Record Sheet
GIVE CLOSE EXAMINATION TO THEIR LANGUAGE AND YOURS A Vague statements
B. Unspecified verbs : “He ruined the relationship” (how, what way?). “I am scared” (of what) C. Specify comparison: “He is lazy” (compared to whom)
D. Empty nouns: respect, love, anger, depression E. Generalization: all, none, always, never F. Cannot/will not vs. doesn’t /did not
G. Characterizations lazy, aggressive
H. Challenge claims: “How do you know you feel depressed”
• COMMUNICATION SKILL-BUILDING TECHNIQUES
More often than not, it's a family's communication patterns and styles that lead to conflict and division.
Communication patterns and processes are often major factors in preventing healthy family functioning. Faulty communication methods and systems are readily observed within one or two family sessions. A variety of techniques can be implemented to focus directly on communication skill building between a couple or between family members.
Communication techniques are used to build skills that allow for effective communication between family members.Listening techniques including restatement of content, reflection of feelings, taking turns expressing feelings, and nonjudgmental brainstorming are some of the methods utilized in communication skill building.
REFLECTING involves having a member express her feelings and concerns, then having another member repeat
back what he heard that person say.
REPEATING techniques involves having a member state how he feels, while another member repeats back what
was said. Repeating and reflecting techniques allow members to better understand where the other is coming from and why she feels as she does.
FAIR FIGHTING TECHNIQUES focus on attentive listening and expressing feelings and concerns in a
nonthreatening manner.
• CONCLUSION
The techniques suggested here are examples from those that family therapists practice. Counsellors will customize them according to presenting problems. With the focus on healthy family functioning, therapists cannot allow themselves to be limited to a prescribed operational procedure, a rigid set of techniques or set of hypotheses. Therefore, creative judgment and personalization of application are encouraged.
•
CONFIRMATION OF A FAMILY MEMBER:
Using an affective word to reflect an expressed or unexpressed feeling of that family member. The therapist can join families from different positions of proximity.In the close position of proximity, he can affiliate with family members, perhaps even entering into coalition with some members against others.
Probably the most useful tool of affiliation is confirmation.
The therapist validates the reality of the family member(s) he joins. He searches out positives and makes a point of recognizing and awarding hem.
• DETRIANGULATION
The process by which an individual removes himself or herself from the motional field of two others.
(triangulation is: Detouring conflict between two people by involving a third person, stabilizing the relationship between the original pair.)
• DIAGNOSING
Diagnosing is done early in the therapeutic process. The goal is to describe the systematic interrelationships of all family members to see what needs to be changed or modified for the family to improve. By diagnosing interactions, therapists become proactive, instead of reactive.
• DIFFERENTIATION OF SELF
Psychological separation of intellect and emotions and independence of self from others; opposite of fusion. (Fusion is a blurring of psychological boundaries between self and others and a contamination of emotional and intellectual functioning; opposite of differentiation.)
• DISEQUILIBRIUM TECHNIQUES
The following techniques are used to create a different perception of reality.
REFRAMING: The technique of reframing is a process in which a perception is changed by explaining a situation in terms of a different context. For example, the therapist can reframe a disruptive behaviour as being naughty instead of incorrigible allowing family members to modify their attitudes toward the individual and even help him or her makes changes.
PUNCTUATION: Punctuation is “the selective description of a transaction in accordance with a therapist’s goals”. Therefore it is verbalizing appropriate behaviour when it happens.
UNBALANCING: This is a procedure wherein the therapist supports an individual or subsystem against the rest of the family. When this technique is used to support an underdog in the family system, a chance for change within the total hierarchical relationship is fostered.
• EMOTIONAL CUT-OFF
Bowen's term for flight from an unresolved emotional attachment
• THE EMPTY CHAIR
The empty chair technique, most often utilized by Gestalt therapists (Perls, Hefferline, & Goodman, 1985), has been adapted to family therapy. In one scenario, a partner may express his or her feelings to a spouse (empty chair), then play the role of the spouse and carry on a dialogue. Expressions to absent family, parents, and children can be arranged through utilizing this technique.
• ENACTMENT
The process of enactment consists of families bringing problematic behavioural sequences into treatment by showing them to the therapist a demonstrative transaction. This method is to help family members to gain control over behaviours they insist are beyond their control. The result is that family members experience their own transactions with heightened awareness. In examining their roles, members often adapt new, more functional ways of acting.
• FAMILY CHOREOGRAPHY
In family choreography, arrangements go beyond initial sculpting; family members are asked to position themselves as to how they see the family and then to show how they would like the family situation to be. Family members may be asked to reenact a family scene and possibly resculpt it to a preferred scenario. This technique can help a stuck family and create a lively situation
• FAMILY COUNCIL MEETINGS
Family council meetings are organized to provide specific times for the family to meet and share with one another. The therapist might prescribe council meetings as homework, in which case a time is set and rules are outlined. The council should encompass the entire family, and any absent members would have to abide by decisions. The agenda may include any concerns of the family. Attacking others during this time is not acceptable. Family council
meetings help provide structure for the family, encourage full family participation, and facilitate communication.
• FAMILY FLOOR PLAN
The family floor plan technique has several variations. Parents might be asked to draw the family floor plan for the family of origin. Information across generations is therefore gathered in a nonthreatening manner. Points of discussion bring out meaningful issues related to one's past.
Another adaptation of this technique is to have members draw the floor plan for their nuclear family. The importance of space and territory is often inferred as a result of the family floor plan. Levels of comfort between family members, space accommodations, and rules are often revealed. Indications of differentiation, operating family triangles, and subsystems often become evident. Used early in therapy, this technique can serve as an excellent diagnostic tool (Coppersmith, 1980).
• FAMILY LIFE CYCLE
Stages of family life from separation from one's parents to marriage, laving children, growing older, retirement, and, finally, death.
Jjust like an individual, a family has developmental tasks and key (second-order) transitions like leaving home, joining of families through marriage, families with young children (the key milestone, and one that initiates vertical realignment), families with adolescents, launching children and moving on, families in later life. Key question: "How well did the family do on its last assignment?" Horizontal stressors are those involving these transitional assignments; vertical stressors are transmitted mainly via multigenerational triangling. Symptoms tend to occur when horizontal and vertical stressors intersect. Divorce adds extra developmental steps for all involved families. Carter and mcgoldrick elaborated the family life cycle
a. Leaving home
b. Joining of families through marriage c. Families with young children
d. Adolescence
e. Launching children and moving on f. Families in later life
• FAMILY PHOTOS
The family photos technique has the potential to provide a wealth of information about past and present functioning. One use of family photos is to go through the family album together. Verbal and nonverbal responses to pictures and events are often quite revealing. Adaptations of this method include asking members to bring in significant family photos and discuss reasons for bringing them, and locating pictures that represent past generations. Through discussion of photos, the therapist often more clearly sees family relationships, rituals, structure, roles, and
communication patterns.
• FAMILY SCULPTING
Developed by Duhl, Kantor, and Duhl (1973), family sculpting provides for recreation of the family system, representing family members relationships to one another at a specific period of time. The family therapist can use sculpting at any time in therapy by asking family members to physically arrange the family. Adolescents often make good family sculptors as they are provided with a chance to nonverbally communicate thoughts and feelings about the family. Family sculpting is a sound diagnostic tool and provides the opportunity for future therapeutic
interventions.
An activity in which family members place themselves in postures symbolic of the family dynamics. Satir placed people in position herself to activate right-brain experiencing.
• FAMILY SYSTEM STRATEGIES
A family operates like a system in that each member's role contributes to the patterns of behaviour that make the system what it is. Certain therapy techniques are designed to reveal the patterns that make a family function the way it does. The tracking technique is a recording process where the therapist keeps notes on how situations develop within the family system. Interventions used to address family problems can be designed based on the patterns uncovered by this technique. Family sculpting is another technique that's used to realign relationship patterns within the group. Members are asked to physically arrange where they want each member to be in relation to the others. This technique provides insight into relationship conflicts within the family.
• FRAMING QUESTIONS
Questions asked can elicit information about strengths, abilities, and resources. Perceptions of problems then change significantly in this context.
1. THE MIRACLE QUESTION: Suppose that one night, while you were asleep, there was a miracle and this problem was solved. How would you know? What would be different?
This type of question seems to make a problem-free future more real and therefore more likely to occur. The therapist gives guidelines and information to help the client go directly to a more satisfactory future. 2. FAST-FORWARDING QUESTIONS can be used when clients can’t identify exceptions or past solutions. Clients are asked to envision a future without the problem and describe what that looks like. (The miracle question or a magic wand question). => “What will not would be different?”
3. THE EXCEPTION QUESTION: Asks the client to focus on times when problem does not occur or has not occurred when they expected it would. They may discover solutions they had forgotten or not noticed. The therapist might find clues on which to build future solutions.
Example: “What is different about those times when things are working?”
• THE GENOGRAM
One of the best ways to begin therapy and to gain understanding of how the emotional system operates in your family system is to put together your family genogram. Studying your own patterns of behaviour, and how they relate to those of your multigenerational family, reveals new and more effective options for solving problems and for changing your response to the automatic role you are expected to play.
The genogram, a technique often used early in family therapy, provides a graphic picture of the family history. The genogram reveals the family's basic structure and demographics. (McGoldrick & Gerson, 1985). Through symbols, it offers a picture of three generations. Names, dates of marriage, divorce, death, and other relevant facts are included in the genogram. It provides an enormous amount of data and insight for the therapist and family members early in therapy. As an informational and diagnostic tool, the genogram is developed by the therapist in conjunction with the family.
• GOAL SETTING
Start small — “What will be the first sign that things are moving in the right direction?” Goals must be concrete.
• IDENTIFICATION
Family therapy techniques are used with individuals and families to address the issues that effect the health of the family system. The techniques used will depend on what issues are causing the most problems for a family and on how well the family has learned to handle these issues. Strategic techniques are designed for specific purposes within the treatment process. Background information, family structuring and communication patterns are some of the areas addressed through these methods.
• INFORMATION-GATHERING TECHNIQUES
At the start of therapy, information regarding the family's background and relationship dynamics is needed to identify potential issues and problems.
• The genogram is a technique used to create a family history, or geneology. Both the family and therapist work to create this diagram.
• Having family members bring in meaningful family photos is also a technique used to gather information as to how each member perceives the others.
• One other technique involves having family members draw up floor plans of their home. This exercise provides information on territorial issues, rules, and comfort zones between different members.
• INTENSITY
Intensity is the structural method of changing maladaptive transactions by using strong affect, repeated intervention, or prolonged pressure. Intensity works best if done in a direct, unapologetic manner that is goal specific.
• INTERVENTION TECHNIQUES
Intervention techniques are directives given by the therapist to guide a family's interactions towards more productive outcomes. Reframing is a method used to recast a particular conflict or situation in a less threatening light. A father who constantly pressures his son regarding his grades may be seen as a threatening figure by the son. Reframing this conflict would involve focusing on the father's concern for his son's future and helping the son to "hear" his father's concern instead of constant demands for improvement. Another technique has the therapist placing a particular conflict or situation under the family's control. What this means is, instead of a problem controlling how the family acts, the family controls how the problem is handled. This requires the therapist to give specific directives as to how long members are to discuss the problem, who they discuss it with, and how long these discussions should last. As members carry out these directives, they begin to develop a sense of control over the problem, which helps them to better deal with it effectively.
• JOINING
This is the process of coupling that occurs between the therapist and the family, leading to the development of therapeutic system. In this process the therapist allies with family members by expressing interest in understanding them as individuals and working with and for them. Joining is considered one of the most important prerequisites to restructuring. It is a contextual process that is continuous. There are four ways of joining in structural family therapy.
• Tracking: In tracking, the therapist follows the content of the family that is the facts. Getting information through using open-ended questions. Tracking is best exemplified when the therapist gives a family feedback on what he or she has observed or heard.
• Mimesis: The therapist becomes like the family in the manner or content of their communications.
• Confirmation of a family member: Using an affective word to reflect an expressed or unexpressed feeling of that family member.
• PARADOXICAL INJUNCTIONS
A paradox is an apparently sound argument which leads to a contradiction. It is used to motivate family members to search or alternatives. Family members may defy the therapists and become better or they may explore reasons why their behaviours are as they are and make changes in the ways members interact.
• PRAGMATIC FICTIONS
Formal expressions of opinion to help families and their members change.
• PRESCRIBING INDECISION
The stress level of couples and families often is exacerbated by a faulty decision-making process. Decisions not made in these cases become problematic in themselves. When straightforward interventions fail, paradoxical interventions often can produce change or relieve symptoms of stress. Such is the case with prescribing indecision. The indecisive behaviour is reframed as an example of caring or taking appropriate time on important matters affecting the family. A directive is given to not rush into anything or make hasty decisions. The couple is to follow this directive to the letter.
• PROBLEM SOLVING TECHNIQUES
1. Dissolve the idea that there is a problem: Help people see their situations in new ways. 2. Negotiate a solvable problem: Reduce the size of the problem in the client’s eyes. (Get specific about the problem; focus on when it is not so serious a problem).
3. Frame towards the idea that clients have all the abilities and resources to solve the problem: Create an atmosphere that facilitates the realization of strengths and abilities.
• PUNCTUATION
Punctuation is “the selective description of a transaction in accordance with a therapist’s goals”. Therefore it is verbalizing appropriate behaviour when it happens.
Punctuation: thinking that you cause what I say.
• PUTTING CLIENT IN CONTROL OF THE SYMPTOM
This technique, widely used by strategic family therapists, attempts to place control in the hands of the individual or system. The therapist may recommend, for example, the continuation of a symptom such as anxiety or worry. Specific directives are given as to when, where, and with whom, and for what amount of time one should do these things. As the client follows this paradoxical directive, a sense of control over the symptom often develops, resulting in subsequent change.
• REFRAMING
Most family therapists use reframing as a method to both join with the family and offer a different perspective on presenting problems. Specifically, reframing involves taking something out of its logical class and placing it in another category (Sherman & Fredman, 1986). For example, a mother's repeated questioning of her daughter's behaviour after a date can be seen as genuine caring and concern rather than that of a nontrusting parent. Through reframing, a negative often can be reframed into a positive.
The technique of reframing is a process in which a perception is changed by explaining a situation in terms of a different context. For example, the therapist can reframe a disruptive behaviour as being naughty instead of incorrigible allowing family members to modify their attitudes toward the individual and even help him or her makes changes.
• REFRAMING PROBLEM DEFINITIONS
Solution Oriented therapists offer new, more workable problem definitions that are within the power of the client and therapist to solve. They usually help the client reframe the problem definition to a more positive one or listen for a hint of something in the client’s complaint that can be solved. This co-creates the experience that the problem is solvable and the client has some ability to solve it.
• RESTRUCTURING
The procedure of restructuring is at the heart of the structural approach. The goal is to make the family more functional by altering the existing hierarchy and interaction patterns so that problems are not maintained. It is accomplished through the use of enactment, unbalancing, and boundary formation.
• SHAPING COMPETENCE
The family therapists help families and individuals in becoming more functional by highlighting positive behaviours.
• SPECIAL DAYS, MINI-VACATIONS, SPECIAL OUTINGS
Couples and families that are stuck frequently exhibit predictable behaviour cycles. Boredom is present, and family members take little time with each other. In such cases, family members feel unappreciated and taken for granted. "Caring Days" can be set aside when couples are asked to show caring for each other. Specific times for caring can