FAMILY SYSTEMS THERAPY–STRUCTURAL THERAPY (MINUCHIN) – Flashcards

THE INVISIBLE SET OF FUNCTIONAL DEMANDS THAT ORGANIZES THE WAYS IN WHICH THE FAMILY MEMBERS INTERACT--in essence, a set of rules that tells who talks to whom, who plays with whom (and in what ways), and so forth

TWO OR MORE MEMBERS BECOME CLOSE BUDDIES

These are critical because they tend to be repeated and institutionalized, become part of the family's and individual member's identities, and determine how everyone is to behave. They also tell you about hierarchical power in families. IN ESSENCE, THESE REPEATED PATTERNS OF INTERACTION ARE THE FAMILY STRUCTURE.

Families naturally differentiate into subsystems, or smaller groupings within the family. They help to get the work of the family done, such as when the adult partners form a parental subsystem to raise kids. Subsystems take many forms--even an indiv can be a subsystem.

Rules that specify who participates in a subsystem. Boundaries protect the integrity of a subsystem, and should be flexible but clear. When boundaries are too rigid, the system is said to be DISENGAGED. when they are very unclear, the system is ENMESHED. BOUNDARIES CAN BE OBSERVED in various ways--who sits next to who? who speaks for whom?

focuses on dev of family, not indv. 4 main stages of family dev: 1. couple formation (shifting loyalties from fam of origin) 2. families with young children 3. families with school age children 4. fams with grown children Minuchin maintained that the individual's personal identity is composed of a balance between individuality and belonging. SYSTEMS ARE EVER CHANGING BASED ON ELEMENTS OF DEVELOPMENTAL STAGES

ADAPTIVE FAMILIES modify their structure based on changing circumstances (accommodation). PROBLEM FAMILIES maintain and increase rigidity of their (non-functional) structures based on circumstance. FAMILIES TEND TO EXPERIENCE DIFFICULTIES WHEN OLD PATTERNS OF RELATING DON'T WORK--VERY EVIDENT IN TIMES OF TRANSITION. ENMESHED families respond instantly to threat by freaking out cuz blurred boundaries enable immediate and intense transmission of stress. DISENGAGED families seem not to care about its members, and seem not to respond to stress cuz the rigid boundaries in the system deep the stress from being transmitted to al members

families in which children present with symptoms that are more severe than would be expected based on the biological aspects of the disorder, such as asthma or anorexia--in essence, the child's symptom serves as the regulator in the system, assisting in the avoidance of conflict between the parents. Minuchin maintained that psychosomatic families are enmeshed, overprotective of members, rigid in the face of change, and have difficulties resolving conflict. The key characteristic though, is the child's involvement in the parental relationship.

1. detouring or scapegoating--the couple system looks united, but they are channeling their stress to the child. The child is defined as the family's problem, becomes a victim, and develops symptoms 2. parent-child coalition--when the child is recruited into a stable partnership with one parent in opposition to the other 3. Triangulation--the child finds himself caught in the middle

The first thing the structural therapist does is assess family structure--duh. No formal assessment is done; the therapist simply asks himself a series of questions like: who is the spokesperson of the fam? what are the other members doing while the spokesperson talks? Genograms can be used to assess the structurally oriented historical explanation.

Active and present focused atmosphere: the tool of therapy is to modify the present, not explore and interpret the past. The role of the therapist is that of expert. He joins the family, but maintains a stance as leader in the counseling process.

Change the structure of the fam, and thereby the experiences of its members. Problems are solved by the therapist joining the family in ways that impede old patterns of thinking and relating and build on their strengths to generate new patterns leading to immediate, palpable results.

THE structural family therapist is the leader of the system but also must become a member of it--this process is called JOINING--IT IS NOT A TECHNIQUE, BUT A MENTAL SET that conveys to the family that he is on their side. JOINING INVOLVES: disclosing similarities with them, supporting family members, and by conveying understanding of their perspectives. Therapists must be able to move in and out of family interaction. 4 STEP MODEL OF FAMILY INTERACTION: 1. OPENING UP THE PRESENTING COMPLAINT (REFRAME THE PROBLEM AS SYSTEMIC) 2. HIGHLIGHTING PROBLEM-MAINTAINING INTERACTIONS (CLARIFYING AND EMPHASIZING THE THING THAT THE FAMILY DOES TO MAINTAIN THE PROBLEM) 3. STRUCTURALLY FOCUSED EXPLORATION OF THE PRESENT, RESTRICTED VIEWS OF THEMSELVES AND OTHERS (KEEP THE FOCUS OF HISTORICAL ELEMENTS ON ISSUES THAT BEAR DIRECTLY ON THE PRESENTING PROBLEM) 4. AN EXPLORATION OF ALTERNATIVE WAYS OF RELATING (CLIENTS AND THERAPIST EXPLORE ALTERNATIVES TO THE PRESENT PROBLEM-MAINTAINING INTERACTIONS)

JOINING AND ACCOMODATING ENACTMENT--psychodrama FOCUSING--Basically, the therapist chooses the most important element in the family's presentation, and that choice is dictated by structural theory. BEWARE OF THEORETICAL TUNNEL VISION! Focusing can be used to take the spotlight off the identified patient by examining other dynamics in the family ACHIEVING INTENSITY--hearing the therapists message. Also, the therapist can ask the family to go beyond the point at which they tend to interrupt stressful interactions--breach homeostasis! STRUCTURAL MAPPING HIGHLIGHTING AND MODIGYING INTERACTIONS BOUNDARY MAKING-- UNBALANCING--to change the family hierarchy and foster empowerment of less powerful members CHALLENGING UNPRODUCTIVE ASSUMPTIONS TEACHING COMPLIMENTARITY--teaching the fam that they are part of something larger.

Interview the whole family Observation (enactments and spontaneous behavior sequences to guide the family to display new behaviors when trying to solve a problem. Joining

1. OPENING=JOINING AND ACCOMODATING, WORKING WITH INTERACTION, STRUCTURAL MAPPING 2. FOCUS ON UNDERLYING STRUCTURE--highlighting and modifying interactions 3. TRANSFORMING STRUCTURE--boundary making, unbalancing, challenging unproductive assumptions

Feminist therapists have great difficulty with traditional FS theory, believing that the neutral stance of systems theory and concepts such as circular causality can result in excusing the perpetrators of battering and child abuse. The "dysfunctional triangle" of the overinvolved mother, distant father, and smothered child is a natural outgrowth and microcosm of our patriarchal culture. FS therapists also argue that FS theory reinforces traditional family structure based on male model of power. The idea of enmeshed mother is the result of cultural factors that deprive women of other outlets and pressure them to conform. CULTURAL BIAS: Most models of ideal family functioning were developed based on the caucasian middle-class nuclear family (except for structural therapy)