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Essential Learning Components in Brief Family Therapy.docx

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York University
PSYC 3410
Michael Luther

Essential Learning Components in Brief Family Therapy pg 1 INTRODUCTION - Looks at the 4 delivery formats of Brief Therapy: Frames; Narratives; Roles; & Pattern Interruption + Feuerstein’s Taxonomy of 13 essential components to deliver MLE Kenneth - Argued that “family” is the most important institutions that either Ishwaran (1970) makes or breaks a society, especially a child Skuy (1992) - One of the first to talk about widespread cognitive remediation for deprived people in South Africa SECTION ONE: DELIVERY FORMATES IN BRIEF THERAPY FRAMES - Is a process of creating a story in the present and future tense, as if it is reality, and the goals have been achieved White & Epston - Influential in the adaptation of the “FRAMING/NARRATIVE” metaphor – which attempts to create “stories” about the patient’s life - ‘Problems’ are present when the retold story does not resemble reality Known for: or is “problem-saturated” Narrative Frame - Emphasis on the therapist being a “co-author” or “navigator”, aiding Approach the patient piece together incongruent life stories (re-authoring) (NFA)  Regardless of whatever story is raised – whether good or bad, the story that emerges is always reframed into a positive one - Is similar to Walter and Peller’s framing - Emphasis on “externalizing” and “objectifying” on the problem and not the person  Acquired by having the therapist probe questions that will explore how the problem is “kept alive” by “agents”, cultural practices, and mainstream beliefs - The therapist portrays themselves as taking an “interested stance” “establishing therapy as a context for curiosity… a co-operative endeavor and an inquiry into new possibilities” Walter & Peller - Created a path/map for illustrating various routes therapeutic conversations can take - Steps include: Known for: i. Pose questions re the goal of their frame (what they want to Solution Focused achieve in therapy) – is to be stated in a positive and not Approach negative (do not emphasize things to avoid) (SFA) ii. Discuss exceptions (situations where the problem is non- existant)  Goal to identify and build up several instances to remind the client that ‘the problem’ is not overwhelming nor static, to show that change breeds change, and that “exceptions suggest solutions” iii. Discuss hypothetical solutions (what would you do in that scenario)  “The Miracle Question” – questions pertaining to what they would do differently if a miracle occurred and the problem disappeared  “The On Track Question” – questions that create a scenario as if the Essential Learning Components in Brief Family Therapy pg 2 person is on track with achieving a goal - Goal is to help free the client from beliefs and behaviours that maintain a problem by trying to influence their ways of viewing a problem (conversion from negative to positive) NARRATIVES - Main idea is to rework a problem & its relationship to the self – with an emphasis on externalizing the problem, and developing positive ways of retelling their story (Main context for - Narrative therapy is NOT goal oriented – therapist does not know Michael White & where the client will end up, therapist merely charts conversations on NFA) to “maps”, while the client is in charge - Does not try to “reframe” a problem, but looks for “doorways” to “alternative stories” (it isn’t me that’s wrong… it’s… *externalization+) - Main focus on “rich story development” - Has the client provide documentation (awards, certificates, degrees, art, letters, etc.) that contradict negative dominant stories Lazowski - Believes in the inclusion of significant others in the therapeutic process along with the “identified client”  Provides additional input for building the current story  Can function as a source of motivation – “recruits” an audience to praise the client’s progress ROLES - Is critical in Transactional Analysis (TA) The Freeds (Freed - TA involves teaching the client/patient to be aware of 3 different states & Freed) of ego: “Adult”, “Child”, & “Parent”, and understanding that they may be acting in any/ all ego states - Steps include: Known for: i. Learning to differentiate behavior when in a particular state Transactional ii. Therapist provides hints to staying in a desired state (Adult- Analysis (TA) Rational) which can be mediated to the individual and taught as an ideal state to achieve iii. Clients are taught to identify and avoid “hooks” that cause the person to enter mind games (e.g., avoid getting into arguments by ignoring the taunt of others) Dreikurs - Asks problematic children direct questions re negative roles (e.g., vengeful, power-seeking, attention-getting, and inadequate) they have chosen for themselves - Role-playing patterns are broken/targeted at home or at school PATTERN - Interrupting one’s own patterns, typically but not limited to, INTERRUPTION counterproductive ones  Idea that by changing a person’s behavior, s/he may in turn influence/change others (e.g., Family dynamic) behaviours - Main idea behind Social Interactionist Approach (SIA) Christensen - Deals mainly with the individual’s way of handling their interaction with others - Emphasizes a 2 step process: Essential Learning Components in Brief Family Therapy pg 3 Known for: i. Suggests that in order to change behavior in other and in effect Social their relationship to you, you must first change your own Interactionist behavior Approach ii. To change one’s counterproductive behavior requires one to (SIA) change their own behavior Christensen & Pass (1983) – had fearful clients inhibit activity in the face of fearful cues Fisch, Weakland, - Believed that by allowing clients the opportunity to experience & Seagal (1991) alternate ways of responding, they can in turn develop some form of self-control Dreikurs - B. Mod. Can be used to reward preferred behaviors and to extinguish through non-reward troublesome behavior, doing so disrupts maladaptive patterns Behaviour - Can be executed in the form of “verbal conditioning” which uses facial Modification gestures, nods of the head, and brief verbal responses (B. Mod.) (Perspective) Wesley Coons - Suggested that it only takes a mere 20 minutes before positive self- references, from the therapist using verbal conditioning, to produce positive emotional effects SECTION TWO: 13 COMPONENTS OF MLE (FEURESTEIN) THE TAXONOMY - Made up of 13 components that are designed and use to create long lasting cognitive change via MLE - (Analyzed work will comprise of all highlighted individuals + additional ones including Feuerstein himself that are conducted on a short-term basis) - Feuerstein is a traditionalist who believe in family values, and the maintenance and strengthening of the family unit 1. INTENTIONALITY & RECIPROCITY - Perhaps the most important MLE component of the learning in the family therapeutic process Feurestein - Described as a conscious attempt to change the state of the subject - Indicates that there is a focused effort on the practitioner to work according to preset, determined goals on behalf of the patient - Makes the client more aware and ready to attend to relevant cues in his/her life Christensen (SIA) - Described as an attempt to have the client inhibit activity towards “troubling stimuli” - Clients are taught how to:  Use adaptive ways of dealing with events that are normally troubling  Better planning & coping skills to change beliefs and perceptions of the client - Main goal is to teach the client to be assertive Freed (TA) - Achieved by intentionally having children and teens try to stay in a Essential Learning Components in Brief Family Therapy pg 4 rational “Adult mode” of being - Emphasizes “straight” communications instead of “crooked” communications – remaining rationale when dealing with others and avoiding hooks  Doing so forces clients to keep open and unambiguous channels of communications - Main goal is to teach clients how to maintain honest and straightforward ways of communication in problem-solving situations while interacting Martin Seligman - (Emphasizes heavily on optimism and its benefits) - Client is taught to be more optimistic in self-conversations – includes ABC Method extinguishing pessimistic self-references and thoughts (ABC) - Client learns to externalize blame and see personal problems as non- internal, non-stable, and non-global (faulty beliefs – Aaron Beck) Albert Elis - Emphasizes the use of logic to prevent “sick” thinking and personal turmoil. Rational Emotive Therapy (RET) Walter & Peller - Clients intentionally focus on the positive aspects of their lives while (SFA) ignoring the negative aspects - Clients also intentionally focus on solutions for a better future White (NFA) - Clients create narratives about their lives that are presented in a more optimistic light RECIPROCITY - Pertains to the ability of the therapist to engage in a “give-and-take” arrangement – therapist must be open to change and must provide two-way communication - Empathy will require extreme reciprocity (Cook, 2007) Feuerstein - Believes that both intentionality and reciprocity serve as “metacognitive components for self-reflection, insight, and articulation of the global learning experience” Thomas Gordon - Stresses that a therapist must be an active listener (1974) - Active listeners are most used in the TA approach (Freed) & NFA (White Brief Therapy - Portrayed as a feedback loop b/w therapist and patient - Therapist must buy the client into the therapeutic system by behaving like the client (utilization) – doing so ensures “chameleon-like way” of achieving reciprocity White (NFA) - To ensure reciprocity, the therapist must act like a “curious person” in the conversation, and the client should be known that the therapist is “privileged” to be involved in the relationship 2. TRANSCENDENCE - Referred to as “generalization” & “transfer” of training Freed (TA) - Relates back to the development of “straight communication” and being able to transcend this into all sorts of situations whether good or bad Essential Learning Components in Brief Family Therapy pg 5 Walter & Peller - Involves being able to reframe experiences & pay attention to positive (SFA) aspects of every situation  Will include the ability to re-author negative aspects of one’s experiences into more positive stories - eaches the individual to also view scenarios without problems, as well as becoming more solution-oriented as opposed to problem-oriented White (NFA) - Is reflective of the proverbial “silver lining in the dark cloud” – clients are trained to transform almost every negative story into a positive one Seligman (ABC) - Skill that is transcended is: positive thinking which can lead to a longer and healthier life - Views therapy as a way of modifying one’s “explanatory style” in positive ways when faced with the challenges of everyday life Christensen (SIA) - Involves teaching the client to take on a more active role as a “scientist” interpreting social situations in more realistic ways - Client can also become desensitized to troubling social stimuli - Transcendence can pertain to getting away from the “here & now” and attempts to focus attention on generalizing behaviors, thoughts, & attitudes towards more remote goals outside of therapy 3. MEANING Victor Frankl - Psychotherapist & concentration camp survivor (like Feuerstein) (2008) - Wrote: “Man’s Search For Meaning” - Meaning seen as the apogee of Man’s existence (reason for living) Feuerstein - The mediator is responsible for creating an orientation to search for meaning, to internalize it, and then energize it into action - Therapist is able to help the individual overcome “sweeping perception” via opening perceptual systems that might have been closed to certain experiences B.Mod. - Places LESS emphasis on meaning - Views social stimulus as being a conditioned event that is associated with rewards and punishments - Meaning is developed and changed by paying attention to stimuli that leads to rewards vs those that lead to punishment - Change is more likely to occur if problem is perceived as being behavioural based as opposed to be biological White (NFA) - The most direct aspect of meaning in family therapy - Gave “ascription (acknowledgement) of meaning” to past events] - Tampers with an individual’s perception of the past and the present in order to create a more optimistic future - White objectified the problem that is originally seen to be “within” the client, and had the problem “exorcized”, or placed in another (external) domain Walter & Peller - Meaning seen as a way of allowing a client to have a more positive way (SFA) of imaging life without THE problem - Highly effective with families and couples – provides different venues for behaving and ways of being Christensen (SIA) - Uses “cognitive reappraisals” to reevaluate the significance of social events Essential Learning Components in Brief Family Therapy pg 6 - Clients are taught more accurate ways of attending to salient features of the social landscape Freed (TA) - Involves learning to identify and attend to cues signaling other people’s “ego states” while remaining in a rational “Adult” state  Allows the patient to avoid unwanted/ prepare to overcome scenarios  Allows the individual to self-monitor themselves in order to avoid falling into a childish/parent state Brief Therapy - Focuses on the value and relevance of information that is important to the client’s functioning in a positive way. - Emphasis on getting the client to provide more positive meaning to negative life experiences, and creating a positive orientation 4. MEDIATION OF FEELINGS OF COMPETENCE Feuerstein - Involves offering the client an opportunity to display forms of mastery + being able to effectively identify strategies used to overcome the obstacle to promote competence Christensen (SIA) - Involves providing the client an opportunity to rehearse adaptive ways of dealing with “troublesome stimuli”, and becoming more confident Freed (TA) - Achieved when the client feels fine when they are neither in a subordinate (Child) or a controlling (Parent) communicative role - Achieving competence by staying in the adult phase also helps to foster friendship Seligman (ABC) - Competence is seen to enhance optimism, and vice versa - Competence grows from teaching clients to challenge traditional
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