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Marital Contract
(Sager)
Concentrates on dissatisfaction form needs not met.

Focuses on unconscious.

Goal: Freedom from hidden introjects from past.

Examines the past.
Extended Family Therapy
Solid Self
A person:
 - works toward consistency and independnce

 - has clear values and beliefs.

 - makes independent decisions.
Extended Family Therapy
Pseudo Self
A person:
 - has a false or pretend self.

 - changes according to pressure on self.

 - has random, discrepant beliefs and principles chosen in order to conform.

 - displays a low level of differentiation.
Genogram
A structural diagram of a family's relationship system going back three generations and schematically depicting family members.
Family Projection Process
The mechanism by which parental conflicts are transmitted (projected) onto the children.
Emotional Cutoff
The process of separation, isolation, withdrawal, running away, or denying the importance of the parental family.

 - Running away from unresolved emotional ties to one's family.
Multigenerational Transmission Process
Severe dysfunction within a family is conceptualized as the transmission of the family's emotional system over several generations.
Differentiation of Self
The extent to which a person is able to separate intellect and emotions.

Intrapsychically: the ability to separate thoughts from feelings.

Interpersonally: the ability of an individual to resist being overwhelmed by the emotional reactivity of their family.
Triangulation
In a two person emotional system uder stress, the tendency to recruit a third person into the system to lower stress and anxiety and become more stable.
Multi-Generational Family Therapy
Eight Forces Shaping Family Functioning
(Bowen)
1. Differentiation of self.
2. Triangles
3. Nuclear family emotional system.
4. Family projection process.
5. Sibling positions.
6. Multigenerational transmission process.
7. Emotional cutoff.
8. Societal regression.
Multi-Generational Family Therapy
Key Concepts
(Bowen)
Opposing forces, those that bind a family together vs those that lead to individuality.

Unresolved emotional attachments to one's F.O.O. must be resolved before one differentiates.

Focus: present and past F.O.O. patterns
Extended Family Therapy Goals
 - Differentiation of each family member.

 - Detriangulation

 - Disruption of hte family projection process.

 - Redirection of anxiety and relief from symptoms.
Extended Family Therapy
Methodology/Interventions
 - Use of genogram.

 - Exploration of the F.O.O

 - Exploration of present family functioning.

 - Therapist is a coach.

 - Practicing of differentiated behavior (role play)

 - Partners talk directly to the therapist.
Object Relations Family Therapy
Theory
Focus on interpersonal relationships and intrapsychic structure.

Therapist identifies projective mechanisms and brings them back to the marital relationship in order to assist the client in acknowledging and accepting previously split-off parts of the ego.
Object Relations Family Therapy
Goals
 - To modify personalities of individual family members so that they can related to each other.

 - Uncover dysfunctional interactional patterns.
Psychodynamic Family Therapy
General Theory
 - Focus is on the exploration of past history/early experiences.

 - Insight -oriented.

 - Unit of treatment is individual.
Psychodynamic Family Therapy
Goals
Insight, strengthening of ego functioning, reduction in family dysfunction, and more satisfying object relations.
Experiential Family Thearpy
 - Provides a here-and-now experience for the client with each person being both a client and a therapist.

 - Works with the family as a unit.

 - Defocuses the identified Patient (IP)
Gestalt Family Therapy
Theory
 - Concerned with how people deal with their immediate existence.

 - Focused on how reality is perceived and experienced by each individual member (as well as family as a whole).

 - Focus is on the immediate moment.

 - Self-disclosure and open, honest communication are the framework for dealing with family problems.
Gestalt Family Therapy
Goals
Help the client become aware of self-defeating behaviors.  Self-awareness leads to self-direction.

 - Increase affective intensity.
 - Expand the ability to experience the present.
 - Promote freater freedom of choice.
 - Increase personal integrity.
 - Facilitate the reintegration of disowned parts of self.
Experiential Family Therapy Goals
(Satir)
 - Growth
 - Identify the role a person plays in the family system
 - Develop healthy communcaition patterns
 - Stress Family intimacy
 - Build self-esteem
 - Decision through negotiation and exploration rather than power.
Gestalt Family Therapy
Methodology/Interventions
(Satir)
 - Family Life Chronology.
 - Uncovering of family games.
 - Teaching Communication skills.
 - Explanation of the family process.
 - Family Sculpture.
Rescue Game
One family member placates (agrees), one blames (disagrees), and one is irrelevant (distracts).
Coalition Game
Two people always agree and a third disagrees, or two disagree and one agrees.
Lethal Game
All agress with everyone else at teh expense of their own needs.
Growth Game
People either agree or disagree, according to their experiential reality, while remaining a part of the system.
Styles of Communication: Placaters
(Satir)
Fear disapproval, try to please, are dependent
Styles of Communication: Blamers
(Satir)
React by attacking (finding fault, accusing) in order to cover up feeling empty and unloved.
Styles of Communication: Super Reasonable People - AKA Computers
(Satir)
Only feel safe at a distance. Rely on intellect to keep from acknowledging that they have feelings and are vulnerable. Remain detached, calm, not emotionally involved.
Styles of Communication: Irrelevant People - AKA Distractors
(Satir)
Often the youngest child in a family. Gain approval by acting cute and harmless. Distract others, seems unable to relate to anything going on.
Experiential Family Therapy:
Basic Theory
(Satir, Kemper, Whitaker)
 - Deal with the present
 - Emphasixe the here-and-now relationship between the therapist and the family.
 - Structure interactions to help the family develop more growth-enhancing behavior.
 - Do NOT emphasize indight or interpretation.
 - Provide an experience that is a stimulus to growth.
Satirian Theory
 - Therapist and family Join forces to achieve a health-promoting process.
 - Sympotms are seen as signaling a blackage in growth.
 
 - Focus on building self-esteem, promoting self-worth, correcting problems in communication, alleviating family pain.
 - Clarification of styles of communication.

 - Works in the here and now.
Operant conditioning
A form of learning whereby a person is rewarded for performing certian behaviors.

Reinforcement increases the probability of continued desireable response
Classical Conditioning
A form of respondent learning in which an unconditioned stimulus (UCS) such as food, leads to an unconditioned response (UCR), such as salivation.  This UCS is paired with a conditioned stimulus (CS) such as a bell, resulting in the same response.
Systematic Desensitization
The therapist constructs a stimulus hierarchy in which different situations that the client fears are ordered on a continuum from mildly stressful to very threatening.
Behavioral Marital Therapy Theory
(Liberman and Stuart)
To apply basic learning principles (positive reinforcement and shaping) to create significant behavioral changes in the partners.
Behavioral Marital Therapy Techniques
(Liberman and Stuart)
 - Increase a couples's ability to participate in and initiate pleasing interactions.
 - Decrease a couple's negative interactions.
 - Train partners in effective use of problem-solving and communication skills.
 - Teach contingency contracting to negotiage resolution of recurrent problems.
 - Administer marital pre-counseling inventory.
 - Caring days technique  -
Structural Family Therapy Theory
(Minuchin)
 - Geared to the present
Therapist
 - challenges family's patterns of interactions.
 - Encouraged family members to view the locus of pathology as residing within the context of the family structure rather than the symptoms of the IP.

 - Change in family structure must take place to create change.
 
 - Focus: on underlying structure of the family (subsystems, alliances,, coalitions, boundaries) and the resulting dynamics
Systemic Family Therapy Goals
 - Uncover connecting patterns (rules)
 - Reveal family games.
 - Point out faulty communication patterns.
Change rules in order to change behavior.
Systemic Family Therapy Methodology and interventions
 - Systemic Intervention
 - Use of counter-paradox
 - Positive connotation, circular questioning, hypothesizing.
 - Therapist remains neutral and offers information as a method of infuencing and helping the family change.
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