trust and intimacy of the couples‟ relationship People who are suffering from compulsive sexual behavior seek help through recovery programs
  34. 34. Home-based Services home-based services aims to provide the family as a major recipient of mental health care Home-based services has four elements: family support services, therapeutic intervention, case management and crisis intervention
  35. 35. Family support service involves respite care and assisting the family to provide food, shelter, and clothing. Therapeutic intervention involves individual, couples or family therapy. The main goal here is to empower family to find their own strengths to solve their problems by themselves. Case management include finding connections in the resources that community provide such as medical care, education and job trainings. Crisis intervention refers providing 24 hours available emergency services by contacting home-based agency or an outside mental health emergency service
  36. 36. For a therapist, visiting the family at their home is a great way to understand their family history, their identities and religious beliefs. For example looking through photo albums may be a good way to the therapist to join the family Studies have found that in home based therapies, the most important thing is therapeutic relationship between the family and the therapist. Therapist‟s warm attitude may contribute to the relationship
  37. 37. Medical Family Therapy & Psychoeducation medical family therapy which emphasizing helping families who are dealing with chronic illnesses such as diabetics, cancer and psychoeducational family therapy which had its roots from working with families who have a schizophrenic family member.
  38. 38. Psychoeducation and Schizophrenia schizophrenia is Some studies showed that the course of affected by the amount of stress that the patients‟ experience after coming back to their homes it is important for schizophrenic patients to have rather a peaceful environment at their houses in order to prevent relapses Psychoeducation aims to help families of schizophrenic patient get enough knowledge to understand the disease and have a sense of mastery, reduce the guilt and shame and conflict Main goal for the family is to help them learn coping strategies while living with a schizophrenic patient and preventing relapse and rehospitalization
  39. 39. Medical Family Therapy Medical family therapy aims to help families while coping with a chronic disease. It involves not just the family of the patient but their physician and nurses who take care of them; aimed to provide communication and support between the family and their health care provider team
  40. 40. Relationship Enrichment Programs developed by Bernard Guerney, Jr. in 1977 to help couples clarify their conflicts, be open about their feelings and acknowledge each other‟s feelings and work through problems and finally become satisfied with being emotional partners three core skills: Expressive(owning) skill which refers to an awareness towards one‟s own feelings and taking responsibility about these feelings while not projecting them to others; Emphatic Responding (Receptive) skill refers to listen others feelings; Conversive(Discussion-Negotiation/Engagement) skill refers to learning to acknowledge what was heard.
  41. 41. PREPARE: Premarital Personal and Relationship Inventory is developed by David Olson and his colleagues to assess the couples history and expectations, communication, and the areas where they might face a conflict in the future and promoting discussions about these possible problems. Marriage Encounter Weekend: first organized by a church in Barcelona to provide support and enrichment for Catholic couples. In these events, couples get to work on their communication and problem-solving skills, sexual intimacy and spiritual issues. PREP: Prevention and Relationship Enhancement Program developed by Floyd, Markham, Kelly, Blumberg and Stanley in 1995 which aims to teach communication and conflict resolution skills and explore expectations and attitudes about marriage and avoid couples to develop unhealthy defensive patterns in their relationships
  42. 42. References Barnes, G. G. (2004). Family Therapy in Changing Times. New York: NY: Palgrave Macmillan. Dallos, R. & Draper, R. (2010) An Introduction to Family Therapy: Systemic Theory and Practice. Berkshire, England: Open University Press. Nichols, M. P. (2013). Family Therapy: Concepts and Methods. Upper Saddle River: New Jersey: Pearson Education Inc. Rovelli, C. (2012). This will make you smarter. J. Brockman (Ed.). New York, NY: HarperCollins. Silverstein, L. B. & Goodrich, T. J. (Eds.). (2003). Feminist Family Therapy: Empowerment in Social Context. Washington, DC: American Psychological Association. Walsh, F. (Eds.). (2009). Spiritual Resources in Family Therapy. New York, NY: The Guilford Press.
  43. 43. “Type a quote here.” –Johnny Appleseed