Family Counseling Approach
It is said that in the early years of couples’ lives, they intensely want each other. Meanwhile, the middle years with the presence of children are crucial due to conflicts related to communications, parenting issues, in-laws, finances, partner’s infidelity, and other related issues, and in the late years of their life they need each other (Broderick & Schrader, 1991). Improving a marriage relationship and resolving specific concerns before they get worse are one of the major objectives of family counseling (Atwood, 1995).
Family counseling may help in promoting better relationship and understanding within a family (Berg, Sperry, & Carlson, 1999). All families have conflicts or disagreements at times, and resolving their differences in a positive manner with respect to the interest and needs of each member is possible with the aid of family counseling approaches (Berg, Sperry, & Carlson, 1999).
Different types of family counseling therapy can help in improving the lives of each family member with focus on different orientations, including the past family origin and early life difficulties, the present happenings which may either be satisfactory or unsatisfactory, their thoughts, behaviors, and emotions (Berg, Sperry, & Carlson, 1999). What causes the pain in the lives of family can be healed and have great potential to move into more productive ways through different family therapy approaches (Eisenberg, J. , & Wahrman, 1991).
The Psychodynamic or Transgenerational Models, Cognitive Behavioral or Behavioral Models, and Structural/Strategic/MRI Models are some of the more well-known family counseling approaches that will be explored and analyzed in this study (Eisenberg, J. , & Wahrman, 1991). Comparing and contrasting the Cognitive Behavioral Models of family therapy with other major models of family therapy can help better understand the family system’s boundaries, complementarities, family ties, capacity for change, and ability to change, as well as balance the relationship (Ellensweig-Tepper, 2000).
A personal integration approach has been included in this study in an attempt to ensure that the expressed concerns can encourage each family member to have positive ways of communication patterns from the chosen model. The Evolution of Family Counseling The evolution of family counseling therapy can be traced in the social and theoretical development and changes in the field of psychology.
The practice of family counseling therapy evolved out of the paradigm of the patients’ treatment needs that go beyond the medical and psychoanalytic workroom, and a way to explain the cause of individual’s emotional distress can be traced from the social context of the family (Gingerich & de Shazer, 1991). The focus on the mutually influential and interpersonal interactions to a systemic perspective is based from the studies of different small group dynamics on family and marriage counseling, child guidance movement, etiology of schizophrenia and social work practices.
In 1920, a research conducted by Kurt Lewin led to the conceptualization and understanding that maladaptive patterns of individual behavior were brought by disrupting patterns of group’s accepted behavior and postulated that a group is more than a sum of its part (Bell-Gadsby & Siegenberg, 1996). It was further studied that group discussion is more instrumental than lecturing in changing one’s behavior and ideas (Bell-Gadsby & Siegenberg, 1996). The principle is highly relevant to family counseling therapists and professionals that work with entire family systems.
One good example of the influence of family to a child is when a troubled child needs to take the role of an obedient and good child to avoid family distress, a kind of role reciprocity in a family dynamics. Other aspects that contributed to family therapy approaches are the acting out of family conflicts and unresolved family issues in an objective setting (Leupnitz, 1992). The focus of correction is from individual to the entire family. Other fields that made significant contributions on the evolution of family counseling include the field of social work with family oriented training.
The research on schizophrenia in Palo Alto, California by Gregory Bateson who was able to developed a theory on communication that an individual’s schizophrenic behavior is derived from familial environment with homeostatic imbalance in the family, although it was proved later to be incorrect. Nevertheless, Bateson/s theory functioned as a springboard in developing the field of family therapy, the professional marriage counseling field, and the psychological clinical practice (Broderick & Schrader, 1991). Cognitive Behavioral Model Explained
Family therapy emphasizes the importance of intimate family relationships to nurture change and development with focus on the patterns of interaction that maintain the problem instead of identifying the cause (Nichols, 1987). The assumption that a whole is larger than the sum of its parts will describe the strength of the family as a social network. Family counseling practitioners are specifically qualified or licensed to conduct the therapy such as psychologists, psychiatrists, social workers, nurses and counselors.
Family counseling often helps resolve issues within the family because the presence of family therapy professionals, who serve as a disinterested party, do not favor any member of the family and can render effective counseling (Broderick & Schrader, 1991). The treatment and assessment of therapy in progress varies, and many therapists use behavior techniques or the combination of cognitive and behavioral techniques. The Cognitive-Behavior Model employs the same general premise in family therapy but usually takes much less time and cost than other family therapeutic techniques.
Aaron Beck is one the theorists whose focus on Cognitive therapy is the changing of an individual’s certain thoughts and patterns of behavior that was influenced by the environment and other individuals (Bell-Gadsby & Siegenberg, 1996). On the other hand, Albert Ellis, the theorist who developed the Rational Emotive Behavior Therapy or REBT, focused on pure behavioral aspects of classical conditioning but later on mixed the cognitive and behavioral element and called his model as Rational Emotive Therapy or RET.
This is a reflection that the individual’s rational beliefs, emotions and behavior are interdependent (Bell-Gadsby & Siegenberg, 1996). The central premises of cognitive-behavior therapy maintain the dyadic family interactions; an individual’s personality is not as important as his family’s interaction. The past history of the family is not the focus on Cognitive-Behavioral Model but the here and now. Marital satisfaction and child care are possible with the absence of negative affect and effective communication to solve conflicts.
The goal of Cognitive-Behavioral Therapy is specific and is tailored to fit each family member to increase their positive and compatible behavior by beginning to redefine the family problems in terms of positive behaviors of each member and fostering conscious understanding. The models of family therapy vary and have been presented in numbers of studies. These models are considered effective than no treatment. The Cognitive Behavioral or Behavioral Models gain most support at the beginning of the twenty-first century with empirical support and several promising researches on family focused therapies (Bell-Gadsby & Siegenberg, 1996).
One of the most validated models of behavioral model is the Behavioral Couple’s Therapy or BCT which is derived from the social learning and social exchange theories built upon the idea that the couple’s satisfaction is determined according to the spouses’ interaction with each other. One good example of the couples’ behavioral model is when the partners are unable to communicate with each other in time of distress that will lead to feeling of unhappiness and frustration. These negative reactions will result in reward reduction.
However, with the aid of Behavior Couples Therapy, the ratio of positive of behavior patterns will be decreased by teaching couples the effective communication behaviors needed in handling marital and family difficulties. With the aid of the therapist, the couples in the Behavior Couple Therapy will learn to increase the number of positive behaviors that they knew on their partner and guide them in generating positive actions that they could do for each other and encourage them to do the positive interactions.
An example of generating positive actions is when one of the partners will compliment the other for a breakfast that he or she fixed for one or both of them. Although this is a simple interaction, it means a lot to boost one’s morale. Couples should learn how to enhance and improve their problem-solving strategies to address day-to day dilemmas of family relationship and improving their communication skills without blaming each partner. The inclusion of positive feeling with each partner will generate an alternative and compromise solutions for every problem that the couples may encounter.
The Cognitive Behavioral Couples Therapy of CBCT is one of the family therapies that can help the family during disagreement on parenting, emotional outpouring, communicating difficulty, and many other reasons (Bell-Gadsby & Siegenberg, 1996). The family counseling intervention includes cognitive restructuring and changing the unrealistic and inaccurate assumptions about each partner through the assistance of a therapist who will help the partners or couples work out their differences together.
Another adaptation of Behavior Couples Therapy is the Integrative Behavioral Couples Therapy which focuses on individual change and acceptance of the problem that exists but is difficult or impossible to correct or change. Acceptance of one’s deficiencies is the key component to increase the emotional closeness of the couple. By restructuring their interactions and redefining their relationship, they can create a more satisfying relationship. The rigid interaction pattern that was guided by family therapist can be of great help in securing the much needed attachment and security by each partner in their relationship.
There are many common unhealthy and damaging communications during the family interaction, including hostility, verbal abuse, physical attacks, name-calling, contempt for the partner, defensive responses, involvement of past information or experiences during a current argument, withdrawal from disagreement, and escalating negativity. However, through family counseling therapy, the disagreement and various difficulties encountered by members of the family will be avoided. The family counseling assessment includes interviewing the family members, observation and baseline data collection techniques.
Identification of the problem involves the measurement and functional analysis of the family member’s problematic behavior, the antecedents, consequences, and match with corresponding treatment like contingency management, shaping, contracting, on-going therapy and evaluation of outcome. The different theoretical models and approaches of family counseling exist, but whatever the approach, the main objective is to improve the relationship of family members to one another and aid the family’s progression into a harmonious unit of society.
Compare and Contrast the Models of Family Therapy Whatever family therapy approach is used, the primary unit of treatment is the family and implies a system of circular causality that occurs within a network of interacting members of the group (Leupnitz, 1992). The family structure has subsystems, boundaries, hierarchies, and alliances. The key subsystems are the spousal, parental and siblings. The boundaries can be categorized as diffused, rigid or overly restricted, and disengaged families.
The family regulation is responsible for the stabilization of the family system. It is like a thermostat which is designed to maintain the balance within the family despite of feedback and loopholes in their interactions. The rules within the family serve as the parameters of permissible behavior. Although the rules may be non-verbal, they are understood by each member and are considered the family’s assumptive and unique world. Certain member of the family is held responsible for the family’s problem and assumes the assigned role.
The different models of family counseling and therapy have a common belief that, regardless of the family problem’s origin and family issue, the direct involvement of family members in the therapy session is crucial for the success of the therapy. The definition of family in a traditional manner includes parents and children, but as the field of family counseling evolved, the concept of family has been defined as the strongly supportive, long-term relationship between individuals who may or may not be blood related.
The full range of human dilemmas has been addressed by different family counseling models regardless of the category of family relationship. There are ranges of counseling and other family therapy techniques, but the most common are the application of communication theory, psychotherapy, psycho education, systemic coaching, media psychology, and reality therapy. Albeit the counseling approach, the viewpoint regarding family therapies involve their common interest on what goes between the family members or individuals rather than the individual himself.
The thrust is to solve and balance the problem rather than identify a single cause. The different models of family therapy pass through stages which can be likened to that of house remodeling that often makes people see the worse before getting better. Thus, the therapy may be difficult or painful, but the therapist will not stop treatment and will keep on moving forward for a satisfactory outcome (Bell-Gadsby & Siegenberg, 1996).
There are other therapy approaches that evolved specifically for family settings including the Family Systems which view the family as system to sustain the balance of every family members; the Bowenian Family Therapy which takes into consideration the generational patterns that are handed down in the families and how “triangles” are formed in their relationship that pull others into a matter that actually concerns only two individuals; and Structural Family Therapy, which takes into consideration the generational alliances in families to strengthen their role in the family (Leupnitz, 1992).
Some of the well-known family therapy approaches are the Psychodynamic or Transgenerational Models, Cognitive Behavioral or Behavioral Models and Structural/Strategic/MRI Models. The Psychodynamic or Transgenerational Model is used in helping clients understand themselves more fully (Allgood, Parham, Salts, & Smith, 1995). This approach traces back the past, especially adverse childhood experiences and other unconscious conflicts of family members that incite feelings of anxiety, low self-esteem, and inadequacy or incompleteness (Leupnitz, 1992).
With Psychodynamic Therapy or Transgenerational Model, there are presumptions that some facets of lives are hidden in the subconscious mind and serve as protective defense mechanisms that will affect their family interaction with other members of the family. This kind of family therapy will be for long-term treatment that will take place several times per week (Allgood, Parham, Salts, & Smith, 1995). In contrast to Cognitive-Behavioral Therapy, the Psychodynamic Model provides more emphasis and insights about unconscious motivation which is responsible for changing the individual’s way of interaction with each family member (Leupnitz, 1992).
This therapeutic technique is more dependent on the subconscious insights of an individual rather than his family title or role. The Psychodynamic Model, Cognitive Behavior Therapy and Structural/Strategic/MRI Models can adapt in working with couples, families or groups. The Cognitive Behavioral Therapy involves the identification of harmful and ineffective patterns of thinking and behavior and substitutes them with more positive, helpful, and productive thinking patterns without changes in their behavior. The changes in individual’s thoughts lead to changes on the way they act or feel.
The Cognitive Behavior Therapy initiates a homework assignment of practicing the different ways of thinking and behaving in family setting. The analytical interventions in Cognitive Behavior Therapy utilizes the logical approaches that different matters are significant in an individuals day-to-day dealing with family members with the best possible outcome. The Cognitive Behavior Therapy is advisable and the treatment preferred for conditions of family members affecting family relationship such as phobias, panic attacks, anxiety, depression and eating disorders.
It is logical to include family members when issues will affect other members of the family. The Structural/Strategic/MRI Models of Family Therapy, in contrast to Cognitive Behavior Therapy and Psychodynamic Therapy, focuses on how families are organized according to family rules and how the competing demands of the rigid family rules, hierarchy, power, alignment, and boundaries can either loosen or strengthen the family relationship (Leupnitz, 1992). The Cognitive behavior Therapy, on the other hand, searches for the problem and not for a cause of difficult family relationship without looking into the existing family rules.
The Psychodynamic Model of Family Therapy stresses that the differentiation of family members’ outlook stems from the fusion and symbiosis of their separate identities. The developmental problems of the parents will greatly affect the individual development of other family members in Psychodynamic Model. The different types of family counseling therapy including the Psychodynamic and Transgenerational Models, the Cognitive Behavior Therapy, and the Structural/Strategic/MRI Models of Family Therapy have been found to be useful in dealing with certain types of problems.
The best model of therapy will always have a best therapist and clients’ cooperation (Leupnitz, 1992). The comfortable feeling of client or patient to a therapist will result in developing trust that will help the family members to move ahead regardless of circumstances. Family therapy involves a group participation in therapy sessions in the presence of professional therapist who will act as facilitator. The focus of the session is the family often with the entire family group who may or may not have emotional or behavioral disorders, but the outcome will affect the entire family.
The full integration of family therapy serves as a basis for treatment and intervention. For effectiveness, family therapies incorporate family counseling and take into consideration the age-appropriate intervention for children members of the family in the program. Family therapy is effective in improving family member’s communication skills and problem-solving skills, in determining accountability, and in enhancing impetus for change. Any type of family dilemma will have a neutral forum through family therapy wherein each member can meet to solve the problems (Nichols, 1987).
In addition, family therapy, regardless of approaches and techniques, is applicable to different cultures, ethnicity, religions, races, and gender. The incorporation of family approaches is necessary to discern each family member to have readiness for change and treatment. The challenging tasks for both the therapist and family members to succeed will depend on the degree of creativity, judgment, and cooperation of every participant in the therapeutic technique. It is crucial to know the appropriateness of the family therapy initiated to particular family issues.
Generally, family therapy attends to the process of family interaction, but the assessment differs in various family counseling models. The sources of any family dysfunction cannot be revealed by simply asking the family members to identify the problems within their family. The professional family therapist will consider screening for any signs of mental or physical illness of every member of the family in distress and the possibility of physical or sexual abuse and substance abuse.
The family therapist expertise on a variety of barriers in the treatment approaches is reviewed for appropriate intervention. The diverse field of family therapy is influential to some extent than other therapy techniques, but the continuum of treatment includes family collaboration, education and integration. Integration Care must be taken in the choice of families on which family counseling approach would best fit their family issues and dilemmas and must be congruent with their culture and realities of treatment context (Leupnitz, 1992).
The Psychodynamic Model and Transgenerational Therapy, Cognitive Behavior Therapy, and the Structural/Strategic/MRI Models of Family Therapy are among the frequently used models for family treatment and interventions (Nichols, 1987). The Cognitive Behavioral or Behavioral Therapy as chosen model in its pure forms is a blend of behavioral and cognitive technique which involves amount of thought awareness. Awareness need not be extensive in utilizing the Cognitive Behavioral or Behavioral Model of treatment, but some philosophical processing makes it sophisticated.
The goals for change in Cognitive Behavioral or Behavioral Model are to look beyond the simple behavior of each family member in the process as well as its motives and consequences (Efron & Veenendaal, 1993). One good example of comparison of Cognitive Behavior and Behavioral Model is when an individual plans to travel and check the car condition including the gas and oil, rather than just turning the key and keep going. It is like understanding the components of the current feeling of family members to resolve the family differences.
The central theory of what is the cause of an individual’s problem and the need to resolve for change occur due to the own effort of every family member who undergoes the process of Cognitive Behavior or Behavioral Models. Although the therapist can act as a facilitator and every family member may be willing to provide support, there is no one who can do the work for change except the individual himself. Family therapy is not like getting rid of the symptoms. Rather, family therapy is about making peace through listening and understanding the family member’s problems and sentiments (Allgood, Parham, Salts, & Smith, 1995).
The individual’s problems must be heard, and every family member must not fear to know the family dilemma so that everyone will be enlightened and the reality will serve as great blessing for their family. The behavioral changes that are targets of change in Cognitive Behavior or Behavior Model is not sufficient in itself in bringing the changes, but there must be insights to discover that certain possession of bad behavior will serve as motivation to change the present into positive, constructive and pleasant ones (Efron & Veenendaal, 1993).
The Cognitive Behavior or Behavior Model emerged as part of family systems whose main influence is the family. Focusing on strengths and resources involves changing the problematic interaction pattern with the aid of family as therapeutic environment for family members to respond on emotionally stable condition and maintain their separate identities and perspective while performing their function as part of the family.
The focus of Cognitive Behavior or Behavior Model approach is to encourage the affected family members and the entire family to learn altering the various physiological processes with negative impact on their family. This process uses electronic devices for biofeedback as well as the individuals, breathing rate, heart rate, muscle tension, and skin temperature. The goal of Cognitive Behavior Therapy is to change the state of nervousness and feeling of incomplete to a state of deep relaxation.
Biofeedback is a device that, though quite expensive, will be of great help for more imaginative relaxation technique with the aid of a family therapist with considerable training. On the other hand, the feedback approach focuses on feelings of family members and encourages relaxation of progressive muscles, guided imagery or visualized technique, and the autogenic where one can learn to create a feeling of warmth throughout the body.
The client family may know that the Cognitive Behavior or Behavioral Model of treating family problems is very helpful by the simple process of synthetic desensitization wherein each family members will have a chance to create their anxiety hierarchy and pair each item with anxiety-provoking items and proceed with pairing each item while conditioning the mind to feel relaxed despite of anxiety provoking situations (Allgood, Parham, Salts, & Smith, 1995).
This is one of the family therapies that teach each family member to learn the relaxation techniques and remain clam in most of the situation. The issue on hypnosis was often misunderstood by clients in dealing with models of family therapy. However, the process of hypnosis primarily calls for a state of deep relaxation that can be achieved and anew way to experience in one’s life. Applying the Cognitive Behavior or Behavior Model through the process of hypnosis can help in utilizing the already possess family members skills (Nichols, 1987).
This process is one of the healthier ways to set foot in the world and utilize the fact that every individual wants to get better. The mastery of Cognitive Behavior Technique or Behavioral Model has great potential to improve the lives of troubled couples; the first few session of treatment is devoted towards defining the exact problem, behavior, attitudes, and the process of interaction within the family. The Cognitive Behavior approach focuses on dyadic interactions or the husband-wife, parent-child relationship, and positive reinforcements (Efron & Veenendaal, 1993).
Couples and entire family members will be happy to learn that the Behavioral Models will encourage them to practice caring days and serve as reinforcing objects to each other. One good example that the Cognitive Behavior or Behavioral Model works is the intervention that will support Working wife and husband by empowering the moral of the latter and be comfortable to the new social demands of the situation. The wide assortment of family therapy procedures follows ethical guidelines of discipline and confidentiality concerning the family issues which is unique to their group (Nichols, 1987).
These models are not an overnight process, but they have good evidence in terms of effectiveness by challenging the negative thoughts of the family members to re-interpret in a more realistic insight as part of coping strategies. The Psychodynamic and Transgenerational Model, the Cognitive Behavior Theory or Behavior Models, and the Structural/Strategic/MRI Models are action-oriented form of psychosocial therapy that focus on changing the family member’s maladaptive thoughts, behavior and negative emotions into a counter-productive behavior and rational thinking patterns.
Replacing undesirable behavioral patterns with desirable behavioral patterns is the restructuring approach of Cognitive Behavior Therapy. The number of different techniques in family counseling, including Psychodynamic Model, Cognitive Behavior Model and Structural Models, helps in changing the family members’ thoughts, modified and readjust their behavior to prevent them from feeling of isolation and the fear of being rejected. The goals of family therapy include the ability to love, work, and play, even the older members of the family, so that each of them would have a chance to informally explore the inner thoughts of every member.
Conclusion Family therapy is a way of thinking and a novel development in the field of human arena, the challenge for new ideas will serve as a continuum of broadened responses in the treatment process. The vigorous attempt in developing family therapy approaches must not only be place in theory but as well as in practice. Every model is conceptualized as a way of encouraging every family member to do their part in enriching their relationship. The emotional togetherness binds them all and enriches their interpersonal experiences fit them together.
Within the field of family therapy is the seeming likeness and common roots that need a vision to further progress that will serve as benchmark of their new generation brought by better family treatment and family counseling approaches. With my Christian point of view, the healing of the family is the healing of the global society, and the emergence of unconditional love and understanding by every human being is a therapy in itself that can aid the entire humanity for mutual enhancement.
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A Social Constructionist Approach to Counseling the Single Parent Family, Journal of Family Psychotherapy, 6(3), 1-32. Bell-Gadsby, C. & Siegenberg, A. (1996). Reclaiming Herstory: Ericksonian Solution- Focused Family Therapy for Sexual Abuse. New York: Brunner/Mazel. Berg, I. K. , Sperry, L. , & Carlson, J. (1999). Intimacy and culture: A solution-focused perspective: An interview. In J. Carlson & L. Sperry (Eds. ), The Intimate Couple (pp. 41-54). Philadelphia, PA: Brunner/Mazel.Sample Essay of Custom-Writing