Family Systems Therapy
C6436 Individual Counseling
Theory and Practice
James J. Messina, Ph.D.
Family Therapists Leaders
Alfred Adler-Rudolf Driekurs-open forum Child Guidance
Clinics
Murray Bowen-Multigenerational Model-Triangulation,
Differentiation of Self
Virginia Satir-Conjoint Family Therapy-Human
Validation, Relational Family Therapy
Carl Whitaker-Experiential Symbolic Family Therapy-
therapist coach influences change
Salvador Minuchin-Structural Family Therapy-create
structural change
Jay Haley-Strategic Family Therapy-solves problems
now
Cloe Madanes- Wife Haley-Strategic Family Therapy
The Family Systems Perspective
Individuals ~ are best understood through
assessing the interactions within an entire family
Symptoms ~ are viewed as an expression of a
dysfunction within a family
Problematic behaviors ~
Serve a purpose for the family
Are a function of the family’s inability to operate
productively
Are symptomatic patterns handed down across
generations
A family ~ is an interactional unit and a change
)
in one member effects all members
Difference between Systemic &
Individual Therapy models
Individual Therapist Systemic Therapist
Obtain accurate diagnosis Explore System for family
DSM IV process & rules
Begin Therapy right now Invite in parents, siblings
Focus: causes, purposes, Focus: family relationships
processes
Concern with individual Concern transgenerational
experience & perspective meanings, rules
Intervene to help individual Intervene to change context
learn to cope within family system
Beliefs of Family Therapists
Individual’s affiliations & interactions have
more power in person’s life than a single
therapist could ever hope to have
Working with family or community
therapists sees how individual acts and
serves needs of these systems
Seeing individual in active in a systems
assists in developing types of
interventions needed
Systemic Perspective
Individual may carry a symptom for the entire
family
Individual’s functioning is a manifestation of way
family functions
Individual can have symptom existing
independent of family structure
Symptoms always have ramifications for family
members
Change the systems and individuals will change
Change dysfunctional patterns of relating &
create functional ways of interacting & relating
Adlerian Family Therapy Outline
1. Key Concepts
2. Therapy Goals
3. Therapist’s functions
Adlerian Family Therapy Key
Concepts
Adlerians use an educational model to counsel
families
Emphasis is on family atmosphere and family
constellation
Therapists function as collaborators who seek to
join the family
Parent interviews yield hunches about the
purposes underlying children’s misbehavior
Family Atmosphere
Unique: conjunction of all the family forces-
climate of relationships that exist between
people
Family is a system & each member exerts
influence on every other member
Autocratic or permissive common in West
Parent role model of how genders relate, how to
work, participate in world
Emotional role models for children as well
Family value: value all members support &
cannot be ignored: religion, education, money
achievement, right and wrong
Family Constellation
Consists of parents, children, extended
family members
Birth order
How member find place in family system &
how relate to one another to be unique
Alignment of family members
Develop genogram of family-starting point
for client communication meaning of life
Role of Birth Order
Motivates later behavior:
First-born: favored, only, pseudo-parent-
high achievers
Second-born: rivalry & competition
Last-born: more pampered,
“baby”-creative, rebellious, revolutionary,
avant-garde
Birth Order
Adler’s five psychological positions:
Oldest child ~ receives more attention, spoiled,
center of attention
Second of only two ~ behaves as if in a race, often
opposite to first child
Middle ~ often feels squeezed out
Youngest ~ the baby
Only ~ does not learn to share or cooperate with
other children, learns to deal with adults
Mistaken Goals: Interactional
View
Four goals for children’s behaviors:
Attention getting
Power struggle
Revenge
Demonstration of inadequacy
Short hand explanations, descriptions of
consistent patterns
Describe child’s misbehavior
Parent’s reaction to behavior
Child’s reaction to parents’ attempt to discipline
Mistaken Goal: recognition flex –smile, twinkle
Goal recognition and disclosure
Adlerian Family Therapy Goals
Unlock mistaken goals and interactional patterns
Engage parents in a learning experience and a
collaborative assessment
Emphasis is on the family’s motivational
patterns
Main aim is to initiate a reorientation of the
family
Assist family member to have Social Equality-
the sense that everyone has an equal right to be
valued and respected in the family
Adlerian Therapist Functioning
Open forum
Parent Interview alone they are leaders
Problem Description parents concerns
Goal Identification What did you do about it?
Typical Day repeated patterns of interaction
Child Interview
Goal Disclosure Do you know why you do…
Posit tentative goals: Could it be that…
Concluding Remarks to generate new
approaches to end mistaken interactions to lead
to more democratic, harmonious, effective living
Multigenerational Family Therapy
Outline-Murray Bowen
1. Key Concepts
2. Therapy Goals
3. Therapist’s functions
Multigenerational Family Therapy
Murray Bowen 8 Key Concepts
The application of rational thinking to
emotionally saturated systems. A well-
articulated theory is considered to be essential
2. Differentiation of the self
3. Triangulation
4. Nuclear Family Emotional System
5. Family Projection Process
6. Emotional cutoff
7. Multigenerational transmission process
8. Sibling position
9. Societal regression
Differentiation of the self
A psychological separation of intellect & emotion
& independence of self from others
Differentiated =Being able to be guided by
thoughts or emotions – separateness
Undifferentiated=difficulty separating self from
others-fuse with dominant family emotional
patterns-physical but not emotional leaving
Unproductive family dynamics of previous
generation transmitted by marriage of
undifferentiated individuals
Need for self-identify while still belonging to
one’s family
Triangulation
A third party is recruited to reduce anxiety and
stabilize a couple’s relationship
Underlying conflict not addressed & worsens
Once the 3rd person is resolved the balance
achieved is off again
Change in one part of family system affects the
whole system
Therapist must be highly differentiated so as not
to get caught up in triangulation with couple
Multigenerational Family Therapy
Goals
With the proper knowledge the individual can
change
Change occurs only with other family members
To change the individuals within the context of
the system
To end generation-to-generation transmission of
problems by resolving emotional attachments
To lessen anxiety and relieve symptoms
To increase the individual member’s level of
differentiation
Multigenerational Family Therapy
Therapist Functioning
Genogram work: look at family over three
generations
Look for critical turning points in family emotional
process
Characteristics of family members
Evolutional picture of family: tools for assessment
Asking Questions: What role did you play with
that person in the family? Looking for fusion
within the family.
Conjoint Family Therapy Outline
1. Key Concepts
2. Therapy Goals
3. Therapist’s functions
Conjoint Family Therapy Key
Concepts-Virginia Satir
Enhancement and validation of self-
esteem-Human Validation Process Model
Family rules
Congruence and openness in
communications
Sculpting
Nurturing triads
Family mapping and chronologies
Conjoint Family Therapy Goals
Open communications
Individuals are allowed to honestly report their
perceptions
Enhancement of self-esteem
Family decisions are based on individual needs
Encouragement of growth
Differences are acknowledged and seen as
opportunities for growth
Transform extreme rules into useful and
functional rules
Families have many spoken and unspoken rules
Family Life
Children enter pre-existing systems which have
rules
Rules about living & interaction
Rules governing Communications-who says
what under what conditions
Rules spoken and unspoken: shoulds and
should nots
Rules become absolutes & often are impossible:
Never be angry with your father. Always keep a
smile on your face
As child accept rules for survival which are not
useful as adult
Functional vs. Dysfunctional
Communications
Functional: each family member give chance to
be individual, separate life – lots of freedom and
flexibility in family with open communications
Dysfunctional: closed communications, poor
self-esteem of parents, rigid patterns-resists
awareness, strained relationships, little
individuality, incapable of autonomy or genuine
intimacy: Family members: think, feel and act
the same way: family controlled by fear,
punishment, guilt or dominance
Defensive Stances in Coping with
Stress
1. Placating-enabler, people pleaser,
rescuer
2. Blaming-troubled person
3. Super-responsible-looking good
4. Irrelevant behavior-distracting- acting
out, entertainer
Family Roles and Family Triads
Roles played in family based on one’s behavior
Victim
Keeping the Peace
Stern Taskmaster
Disciplinarian
Hard-working caregiver
Nurturing Triad two parents and child where
child is nurtured
Conjoint Family Therapy Goals
Communicating Clearly
Expanding awareness
Enhancing potentials for growth in self-esteem
Coping with demands & process of change
Identify new possibilities to the status quo
Encouraging growth in each member
Generating hope, courage to formulate new
options
Assess, strengthen, enhance coping skills
Encourage members to exercise healthy options
Therapist Functions
Focus on emotional honesty, congruence,
systemic understanding
Family sculpting: position family members
by roles they play in family
Family reconstruction: psychodramtic
reenactment significant event in 3
generations of family-unlock dysfunctional
patterns stem from family of origin
Experiential Family Therapy
Outline-Carl Whitaker
1. Key Concepts
2. Therapy Goals
3. Therapist’s functions
4. Techniques
Experiential Family Therapy –
Carl Whitaker
A freewheeling, intuitive, sometimes outrageous
approach aiming to:
Unmask pretense, create new meaning, and liberate
family members to be themselves
Techniques are secondary to the therapeutic
relationship
Pragmatic and atheoretical
Interventions create turmoil and intensify what is
going on here and now in the family
Experiential Family Therapy Key
Concepts
Subjective Focus: subjective needs of the
family members
Assumption all family members have a
right to be themselves
Needs of family may be suppressing rights
of the individual
Goal for authenticity, no right or wrong
way to be
Atheoretical Stance
Pragmatic stance
Theory can be hindrance to clinical work
Often times theory is way for therapist to create
distance from clients and control anxiety of the
therapist to hide behind
Intensify present experiencing of family
members to reach unconscious to understand
what is really going on in the family
Process to help tap into: Family secrets just
keeping the secrets keeps the family crazy
Experiential Family Therapy
Goals
Facilitate individual autonomy and a sense of
belonging in the family
Help individuals achieve more intimacy by
increasing their awareness and their
experiencing
Encourage members to be themselves by freely
expressing what they are thinking and feeling
Support spontaneity, creativity, the ability to
play, and the willingness to be “crazy”
Therapist Function in Experiential
Family Therapy
Create family turmoil
Coach family how to get out of the turmoil
Highly involved therapist model: must be
transparent, take risks, get involved with family
in the sessions
Help family member experience the here and
now by therapist “BEING WITH” the family
Three phases: engagement (all powerful),
involvement (dominant parent figure, adviser) &
disentanglement (more personal, less involved)
Structural Family Therapy Outline
- Salvador Minuchin
1. Key Concepts
2. Therapy Goals
3. Therapist’s functions
Structural Family Therapy -
Salvador Minuchin
Focus is on family interactions to understand the
structure, or organization of the family
Symptoms are a by-product of structural failings
Structural changes must occur in a family before
an individual’s symptoms can be reduced
Techniques are active, directive, and well
thought-out
Focus on the how, when, and to whom family
members relate
Key Concepts Structural Family
Therapy of Salvador Minuchin
Family Structure: invisible set of functional
demands or rules that organize way family
members relate to one another-
Observe family to see the structure:
who says what to whom,
in what way,
with what result
Family Subsystems
Spousal: wife & husband
Parental: mother & father
Sibling: children
Extended: grandparents, other relatives
Family member play a different role in
each of the subsystems they belong
Structural difficulty when one subsystem
takes over or intrude another
Boundaries
Emotional barriers that protect & enhance the
integrity of individuals, subsytems & families
Extremes of boundaries
Disengagement-overly detached-rigid
Enmeshment-very involved as one-diffuse-
fosters dependency on parents
Clear healthy boundaries-attain sense of
personal identity yet allow sense of
belongingness within family system
Structural Family Therapy Goals
Reduce symptoms of dysfunction
Bring about structural change by:
Modifying the family’s transactional rules
Developing more appropriate boundaries
Creation of an effective hierarchical structure
It is assumed that faulty family structures
have:
Boundariesthat are rigid or diffuse
Subsystems that have inappropriate tasks and
functions
Structural Family Therapist
Function
To actively engage family as unit to initiate
structural change by:
1. Joining the family in a position of leadership
2. Mapping its underlying structure
3. Intervening in ways designed to transform an
ineffective structure
The Therapeutic Endeavor is challenging rigid
transactional patterns
1. Pushing for clearer boundaries
2. Increasing degree of flexibility in family interactions
3. Modifying dysfunctional family structures
Structural Family Techniques
Joining: build & maintain therapeutic alliance
with family
Family Mapping: draw map to identify
boundaries , transactional styles
Enactments: family engages in conflict situation
that would happen at home
Reframing: new light or different interpretation
on problem situation in family
Strategic Family Therapy Outline
1. Key Concepts
2. Therapy Goals
3. Therapist’s functions
Strategic Family Therapy Key
Concepts
Focuses on solving problems in the present
Presenting problems are accepted as “real” and
not a symptom of system dysfunction
Therapy is brief, process-focused, and solution-
oriented
The therapist designs strategies for change
Change results when the family follows the
therapist’s directions and change transactions
Strategic Family Therapy Goals
Resolve presenting problems by focusing
on behavioral sequences
Get people to behave differently
Shift the family organization so that the
presenting problem is no longer functional
Move the family toward the appropriate
stage of family development
Problems often arise during the transition
from one developmental stage to the next
Strategic Family Therapist’s
Function
Therapist: consultant, expert, stage director-
change is therapist’s responsibility
Use of Directives: designed to change the
system: advice, suggestions, coaching, giving
ordeal-therapy assignment
Paradoxical Interventions: exaggerate or perfect
a problematic behavior
Reframing: reinterpreting problematic behaviors
which are entrenched-giving new meaning to
behaviors may produce new behaviors that fit
the new interpretation
Social Constructionism
The client, not the therapist, is the expert
Dialogue is used to elicit perspective,
resources, and unique client experiences
Questions empower family members to
speak, and to express their diverse
positions
The therapist supplies optimism and the
process
Social Constructionism Therapy
Goals
Generate new meaning in the lives of family
members
Co-develop, with families, solutions that are
unique to the situation
Enhance awareness of the impact of various
aspects of the dominant culture on the family
Help families develop alternative ways of being,
acting, knowing, and living
