A Family Therapy Approach
Corinne approached me a while back asking if she could contribute to MyShrink and I was delighted. And when I learned she did family therapy . . . well I jumped on that one pretty fast.
Family therapists - in my view - are hard to find. Lots of therapists do indivdual therapy or even couples work, but there are relatively few experienced family therapists. Basically it's because this kind of practice requires a level of training and sophistication that's hard to come by.
So what does a family therapy approach look like? What's a typical problem that's encountered in family therapy? These are questions this article attempts to answer.
And by the way, look for the "post a question" section at the end. Corinne has generously given her time to answer some questions.
How Family Therapy Works
By: Corinne Scholtz MFT
Reviewed by: Dr. Suzanne LaCombe
Here's a real live example that's typical for how a family therapist might approach a problem. All the names have been changed to protect confidentiality.
A family with two young children, Sean age 5 and Alexandra, age 3, seeks therapy after noticing new and different behaviors by Sean.
Mom and Dad notice that lately he has shown a tendency to become angry with his little sister and to act out his frustrations by yelling, hitting, and sometimes biting. Sean’s schoolteacher reports that Sean acts very shy around his classmates except when he becomes bothered or frustrated – then he may hit the other child.
Mom and Dad are concerned and they argue over the best way to handle Sean’s behaviors. On a referral by a close friend, they decide to call a local and respected Family Therapist. Being curious about family therapy, these are some of the questions they ask during the initial phone call:
1. How long will the session be?
The typical session lasts fifty minutes.
2. Do you have experience in dealing with young children?
Depending on the practitioner, this could be answered in many ways. Make sure that your therapist is comfortable working with families with young children.
3. Do you need to meet with all of us at the same time?
Sometimes the therapist will meet with the entire family, and at other times will see the parents or the children alone. This will depend on the goals determined for treatment. A lot can be gained by meeting with the entire family for a few sessions.
4. How soon will the situation start to look better?
Among other things, this will depend on the kind of issues facing the family and the therapeutic goals they have agreed upon. For some people things begin to change with the first phone call!
5. How many sessions will be necessary?
Many family therapists are able to help their clients to substantially meet their goals in about twenty sessions.
Questions asked by the therapist during the first session:
To Mom and Dad separately:
1. How would you describe the problem?
From this the therapist learns that Dad feels Sean’s behavior is a response to Mom going back to work. Mom says that she thinks Dad is too rough when disciplining Sean and needs to go easier on him.
2. What effect do you see this having on the family?
Dad and Mom both state that they are tired and stressed and dislike the arguing that is taking place between them. Mom has started to feel guilty about her time away from the family and Dad is growing impatient with Sean.
Since Mom perceives Dad as being too rough, she tries to be more nurturing with Sean, but this causes more conflict with her husband, who thinks Sean is being babied.
3. When did these behaviors start to appear?
Sean’s behaviors started about 4 months ago when he began kindergarten.
4. What is different this time?
We learn that Sean used to spend every day with his mom and little sister. Once he started school, mom decided to go back to work and put Alexandra into daycare.
Over the course of therapy, Mom and Dad realize that the family's stress is related to mom returning to work, Sean beginning school, and Alexandra going to daycare.
Mom, Dad and the therapist eventually gain some insight into their predicament and come up with a strategy:
- They realize that there are life cycle issues that occur in all families and that they must find a way to be flexible and to change.
- They learn that they need to talk to each other instead of arguing about Sean’s behavior; they agree that from now on they'll handle the situation as a team. As a result of strengthening the parental unit, Sean escapes being in the middle of his parents arguments.
- They learn that Sean acting nicely around his sister is as deserving of attention as when he is acting badly. They agree to set consistent consequences for Sean's inappropriate behavior but also to observe and acknowledge with positive feedback when Sean treats another nicely.
- They acknowledge that validating Sean’s frustrations, recognizing his triggers and creating other options for dealing with times of anger is a possible goal for therapy as well.
- They also agree to create time with each other that doesn’t revolve around daily tasks.
Do you have a question about family therapy?
Leave your question and Corinne Scholtz will answer it for you. Questions and replies will be posted below.
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Therapy Lingo Article?
Finding The Right Therapist
I'm looking for the right therapist/counselor for my marital issues. The town I live in is not that big and in my search I find nothing but "M.A's" and "M.S.'s". With these being my choices how can I narrow down who can best assist me in my time of need? What kind of clues can I look for who would best suit me and my husband? I don't want to waist alot of time and money before I find the right one. Thank you. Where can I find you? LOL! You sound perfect!
Thanks for writing and for your compliment! Has your search turned up any MFT degrees, or marriage and family therapists? Some clues that you may want to consider as you search for a therapist - do they have a website? If so, how do you feel when you read the site? What type of 'vibe' do you get? Many times we form initial impressions right off the bat just by visiting a website. If they don't have a website, that's a clue too. In this day of social networking and marketing I'd be shocked if they didn't have a site. If they rush you during the first phone call, or don't answer your questions, it may not be a good fit. You want to look for someone who will listen, make you feel heard, and share confidence that they know something about your situation. Word-of-mouth is really a clue too...is there someone you know who may have gone to this therapist before?
I understand your concern about wasting time and money and if you keep these small clues in mind it may help you to find a 'good fit' sooner than later.
How Systemic Therapy Has Shaped Me
Pursuing a marriage and family therapy degree has shaped my view of people and problems dramatically. I see interconnections now, where before I thought more linearly, a = b. But now b also = a, and when this cycle is understood the possibility for significant relationship change presents itself. Clients tend to pursue therapy because they believe something is wrong with them, that in some way they are flawed. Instead of ‘fixing’ the person, seeing the client within his/her environment changes what we think we see. It’s all about perception. A more traditional approach to counselling would probably be to pathologize the client - meaning the client would be diagnosed with a mental/emotional disorder in contrast to seeing the client and their problem in context of relationships and culture. When there is a shift from seeing the client as the 'problem' we are able to honor the client's strengths and efforts to resolve the dilemma. A systemic perspective also considers the relational space between people and investigates how the relationships 'holds' the problem between the two people.
I’m absolutely positive had I not pursued a marriage and family therapy degree, I would be a different person writing this today. We become what we think, and we think because of what we learn…my insights into communication and patterns have developed. This helps me to look at the interactional cycles in my own relationships and to see how I am affecting problems I may encounter. Through the course of my studies, I've also come to see that I tend to orient myself as a feminist, and I'm sure these beliefs influence how I make meaning of what I see. The key is being aware of this!
Spirituality has always been important to me as well as a holistic perspective on life. I feel that systemic learning has complemented how I thought before studying, as well as my values.
I am looking into doing masters in FT and just stumbled into your article. It is very inspiring and i think that I'm blessed by reading it. I would like to keep in touch when I finally get started in 2013.
Thanks for taking the time to send your thoughts! Of course I would enjoy staying in touch and hearing about your journey. You may find my personal website helpful too, as there is a lot of information about family and marital therapy. It's www.connectedliving-fl.com. Congrats on your decision to attend graduate school - it was definitely one of the best times of my career!
Early Marital Problems - Who To See?
I have been married for a short 7 months and am worried that my wife has lost interest in our relationship. She works late every day (and doesn't have to) and intimacy is gone already. If I try to talk things out with her she doesnt want to because she says she doesn't want to argue. What type of therapist do you think we should see?
It does sound as though your marriage is under stress and perhaps your wife doesn't want to argue out of fear it might make things worse. However, having those 'hard-to-talk' about conversations can happen without fighting...
Based only on what you share, it may be a pattern exists where the more worried you become, the more you want to talk about things. As you pursue your wife to talk, she seems to distance and disappears into work. This could be a classic pursuer-distancer relationship pattern that is common and occurs within all couples at different times. It's just one way of managing anxiety within the relationship.
That being said, I would recommend finding a therapist who is an expert in marriage and family therapy. You can search locally, or on websites such as Psychology Today. Take some time during the initial phone call to sense how the therapist makes you feel about their services. Ask about any concerns you may have. Even if you may have to attend sessions by yourself for some reason, a marriage therapist can counsel you as a couple.
Most of the time our struggles, challenges and obstacles in relationships can help to learn more about ourselves and who the other person is.
Referral to a Family Therapist
I was wondering what criteria an intake worker might use to refer families to a family therapist.
A client may be presenting with any number of symptoms that would be appropriate for a referral to a family therapist. The criteria is not any different from other mental health professionals that you might refer to! To give you an idea on the types of services a family therapist provides, and to view a list of issues that we are trained to handle, pls. visit my website at www.connectedliving-fl.com. This way you can also pass along this information to your clients!
As a Bachelors student in Human Resources and Management Can a genogram determine whether a family is beyond help or not?
Nope - a genogram reveals information such as family patterns, emotions, relationship triangles, alliances and coalitions, divorces, marriages, births...but it will never reveal information that can be interpreted as 'beyond help'. Think of it as one tool that allows a therapist to visualize the family relationships over several generations - that's all. It is not intended to be a diagnostic tool looking for signs of being 'beyond help'. Several other students have written questions about this in the past - I think that the answers to these posts may be interesting to you!
A Multigenerational Approach to Family Therapy
What is a multigenerational approach to family therapy?
A multigenerational approach is one way of understanding the relationships in a family. Typically a therapist using a multigenerational lens is considering the current family's functioning as influenced by the past. Often times stories, emotions, and ways of thinking will flow from one generation to the next without our conscious awareness. We then tend to make decisions, choose relationships, and see the world in a particular way due in part to growing up within this family. The power of using a multigenerational approach is discerning patterns from one generation to the next; unspoken emotional processes; timing of specific events; triangles, alliances and coalitions between family members; birth order...all of these variations of family relationships are explored using a multigenerational approach. Most often times this is made visual with the use of a genogram.
This approach can be very useful in therapy because some clients seek to understand and bring into awareness the dynamics and functioning of their family.
When Should A Family Seek Therapy?
My family is very solid and we usually get along well. But we tend to have communication problems. They are very new and have only been going on for about 2 months but they have effected our relationships. Is it smart to go into family counseling now or should we try to figure it out within the family before taking that step?
I'm so glad that you asked this question. I tend to see a huge difference between clients who seek therapy during the beginning of a potential problem versus clients who wait until the problem has hung around for a while. Normally clients who have waited come to therapy because they are in pain, and usually the way they have been trying to solve the problem hasn't worked. However, clients who arrive toward the beginning of a situation tend to be seeking solutions to prevent a problem from becoming more permanent. That being said, I think that you know your family best, and if you have the inclination that family therapy may be helpful, by all means try it out! You have little to lose and so much to gain. Perhaps instead of trying to fix something that's broke, you can gain the tools to prevent something from breaking in the first place. Make sense?
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