Week 6 Case Study Discussion - Strategic Family Therapy

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Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 1

Strategic Models

Communications Outlook

• What Is Occurring in the Family, not Why It It Occurring.

• Social Context for Pathology

• Sequence and Hierarchy of Interactions

• Punctuation

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 2

Strategic Models

• MRI Brief Family Therapy • All behavior is communications

• Communications occur simultaneously and at different levels

• Content (report) and relationship (command)

• Relationships defined by command messages

• Relationships as symmetrical or complimentary

• Symmetrical relationships may become competitive (symmetrical escalation)

• Complementary relationships and superior/inferior roles

• Dynamics of punctuation

• redundant interactive patterns and recursive feedback loops

(continued on next slide)

Strategic Models

MRI Brief Family Therapy (continued)

• Paradoxical Communication • Paradoxical injunction • Double bind message • Redefining, prescribing, restraining

• How Attempted Solutions to Problems Contribute to the Problem Itself

• First Order and Second Order Change

• Relabeling (continued on next slide)

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 3

Strategic Models

Strategic Family Therapy (continued)

• Three Types of Misguided Solutions • Actions needed but not taken

• Unnecessary action taken

• Action taken at the wrong level

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 4

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 5

Strategic Models

• SFT: Haley and Madenes • Brief and active treatment

• The meaning of symptoms/Symptom as strategy

• Power and control

• Triangles, sequences and hierarchies

• Developing therapeutic strategies

• The initial interview

• The use of directives

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 6

Strategic Models

The Milan Systemic Model

• Selvini-Palazzoli, Boscolo, Cecchin, & Prata

• The Early Model • Paradoxes, counterparadoxes, rituals, and positive connotation

• Long brief therapy

• Structured family sessions

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 7

Strategic Models

Milan Systemic Model (continued)

•Hypothesizing, Neutrality, and Circular Questioning • Define each of the above and their role in the theory.

• The role of underscoring “relatedness”with each of these principles

• The invariant prescription

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 8

Strategic Models

• A Post Milan Epistemology

• Karl Tomm • Reflexive questioning

• The addition of “strategizing” to the repertoire of the systemic model

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 9

Behavioral and Cognitive-Behavioral Models

Behavioral Theory

• Leading Figures

• Reinforcements

• Adopting and Family Framework • Couples therapy

• Classical and operant conditioning

• Contingency contract

Behavioral and Cognitive-Behavioral Models

Cognitive Behavioral Theory

• Ellis and Beck

• Cognitive Restructuring

• Schemas

• Role of Assessment • Behavioral analysis

• Problem and functional analysis

• Homework Assignments

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 10

Behavioral and Cognitive-Behavioral Models

• Behavioral Couples Therapy

• Manipulating the Contingencies of Reinforcement

• From Reinforcement to Skills Building

• Therapeutic Contracts

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 11

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 12

Behavioral and Cognitive-Behavioral Models

• Integrative Couples Therapy • Jacobson and Christensen

• Themes of acceptance

• Research on the Behavioral Model • John Gottman

• The four horsemen of the apocalypse

• The 5:1 ratio of positive to negative

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 13

Behavioral and Cognitive-Behavioral Models

• Parent Education (A Behavioral Model) • Family management skills building

• Positive reinforcement, shaping

• Contingency contracting

• Functional Family Therapy • Focus on outcomes of behavior and how to change

them.

Goldenberg/Goldenberg, Family Therapy, 8th

edition © Brooks/Cole Cengage 2013 14

Behavioral and Cognitive-Behavioral Models

• Conjoint Sex Therapy • Sex as a metaphor for couple dynamics

• Need for sexual education

• Skills building

• Masters and Johnson

• Sensate focus, systemic desensitization, communications training

• David Schnarch

• Donald Meichenbaum