FAMILY THERAPY - DEAN AMORY

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What Is Not the Focus of Brief Strategic Family Therapy? BSFT has not been tested with adult addicts. For this reason, BSFT is not considered a treatment for adult addiction. Instead, when a parent is found to be using drugs, a counselor needs to decide the severity of the parent's drug problem. A parent who is moderately involved with drugs can be helped as part of his or her adolescent's BSFT treatment. However, if a parent is drug dependent, the BSFT counselor should work to engage the parent in drug abuse treatment. If the parent is unwilling to get drug abuse treatment, the BSFT counselor should work to protect and disengage the adolescent from the drug dependent parent. This is done by creating an interpersonal wall or boundary that separates the adolescent and non-drug-using family members from the drug dependent parent(s). This process is discussed in Chapter 4 in the section on "Working With Boundaries and Alliances". This Manual This manual introduces counselors to concepts that are needed to understand the family as a vital context within which adolescent drug abuse occurs. It also describes strategies for creating a therapeutic relationship with families, assessing and diagnosing maladaptive patterns of family interaction, and changing patterns of family interaction from maladaptive to adaptive. This manual assumes that therapists who adopt these BSFT techniques will be able to engage and retain families in drug abuse treatment and ultimately cause them to behave more effectively. Chapter 2 will discuss the basic theoretical concepts of BSFT. Chapter 3 will present the BSFT diagnostic approach, and Chapter 4 will explain how change is achieved. Chapter 5 is a detailed discussion of how to engage resistant families of drug-abusing adolescents in treatment. Chapter 6 summarizes some of the research that supports the use of BSFT with adolescents. The manual also has two appendices, one on training counselors to implement BSFT and another presenting case examples from the authors' work. Concepts and techniques discussed by Minuchin and Fishman (1981) have been adapted in this BSFT manual for application to drug-abusing adolescents. Additional discussion of BSFT can be found in Szapocznik and Kurtines (1989). 48
Chapter 2 - Basic Concepts of Brief Strategic Family Therapy The previous chapter introduced the underlying philosophy of BSFT: to help families help themselves and to preserve the family unit, whenever possible. The remainder of this manual focuses more directly on BSFT as a strategy to treat adolescent drug abuse and its associated behavior problems. This chapter presents the most basic concepts of the BSFT approach. It begins with a discussion of five theoretical concepts that comprise the basic foundation of BSFT. Some of these concepts may be new for drug abuse counselors. The five concepts discussed in this chapter are: Context Systems Structure Strategy Content versus process Context The social influences an individual encounters have an important impact on his or her behavior. Such influences are particularly powerful during the critical years of childhood and adolescence. The BSFT approach asserts that the counselor will not be able to understand the adolescent's drug-abusing behavior without understanding what is going on in the various contexts in which he or she lives. Drug-abusing behavior does not happen in a vacuum; it exists within an environment that includes family, peers, neighborhood, and the cultures that define the rules, values, and behaviors of the adolescent. Family as Context Context, as defined by Urie Bronfenbrenner (1977, 1979, 1986, 1988), includes a number of social contexts. The most immediate are those that include the youth, such as family, peers, and neighborhoods. Bronfenbrenner recognized the enormous influence the family has, and he suggested that the family is the primary context in which the child learns and develops. More recent research has supported Bronfenbrenner's contention that the family is the primary context for socializing children and adolescents (for reviews, see Perrino et al. 2000; Szapocznik and Coatsworth 1999). Peers as Context Considerable research has demonstrated the influences that friends' attitudes, norms, and behaviors have on adolescent drug abuse (Brook et al. 1999; Newcomb and Bentler 1989; Scheier and Newcomb 1991). Moreover, drug-using adolescents often introduce their peers to and supply them with drugs (Bush et al. 1994). In the face of such powerful peer influences, it may seem that parents can do little to help their adolescents. However, recent research suggests that, even in the presence of drugusing (Steinberg et al. 1994) or delinquent (Mason et al. 1994) peers, parents can wield considerable influence over their adolescents. Most of the critical family issues (e.g., involvement, control, communication, rules and consequences, monitoring and supervision, bonding, family cohesion, and family negativity) have an impact on how much influence parents can have in countering the negative impact peers have on their adolescents' drug use. Neighborhood as Context The interactions between the family and the context in which the family lives may also be important to consider. A family functions within a neighborhood context, family members live in a particular neighborhood, and the children in the family are students at a particular school. For instance, to effectively manage a troubled 15- year-old's behavioral problems in a particular neighborhood, families may have to work against high drug availability, crime, and social isolation. In contrast, a small town in a semi-rural community may have a community network that includes parents, teachers, grandparents, and civic leaders, all of whom collaborate in raising the town's children. Neighborhood context, then, can introduce additional challenges to parenting or resources that should be considered when working with families. 49
Page 1: AN INTRODUCTION TO FAMILY THERAPY T
Page 5: Cover Illustration: Zirta - Ilustra
Page 8 and 9: Family Therapy - Contents Cover Ill
Page 10 and 11: Strategy: The Three Ps of Effective
Page 12 and 13: Bowen’s Strategic Family Therapy
Page 14 and 15: Milan Systemic Family Therapy or
Page 16 and 17: FAMILY CONTRACTS...................
Page 18 and 19: Systemic Family Therapy Manual.....
Page 20 and 21: BASIC FAMILY THERAPY TECHNIQUES ...
Page 22 and 23: Summary of Family Therapy Theories
Page 25 and 26: Family Therapy - Background Informa
Page 27 and 28: History and theoretical frameworks
Page 29 and 30: Techniques Family therapy uses a ra
Page 31 and 32: Founders and key influences Some ke
Page 33 and 34: was also an active clinical member
Page 35 and 36: John Elderkin Bell Perhaps one of t
Page 37 and 38: Currently, Carter is an active clin
Page 39 and 40: Brief Therapy This name refers not
Page 41 and 42: Brief Strategic Family Therapy From
Page 43 and 44: There are four important BSFT steps
Page 45 and 46: Chapter 1 - Brief Strategic Family
Page 47: The Family Profile of a Drug-Abusin
Page 51 and 52: The Principle of Complementarity Th
Page 53 and 54: Content Versus Process: A Critical
Page 55 and 56: Subsystems that cross generations (
Page 57 and 58: When a family's developmental stage
Page 59 and 60: Conflict Resolution While solving d
Page 61 and 62: Chapter 4 - Orchestrating Change Th
Page 63 and 64: It is possible that despite all the
Page 65 and 66: counselor gains considerable rappor
Page 67 and 68: Reframing negativity might involve
Page 69 and 70: son on regular outings. The counsel
Page 71 and 72: 6. Opening Up Closed Systems Famili
Page 73 and 74: Dealing With Resistance to Engageme
Page 75 and 76: member to the next available family
Page 77 and 78: As a first step in joining and trac
Page 79 and 80: Chapter 6 - Clinical Research Suppo
Page 81 and 82: Among families who were admitted wi
Page 83 and 84: Results showed that 81 percent of f
Page 85 and 86: Liddle, H.A. Multidimensional Famil
Page 87 and 88: Health, Alcohol, and Drug Dependenc
Page 89 and 90: Therapists can do a great deal to i
Page 91 and 92: the problem focused narrative. Unde
Page 93 and 94: Brief (psycho-) therapy From Wikipe
Page 95 and 96: Strategic Family Therapy From Wikip
Page 97 and 98: The goal-setting stage is used to h
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Bowen’s Strategic Family Therapy
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1. Differentiation of Self The firs
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103
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Example: Michael and Martha were ex
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Emotional distance This pattern is
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4. The Family Projection Process Th
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Amy performs less well. Marie is le
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5. The Multigenerational Transmissi
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6. Sibling Position Bowen stressed
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7. Emotional Cut-off This refers to
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8. Societal Emotional Processes The
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Murray Bowen’s approach operates
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These were complementary relational
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They contend that problems that are
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Normal Family Development To Bowen,
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encourages cut off members to retur
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Because the family is not a static
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The last four triangles represent h
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Assumptions of family systems A Juv
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This ongoing process can be arreste
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Therapeutic Goals and Techniques Mi
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Reaction to change: Healthy familie
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Three reasons that make clients mov
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Interventions: Joining and accomod
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Step 7: challenging unproductive as
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Cut games, straighten transactions.
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Communication and Response Patterns
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Milan Systemic Family Therapy or
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Interventive (reflexive) questions
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Second-order change is change that
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the family could be told that famil
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References 1. ^ Wade, 1997, p. 23 2
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Four-Dimensional Interventions As b
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versus Connectedness and Trust over
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Narrative therapy topics Concept Na
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Next, in similar fashion, the thera
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Family Life Cycle: Just like an ind
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9. Fish, V., Post Structuralism in
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I/ INFORMATION-GATHERING TECHNIQUES
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II/ JOINING This is the process of
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V/ INTERVENTION TECHNIQUES Interven
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SPECIAL DAYS, MINI-VACATIONS, SPECI
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UNBALANCING Technique used to creat
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EFFECTIVE COMMUNICATION If each mem
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Summary of Dimension Concepts Probl
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Read more: How to Conduct a Family
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D. Normal family development 1. Mar
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Systemic Family Therapy Manual Ms.
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Appendixes Illustrations Tables 10.
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should still be managed following t
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2.8 Power The therapist should take
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Table 1: Perceptions that are helpf
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how would things be different? What
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4.5 Child Centred Interventions It
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Brainstorm themes/hypotheses/formul
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7. Middle Sessions Goals during mid
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about the difficulties you are expe
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Open up new stories/explanations: E
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To encourage the family to gain a s
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8. End Sessions Goals during ending
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9. Indirect Work There are many are
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10. Proscribed Practices The proscr
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APPENDIXES Appendix 1: Sample Appoi
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Appendix III: Sample Referrer lette
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Appendix V: Closing letter to refer
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Interventions Key points/ideas/deci
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III. Assessment (see Assessing The
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BASIC FAMILY THERAPY TECHNIQUES AC
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ADDING COGNITIVE CONSTRUCTIONS 1.Ad
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In fact, for any given client state
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ln the quoted example the consultan
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as a buffer; mother and daughter co
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any dysfunction or problem in the g
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decisions. The agenda may include a
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IDENTIFICATION Family therapy techn
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After this initial strategy is empl
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the client’s view of the problems
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In the preceding example, it is imp
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one should do these things. As the
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Client: Literally, my husband. He
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The use of particular types of circ
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C: He said that if I didn’t go to
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Tracing past behavioral interaction
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The therapist thereby establishes a
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RESTRUCTURING The procedure of rest
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is able to identify the sequence of
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intake forms, client attitudinal re
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Communications Approaches Contextua
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Family Therapy Survey Nichols and S
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E. The power of family therapy 1. E
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III. Early Models And Basic Techniq
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K. Lessons from early models 1. Gro
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5. From cybernetics to structure a.
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D. Development of behaviour disorde
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E. Goals of therapy 1. Find fulfill
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E. Development of behavior disorder
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9. A major change in family composi
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FAMILY THERAPY - DEAN AMORY

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