MFT Study Guide – Gehart book – Flashcards
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The 3 levels of ethical rules are
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Laws Ethics Standard of Care
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Five principles of ethical practice
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Fidelity - keep promises & loyalty Justice - fairness Autonomy - clients make own decisions Beneficience - actively benefit clients NonMaleficence - avoid harm to clients or others
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The Bateson group of systems theory were (5)
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Bateson, Jackson, Haley, Fry & Weakland
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He was highly influential on brief and solution focused therapies
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Milton Erickson
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Fleshed out second-order cybernetics and the role of the observer on systems
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Bradford Keeney
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Behavioral, emotional and interactional norms that create dynamic stability for a system
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homeostasis
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A stable, predictable system is engaged in what kind of feedback?
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Negative feedback
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A changing system with new information coming in is engaged in what kind of feedback?
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positive feedback
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When a system returns to its previous homeostasis after positive feedback
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first-order change
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When a system restructures its homeostasis and its rules fundamentally shift
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second-order change
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The two elements of a communicated message are
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the report (content) and the command (usually nonverbal, defines relationship between speaker and listener)
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An intense relationship where one gives a conflicting message and the other can't escape responding to the mutually exclusive injunctions to act
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Double Bind
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A relationship where both sides have similar roles and responsibilities
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Symmetrical or Equal Relationship
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A relationship where each has a role that balances the other, often resulting in a hierarchy
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Complementary relationship (emotional/logical, pursuer/distancer, etc)
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How one knows, or the processing of knowing is called
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Epistemology (operating assumptions for cognitions and actions)
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Social Constructionist Theorists were
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Gergen, McNamee, Shotter, Foucault, Wittgenstein, Bakhtin
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Postmodern assumptions (6) are
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1. Subjective reality 2. reality constructed through language 3. reality negotiated in relationships 4.Shared meanings enable social action 5. Consider tradition, culture, oppression 6. humans are able to reflect on what they do
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Picking a theory is like
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dating and eventually marrying, then dancing with others once married
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Therapy that is brief, non-blaming, and focuses on small, indirect changes in family system to let family reorganize in response to the new changes
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MRI Systems Therapy
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When a categorization of an object person or event is recategorized to change someone's perspective
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Reframing
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Process of MRI Systems Therapy involves (6):
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- Problem is interactional, not individual - "problem" sequences were purposeful at one point - explore what has not worked to fix problem - identify pattern that sustains problem - interrupt sequence (not fix or correct it) - continue until problem resolves
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In MRI therapy, solutions that perpetuate the problem are called
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"More of the same" solutions
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in MRI Therapy, a common intervention used to break the problem sequence
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"less of the same" solutions (180 shifts from "more of the same" solutions, not as a literal solution, but to break the pattern and let family reorganize)
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In MRI therapy, unwanted side effects of improved functioning are called
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Dangers of Improvement (no more fighting makes couple feel they are passion-less)
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Strategic Theorists are (4)
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Haley, Madanes, Bobrow & Keim
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Concepts of Strategic Therapy are (5)
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-problems are voluntary (clients choose them); -symptomatic people have cultivated power by receiving special care, making demands, get away with things etc; -symptomatic behaviors can be metaphors for deeper problems in the system; -problem may be a demand for change in heirarchy (child tantrum puts child on top); -problems can be made from love/concern or bid for power
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Strategic has five main interventions:
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Direct interventions paradoxical interventions Metaphorical tasks (indirectly address issue in metaphor) Pretend techniques (fake it til you make it) Ordeal therapy (make the symptom harder than not doing it)
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This theory was an attempt to put Bateson's cybernetics into practice
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Milan Systemic Therapy
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Milan Systemic is functionally different from MRI and Strategic because..
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its interventions are language-oriented instead of action oriented.
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The 5 examples of circular questioning in Milan Systemic Therapy are:
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Behavior sequence (then what does mom do? dad?) Behavior difference (is that different from how X does) Comparison & Ranking (most affected, least concerned) Before and After (how did event change things) Hypothetical Circular (if X happened, who would...) .
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The Milan team consisted of:
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Palazzoli (founder), Cecchin, Boscolo & Prata
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Four main concepts of Milan Systemic are:
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NEUTRALITY of therapist CURIOSITY to multiple meanings & patterns IRREVERENCE (unpanicked approach to "big problems") Unavoidable INFLUENCE of therapist
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Kinds of Systemic Therapies include (3)
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MRI Systemic Milan Systemic Strategic
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The two main contributions of Structural Family Therapy are
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Boundaries (normal, diffuse, rigid) & Enactments (in-office arguments instead of talking about arguments)
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The founders of Structural were (3): (think Mick)
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Minuchin, Aponte, Lindblad-Goldberg
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Main concepts of Structural are (6)
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Role of symptom in family Subsystems Cross-generational coalitions Boundaries Hierarchy Complementarity (over/underfunctioner, etc.)
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Ecosystemtic Structural Family Therapy is what?
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Came from Structural, empirically supported, made by Marion Lindblad-Goldberg. Used with severe problems in children, addresses parent, child and outside support - Like what you did with anxious family.
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The 4 kinds of Experiential Therapy are
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Satir Growth Model Symbolic-Experiential Emotion-Focused Internal Family Systems
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What was the main contribution of the Satir Growth Model?
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Communication Stances (Placator, Blamer, Super-Reasonable, Irrelevant)
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The 4 assumptions of the Satir Growth Model are:
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1. People tend toward positive growth 2. Everyone has the resources for positive growth 3. Everyone and everything impacts everyone and everything 4. Therapy is the interaction between therapist & client, and each person responsible for themselves
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Who developed Symbolic-Experiential? ("therapy of the absurd")
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Carl Whitaker
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The "Battle for Structure" and "Battle for Initiative" came from which mode of therapy?
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Symbolic-Experiential (Whitaker)
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"Therapy of the Absurd" is what kind?
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Symbolic-Experiential (Whitaker) - absurd to perturb the system in a caring way. Playfulness & paradox.
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Symbolic Experiential is focused primarily on what 2 factors?
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1. The structural organization and patterns of the family 2. The emotional processes and exchanges
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For a symbolic-experiential therapist, what are the 3 long-term goals for families?
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1. Increase family COHESION 2. Promote personal GROWTH 3. EXPAND family's symbolic world (e.g. an identity of success might include healthy relationships not just lots of money)
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Symbolic Experiential interventions include (8):
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Perturb system; Here-and-now experiencing; Redefining symptoms as attempts at growth; separate interpersonal and personal distress; confront rigid roles; Amplify despair/pessimism; Absurd fantasy alternatives; reinforce parental hierarchy
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Internal Family Systems theory was started by who?
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Richard Schwartz
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The main concept of Internal Family Systems is:
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The system inside the individual, consisting of a healthy core self and numerous parts
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Examining "therapist's parts" is part of what theory?
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Internal Family Systems
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What are the "parts" in Internal Family Systems?
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The Self; Exiles; Managers & Firefighters
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The concept of Self-Leadership comes from which approach?
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Internal Family Systems
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What are the main contributions of Bowenian Theory? (2)
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Differentiation & Genograms
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What two concepts are involved in differentiation?
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Intrapersonal (respond not react) and Interpersonal (know where self ends and others begin)
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Who are main contributors to Bowenian Theory? (6)
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Bowen, Kerr, Guerin & Fogerty, McGoldrick, Schnarch
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What is most important about a Bowenian therapist's demeanor? (think anxiety)
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That they remain non-reactive, non-anxious. A calm center.
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The multigenerational transmission process is central to which theory?
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Bowenian Theory
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Emotional triangles are part of what theory?
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Bowenian
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Emotional cutoff is part of what theory?
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Bowenian
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What are the 2 main goals of Bowenian therapy? (think enmeshment and anxiety)
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Increase each person's differentiation Decrease emotional reactivity
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The "sexual crucible" was developed by whom?
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Schnarch (Bowenian)
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Who are main contributors to Psychoanalytic Family Therapy? (4)
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Ackerman, Boszormenyi-Nagy, Framo, Scharff & Scharff
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What is the main contribution of Psychoanalytic?
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Ethical systems and Relational Ethics (keeping track of fairness, entitlement & indebtedness)
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Transference & Countertransference are concerns of which theory?
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Psychoanalytic
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Main concepts of Psychoanalytic Family theory include (7):
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Interlocking pathologies, Self-Object Relations, Splitting (black & white), Projective Identification, Repression, Parental Interjects, Ledgers
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What are 4 main goals of Psychoanalytic Family Therapy?
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- increase autonomy and unconscious becoming conscious - Decrease projections or revolving entitlements (kicking the family dog) - Increase capacity for intimacy without fusion - reciprocal commitments with a fair ledger
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What has been the largest contribution of CBFT?
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Parenting training
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Who are some of the main contributors to CBFT? (5)
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Patterson & Forgatch, Jacobson & Christensen, Epstein, Gottman, Dattilio
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What are some defining features of CBFT? (6)
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Written contracts Present-day definable problems Tracking symptoms Shaping behaviors psychoeducation Homework
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Ellis's ABC theory is used in which kind of therapy?
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CBFT (activating event-->Belief about A --> emotional/behavioral consequence of B)
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What 3 marital myths are part of Gottman's approach?
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1. Communication training helps 2. Anger is dangerous/to be avoided 3. Quid Pro Quo (contingency contracts) are good for couples
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What are the 4 Horsemen of the Apocalypse?
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Criticism, Defensiveness, Contempt, Stonewalling
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What is the ratio of positive to negative interactions for healthy couples? (according to Gottman)
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5 to 1
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What makes up the Sound Relationship House?
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The 7 steps in Gottman's book (love maps, turning towards, admiration, etc.)
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What is considered the "third wave" of behavioral therapy?
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Mindfulness-based approaches
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What is so paradoxical and unique about mindfulness approaches?
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They coach *accepting* difficult or negative thoughts in order to change them. Clients are taught to relate to
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Who were the biggest contributor to creating Solution-Focused Brief therapies? (2)
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Steve de Shazer & Insoo Kim Berg
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What are 4 common myths about Solution Focused therapy?
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- SF therapists propose solutions - SF therapists never talk about problems - ST therapists never talk about the past - Emotions are not discussed
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The most significant contribution of solution-focused therapies is:
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Assessing & focusing on clients' strengths
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Who created Solution-Oriented therapy? (1)
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Bill O'Hanlon
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What is the overall purpose or driving force of solution-focused therapies?
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Making small steps to enact solutions
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From which therapy approach does the cocept of "beginner's mind" come form?
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Solution-focused therapies ("In the beginner's mind there are many possibilities; in the expert's mind there are few")
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How does Solution-focused therapists use language as intervention?
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Point out exceptions via the words clients and therapist use (past tense instead of chronic, partial instead of always, perception rather than objective truth)
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Optimism and hope are most central to which mode of therapy?
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Solution-focused therapies
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What are hallmark techniques of solution-focused therapies? (4)
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Strengths & Resources Looking for exceptions Miracle Questions Small Steps with scaling questions
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Who developed Collaborative Therapy? (2)
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Harlene Anderson & Harry Goolishian
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Who developed Narrative Therapy
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Michael White & David Epston
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From which therapy does the approach of "not knowing" come?
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Collaborative Therapy
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What does the concept of "not knowing" mean?
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Approaching each client's situation as entirely unique and with the curiosity of meeting something totally new (e.g. "depressed" people each have widely different experiences and expressions of their depression, and it causes different difficulties for each)
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The main thing Collaborative therapists try to avoid is:
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Dueling Monologues (each person defending their position without listening to the other) which creates therapeutic impasse. (which leads many therapists to label clients as "resistant")
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Why is Collaborative therapy hard to "pin down"?
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It focuses on the process of therapy more than having specific interventions; it posits that dialogical conversations themselves inevitably lead to change. (Very similar to Symbolic Interactionism)
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What is the most significant contribution of Narrative Therapy?
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The concept of "Dominant discourses" from broader society, which color our foundational meanings. Vs "Local discourses" which occur in our heads, close relationships, and subcultural communities (not mainstream/dominant culture)
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What are main techniques of Narrative Therapy? (3)
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Separating the person from the problem (externalizing problem and fleshing out the person) Enacting preferred narratives instead Having preferred narratives witnessed by significant others
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How does one "thicken descriptions" according to Narrative Therapy?
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In addition to the problem-focused details clients focus on in their story, therapists start to add in preferred details to flesh out their story in a more positive, varied way. (combating confirmation bias)
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What was the most significant contribution of Emotionally Focused Therapy?
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Applying attachment theories to adults and adult love: humans need secure intimate attachments *across the lifespan.*
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Who were the developers of Emotionally Focused Therapy? (2)
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Sue Johnson & Les Greenberg
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What are the 3 stages of Emotionally Focused Therapy?
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1. De-escalation of Negative Cycles 2. Promote understanding of partner, acceptance of partner's experience and direct expression of needs 3. New solutions to old problems, solidify new patterns
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Primary and Secondary emotions are a focus of which kind of therapy?
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Emotionally Focused therapy (helplessness, fear of abandonment, etc. VS anger, withdrawal, etc.)
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Attachment injuries are part of which therapy?
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Emotionally focused therapy (betrayal, abandonment or violation of trust in a relationship)
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Functional Family Therapy is empirically validated for which kinds of problems? (2)
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Conduct disorder and delinquency
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In Functional Family Therapy, all behavior is viewed as adaptive, attempts to achieve two functions:
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1. BALANCE closeness and independence in the family system 2. Define who has INFLUENCE and CONTROL
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The job of the therapist in Functional Family Therapy is:
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To identify how the behaviors maintain connection/independence and define hierarchy, then find more adaptive ways to do the same.
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The main contribution of Functional Family Therapy is:
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The best way to treat troubled youth is through a multisystemic focus (incl. community & peers) with the *family*, not just the individual youth.
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The main developers of Functional Family Therapy are: (3) (A, P & S)
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Alexander, Parsons & Sexton
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What are the main contributions/differences of Milan, MRI and Strategic?
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Milan: circular questions, change family epistemology MRI: systemic reframing (introduce alternative perspectives) Strategic: perturbing directives/homework
