Postmodern Approaches to Family TherapyMarriage and Family Counseling

Dr. Sparrow

ReviewFamily therapy (Bateson, Jackson, Haley) initially viewed family as resistant (homeostasis)

There was a gradual move toward collaborating with the family, and serving as a highly active, involved expert who could help the family meet its goals (SFT)

SFT was a bridge between the early approaches and the post-modern approaches, in which the therapist does not direct, but assists clients in:

Finding solutions that are within their capabilities (Solution Focused)“Deconstructing” the myths that rule their lives. (Narrative)

Social Constructivism as the Catalyst for ChangeSocial Constructivism emphasizes that people create their own realities

Social constructionism, integrates the idea that our interaction with others co-creates our reality. It challenged the idea that we can ever be objective

Challenged the mechanisitic approach of the cyberneticistsCaring is valued more than curingExpert becomes egalitarian partner.Family perspectives and beliefs define “reality” in the therapeutic environment

Three Implications of Social ConstructionsmNo one has a corner on the “truth.”

Encourages therapists to assist clients in understanding the source of their beliefs, even the “sacred cows” that normally are accepted without question.

Therapy is a linguistic exerciseConstructing new viewpoints can bring about solutions (reframing again)

Therapy should be collaborativeSince no one possesses the truth, then meaning and direction develop through dialogue between therapist and clients.

Solution focused therapy

Is similar to the Cyberneticists, in that it focuses on resolving the presenting complaint as simply as possible

Instead of focusing getting clients to do less of what doesn’t work, SFT focuses on getting clients to do more of what does work.

Is different from the Cyberneticists in that they

Trust the client to resolve the problemFocus on successes rather than failures in therapy.

Influence of Milton Erickson

Erickson used hypnotic language tobypass conscious RESISTANCE, andrelease unconscious POTENTIALS

Jackson, Haley, etc. focused on RESISTANCE and drew on Ericksonian methods to defeat or circumvent resistance to change.

ParadoxIndirect communication

Influence of Erickson, cont.

Solution focused therapists focus on the latent, or unconscious POTENTIALS within the client, and use Ericksonian methods to elicit these potentials.

Looking for exceptionsBuilding on competencies “How did you do that?”Use of hypnotic suggestions “I’m wondering what will new thing will happen when you go home and get into the next dispute.”

Solution Focused Theory

People really want to change, and have the potential to change–– de Schazer pronounced the “death of resistance.”

They have already experienced success, but are not focused on their successes

The exceptions to the problem show us where the client already knows what to do.

The therapist helps the client become aware of these successes, and uses language to frame these exceptions as solutions.

Then the therapist and client focus on the future, where these competencies can be expressed more fully.

Solution Focused Theory, cont.

While the sources of problems are very complex, the solutions are usually quite simple.

Language creates reality, a basic constructionistic principle

But another part of the Solution focused evolving idea is that the therapist/client relationship is crucial, especially the positive impact of a hopeful therapist.

Solution focused therapy

Therapist does not impose view of reality

Focuses on the way people describe themselves and their problems

There is hardly any focus on the origins of problems, only the solutions.

Therapist helps client to do or think differently so they can become more satisfied with their lives.

Willing to settle for modest goalsbecause of the basic belief in a person’s ability to solve his or her problems, andbecause any success will affect other areas (equifiniality)

Solution Focused ApproachAssessment of who is the client? -- Visitors,

complainants and clients

Problem description, what efforts have been made

Setting future goals, and how client will know when goals have been met

Amplify goals, resources, and exceptions

Create a context where strengths can be acknowledged and expressed

Main techniqueReframe problem as as more functional Clarify logical bindLinking hypnotic-like directive to ineveitable sign of progress

Solution FocusedSpecific Techniques

Coping questions

Formula first session task

Exception question in order to formulate solutions

Miracle question

Scaling questions

Compliments focused on doing more of what works.

Solution FocusedTherapeutic Language Patterns

How did you do that? (Coping question)

How will you know when you have succeeded?

What needs to happen for you to know that you have succeeded?

I am impressed by how resourceful/creative/courageous you have been. Have you always been that way?

I’m not surprised that you are so depressed. There would be something wrong if you weren’t. (Dr. Sparrow)

I’ll be interested to know what works for you this week.

Solution focused suggestions

Formula first session task -- observe what you would like to continue to have happen

Do more of what is working

Do something different

Go slowly

Do the opposite

Prediction task -- will the problem be better tomorrow, or not?

Some recently criticisms

Simplistic

Therapist needs to remain connected with client’s reality for therapy to work, so consequently…

Therapist needs to validate client’s perception of the problem.

Narrative Therapy

Concerned only with the ways that people construct meaning (with language) rather than on their behavior.

The “facts” are part historical and part social construction. The constructions may or may not be helpful to the client.

Rather than imposing a reframing of a problem, the therapist explores new ways that the client himself can construct a new view.

Narrative Therapy, cont.

Focuses on self defeating cognitions, as opposed to self defeating behaviors (focus of the cyberneticists)

Focuses on how the problem impacts the family, as opposed to how the family impacts and perpetuates the problem

Externalization of the problem helps the clients see themselves as victims of labels and culturally authored stigmas that may have little to do with the person.

Narrative Theory

Reality is created, not discovered

We create stories that fit our assumptions, which are in turn driven by social and cultural biases.

Narrative Therapy’s Methods

Therapists mustTake a collaborative, empathic interest in the client’s story.Search for past incidences of strength and resourcefulnessUse questions to respect the emergence of a new story.Never labelHelp clients question dominant cultural narratives

Narrative Therapy’s Methods

Shifting from problem saturated language

Shifting away from totalizing views

Externalizing the problem

Exploring for history of unique outcomes, that is, times when client has successfully resisted the problem.

Deconstruction and reconstruction of stories

Narrative Therapy’s Specific Techniques

Everything in the form of questions (remember Bowen?)

Externalizing

Relative influence questions about the effect of the problem on the family

Sparkling events or unique outcome questions

Reauthoring story, “What does it say about you that you were able to…”

Reinforcing new storyfinding an audience to support new storyLetter writing by therapist.

Deconstructing cultural assumptions

Narrative Therapy’s Methods

Three stages of therapyRecasting the problem as an external afflictionfinding partial triumphs over the afflictionfinding support for the new story

Narrative Therapy’s Weaknesses

Overlooks that symptoms are often related to family conflict

Dismisses interactional nature of family distress

Doesn’t treat family as a unit

That’s All FolksNow for the quiz…