Comparison Chart of Models of Marriage & Family Therapy
Bowen
Contextual
♦ Anxiety.
♦ Differentiation.
* Emotional cutoff.
* Emotional system.
♦ Family projection
process.
* Functional level
of differentiation.
♦ Fusion.
* Multigenerational
transmission
process.
♦ Nuclear family
promotional
system.
♦ Sibling position.
♦ Triangulation.
♦ Lack of differenti
ation results in
marital conflict
dysfunction in a
spouse, or symp
toms of dysfunc
tion in one or
more children.
Object
Relations
MRI Brief
Strategic
Haley
♦ Family system is
constantly evolv
ing.
♦ Hypothesizing.
♦ Circularity.
* Neutrality.
♦ Double Bind.
♦ Invariant pre
scription.
* Homeostasis.
♦ Attend to beliefs
rather than
behavior.
♦ Positive
Connotation.
♦ Alliances.
* Boundarie
* Coalitions
* Disengage
* Detouir^g
♦ Enmeshrj
* Parentif*
* Restricts
♦ Structure.
* Structura
* Subsy stem
* Triangles.
♦ Projection of
internalized,
repressed ego
objects.
♦ Internal objects
built from experi
ence and expecta
tion.
♦ Interpersonal
view of individual
& family develop
ment
♦ Negative aspects
of internalized
object
♦ Current relating
based upon
expectations
formed in early
experience.
♦ Societal norms &
values, unconscious behavior.
forces and personal ♦ Life cycle transition
points are significant
values.
♦ Unresolved family
of origin issues.
tion and life cycles.
♦ Focus on presenting problem.
♦ The trustworthi
ness of relation
ships breaks
down because
fairness, caring
and accountabili
ty are absent
♦ Negative aspects
of repressed,
introjected early
objects are pro
jected onto the
spouse or
children.
♦ Attempts at solu
tions become the
problem.
♦ Vicious cycles of
mishandled
attempts to solve
the problem.
♦ Family engages in
“more of the
same”, maintain
ing the problem.
♦ Symptoms main
tained by family’s
unsuccessful
problem solving
efforts.
♦ Inability to adjust
to life cycle tran
sitions.
♦ Dysfunctional
hierarchy.
♦ Triangulation or
coalitions.
adapt to i
mental m
uational i
lenges.
♦ Rigid or <
boundari
temology does not * Enmesbe
fit its current
engaged
ships.
pattern of
behavior.
.
♦ Problems stem
from the dilemma
between love and
violence
(Madanes).
♦ Clear rules should
govern the hier
archy.
* Flexibility.
♦ Influenced by
Bateson, Erickson
& Minuchin.
♦ Symptoms are
communicative
acts embedded in
a pattern of inter
actions.
* There needs to be
a large repertoire
of behaviors for
problem resolu
Structural
* Destructive
entitlement
♦ Entitlement
♦ Exoneration.
♦ Justice / fairness.
♦ Ledger.
♦ Legacy.
* Loyalty (filial &
invisible).
♦ Merit
♦ Multidirectional
partiality.
* Parentification.
♦ Relational
determinants
(facts,individ.
psychology,
behavioral
transactions,
relational ethics.
♦ Revolving slate.
♦ Trustworthiness.
-
♦ Communication
theory (levels,
rules &
congruence).
♦ First vs. second
order change.
♦ Cybernetics/posi
tive feedback
loops.
♦ Focus on the pre
senting com
plaint
♦ Most motivated
person in family
is used.
♦ Unit of treatment
can be one per
son.
♦ Primary determinant
of behavior
is other people’s
Milan
Systemic
♦ Family caught
* Inflexible structure
in unacknowl
edged “dirty
game”.
♦ Problems main
tained by behav
ioral sequences.
♦ Family’s old
♦ Increasing the
♦ A preventative
♦ Expression of
♦ Change the com-
♦ Increase
♦ Develop alterna * Reorgaa
ability to distin
guish between
thinking and feeli. ing within self
and others. Use
f this skill to direct
| one’s life and
V solve problems.
plan for current
and future gener
ations.
♦ Restore people’s
capacity to give
thru fair relating
and trust.
repressed objects.
♦ Resolution of neg
ative aspects of
repressed objects.
♦ Individuation.
♦ Detachment from
the “bad” object
plimentarity,
interdependent
nature of the
symptoms.
♦ Change sequences
by identifying the
“viscious cyde”.
♦ Strategies for
developmental
change.
* Reassert hierar
chy.
♦ Eliminate prob
lem coalitions &
triangles.
tive episteraology
by creating an
environment in
which new infor
mation is intro
duced into the
family.
family s*
* Clear aa
booadac
berweea
tems.
* Funcboa
tive pata
assist di
Experiential
* Alienation.
♦ Battle for
Structure.
♦ Battle for
Initiative.
* Communication.
♦ Use of “crazi
ness”.
* Creativity.
* Experiential.
* Family recon
struction.
* Growth thru
immediate shared
experience.
* Intergenerational
themes.
♦ Self worth.
Emotional
Solution-
Narrative
- Focused
Focused
* Negative interac
tion cyde.
* Core Conflicts
♦ Secondary reac
tive emotions.
* Primary
Emotions
* Separateness-connectedness
♦ Dependence-independence.
* Clinical focus on
solutions.
* Co-construction.
♦ De-emphasis on
history and
pathology.
♦ Deconstruct
* Exception.
♦Finding when the
problem is not a
problem.
♦ Focus on future.
* Problem and
cause are con
structions of real
ity.
♦ Scaling.
* No absolute reali
ty. Do not impose
view of “normal”.
* Co-construction.
* Flexibility and
creativity
♦ Language is all
important
emphasis on
meanings.
* Dominant story.
♦ Hermeneutics.
♦ Objectification.
♦ Problem creates
the system.
♦ Re-authoring.
♦ Subjugated story.
* Symptoms are in
the relationship,
not in the person.
♦ Beliefs about an
event are insepa
Collaborative
CBT
Psychoeducational
♦ Dialogical conver
sation.
* Languaging.
♦ Multiversatile.
* Non-pathologizing perspective.
♦ Philosophical
stance.
♦ Postmodern
theory.
* Problem-deter
mined system.
♦ Problem-organiz
ing and problemdissolving system.
♦ Socially con
structed knowl
edge.
♦ Stuck system.
♦ Couples hide
their actual emo
tions and exhibit
defensive or
coercive emotions
leading to nega
tive interactions.
♦ The meanings
attributed to
behavior puts
limits on the
range of alterna
tives that can be
applied to the
solution.
♦ Excessive focus
on the problem
and limited set of
behaviors.
♦ Family members’
partidpation in
the problem.
♦ Internalization of
the problem.
♦ Family unable to
distinguish prob
lem in “time”.
♦ “Desperation”
signals readiness
for change.
♦ Shared experi
ence leads to
growth.
♦ Creativity, spon
taneity & play.
♦ Helping the cou
ple to access their
actual emotions,
altering negative
interactional
sequences, and
enhancing the
emotional bond.
♦ Generate solu
tions.
♦ Creative expan
sion of solution
behaviors.
♦ Learn from
exceptions.
♦ Family members
realize partidpa
tion in the prob
lem.
♦ Time is “col
lapsed”.
♦ Finding alterna
tive solutions.
♦ Maximize func
tioning and cop
ing ability of all
family members.
♦ Establish collabo
ration among
family members.
♦ Support
♦ Structure.
♦ Coping mecha
nisms.
♦ Learning from
the family.
♦ Belief that the
family can help
the patient
♦ Reciprocity.
♦ Successive
approximation
(shaping).
♦ Time-out
rable from how it is
experienced.
♦ Unique outcomes.
♦ You cannot know
objective reality.
♦ Scapegoat pro
vides relief from
anxiety.
* Difficulty in toler
ating interperson
al stress.
♦ Role and commu
nication rigidity.
* Intolerance for
differences.
♦ Symptoms are
nonverbal mes
sages.
♦ Baseline.
♦ Behavioral
exchange theory.
♦ Classical condi
tioning.
♦ Cognitions.
* Discriminative
stimulus (cue).
* Extinction.
♦ Functions.
♦ Modeling.
* Negative & posi
tive reinforce
ment
* Operant condi
tioning.
♦ Punishment.
* Redprocal inhibi
tion.
* Problems are
maintained in
language by a
problem-deter
mined system.
♦ The view of the
problem hampers
any successful
means of resolu
tion.
♦ Maladaptive,
symptomatic
behaviors are
learned respons
es, involuntarily
acquired and
reinforced.
♦ Generate new
meaning about
the problem.
♦ Family takes new
action to resolve
the problem.
♦ Modify spedfic
behavior patterns.
♦ Rewarding
appropriate,
adaptive behavior.
♦ Change contin
gencies of social
reinforcement
♦ Family has beea
hurt by insensi
tive professionals.
♦Need for informa
tion and educa
tion.
♦ Learn different
coping strategies.
♦ Anxiety and grief
render the lamah
dysfunctional.
♦With edncascc
and attention to
family needs.
family members
may learn new
strategies to cope
with the problem.
♦ Change ideas
about (leafing
with paftrwt.
Bowen
* Emphasize
extended family.
* Entire family
need not be present
* Use of genogram.
* Reduce anxiety
♦Increase differentiation.
* Open communication, resolve triangles.
Neutral.
* Objective.
* Coach.
* Process
over
content
* Genogram.
* “I” position.
* Detriangulation.
* Create therapy
triangle.
* Often long term.
* Self-reports.
* Level of
differentiation use of scale.
* Degree of cut-off.
* Level of family
anxiety and reactivity.
* Triangles.
Contextual
* Unit of treatment
is chosen by therapist
* Engagement
* Cognitive exploration of fam. history.
* Alter perceptions.
* Expand trust to
increase options.*
* Active.
* Personal.
* Co-therapy.
* Relational balances.
* Catalyist
* Advocate for all.
* Multidirectional
partiality.
* Listening.
* Observing.
* Responding to
unconscious
material.
* Therapist
decides whom to
see.
* Couple therapy
is not separate
modality.
♦Focus on family
resources.
* Observations
made on aO 4
dimensions.
* Assessment is an
ongoing process.
* Developmental
stage
and
interpersonal Ioy
allies
lead
to
beliefs.
*Triangles assessed.
Object
Relations
MRI Brief
Strategic
Haley
Milan
Systemic
Structural Experientia
l
* Entire family
seen.
* Pre-session.
* Session interview.
* Hypothesis testing.
* Team discussion.
* Therapist presents conclusions.
* Post-session.
* Short-term theapy.
* Entire
family
present
* Join from
p«
of
leaders
* Map
underb
structure.
* Interventio
n transform
ti structure.
* Short-term
Emotional
Solution-
- Focused
Focused
* Engagement
* Projective identification.
* Confrontation.
* Termination.
* Often long terra.
* Setup
and
definition of the
problem.
* Identify
&
interrupt
behavior
maintaining the
problem.
* Set goals.
* Intervention.
* Termination.
* Short-term therapy.
* Initial interview:
1. Social.
2. Problem ident
3. Interactional.
4. Goal setting.
* Observation.
* Intervention.
* Termination.
* Short-term therapy.
* Non-directive^
* Observer.
* Insight and
understanding.
* Active.
* Clients are
viewed as
customers.
* Attend to process
over content.
* Team and one
way mirror often
used.
* Active and deliberate.
* Join with the
family.
* Responsible
for therapy.
* Presenting problem.
* Use language
of the family.
* Observer.
* Mixed gender
treatment teams.
* Neutrality.
* Ways to think
differently.
* Generate
hypotheses.
♦ Most motivated
person in system.
* Symptom-focused.
♦ Tasks.
* Paradox & reframe.
♦ Encourage interaction.
♦ Observe
sequences.
♦ Define maladaptive sequences.
* Problem resolution.
* Non-historic.
* Symptomfocused.
* Sequence of
symptom-main
taining behaviors.
♦ Instances of
circu lar causality.
* Directives, direct
and paradoxical.
* Enactment
* Feedback.
* Pretending.
* Ordeals.
* Reframing.
* Hypothesizing.
* Circularity.
* Neutrality.
* Invariant
prescription.
* Rituals.
* Paradox.
♦Positive
Connotation.
* Joining/acc
t dating.
* Diagnosing.
* Modify
intes tions.
* Boundary
* Unbalancing
* Challenging
* Enactments
* Reframing.
* Tasks.
* Paradox.
♦ Metaphor.
♦ In-session
interaction.
♦ Sculpting (Satir).
♦ Family reconstruction.
♦ Parts Party
(Satir).
♦ Temperature
reading.
Changing interactional positions.
♦ Information
learned before
meeting is used in
formulating the
hypothesis.
♦ Hypothesis leads
directly to interventions.
♦ Family stra
♦ System flerij
♦ Family maf
♦ Enmesh
me
disengages
♦ Family life <
♦ Family
dew mental
staf
♦ Observatia
session.
♦Degree of anxiety.
♦ Battles
for
Initiative
&
Structure.
* Therapist’s own
feelings.
* Degree
of
separateness;
ability to play.
♦ Intergenerationa
l themes & life
cyde.
♦Desire for change.
♦ Delineate
the
issues presented by
the coup
and
assess how these
issues express core
conflicts in the
areas
of
separateness-connectedness
and
depen
denceindependence.
♦ Identify
the
negative
interaction cyde.
♦Access
unacknowledged
fedings underlying
interactional
positions
* Listening.
* Observing.
* Responding to
unconscious
material.
* Interpreting.
* Developing
insight
* Self-report
* Family of origin
history.
* Defensive
system of the
family.
♦Individuation.
* Intrapsychic
material.
♦ Non-historic.
♦ Family life cycle
transition points.
♦ Self-report
♦ Observing
family ineractions.
* Active.
* Involved.
* Leadership.
*
Gather
information.
* Increase affect
and expressiveness.
* Expansion of self.
* Termination
upon achieving
goals.
* Satir: making
contact,
chaos,
integration.* Pretreatment, middle, late phases.
* Involved & active.
* Self-disclosing,
warm,
responsive,
positive.
* Consultant
* Alternating
between provocation and support
* Delineate
core
* Identify the
negative interaction
cycle.
* Access underlying
interactional
positions.
* Redefine the
problem.
* Promote
identification with
disowned needs
and aspects of self„
* Promote
acceptance of each
partner’s
experience.
* Restructure the
interaction.
* Generate new
solutions.
* Consolidate new
positions.
Narrative
Collaborative
CBT
Psychoeducational
* Initial session:
previous solutions, exceptions,
goals, tasks.
* Later sessions:
feedback on tasks,
perception of
change, exceptions.
* Termination:
upon reaching
goals.
* Brief therapy.
* Externalizing
the problem.
* Relative influence.
* Collapsing time.
* Raising dilemmas.
* Setting experiments.
* Short-term
therapy-
* Therapy is a
continuous
process.
* Focus on language.
* Dialogical
conversation.
* Termination col
Iaboratively
determined.
* Directive.
* In control.
* Engage in solution oriented con
versation.
* Co-create
system with the
family.
* Neither direct
nor indirect
* Clients have
voice in treatment
process.
* Multipartial.
* Not knowing.
* Honor client’s
reality.
* Listener.
* Responsive.
* Compassionate.
* Egalitarian partnership; coexplorer.
* Directive.
* Teacher.
* Coach.
* Model.
* Reinforcer.
♦Active.
* Learn from faash.
* Direct & empathic.
* Provide information.
* Brief therapy.
♦ Complimenting.
♦ Formula first-session task.
♦ Scaling questions.
♦ Miracle question.
♦ More of the same.
♦ Questions and
summaries.
♦ Externalizing
problems.
♦ Dilemma
questions.
♦ Escape meetings.
♦ Note
taking/sharing.
♦ Landscape of
action & meaning
questions.
♦ Certificates.
♦ Therapeutic letters.
* Family’s experience of the problem.
* Language of the
family.
* Ways that family
members participate in the problem.
* Conversational
questions.
* Not-knowing
approach.
* Reflecting Team.
* Shared inquiry.
* Operant techniques (shaping,
token economy,
contingencies)
* Respondent con
ditioning (desen
sitization,
assertiveness,
aversion).
* Cognitive
affective
(thoughtstopping, rational
emotional).
♦ Function
of
*mPaalraednatping trainitnivge
beahnadvciornst.racts.
♦Sequences
with
embedded
problems.
♦ Interview/self-report
* Remo e Miw
♦Unconditional
positive regard.
* Identify solutions.
* Can
family
identify
exceptions?
* How does the
family answer the
miracle question?
* Can
family
follow thru on
interventions?
* Degree of focus.
* Shared inquiry.
* Presentation of
problem by client
system.
* Conversational
questions utilized
in assessment.
* Identification of
problem behavior.
* Behavioral goals.
* Behavioral interventions & homework.
* Sympto
m
removal.
* Termination.
* Brief therapy.
♦ Observation
of
problem-solving &
communication.
♦Functional
analysis
of
behavior.
* Initial interview.
* Information star
ing.
* Other resources.
* Assigning tadi.
* Respond
to
prob Iems in
family structure.
* FjiwinrapF
* Contracting.
* Survival Sk3b
Workshop.
* Training with
family.
* Lowering
expectations.
♦ History of the
problem
* Evaluate fiat's
understands^ :/
* Evaluate bash i
needs for iafor
maticn.
♦ Evaluate
attempts at
t