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Family Therapy, Ch. 2- History

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In the 1950s, two puzzling ailments forced therapists to recognize the family’s power to alter the course of treatment:
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(1.) The tendency for another family member to get “sick” as the client got better (2.) After clients had improved their condition in the hospital, they got worse when they went home.
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Who was William McDougall? (Book, year, contribution)
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The Group Mind, 1920, group dynamics
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The Group Mind made three points:
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(1.) a group’s continuity depends on the group being an important idea in the minds of its members (2.) the group needs boundaries and structures in which differentiation of function can occur (3.) customs and habits are important so that relationships can be fixed and defined.
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Who was Kurt Lewin? (When, topics)
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1940’s, field theory, quasi-stationary social equilibrium, unfreezing, (lead to notions of understanding the importance of homeostasis in families)
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group dynamics
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interactions among group members that emerge as result of the properties of group rather than merely of their individual personalities, are relevant to families for group life is complex blend of individual personalities and other properties of group
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field theory
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the group is more than the sum of its parts (Kurt Lewin, 1940’s)
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quasi-stationary social equilibrium
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changing group behavior 1st requires unfreezing: only after something shakes up the group’s beliefs are its members likely to accept change
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family homeostasis
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Families are units that resist change.
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Who was Wilfred Bion? (When, topics)
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1948, most groups become distracted from their primary tasks by engaging in patterns of fight-flight, dependency, or pairing. He created the concepts of process vs. content and role theory.
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process/content
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distinction between how members of family/group relate to each other in terms of the process vs. what they talk about in terms of content (how it’s said/roles vs. what is said)
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role theory
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expectations that roles carry bring regularity to complex social situations
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Who was Virginia Satir? (Book, year, contribution)
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Peoplemaking, 1972, roles tend to be stereotypical, reciprocal, and complementary
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Similarities between group therapy and family therapy:
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Each patient must react to a number of people not just the therapist, and therapeutic use of this interaction is a definitive mechanism for change.
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Differences between group therapy and family therapy:
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family members have a long history and future together, serious harm can happen when family members share too much; sharing w/ strangers in a group is usually easier
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In family therapy, the “official patient” is likely to feel…
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isolated and stigmatized; after all, he or she is “the problem.” Thus, there isn’t a sense of protection/ compassion like there would be in a group setting.
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How did Alfred Adler contribute to family therapy?
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This person postulated that treating the growing child might be most effective way to prevent adult neuroses. He offered encouragement and support in atmosphere of optimism and confidence through child guidance clinics.
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How did David Levy contribute to family therapy?
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This person created the concept of maternal overprotectiveness.
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How did Frieda Fromm-Reichmann contribute to family therapy?
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This person coined the term schizophrenigenic mother (aggressive/domineering mothers thought to precipitate schizophrenia in their kids.) Blaming parents for their kids’ behavior is no longer a part of the field, but exploring parent/child relationship interaction paved the way for family therapy.
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The emphasis in the child guidance movement eventually changed from…
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seeing parents as the problem to seeing problems in the relationship between the patient/parents/significant others.
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How did John Bowlby contribute to family therapy?
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This person found that family meetings might be a useful catalyst as a single session, but only as adjunct to individual therapy.
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How did Nathan Ackerman contribute to family therapy?
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This person saw family therapy as the primary form of treatment and valued dealing with the family as a unit when addressing a disturbance in any of its members.
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Since the beginning of the profession, social workers have been concerned with the family both as …
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a critical social unit and as a focus of intervention.
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friendly visitor
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a caseworker who visits families in their homes. These visits broke the artificiality of the doctor-patient model.
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How did Mary Richmond contribute to family therapy?
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(1917) This person was a social worker who treated the whole family and warned against isolating family members from their natural context. This person coined the term “family cohesion.”
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family cohesion
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the idea that the degree of emotional bonding between family members is critical to their ability to survive and flourish.
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What did Gregory Bateson do?
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This person started a schizophrenia project in Palo Alto, California, to study the nature of communication: How are schizophrenics created by families? This person wrote that all communication has two different levels of communication: report and command
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metacommunication
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the covert messages within language that show how individuals relate to each other in terms of power
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communication theory
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explains origin/nature of schizophrenia, particularly in the context of families
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double bind
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Conflict is created when person receives contradictory messages on different levels of abstraction in an important relationship and can’t leave the relationship or comment on the inconsistency.
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Double bind steps (6)
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(1.) 2+ persons in important relationship (2.) Repeated experience (3.) Primary negative injunction, perhaps verbal (4.) 2nd injunction at more abstract level conflicting with the 1st, but also enforced by punishment/perceived threat (5.) Tertiary negative injunction prohibiting escape/demanding response, w/o this restriction victim won’t feel bound (6.) Complete set of ingredients is no longer necessary once victim is conditioned to perceive world in terms of double binds; any part of sequence becomes sufficient to trigger panic/rage.
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True or False: Schizophrenia is biological.
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True.
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identified patients
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symptom-bearer or official patient as identified by family
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What did Theodore Lidz do?
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This person turned his attention to how defects in the marital relationship affected the family.
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role reciprocity
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In a successful relationship, it is not enough to fulfill your own role (aka: be an effective person); it is also necessary to balance your role with your partner in order to be an effective pair.
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marital schism
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husbands/wives undercut each other’s worth and compete openly for kid’s affection
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marital skew
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one partner becomes passive and dependent while the other appears strong but is, in fact, a pathologic bully
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What did Lyman Wynne do?
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This person’s studies linked communication deviance in families to thought disorder in schizophrenic families.
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pseudomutuality
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façade of family harmony that characterizes many schizophrenic families. There is no room for separate identities within the family.
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pseudohostility
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Superficial bickering that resembles situation-comedy in schizophrenic families. This bickering obscures alignments and splits.
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rubber fences
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the boundary surrounding many schizophrenic families, which allows only minimal contact with the surrounding community, and which springs back if the family member goes too far outside of the family
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communication deviance
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Communication is a vehicle for transmitting thought disorders. When communication within families become disordered, family members can become disordered, too. The more severe the deviance, the more prone members are to more severe pathology.
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What did John Spiegel do?
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This person was a role theorist, a person who described how individuals were differentiated into different social roles within family systems. This person acknowledged that the therapist plays a role in the family system. This person distinguished interactions from transactions.
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second-order cybernetics
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idea that anyone attempting to observe/change system is therefore part of that system
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interactions
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Two things can collide and alter each other’s course but not change each other, like billiard balls.
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transactions
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When two people collide or come together, they alter each other’s course and change each other.
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What did R. D. Laing do?
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This person’s observations helped popularize the family’s role is psychopathology in the 1960’s.
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mystification
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This term was borrowed from Marx and is applied to the “politics of families.” Many families distort their children’s experiences by denying or relabeling them. This helps to maintain the status quo and causes the child to become inauthentic.
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false self
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Self presented to the world for the sake of acceptance.
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real self
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Self protected from the world and kept hidden.
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If the real self/ false self split is carried to extremes…
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the result is madness.
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The first professional centers for marriage counseling were opened in about (year)
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1930.
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What did Paul Popenoe do?
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This person opened the American Institute of Family Relations.
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What did Clarence Oberndorf do?
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This person found that married spouses have interlocking neuroses that are best treated in concert.
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What did Bela Mittleman do?
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This person determined that spouses can be treated by same analyst and that by seeing both, it is possible to reexamine their irrational perceptions of each other. The couple’s reactions to each other may stem from their relationships with their parents. Later on, this person began to think that most couples should provide both spouses with individual therapists
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True or false: There is a major difference between family therapy and marital therapy.
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False.
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Who was John Elderkin Bell?
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This person founded family group therapy, a process which relied primarily on stimulating open discussions to help families solve their problems. The group model intervened to encourage silent people to speak up, and interpreting reasons for the defensiveness of the quiet ones. This person believed that family group therapy goes through predictable phases. Therefore, treatment unfolded in a series of stages, each of which concentrated on a particular segment of the family.
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What happened in Palo Alto?
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The Bateson group looked at schizophrenic families. This group included Don Jackson and Jay Haley.
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Who was Don Jackson?
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This person created the concept of family homeostasis and observed that patients’ symptoms preserve stability within their families. Even psychotic symptoms can be meaningful within the family context. This person claimed that the early stages of a relationship are a time to bargain out the rules that subsequently govern the nature of their relationship, rules that form the marital contract.
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symmetrical relationships
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relationships based on equality and similarity, in which everyone does the same thing
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complementary relationships
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partners are different in ways that fit together (if one is logical, the other is emotional, etc.)
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Jackson’s family rules hypothesis
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(1.) within any committed unit, there are redundant behavior patterns (2.) family members use only some of the full range of behavior available to them
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As a result of his family rules hypothesis, Jackson’s strategy was to…
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explore the family rules and to change the ones that are not useful.
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redundant behavioral patterns
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behavioral patterns within a relationship, functional or dysfunctional
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problem maintaining patterns
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dysfunctional behavioral patterns within a relationship
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scapegoat
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usually identified patient who is object of displaced conflict/criticism
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cybernetics
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The study of self-controlling process in systems, especially analysis of positive and negative feedback loops.
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Who was Jay Haley?
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This person explored how covert messages are used in the struggle for control that characterizes many relationships. Instead of reasoning with a patient to cure symptomatic behavior, this person zeroed in on the function that the symptom served and gave directives that made displaying the symptom unattractive.
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coalitions
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alliances between two persons against a third (usually cross-generational, as in one parent ganging up with a child against another parent)
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perverse triangle
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a hidden coalition that undermines generational hierarchies (such as a child running to a grandparent when punished by a parent)
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Who was Virginia Satir?
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This person saw family members as trapped in narrow family roles, like victim, placator, defiant one, and rescuer; these roles constrained relationships and sapped self-esteem. This person worked to free family members from the grip of such life-constricting roles.
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Who was Murray Bowen?
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This person was a psychiatrist who specialized in schizophrenia. This person emphasized theory, and created the concept of differentiation of self and the concept of triangles.
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differentiation of self
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autonomy from others; separation of thought from feeling
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triangles
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diverting conflict between two people by involving a third
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emotional reactivity
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the tendency to respond in a a knee-jerk, emotional fashion, rather than calmly and objectively
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undifferentiated family ego mass
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Bowen’s early term for emotional “stuck-togetherness” or fusion within the family, which is especially prominent in schizophrenic families
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Triangles serve to … but fail to …
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give an advocate for individual family members… provide an advocate for the family system
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One way to stop another person’s efforts to triangulate with you is to…
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tell the person talked about what was said.
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Differentiating oneself from one’s family is accomplished when…
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family relationships are individually maintained without becoming emotionally reactive and when the individual does not take part in triangles.
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Who was Nathan Ackerman?
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This person was a child psychiatrist who claimed that families may appear united but they are spilt into competing factions. The family is the basic unit of treatment. Families will confront some issues but avoid others, especially in the realms of sex and aggression. This person “tickled the defenses” of clients, provoking people to open up and say what’s really on their minds. This person challenged avoidance and emotional dishonesty.
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Who was Carl Whitaker?
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This person created tension by teasing and confronting families because he believed that stress is necessary for change. His interventions promoted flexibility and challenged people to open up, to become more fully themselves and more fully together.
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True or false: Nathan Ackerman thought family secrets should be aired and addressed in the family.
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True.
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Who was Ivan Bozormenyi-Nagy?
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This person added ethical accountability to therapy goals/techniques. He believed that family members have to (1.) base their relationships on trust and loyalty and (2.) balance entitlement and indebtedness in the relationships so that members are even.
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network therapy
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Therapy developed by Ross Speck in which a large number of family and friends are assembled to help resolve the patient’s problems.
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Who was Salvador Minuchin?
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This person saw troubled families as either too enmeshed or too disengaged. He saw both as threats to effective leadership. He was a structuralist and wrote a seminal work in the field of family therapy: Families and Family Therapy (1974.)
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Enmeshed parents are ineffective because…
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parents are too entangled with their children to exercise leadership.
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Disengaged parents are ineffective because…
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parents are too distant to provide effective support.
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first-order change
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change in the behavior of one individual within a system without the system changing
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second-order change
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basic change within structure and function of the family system itself
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Structural family therapy relies on two primary strategies (big picture):
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(1.) the therapist must accommodate the family in order to “join” them (2.) once the therapist is joined, the therapist many begin restructuring techniques
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restructuring techniques
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disrupting dysfunctional structures by strengthening diffuse boundaries and loosening rigid ones
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Who wrote the most popular book in the history of family therapy?
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Salvador Minuchin
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Who was Robert MacGregor?
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This therapist created multiple impact therapy and worked intensely with families in a short amount of time.
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Who was Norman Paul?
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This therapist used operational mourning to resolve impacted grief.
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Who were Fred & Bunny Duhl?
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These therapists created integrative family therapy. (Animal and person connecting)
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multiple impact therapy
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intensive, weekend-long family therapy that developed out of meeting the needs of a constituency that had to travel long distances to come to therapy (You get beat up all weekend.)
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During what time period did family therapy receive the most attention?
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the 1970s and 1980s
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What issues have “turned people off” to family therapy?
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structural family therapy seemed like bullying, strategic approaches felt manipulative, “stubborn families” resisted change, prozac became popular, calling the family the problem in abuse cases felt wrong, AA worked, etc.
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Who is Harry Aponte? (For the trick, think A Pointy)
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a contemporary structural therapist (from the Pamela video) (He is structural so he has ___ head.)
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Who is Bill O’Hanlon?
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a post-modernist therapist who is solution-focused (from the Pamela video)
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Who are David & Jill Sharf
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object-relations therapists (from the Pamela video)
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family rules
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a descriptive term for redundant behavioral patterns
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family system
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The family conceived as a collective, whole entity made up of individual parts plus the way they function together
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homeostasis
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a balanced steady state of equilibrium
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metacommunication
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every message has two levels, report and command; ___ is the implied command or qualifying message
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schizophrenogenic mother
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Fromm-Reichmann’s term for aggressive, domineering mothers thought to precipitate schizophrenia in their offspring