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Framework for Systemic Therapy

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Directs Attention away from the individual and individual problems viewed in isolation

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Framework for Systemic Therapy 2

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Directs Attention toward relationships and relationship issues BETWEEN individuals

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General Systems Theory

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A system is an entity with component parts that interact so each influences and is influenced by other parts together produce a whole

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Systems Theory

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A generic term for studying a group of related elements that interact as a whole entity, i.e. family or birds

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Simple Cybernetics

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First Order Change, Black Box Concept, Input and Output, Observed and Observer, Outside of the System

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Systemic Cybernetics

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Second Order Change, Meaning is Relational, Causality is Reciprocal, Assumes Power and Responsibility are, bilateral and equal

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Wholeness

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A whole is greater than the sum of its parts. The relationship is more important than summing up separate individuals which make up the family

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Organization (Systems)

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Members of a family will have some CONSISTENT relationship to each other and will interact in an organized way.

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Circular Causality

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Causality is seen as circular not linear. Events move in circular-repeating patterns Circular Questioning

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Family Rules (Systems)

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Rules govern and organize family Interactions Rules may be overt or covert causing emotional pain and conflict

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Symmetrical Behaviors

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Relationships that are parallel or of equal form. Examples: Equalitarian Relationships -Symmetrical Struggles

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Complementary Behaviors

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Relationships based on difference that fit together where qualities of one makes up for what the other lacks. Examples: Assumes Power Imbalances, Pursuer-Distancer, Overfunctioner-Underfunctioner, Villain-Victim

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Homeostasis

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any internal, ongoing interactional process within the family to assure balance.

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The symptom (Systems)

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shows the family system is unbalanced and the symptomatic individual may be a homeostatic mechanism.

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Feedback information

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informs the past, the environment and family history restores the homeostasis in the family

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Equifinality

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Is the same final state may be reached from different initial conditions in different ways

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Equipotentiality

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Is the notion that different END states may be arrived at from the same initial conditions

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Morphostasis

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Is a system's tendency toward stability, a state of dynamic equilibrium

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Morphogenesis

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Refers to the system-enhancing behavior that allows for growth, creativity, innovation and change.

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Feedback Loop

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Information travels back and forth within feedback loops that reinserts in a system the results of its past performance in order to regulate the system

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Negative Feedback Loop and Attenuating Loops

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Introduces information from past performance into system that SLOWS DOWN and returns the system to previous balance, corrective in nature.

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Positive Feedback Loop and Amplifying Loops

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Introduces information from past performance into system that SPEEDS UP and promotes change.

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Boundaries (Systems)

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Invisible lines to separate system from environment, subsystems and individuals

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Open System

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Has permeable boundaries that family members move in and out of system

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Closed System

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Has rigid boundary that family members feel/are isolated and cut off from environment

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Subsystems (Systems)

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Parts of Larger system to carry out particular FUNCTIONS within the whole system

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Subsystem Types (Systems)

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Couple/Spousal, Parental/Custodial, Sibiling

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Systemic Family Therapy

answer

Recognizing subjectivity Using the basic ingredients to create recipes appropriate to each client system How the problem is being maintained and the solutions desired by the client A story about stories

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Systemic Family Therapy 2

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How the Therapist thinks about who is in the room People in context/independence Interaction, recursion, mutual influence Understanding the logic of what appears paradoxical

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Systemic Family Therapy 3

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How we each participate in creating our reality Both/and complementarities Process What is going on/the logic of behavior in context

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Major Theorist (SFT)

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Braulio Montalvo, Harry Aponte, Jay Haley, Jorge Colapinto, Marianne Walters, Jay Lappin, Michael Nichols, Charles Fishman, Bernice Rosman

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Structural Family Therapy

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offers a blueprint for analyzing the process of family interactions and provides a basis for consistent strategies of treatment

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Philosophy of Structural Family Therapy

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Focuses on the present and future History of the family is manifested in the present History is accessible through interventions in the here and now

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Philosophy of Structural Family Therapy 2

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Reciprocal nature of systemic causality is acknowledged An individual's behavior influences and is influenced by his or her social system Process over Content The "How" of Communication over the "What"

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Structural Family Therapy concepts

answer

Alliances, Boundaries, Coalitions, Disengagement, Detouring, Enmeshment, Parentified Child, Restructuring, Structure, Structural Map, Subsystems

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Family Structure (SFT)

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A Complementary Demands and Expectations regulates the Family

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Family Transactions (SFT)

answer

determine how members relate and can be verbal or nonverbal-known or unknown

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POWER HIERACHY (SFT)

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dictates the authority and decision making in the family

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POWER HIERACHY 2 (SFT)

answer

Mutual expectations formed by negotiations over time are determined and fulfilled by individuals in the family

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Subsystem (STF)

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Components of the family structure that exist to carry out various family task

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Adult Subsystem (SFT)

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Couple, Marital or Spousal Subsystem This component of a family system includes the couple dyad, or adult significant others and teaches the children about intimacy and commitment

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Boundaries (SFT)

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Subsystem boundaries are made up of a set of rules that defines who participates in the subsystem and how individuals participate

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Adaptation to Stress (SFT)

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How families adapt to tense situations caused by internal and external sources of stress. Families work hard to maintain the integrity of the family

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Developmental Family Life Stages (SFT)

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Families become more vulnerable with the complexity of family stages

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Dysfunction (SFT)

answer

family system occurs when a stressor overloads the family's adaptive and coping mechanisms

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Change (SFT)

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Reorganization of family structure Clear and flexible boundaries between subsystems Functional adaptive patterns assist change

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Stages (SFT)

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Entire family present Join from position of leadership Map underlying structure Interventions transform the structure Short-term therapy

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Role of the Therapist (SFT)

answer

Expert Active and Directive Inserts Self into the Family System Conducts Orchestrates

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Methods (SFT)

answer

Joining/Accommodating, Diagnosing, Modify Interactions, Boundary Making, Unbalancing, Challenging, Enactments, Reframing, Tasks, Paradox

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Assessment and Diagnosis (SFT)

answer

The therapist develops working hypotheses about the family structure based on observations of family interactions

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Assessment and Diagnosis 2 (SFT)

answer

Interventions are designed to effect structural change flowing from the assessment

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Structural Diagnosis

answer

Is an ongoing evolving process in structural family therapy that is based on data from six major areas

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Structural Map Symbols

answer

Clear Boundary (-------) Diffuse Boundary(.........) Rigid Boundary (_________) Mother M Father F Stepmother SM Stepfather SF

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Structural Map Symbols 2

answer

Husband H Wife W Boy B Girls G Therapist Th Coalition ) Conflict _____] [______ Affiliation = Detouring -->

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Goals of Treatment (SFT)

answer

To solve problems in the family and to change the underlying systemic structure.

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Treatment Process (SFT)

answer

Structural change that modifies the family's functioning so that they can better perform necessary tasks Joining/Accommodating Structural Diagnosis Restructuring

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Joining or Accommodating Techniques

answer

Maintenance, Tracking, Mimesis

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Maintenance

answer

the therapist supports specific behaviors or verbalizations to increase the strength and independence of individuals, subsystems or alliance

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Tracking

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the therapist uses clarification amplifications and approval of family communication to reinforce individuals and subsystem

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Mimesis

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the therapist adopts the family's communication style and conforms to its affective range

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Restructuring Techniques

answer

These techniques challenge and unbalance the family system creating movement that forces the family to seek alternative transactions and solutions (Enactment)

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Enactment (SFT)

answer

the therapist has family members perform an interaction that may or may not relate to the presenting problems

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Enactment 2

answer

used to diagnose family structure, increase intensity and restructure family system

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Leading Figures (Bowen)

answer

Michael Kerr Daniel Papero Philip Guerin Thomas Fogerty Monica McGoldrick Betty Carter

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Individuality and Togetherness

answer

Two counterbalancing life forces are relevant to family functioning

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Individuality

answer

is a natural force rooted in an instinctual drive to be a self-contained independent organism

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Togetherness

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is a natural force rooted in an instinctual need for others and a sense of being connected to another person or a group

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Bowen Philosophy

answer

Anxiety is an organizing factor Anxiety escalates emotional intensity Anxiety can create fusion in intellectual and emotional systems

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Bowen Philosophy 2

answer

Thinking and Behavior become more emotionally determined and choice is compromised

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Bowen Major Concepts

answer

Anxiety, Differentiation, Emotional cutoff. Emotional system., Family projection process., Functional level of differentiation, Fusion, Multigenerational transmission process., Nuclear family emotional system., Sibling position., Triangulation

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Eight Interlocking Core Principles

answer

Nuclear Family Emotional Process Differentiation of Self Triangles Family Projection Process Emotional Cut Off Multigenerational Transmission Process Sibling Position Emotional Process in Society (societal regression)

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Dysfunction (Bowen)

answer

Lack of differentiation results in marital conflict, dysfunction in one or more children.

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Dysfunctional processes in a family may be manifested by (Bowen)

answer

High levels of emotional intensity Rigid and restrictive relationships (e.g. dependency or isolation) Low levels of individual differentiation of self Overt symptoms in individual family members

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Change (Bowen)

answer

Increasing the ability to distinguish between thinking and feeling within self and others. Use this skill to direct one's life and solve problems

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Stages (Bowen)

answer

Emphasize extended-family. Entire family need not be present. Use of genograms. Reduce anxiety Increase differentiation. Open communication, resolve triangles

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Therapeutic Stance (Bowen)

answer

Emotional Neutrality, Objective, Coach

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Methods (Bowen)

answer

Process over content. Genograms. "I" position. Detriangulation. Create therapy triangle. Often long term.

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Methods (Bowen) 2

answer

Factual Questioning Didactic Teaching Role Playing Empty Chair Journaling Letter Writing Multiple Family Groups

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General Framework (Bowen)

answer

History of Presenting Problem History of the Nuclear family History of the Each Partner's Extended Family

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Assessment (Bowen)

answer

Self reports Level of differentiation - use of scale Degree of cutoff. Level of family anxiety and reactivity. Triangle.

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Major Theorist (CFT)

answer

Ivan Boszormenyi-Nagy Barbara R. Krasner Peter Goldenthal David Ulrich

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ContextualMajor Concepts

answer

Destructive entitlement, Ledger Entitlement, Exoneration, Justice/ fairness, Legacy, Loyalty (filial & invisible), Merit, Multidirectional partiality, Parentification, Relationship determinants (facts, individual, psychology, behavioral transaction, relational ethics), Revolving slate, Trustworthiness

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Contextual Family Therapy Philosophy

answer

Emphasis on the relational context of family functioning extending to many prior generations

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Contextual Family Therapy Philosophy 2

answer

Contextual Therapy is embedded in the belief of social justice and that all families must have: Ethical Accountability Justice Fairness Give & Take Trust Worthiness

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Contextual Family Therapy Philosophy 3

answer

Goal is to help families make changes in ways they think and behave in relationships by promoting trustworthy relatedness (rejunctive vs. disjunctive behaviors) with the aim of moving toward greater balance and growth

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Contextual Family Therapy Philosophy 4

answer

A goal is to facilitate family members abilities to acknowledge each other's positive efforts

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Dysfunction (CFT)

answer

The trustworthiness of relationships breaks down because fairness, caring and accountability are absent.

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Functional Families

answer

are viewed as flexible, fair and equitable

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Change (CFT)

answer

A preventative plan for current and future generations. Restore people's capacity to give thru fair relating and trust

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Contextual Therapy Theoretical Concepts

answer

A balance of Fairness or Relational Justice is a major issue in all close relationships.

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Contextual Therapy Theoretical Concepts 2

answer

Family Members should be able to both state and claim their own side in a conflict

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Dimension I

answer

Objective Facts, Treats issues of Individual family history

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Dimension II

answer

Individual Psychology Includes Individual Psychology

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Dimension III

answer

Systems of Transactional Patterns Encompasses family systems variables

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Dimension IV

answer

Ethic due consideration or merited trust Treats Fairness Issues

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Multidirected Partiality

answer

Contextual Therapy commits to considering the welfare of all those people whose lives are affected by what happens in therapy

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Multidirected Partiality 2

answer

prepares the therapist to be partial to everyone and if necessary take their side

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Multidirected Partiality 3

answer

Multidirected Partiality to one person does not preclude demonstrating partiality to others

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Stages (CFT)

answer

Unit of treatment is chosen by therapist Engagement Cognitive exploration of family history Alter perceptions Expand trust to increase opinions

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Therapist Stance (CFT)

answer

Active Personal Co-therapy Relational balances Catalyst Advocate for all

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Methods (CFT)

answer

Multidirectional partiality Listening Observing Responding to unconscious material Therapist decides whom to see Couple therapy is not separate modality

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Assessment (CFT)

answer

Focus on family resources Observations made on all 4dimensions Assessment is an ongoing process Developmental stage and interpersonal loyalties lead to beliefs Triangles assessed

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Object Relations Major Theorist

answer

Melaine Klein Ronald Fairbairn H.V. Dicks Donald Winnicott David & Jill Scharff David Schnarch Judith Siegel

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Object Relations Family Therapy

answer

Emphasizes relationships and attachment vs. libidinal and aggressive drives

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Object Relations Theory

answer

can be defined as internalized images of self and others based on early parent-child interactions which determines a person's mode of relationships to other people

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Object Relations Family TherapyGoal

answer

To provide a therapeutic environment in which family can understand and resolve unconscious issues that are problematic to current family functioning

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Object Relations Family Therapy Goals 2

answer

To achieve an integrated view of reality through accepting repressed and forgotten memories, Access latent meaning behind attitudes, motives and behavior

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Objects Relations Major Concepts

answer

Projection of internalized repressed ego objects, Internal objects introjected from early childhood experience, Interpersonal view of individual & family development, Negative aspects of internalized object, Current relating based upon expectations formed in early experience, Societal norms & values, unconscious forces and personal values, Unresolved family of origin issues, Splitting

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Object Relations Family Therapy Philosophy

answer

The word "object" refers to "internal object" which is a mental structure inside the ego The ego is a composite of "introjected experiences with significant others over the course of development

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Dysfunction (OR)

answer

Negative aspects of repressed, introjected early objects are projected onto the spouse or children

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How are problems maintained? (OR)

answer

Problems persist because families are involved in a process of unconscious collusion in perpetuating the projective identification process

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Change (OR)

answer

Insight is Required, Expression of repressed objects, Resolution of negative aspects of repressed objects, Individuation, Detachment from the "bad object", Integration of "good" and "bad" objects, Creation of balance and decrease need for splitting

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Stance (OR)

answer

Non-directive Observer Insight and understanding Monitors own transference as tool to evaluate clients intrapsychic system

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Stages (OR)

answer

Engagement Projective identification Confrontation Termination Often long term

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Methods (OR)

answer

Listening Observing Responding to unconscious material Interpreting Developing Insight

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Assessment (OR)

answer

Self-Report Family of Origin History Defensive system of the family Individuation Intrapsychic material

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Introject (OR)

answer

repressed memories of early caregivers that reflect reality and fantasy, these mental images influence views of self and other

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Splitting (OR)

answer

a basic coping mechanism to reduce anxiety by isolating and repressing undesirable features of the caregiver

question

Projective Identification (OR)

answer

unconscious process by which a partner or child assumes another person's undesirable internalized features negative aspects of self are denied and assigned to other

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Holding Environment (OR)

answer

a setting where clients feel protected and safe because the therapist permissively accepts any free associations or spontaneous interactions

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Boundaries (OR)

answer

the level of perceived differentiation between members in the couple or family

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Transference (OR)

answer

the clients emotional reactions are overlaid onto other family members or the therapists-these reactions reflect early family relations instead of current relationships

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Empathic Listening (OR)

answer

attention to detect the latent meaning behind speech or interactions; also conveys acceptance and understanding of the client

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Interpretation (OR)

answer

therapist offers subjective meaning or motive behind behavior, affect or opinions

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Countertransference (OR)

answer

the therapist's use of self or analysis of spontaneous reactions toward a client's transference process

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Experiential Family Therapy History

answer

Seminal First Generation Family Therapy Model, Peaked in the 1970's

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Experiential Family Therapy

answer

Emphasizes Immediate, Here and Now Experiences, Borrows from Individual and Group Therapies Psychodrama, Gestalt and Encounter Groups

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Treatment Foci (ExFT)

answer

Individual experiences and expression of feeling as necessary for the achievement of personal and family fulfillment

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Leading Figures (ExFT)

answer

Carl Whitaker Virginia Satir Fred and Bunny Duhl August Napier David Keith Leslie Greenberg Susan Johnson

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Major Concept (ExFT)

answer

Alienation, Battle for Structure, Battle for Initiative, Communication, Use of "Craziness", Creativity, Experiential, Family Reconstruction, Growth thru immediate share experience, Intergenerational themes, Self Worth

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Satir's Experiential Family Therapy

answer

Approach seeks to enhance the self-esteem of individuals in a family while concurrently affecting change in the interpersonal system

question

Models (ExFT)

answer

Communication Validation Model Conjoint Family Therapy Process Therapy Human Validation Process Model

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Satir's Philosophy

answer

Humans have innate growth tendency, All behavior is oriented toward growth including nontraditional behavior

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Satir's Philosophy 2

answer

Self is the CORE of the "Human Mandala" Growth and access to life experiences as occurring through eight aspects of the Mandala

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Manadla Or Holistic System

answer

Physical body, Intellect, Emotions, Five Senses, Social Needs, Nutritional Needs, Life Space Needs, Spiritual Needs

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Systems Perspective (ExFT)

answer

People and the social and organizational systems are viewed as holistic systems Rules have an impact on the effectiveness of family functioning by influencing roles, communication processes and responses to stress An awareness of the here and now allows for growth to occur in individual and family systems

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Satir Theoretical Tenets (ExFT)

answer

Self-Esteem, Assumptions, Communication, Rules of the Family

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Self-Esteem (ExFT)

answer

Refers to the meaning and value people associate with the whole of their personal mandala

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Individual Self-Esteem (ExFT)

answer

affects both individual behavior and the interactions among members of a system Relationship between communication and self-esteem e.g. low self esteem is associated with poor communication

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Family Self-Esteem (ExFT)

answer

Affects the way an individual feels about his or her involvement in the system

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Communication (ExFT)

answer

a major factor influencing relationships with others and ourselves, The way we communicate (send and receive information) is learned and can be unlearned

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Noncongruent Communication (ExFT)

answer

Distorted, incomplete communication involving assumptions or ambiguous double messages. Conflicting internal feelings arise as a result

question

Congruent Communication (ExFT)

answer

Straight, Direct Communication on both verbal and nonverbal levels Congruence involves using words that match feelings and experience. Double-Bind Messages are Avoided A congruent person is alert, balance and in touch with resources

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Incomplete Communication (ExFT)

answer

A statement that lacks details and may cause confusion or assumptions on the part of other members

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Assumptions (ExFT)

answer

Misinterpretation of meaning in the communication of others

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Ambiguous Communication (ExFT)

answer

mixed messages sent by one member that causes other members to make incorrect or inaccurate judgment regarding members' feelings.

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Double Messages (ExFT)

answer

When information conveyed by one family member can have several meanings for the other members resulting in unclear communication and confusion over intentions

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Roles of Family Members are Characterized by Five Communication Styles (ExFT)

answer

Blamer, Placator, Computer, Distractor, Leveler

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The Blamer (ExFT)

answer

engages in fault-finding, name calling and criticism

question

The Placator (ExFT)

answer

engages in apologetic, tentative, and self-effacing communication that is designed to please others

question

The Computer (ExFT)

answer

engages in extreme intellectualizing or overly rationale with a void of affective content

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The Distractor (ExFT)

answer

frequently produces irrelevant verbalizations that serve to focus attention away from the foci issue

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The Leveler (ExFT)

answer

engages in honest, direct, clear communication with affect that is congruent with the content of the message

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Rules of the Family (ExFT)

answer

The family members develop unwritten rules that govern the daily functioning of the family

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Family Rules (ExFT)

answer

informs you about the communication and emotional closeness of the family (Rigid Flexible)

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Healthy family function (ExFT)

answer

Clear communication in the family system, Effective roles Implementation of Family Rules Reasonable, Relevant and Flexible Rules

question

Dysfunction (ExFT)

answer

characteristics of a closed system-poor interchange of information and resources within and without the system that is maladaptive and rigid.

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Dysfunction 2 (ExFT)

answer

Families are unable to cope effectively because they have rules that are fixed, arbitrary and inconsistently applied Rules maintain the status quo and may serve to bolster parent self-esteem

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Dysfunction 3 (ExFT)

answer

Scapegoat provides relief from anxiety Difficulty in tolerating interpersonal stress Role and Communication rigidity Intolerance for differences Symptoms are nonverbal messages

question

Assessment & Diagnosis (ExFT)

answer

Assessment is simultaneous process with Therapy Symptoms are framed from a relational perspective Focus on what blocks or distorts growth

question

Assessment & Diagnosis 2 (ExFT)

answer

Asking Questions or Observing the Family Dynamics is the primary task of assessment Defining the major triadic relationships and uncovering roles, rules and communication process in the family is the second task

question

Assessment & Diagnosis 3 (ExFT)

answer

Examine the Relationship Messages Content Component of Communication Here and Now Focus

question

Stance of the Therapist (ExFT)

answer

Involved & Active Self-disclosing, warm, responsive, positive Consultant Alternating between provocation and support

question

Stance of the Therapist 2 (ExFT)

answer

Create comfortable threat-free environment in the sessions Structure the therapeutic process and set the rules for interaction to decrease threat and create a safe therapeutic environment Allay individual and family defenses by interpreting anger as hurt or by explaining the purpose of pain

question

Stance of the Therapist 3 (ExFT)

answer

Educate clients about their roles to increase self-control and accountability Complete gaps or interpret communication, particularly when incongruence exists between the content and the relationship messages Models effective communication

question

Goals of Treatment (ExFT)

answer

When Family Members can Complete Transactions, Check and Ask for Feedback

question

Goals of Treatment 2 (ExFT)

answer

Instill Hope and Encouragement in Family Members Is to Access, Enhance, and Create Coping Skills To Facilitate Growth-Oriented Movement in the Family

question

Goals of Treatment 3 (ExFT)

answer

Growth in family and members in terms of self-esteem and effective communication

question

Treatment Process (ExFT)

answer

Establish Trust Develop Awareness Through Experience Create new understandings in family members through the new or increased awareness of their family dynamics Have family members express and apply these new understandings through different behaviors during session Have family members use the new behaviors outside the therapeutic environment

question

Techniques (ExFT)

answer

Interventions are spontaneously out of observations and intuitions regarding the families in therapeutic moment

question

Techniques 2 (ExFT)

answer

Family Sculpting Family Maps Ropes Family Life Fact Chronology Drama Family Reconstruction Reframing

question

Techniques 3 (ExFT)

answer

Humor Verbalizing Presuppositions Denominalization Anchoring Multiple Family Therapy

question

Family Sculpting (ExFT)

answer

A family member or Therapist acting as "director" physically arranges the members of the family to represent the person's symbolic view of family relationships

question

Family Maps (ExFT)

answer

Visual representations, similar to genograms, are created of family structure over three generations

question

Drama (ExFT)

answer

Family members enact significant events in the family's history, providing an opportunity for new perspective and greater insight

question

Ropes (ExFT)

answer

The binds and pulls of ropes are used in the session to provide concrete representations of the dynamics in family system

question

Family Life Fact Chronology (ExFT)

answer

A holistic family history is made extending from the birth of the oldest grandparents to the present

question

Family Reconstruction (ExFT)

answer

Family Reconstruction involves enactment of events from the family history based on information derived from family life fact chronology or family maps

question

Reframing (ExFT)

answer

The therapist offers a reinterpretation of a situation to create a shift in the perceptions of family members

question

Humor (ExFT)

answer

Humor can be used to promote contact between the therapist and family as well as among family members to exaggerate a dynamic, etc.

question

Verbalizing Presuppositions (ExFT)

answer

The therapist overtly states presuppositions that are evident in a family's behavior

question

ex (ExFT)

answer

Satir would express hope and encouragement because family members are involved in therapy

question

Denominalization (ExFT)

answer

The therapist has a family member provide specific behavioral descriptions for words such as love and respect and discovers exactly what must be done for the person to perceive that he or she is receiving the behavior that is defined.

question

Anchoring (ExFT)

answer

The therapist helps family members learn to associate a specific stimulus (or response) with the response it predictably triggers. Feelings are raised to level of interpersonal physical experience

question

Multiple Family Therapy (ExFT)

answer

Numerous unrelated families are brought together for joining family sessions

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