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Sonja A. Sutherland, MS, LPC, NCC

Sonja A. Sutherland, MS, LPC, NCC

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Sonja A. Sutherland, MS, LPC, NCC

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  1. Sonja A. Sutherland, MS, LPC, NCC Clinical Therapist Life Coach Adjunct Professor, Grand Canyon University PhD Student Regent University Counselor Education and Supervision

  2. Systemic Theories

  3. Developed in the 1950’ – 1960’s • Foundational Premise “Individuals can best be understood within the context of their environments” • Influences • Cybernetics • General Systems Theory Systemic TheoriesHistorical Overview

  4. Family systems theory speaks about the individual members of the family, and describes both the inter-relationships between and among members of the family, and the rules that exist to maintain the family in its current functioning. Systemic TheoriesHistorical Overview

  5. Systems & Subsystems • Structure, Roles & Rules • Hierarchy - generational • Power • Boundaries • Feedback loops • Homeostasis Systemic TheoriesOverview: Universal Concepts

  6. Virginia Satir (1916 – 1988) • “Mother of Family Therapy” • Communication / Strategic Family Therapy • Conjoint Family Therapy (The Satir Model) Systemic TheoriesKey Theorists

  7. Key Concepts Key Terms & techniques • Communication • the key to understanding human behavior • Pathology is an interactional process between family members • Function of pathology is homeostatic maintenance • Therapy focuses on change in communication patterns between individual family members • Double Bind Communication • Punctuation • Symmetrical / complementary communication • Schism • Reframing • Prescribing the symptom • Reduction ad absurdum • Therapeutic double binds • Straight / Paradoxical directives Systemic TheoriesCommunication/Strategic Therapy & The Satir model

  8. Murray Bowen (1913 – 1990) • Psychiatrist – Georgetown University • Bowenian Family Therapy Systemic TheoriesKey Theorists

  9. Key Concepts Key Terms • Pathology stems from inadequate differentiation of self from family of origin’s emotional system • Severe pathology such as schizophrenia is the result of a multigenerational transmission process • Goal of therapy is to increase differentiation of self • Therapist’s role is to model differentiated self rather than become caught in family triangles • Differentiation of self • Fusion • Undifferentiated family ego mass • Triangulation • Emotional cut-off • Family projection process • Multi-generational transmission process • Responding from a “responsible I” position rather than “we” or “you” Systemic TheoriesBowenian Family Therapy

  10. Salvador Minuchin (1921 - ) • San Salvador, Entre Rios, Argentina • Russian-Jewish Heritage • Psychiatrist trained in individual psychotherapies • Theory developed within the context of the Civil Rights Era • Power families have over psychopathology Systemic TheoriesKey Theorists Structural Family Therapy

  11. Treatment occurs best within the social and relational contexts of the family, rather than the individual • Delinquency – Anorexia Nervosa - Medical • Focus on the here and now rather than the past • Psychological distress caused and maintained by relationships • Family belief structure – cognitive schema Systemic TheoriesstructuralFamily Therapy

  12. Society Family IP Systemic TheoriesstructuralFamily Therapy Expanded site of pathology

  13. Boundary Continuum Disengaged Normal Enmeshed Family Structure Family Structure Family Structure Rigid Clear Diffuse Isolation, Disengagement, limited Frequent Communication, Encroachment on personal and access between subsystems, weak interdependent, supportive, healthy system boundaries, loss of family connections, system closed healthy autonomy , system open to change, autonomy, system resistant to to change, inflexible organization open to change, flexible organization, adaptable change, enmeshment, poor to external change, belonging but separateness differentiation of self Depression, psychosomatic complaints, antisocial symptoms Incest Systemic TheoriesstructuralFamily Therapy

  14. Systemic TheoriesstructuralFamily Therapy Role of the therapist

  15. Active and Directive • Aware of structure and rules • Focused on the here and now • Problem reframer • Individualistic ideology vs systemic perspective • Focus is on the individual within the system • To interpret role of symptoms Systemic TheoriesstructuralFamily Therapy Role of the therapist

  16. Joining • Ongoing process of entering a family system to engage & influence its members • Enactment • Process of changing patterns of interaction in the here and now • Blocking of unhealthy interactional patterns • Restructuring • Activities that attempt to change family rules • Accommodation • Process of adjusting to and accommodating the rules of the system. • Changing family myths • Challenging family belief systems • Coaching new communication patterns Systemic TheoriesstructuralFamily Therapy Interventions and Techniques

  17. General considerations • Therapist’s interest in the culture • Impacts joining • Family observation Systemic TheoriesstructuralFamily Therapy Multicultural considerations

  18. Specific Populations • Chinese and Hispanic families • Highly structured boundaries and roles • Emphasis on social context • Chinese – American cultural disconnects Systemic TheoriesstructuralFamily Therapy Multicultural considerations

  19. Cultural assessment tools for Therapists • Cultural Auditing through Reflective Practice • What are my initial reactions to this family and what does it tell me about my beliefs, values and assumptions? • In what ways do I assume that we are similar or different because of our cultural backgrounds? • What are my initial hypotheses about the impact of culture on this family’s presenting concerns? How sure am I of the accuracy of my hypotheses? How open am I to being wrong, considering new information, and modifying my assumptions? Systemic TheoriesstructuralFamily Therapy Multicultural considerations

  20. General similarities • emphasis on family as essential for individual growth and development • Bowenian Family Therapy most akin • Emphasis on clearly defined family hierarchies • parent-child relationships (Exodus 20:12; Deuteronomy 21:18; Proverbs 22:6; Proverbs 29:17), • family responsibility (1 Timothy 3:1, 4-5; 5:8), • good communication (Ephesians 6:4; Colossians 3:21) • marriage like union of Christ and the church (Ephesians 5:25-30). Systemic Theoriesconceptualization of faith

  21. Modern • Primary use of techniques like those used in structural therapy • Belief in therapist’s knowledge, expertise and power to influence change • Post Modern • Social constructionist view with focus on relational, narrative paradigm • Therapist takes “not knowing” stance • Use of language and conversation to elicit client’s expertise and story Systemic TheoriesModern – Post Modern framework integration

  22. The Para-Modern Stance • A “both/and” approach to family therapy • Dual positioning allows for more effective treatment • What is most relevant is what works in practice rather than adherence to a theoretical position such as systemic theories or social construction theory. • “An ethical stance allows family therapists to access a range of therapeutic languages and techniques at once. The priority is not what knowledge we use but how we use it…putting theory to work in the service of others.” (Larner, 2009, p. 54) • Concerns • Dearth of evidence-based research documenting effectiveness • Does ethical utilization of theories allow for “mixing and matching” in the name of “integrative practice? • Recent documentation of effectiveness with adolescent depression and eating disorders Systemic TheoriesModern – Post Modern framework integration

  23. Conclusion Systemic Theories

  24. American Counseling Association. (2005). American Counseling Association Code of Ethics, Alexandria, VA. Banmen, J. (1986, December 1). Virginia Satir's family therapy model. Individual Psychology: The Journal of Adlerian Theory, Research and Practice, 42(4), 480-493. Banmen, J. (2002, March). The Satir model: Yesterday and today. Contemporary Family Therapy, 24(1), 7-22. Banmen, J. (2009). Satir model developmental phases. The Satir Journal, 30(1), 14-19. Banmen, J. (2010). Forgiveness as therapy in the Satir model. The Satir Journal, 42(1), 6-23. Beels, C. (2011, March). Family process 1962 - 1969. Family Process, 50(1), 4-11. doi:10.1111/j.1545-5300.2010.01342.x Campbell, J., & Handy, J. (2011). Bound to care: Custodial grandmothers' experiences of double blind family relationships. Feminism and Psychology, 21(3), 431-439. Collins, S., Arthur, N., & Wong-Wylie, G. (2010, Summer). Enhancing reflective practice in multicultural counseling through cultural auditing. Journal of Counseling and Development, 88(3), 340 - 347. DSM-IV-TR. (2000). Arlington, VA: American Psychiatric Association. Jones, S. L., & Butman, R. E. (1991). A comprehensive Christian appraisal: Modern psychotherapies. Downers Grove, Illinois: InterVarsity Press Academic. Systemic TheoriesReferences

  25. Jung, M. (1984). Structural family therapy: Its application to Chinese families. Family Process, 23, 365-374. Larner, G. (2009). Integrative family therapy with childhood chronic illness: An ethics of practice. The Australian and New Zealand Journal of Family Therapy, 30(1), 51-65. Minuchin, S. (1974). Families and family therapy. Cambridge, Massachusetts: Harvard University press. Minuchin, S., Montalvo, B., Guerney, B., Rossman, B., & Schumer, F. (1967). Families of the slums: An exploration of their structure and treatment. New York: Basic Books, Inc. Muir, J. A., Schwartz, S. J., & Szapocznik, J. (2004, July). A program of research with Hispanic and African American families: Three decades of intervention development and testing influenced by the changing cultural context of Miami. Journal of Marital and Family Therapy, 30(3), 285 - 303. Napoliello, A. L., & Sweet, E. S. (1992). Salvador Minuchin's structural family therapy and its application to Native Americans. Family Therapy, 19(2), 155-165. Navarre, S. E. (1998). Salvador Minuchin’s structural family therapy and its application to multicultural family systems. Issues in Mental Health Nursing, 19(6), 557-570. doi:10.1080/016128498248845 Prochaska, J. O., & Norcross, J. C. (2010). Systems of psychotherapy: A transtheoretical analysis. Belmont, CA: Brooks/Cole, Cengage Learning. Vetere, A. (2001). Therapy matters: Structural family therapy. Child Psychology & Psychiatry Review, 6(3), 133-139. Systemic TheoriesReferences