Comprehensive Exam Review

1. Comprehensive Exam Review Click the LEFT mouse key ONCE to continue

2. Helping Relationships Part 3 Click the LEFT mouse key ONCE to continue

3. Major Family Counseling Theories

4. evolved rules of behavior, an organized power structure, negotiating and problem-solving strategies, shared history and perceptions, and overt and covert modes of communication. A “family” has been defined as a natural social system with its own unique properties, including: A family is characterized by economic, physical, social, and emotional intra- and interdependence among the members of the unit.

5. Functional families are characterized (at least) by reciprocal emotional attachments, structural stability, effective coping skills, interactive processes, open channels of communication, and structural and interactive flexibility to cope with the demands of life. The “family life cycle” is the series of stages through which a family evolves over time.

6. Models of the family life cycle typically include the following stages: Independent adults Marital dyad Infant family Pre-School family Grade School family Adolescent family Launching family Mentoring dyad Retirement family Elderly family

7. Family counseling is often considered within the context of systems theory, which holds that a family is composed of interacting components (i.e., family members mutually affect one another). Family systems theory also holds that: a. causality is interpersonal. b. family systems are best understood as repeated patterns of interpersonal interactions. c. symptomatic behaviors must be under-stood from an interactional viewpoint.

8. Basic family counseling concepts Circular Causality is the idea that events are related through a series of interacting feedback loops. Within the context of the circular causality viewpoint, family or family member dysfunctionality is shifted from any individual(s) to the family unit as a whole. Linear Causality is the antithesis of circular causality, suggests that there is cause-and-effect explanation of behavior.

9. Cohesion is the level of emotional bonding among family members. Adaptability is the level of the family’s ability to be flexible and to change. Enmeshment is a situation in which family members are overly dependent upon and/or undifferentiated from one another. Triangulation is when one family member is “pulled” in two different directions by the other members of the triangle.

10. Paradigm Shift is a change in traditional or habitual ways of thinking, with subsequent change in behavior. Identified Patient is the person who bears the symptoms, although the problem is addressed from a family systems perspective. Subsystem is two or more (but not all) family members who form a subsection of the family.

11. Homeostasis is a steady or balanced state of being; families act to maintain homeostasis. Equifinality is when the family uses or reaches the same set of behaviors regardless of the initial impetus for reaction. Feedback is when informational interaction among family members influences future behaviors in a closed loop. Morphogenesis is the ability of the family to meet changing demands.

12. Boundary is the limit of possible input and/or influence permitted. Open System is a family with permeable boundaries that allow for exchanges and/or influence from the community outside the family. Disengaged is when a family member is emotionally separate or distant from other family members.

13. Experientialist Family Counseling Virginia Satir, similar to other Experientialist family counselors, believed that family prob-lems are grounded in suppression of feelings, emotional and/or behavioral rigidity, and lack of awareness and sensitivity. The goal of Experientialist family counseling is to increase intrafamily communication. Experientialist family counselors, unlike most others, often describe family dysfunction using an individual or dyad as the unit of analysis.

14. Satir described four nonproductive roles of communication that family members may use when under stress: Placater - who agrees and tries to please Blamer - who dominates and finds fault Responsible Analyzer - who remains emotionally detached and intel- lectualizes Distractor - who interrupts and constantly chatters about irrelevant topics

15. Another Experientialist, Carl Whittaker advocates the use of a co-counselor to prevent the counselor from becoming enmeshed in the family. Whittaker also emphasized the use of creative, sometimes relatively radical, techniques in family counseling. Whittaker’s primary goals for family counseling are to increase each person’s belongingness in the family as well as individuality within the family.

16. Psychoanalytic Family Counseling Psychoanalytic family counseling is derived from individual psychoanalytic theory, and may be applied in a family or individual context. The primary goal of Psychoanalytic family counseling is to bring to the conscious the unconscious patterns from the family of origin (object relations) through transference and countertransference.

17. Psychoanalytic family counseling attempts to improve relationships by breaking fixations from an earlier stage of development. The interfering fixations constitute an intrapsychic structure known as an introject. Psychoanalytic family counselors attempt to establish effective object relations wherein an individual can have an effective relationship with another (i.e., object) by removing the introjects.

18. Behavioral Family Counseling Major underlying principles of Behavioral family counseling include that: a. behavior is maintained or eliminated by consequences b. adaptive behaviors can be learned c. maladaptive behaviors can be unlearned or changed d. cognitions can be rational or irrational, but can be changed.

19. Behavioral family counseling often involves cognitive change or mediation as a concur-rent strategy. Behavioral family counseling is often criticized as being linear in nature; that is, that problems are viewed as individual, not systemic, and that problems can be solved through logical applications of behaviorism. Behavioral family counseling is used most frequently for treatment of sexual dysfunction between spousal partners.

20. Structural Family Counseling Salvador Minuchin is usually acknowledged as the founder of Structural family counseling. The primary goal of Structural family counsel-ing is to “resolve” presenting problems. Resolution of presenting problems typically results from or in change in the underlying family structure (i.e., pattern of intrafamily interactions).

21. Structural family counseling is action-oriented; the counselor plays a very active role in the therapeutic process. Structural family counseling is based on the idea that family functioning involves family structure, subsystems, and boundaries. The primary goals of Structural family counseling are to resolve problems by “bringing them out into the open” and to facilitate structural changes such as those related to organizational patterns and action sequences.

22. Primary Structural counseling techniques include: Joining, in which the counselor helps to act out the mood of the family. Enactive Formulation, in which the counselor acts to slow down a family interaction. Challenging the Communication Rules of the Family, in which the counselor imposes new communication rules for the family.

23. Reframing, in which a positive connotation is applied to a negative behavior. Relabeling, in which a positive descriptive adjective is used to replace a negative one. Challenging the Structure of the Family, in which the counselor points out ineffective patterns of behavior and/or interaction. Restructuring, in which the counselor intentionally modifies a family’s typical way of interacting.

24. Task Setting, in which the counselor gives a specific homework assignment intended to extend what has gone on in counseling. Making Boundaries, in which the counselor helps family members establish more effective boundaries, usually by placing limitations on specific behaviors. Shaping Competence, in which the counselor helps family members to develop and be recognized as having new competencies.

25. Strategic Family Counseling Jay Haley is recognized as the foremost proponent of Strategic family counseling. Cloe Madanes, another important Strategic family counseling theorist, is noted for her analyses of power in the family. The primary goal of Strategic family counseling is to resolve presenting problems as rapidly as possible, often in terms of behavioral goals and minimizing insights, using action-oriented techniques.

26. Strategic family counseling is intended to be simple and pragmatic, and to focus on changing symptomatic behaviors and rigid rules. Haley was particularly concerned with family life cycle transitions, suggesting that if the family does not adapt to change or stress effectively, one or more family members will become symptomatic.

27. A primary Strategic family counseling tech-nique is the use of directives (aka prescrip-tions), which are “orders” the counselor gives directly or indirectly to the family to achieve compliance or its opposite, rebellion. Key concepts in Strategic family counseling include: The Perverse Triangle, which is a situation in which two family members at different levels of the family hierarchy align against a third member.

28. Double Bind, in which no matter what the person does or says, the person cannot “win.” Power in the Family, which is the authority to make or enforce rules or decisions; power becomes most important in transition or problematic situations. Incongruous Dual Hierarchy, in which a family member holds both a superior and inferior position of power in the family.

29. The Symptom as Metaphor, in which a “symptom” serves as a metaphor for the problem being experienced by another member of the family. Cyclical Variation Maintaining Incongruous Dual Hierarchies, in which the symptoms come and go in cycles but the incongruous hierarchies remain. Pretending, in which one family member is instructed to pretend to have a symptom while others react to it.

30. Solution-Focused (Brief) Family Counseling The primary goal of Solution-Focused family counseling is to change behavior in a relatively brief period of time, particularly by changing family rules (i.e., the governing principles that organize family life). The primary proponents of Solution-Focused family counseling include Don Jackson, Paul Watzlawick, and Steve de Shazer.

31. Jackson focused on changing the interactional patterns among family members using “recalibration,” which is changing or redefining the family rules, such as through: Quid Pro Quo, in which family members are asked what is needed and what can be given, and then change is negotiated. Prescribing the Symptom, in which the family is directed to intensify the symptomatic behavior toward having them rebel and actually reduce the behavior.

32. Watzlawick described first-order change as change of the structure or system, but with no change in the rules, and second-order change as change in the structure or system with associated change in the rules. Watzlawick viewed the goal of Solution-focused family counseling to be second-order change (i.e., removal of symptoms through behavior change). Watzlawick advocated the use of paradoxical interventions in which the family is instruct-ed to implement contradictory behaviors.

33. Steve de Shazer suggested that the ecosystem (e.g., family) is the survival unit, not the individual. de Shazer focused on “ecosystemic epistemol-ogy” suggesting that family members reciprocally gain knowledge and evolve their own reality. de Shazer advocated (but did not require) use of family counseling teams, often with the team behind a one-way mirror and being brought in when therapeutically appropriate.

34. Techniques associated with de Shazer include: Clue, which is an intervention that mirrors family behavior, such as a counterparadox in response to double-bind behavior. Compliment, which is a written message that praises family behavior and relabels previous family behavior. Confusion, in which the counselor admits to confusion about possible resolution following a detailed description of each family member’s behaviors.

35. Past Successes, in which the counselor compliments past successful behaviors but does not directly relate them to current situations. Skeleton Keys, which are “stock interventions” that work in a variety of circumstances.

36. Intergenerational Family Counseling Murray Bowen is the foremost proponent of Intergenerational family counseling. Self-differentiation is the degree to which people can separate cognitions and emotions to function effectively. The primary goal of Intergenerational family counseling is to assist one or more family members to achieve greater self-differentiation.

37. Triangulation is the process of involving a third person in a dyad, particularly when the dyad is stressed or confronting a problem. The Nuclear Family Emotional System is the pattern of emotional interchange among family members in a single generation. Multigenerational Transmission Process is the mechanism whereby emotional adjustment is transmitted across generations in a family.

38. Bowen developed genograms to represent the process and structure of at least three generations of a family. Genograms are used to help family members understand the multigenerational transmission process. Detriangling is a technique to help family members share thoughts and feelings without becoming defensive or putting others down.

39. Ivan Boszormenyi-Nagy developed several Intergenerational family counseling concepts and techniques, including: Ledger of Merit, which is the multigenerational structure of expectations and actions reflecting debts and merits accumulated on each side of a dyadic relationship. Entitlement, which is merit for caring. Delegation, which is the expectation parents or grandparents have for children to conduct the mission of the family.

40. Siding, in which the counselor sides with each family member in expounding on the member’s contributions to the family. Rejunction, in which family members dialogue to obtain entitlement. Crediting, in which the counselor helps to acknowledge various family member’s positive contributions to the family.

41. Consultation

42. Consultation is a helping process in which a counselor works with one or more other professionals, who in turn work with one or more clients. Thus, in consultation, counselors have only an indirect relationship with clients (service recipients). The consultation process usually occurs across several stages.

43. The first stage is called the Entry Stage, because it is the point at which the consultant enters the organization and/or relationship. The relationship is built during the Entry Stage, the problem and its parameters are defined, and a mutually-agreed upon contract is made with the consultees. Typically, there are four phases in the Entry Stage.

44. In Phase 1, the consultant explores the organization’s needs in regard to questions such as Should consultation take place?; Why am I here?; Who are you?; What is likely to happen?; What will be the result?; and What can go wrong? In Phase 2, a contract is developed to agree upon consultation procedures, fees, expectations of participants, and deadlines.

45. The elements of a contract typically include consultation goals, time frame, consultant's responsibilities, agency's responsibilities, consultant's boundaries, and arrangements for periodic review and evaluation of the consultant's work. In Phase 3, the consultant physically spends time working with consultees. In Phase 4, the consultant psychologically enters consultee’s system by establishing the relationship and minimizing resistance to change.

46. The second stage in consultation is the Diagnosis Stage, in which the problem is examined in depth and the consultant and consultee establish goals and generate methods to meet the goals. The Diagnosis Stage also typically has four phases, including (a) gathering information, (b) defining the problem, (c) setting goals, and (d) generating interventions.

47. The third stage is the Implementation Stage, in which the emphasis is on planning and taking action. The typical four phases of the Implementation Stage include (a) choosing an intervention, (b) formulating a plan, (c) implementing the plan, and (d) evaluating the plan.

48. The fourth stage is the Disengagement Stage, in which there is gradual reduction in the activity and dependency on the consultant. The typical four phases of the Disengagement Stage include (a) evaluating the consulting process, (b) planning for post-consultation concerns, (c) reducing involvement, and (d) termination.

49. Organizational consultation involves a counseling professional working either inside or outside an organization to provide technical, diagnostic, prescriptive, or facilitative assistance to individuals or groups from the organization seeking to change, maintain, or enhance the organization's effectiveness. A variety of models of organizational consultation have been presented in the professional counseling literature.

50. Blake and Mouton proposed the “Consul-cube” as a model containing 100 cubes to explain the relationships among units of change (i.e., clients), kinds of interventions, and focal issues (i.e., problems). Schein proposed several models of organization-al consultation.