Keys to Family Therapy
 The concept of the family is a “System.”
– Not a Linear model of Causality
A => B=> C=> . . .
– It speaks of “Circular” Causality
A
E
B
D
C
Keys to Family Therapy
 Within the system, there are people, but
also the RELATIONSHIPS
 It is in the Relationships that you see the
dynamics and the problems of the family.
 To make it easy on us, in an otherwise
complex task of looking at everything:
1. We look at Dyads (two person systems)
2. We look at Triads (three person systems)
Keys to Family Therapy
 Dyads= look at the power and control
 Triads= look at the “odd man out”
Concept of the Scapegoat
Concept of the Identified Patient
 So with this basic use of Systems Theory,
we now see “problems” in families in a
different light.
All Systems Have . . .
 RULES
These rules are communicated through
not only what they SAY, but also what they
DO.
 PURPOSE
Primary purpose is Survival.
 STRUCTURE
Hierarchy and Patterns in Relationships
Added note on STRUCTURE
 Structure breeds Stability
 Stability breeds Security
– This is what we all want.
– It starts with “good structure”
– My view is that the Bible has some great things
to say about families and “good structure.”
– The Family is the first system that God
ordained and therefore it has prominence.
Structure: Starts with the couple.
•THE MARRIAGE PYRAMID:
Intimacy
Conflict Resolution
Communication
Psychological Health of Couple
Research on Real Families
 Healthy Profile
1. Legitimate source of authority.
2. Stable rule system.
3. Nurturing Behavior.
4. Effective childrearing and marriage-focusing
behaviors.
5. Set of Goals (both family-wide and
individual)
6. Flexibility and adaptability to cope.
Research on Real Families
 Emotional Profile
1.
2.
3.
4.
5.
6.
7.
8.
9.
Caring and supportive attitudes.
Respect for all members and their views.
Motivation.
High level of initiation.
Strong marital/parental coalition with boundaries.
Individuality balanced by cooperation.
Congruent methods.
Ability to express affection.
Spontaneity and humor.
Doing Therapy
 I like to keep the first interview very
structured.
 Interview the whole family, if possible.
 Focus on Communication:
BUT NOT CONTENT
LISTEN FOR PROCESS
 Make a note as to who has the POWER.
 Be confident, positive, and in control.
1st Interview
 Social Phase
 Problem Phase
 Interaction Phase
 Goal Setting Phase
 Task Setting Phase
– Involves use of Directives
• Front-door: behavioral and basic communication
• Back-door: utilizes the family’s resistance
Assessing the Family’s Problem
 The family is BLOCKED.
• Simple and straightforward
• Help them past the Hurdle
 There is DISPLACEMENT.
• Scapegoat and Identified Patient issues
• Help them to see the True Problem
 There is DAMAGE.
• On the issues of Structure, Rule, or Purpose
• Help them truly become a NEW SYSTEM
If Blocked . . .
 Teach them what they need.
•
•
•
•
Behavioral interventions
Parenting skills (discipline and nurturing)
Marriage maintenance practices
Connecting with any other institutions
– Educational services
– Social Services
– Churches
• Communication skills
• Genograms
If Displacement . . .
 Help them to see the patterns.
• Dyads: Symmetrical Escalation and Pathological
Complementarity
• Triads: Triangulation
• Seek to balance the relationships
• The “symptom” is held by the family to keep their
family together
• Issue a “block,” a “strategic question,” or a
“reframe”
If there is Damage . . .
 Help them to “Re-structure”
• Challenge family norms
• Clarify boundary issues (disengagement and
enmeshment)
 Help them with New Rules
• Increase Awareness and Introduce New Choices
 Help them with a New Purpose
• Reframing the context or emotional output
• Use of Paradoxical Interventions
“Working” at what?
 Commitment (permanence)
 Value Your Spouse’s Uniqueness
Different, but Necessary
 Nurture Your Friendship
Leave you with a quote:
 “Husbands, live your lives in such a way,
that you would be the kind of man a woman
could LIVE for, and wives, live your lives
in such a way, that you would be the kind of
woman a man would DIE for.