CHAPTER 7:
The Process of Family Therapy
Family Therapy: History, Theory, and
Practice
6th Edition
Samuel T. Gladding
Developed by Nathaniel N. Ivers, Wake Forest
University
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
Overview
•
Common Factors in Therapy
•
Impact of Stressors and Enhancers on the
Therapist
•
Battle for Structure vs. Initiative
•
Problems of Overemphasis and Underemphasis
•
Treatment Interventions in the Initial, Middle, and
Termination Stages of Family therapy
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Common Factors in Therapy
•
Extratherapeutic factors
•
Therapy relationship factors
•
Expectancy, hope, and placebo
•
Model and technique
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Stressors
•
Depression
•
Less time for one’s own family
•
Unrealistic expectation of one’s family
•
Psychological distancing from one’s family due to
professional status
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Enhancers
•
Increased ability to solve one’s family problems
•
Acceptance of a greater ability and desire to
communicate effectively
•
Synergy between personal and professional life
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-5
Common Problems of Being a Family
Therapist: Overemphasis
Overemphasis on . . .
Details
•
•
•
Process versus Content
•
Redirection
Making people happy
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-6
Common Problems of Being a Family
Therapist: Overemphasis
Overemphasis on . . .
•Verbal
expression
•Coming
to an early or too easy resolution
•Dealing
with one member of the family (i.e.,
scapegoat)
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-7
Common Problems of Being a Family
Therapist: Underemphasis
Underemphasis on . . .
Establishing structure
•
•
Battle for structure
• Professional disclosure statement
• Informed consent brochure
•
Showing care and concern
• Therapeutic presence
• SOLER
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-8
Common Problems of Being a Family
Therapist: Underemphasis
Underemphasis on . . .
•
Engaging family members in the therapeutic
process
•Letting
the family work on its problems (i.e., battle
for initiative)
•Attending
to nonverbal family dynamics
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-9
Appropriate Process: Pre-Session
Pre-Session Planning and Tasks
•
•
Obtain certain information
•
Establish a professional but cordial atmosphere
•
Evaluate intake information
•
Form a preliminary diagnosis of what is
happening with the family
•
In doing all this, a family therapist comes up
with a case conceptualization
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-10
Appropriate Process: Initial Session(s)
•
Join the family: Establishing rapport
•
Inquire about members’ perceptions of the family
•
Observe family patterns/assess
•
Family dance
•
Subsystems
•
Triangulation
•
Enmeshment
•
Distancing
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
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Appropriate Process: Initial Session(s)
•
Assess what needs to be done
•
Engender hope for change and overcome
resistance
•
Make a return appointment and give
assignments
•
Record impressions of family session
immediately
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-12
Appropriate Process: Middle Phase of
Treatment
•
Involve peripheral family members
•
Seek to connect family members
•
Establish contracts and promote quid pro quo
relations
•
Emphasize some change within the family system
•
Reinforce family members for trying new
behaviors
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-13
Appropriate Process: Middle Phase of
Treatment
•
Stay active as a therapist
•
Link family with appropriate outside systems
•
Focus on process
•
Interject humor when appropriate
•
Look for evidence of change in the family
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-14
Termination
•
Orientation
•
Summarization
•
Discussion of Long-Term Goals
•
Follow-up and Relapse Prevention
Gladding, Family Therapy: History, Theory, and Practice, 6th Ed.
© (2015, 2011, 2007) by Pearson Education, Inc. All Rights Reserved
7-15