Systems Therapies

Change occurs by understanding multigenerational dynamics and differentiation.

• ● Coach/educator
• ● Supervisor
• ● Investigator
• ● Neutral

• ● Reduce anxiety and emotional turmoil in family system
• ● Self-differentiation within the context of family
• ● Decrease emotional fusion
• ● Improve communication skills
• ● Decrease recurrence of dysfunctional patterns
• ● Reduce emotional reactivity
• ● Facilitate de-triangulation

• Triangles
• Differentiation of Self
• Nuclear Family Emotional System
• Family Projection Process
• Multigenerational Transmission Process
• Emotional Cutoff
• Genogram

• A triangle is a three-person relationship system. It is considered the building
• block or “molecule” of larger emotional systems because a triangle is the smallest stable
• relationship system.

• Families and other social groups tremendously affect how people
• think, feel, and act, but individuals vary in their susceptibility to a “group think” and
• groups vary in the amount of pressure they exert for conformity. These differences
• between individuals and between groups reflect differences in people’s levels of
• differentiation of self.

• The concept of the nuclear family emotional system
• describes four basic relationship patterns that govern where problems develop in a
• family. People’s attitudes and beliefs about relationships play a role in the patterns, but
• the forces primarily driving them are part of the emotional system.

• The family projection process describes the primary way
• parents transmit their emotional problems to a child. The projection process can impair
• the functioning of one or more children and increase their vulnerability to clinical
• symptoms.

• The concept of the multigenerational
• transmission process describes how small differences in the levels of differentiation between parents and their offspring lead over many generations to marked differences in
• differentiation among the members of a multigenerational family.

• The concept of emotional cutoff describes people managing their
• unresolved emotional issues with parents, siblings, and other family members by
• reducing or totally cutting off emotional contact with them.

• Extensive study of family’s history. Acts both as an assessment and
• treatment tool.

• ● Reduce emotional reactivity by having family members talk to the therapist.
• ● Reframing
• ● Genogram
• ● De-triangulation
• ● Increasing Differentiation
• ● Teaching “I” Statements
• ● Opening Cutoff Relationships
• ● Interacts with Family
• ● Models
• ● Bibliotherapy

The presenting problem as a multigenerational problem that is caused by factors beyond the individual.

Assigning reading material.

Demonstrates new ways to interact and communicate.

Interrupts arguments – open conflict is prohibited as it raises anxiety.

Increases differentiation.

• Encouraging and supporting clients to re-engage with
• estranged family members.

Create a multigenerational map of family emotional system.

• Therapist becomes part of a "healthy triangle" where the therapist
• teaches the couple to manage their own anxiety, distance, and closeness in healthy
• ways.

By forming supportive relationship with family members to explore the origins and effects of their families beliefs and behaviors.

• Create a family diagram of multigenerational emotional connections; assess
• individuals’ levels of differentiation and triangulation; identify dysfunctional patterns that have
• been passed along through the generations.

• Teach and model differentiation through communication skill building;
• de-triangulation; encourage reunification from cutoff family members; teach the family how to
• take responsibility for their feelings and thoughts.

Review new skills and knowledge gained in therapy.

• ● Change occurs by helping the system view the problem in the context of the family,
• rather than view an individual as the problem.
• ● The family system becomes the focal point of therapeutic interventions.

• ● The therapist helps the family explore:
• ○ Belief systems and family values
• ○ Rules and roles that are present in the family
• ○ The family hierarchy
• ○ Expectations
• ○ Defense mechanisms and their purpose

• Homeostasis
• Feedback Loops
• Negative Feedback (attenuating)
• Positive Feedback (amplifying)
• Calibration
• Wholeness
• Equifinality
• Equipotentiality
• First Order Change
• Second Order Change
• Nonsummativity
• Boundaries

• Systems tend to resist change and deal with issues by keeping things the
• same rather than dealing with problems. It is maintained through negative feedback
• loops.

• Circular in nature, information pathways that help the system balance
• and correct itself. These can be positive or negative.

• Behavioral reactions used by families that
• correct departures from the system’s normal state and return the system to its
• previous state of homeostasis. Corrects against change.

• Behavioral reactions that amplify departures
• from the system's normal state, which initially destabilizes the system and
• eventually changes the family’s homeostasis. Allows system to adapt to change.

The normal operational system of the family.

• This is the notion that the whole system, all of the units combined, is greater
• than the sum of its parts. The interactions between the individuals have an effect on the
• system as a whole.

• The same results can be accomplished by different family systems.
• ○ Example: A man experienced the death of his mother when he was a young child,
• whereas a woman experienced the divorce of her parents when she was an
• infant. As adults, both of these individuals experienced Major Depression despite
• having different early experiences.

• On the other hand, the same experience in a family system can end up
• with various results later in life.
• ○ Example: Two siblings go through the same experience of verbal abuse when
• they were young. Later in life, one sibling struggles with relationships, whereas the other sibling struggles with depression. Therefore, despite the same
• experience early on, different results occurred.

• Changes that occur in the family that are more surface level and
• temporary. They do not affect the rules or organization of the system. These changes do
• not try to get at the underlying cause of the issues, but are instead behavioral in nature.
• These changes tend to be short-lived.

• Changes that occur at a deeper level and fundamentally alter the
• system’s rules and organization. The system is reorganized in order to achieve a
• different, healthier level of functioning that can survive over time.

• The family system is treated as a whole and not just each individual
• family member.

• Abstract lines that exist between parts of the system and between the
• system and between different systems. They are typically defined by implicit and explicit
• rules.
• ○ Open System
• ○ Closed System

Refers to a system that allows for the continuous flow of information from outside the system.

Systems that maintain boundaries that cannot easily be crossed; they are impenetrable.

• ● Move the system towards an equilibrium.
• ● Assist the family in exploring and recognizing healthier interactions to decrease
• dysfunctional family behaviors or patterns.
• ● Help family challenge and rework their beliefs.
• ● Assist individual family members in seeing their role in any given dynamic.
• ● Increase each family member’s ability to understand the different experiences and
• perceptions of others in the family.
• ● Assist in correcting problematic or unhealthy feedback loops.

• ● Observe the feedback loops that occur within a family system.
• ● Explore the family’s:
• ○ Belief systems and family values
• ○ Rules and roles that are present in the family
• ○ The family hierarchy
• ○ Expectations
• ○ Circular causality between members of the family
• ● Reframe presenting issues as system issues rather than pathologizing one person’s
• symptoms.
• ● Explore each family member's role in dysfunctional interactions.
• ● Challenge the communication that occurs within the system.

Change occurs through action-oriented directives and paradoxical interventions.

• ● Therapist delivers directives that facilitate change, particularly around patterns of
• communication.
• ● Focuses on solving problem/eliminating symptoms
• ● Designs a specific approach for each person’s presenting problem

• ● Solve the presenting problems
• ● Change dysfunctional patterns of interaction

• Paradoxical Directives
• Positioning
• Homework
• Prescribing the Symptom
• Restraining
• Ordeals

• Maneuvers that are in apparent contradiction to the goals of
• therapy, yet are actually designed to achieve them; paradoxical interventions help avoid
• confrontation with therapist’s instructions; undermines resistance by keeping clients in
• charge.

• Therapist takes a more exaggerated and extreme view of the problem and
• the family is obligated to rebel. That leads to them seeing the ways in which they have
• competency.

• Assignments or directives that take place outside of therapy are essential to
• the therapy having a successful outcome. The underlying goal of the homework is to try
• to change the way the family dynamics function around the presenting problem that was
• identified in session.

• A strategy in which the therapist encourages or instructs the
• client to engage in or practice the symptom.

• The therapist will discourage change or changing too quickly in an effort to
• elicit the desire to change from the client.

• Particular type of symptom prescription in which clients are encouraged to
• carry out harmless but unpleasant tasks whenever symptoms occur; example: having to
• get up and clean the basement every time the client cannot sleep.

• Define the problem; determine how the client understands the problem; assess
• family’s destructive patterns of relating and communicating the continued problem; state goals – what behaviors need to change and what would be the signs of change.

• Review attempted solutions; assign ordeals; prescribe the problem; relabel behavior;
• instruct client to respond to the problem in a new way.

• Plan for maintenance of new behavior; plan for future challenges; emphasize positive
• changes made.

Change occurs through restructuring the family’s organization.

• ● Therapist is active and involved.
• ● The therapist helps the family understand how family structure (relationships and
• hierarchies) can be changed, the impact of rituals and rules, and how new patterns of
• interaction can be integrated into the family.

• ● Restructure family system to allow for symptom relief and constructive problem solving.
• ● Change dysfunctional transactional patterns and create new ways of relating.
• ● Help create flexible boundaries.

• Alliances
• Coalitions
• Power Hierarchy
• Subsystems
• Family Map
• Disengaged Boundaries
• Enmeshed Boundaries

Subgroups based on gender, generation, developmental tasks.

• Alignments where 2 or more family members join together to form a bond
• against another family member.

• Leadership and direction must be provided by the adults, typically
• parents. Sometimes when parents are intimidated or insecure, the power is upside down
• and it leads to chaos.

• Families organize themselves by generation, relationship, and necessity.
• Examples: marital subsystem – spouses; parental subsystem: parents; executive
• subsystem: people who run the family; sibling subsystem – kids.

• A tool the therapist will use to depict the relationship dynamics in the family
• including sub-systems, alliances, coalitions and boundaries. This tool is used to
• conceptualize the case outside of the actual therapy. It is not used or shared with the
• family.

• Where family members are isolated from each other. Can lead
• to AOD use and is a result of rigid boundaries.

• Family members are overly dependent and too closely involved
• and reactive to other family members. Can lead to incest.

• Joining
• Tracking
• Mimesis
• Unbalancing
• Reframe
• Enactment
• Boundary Making

• Therapist’s first task; involves blending in with the family, adapting the family’s
• affect, style, and language.

• The therapist pays close attention to family members and how they relate to
• one another during an enactment or spontaneous behavioral sequence, noticing
• boundaries, coalitions, roles, rules, etc.

The therapist tracks the family’s style of communication and uses it.

• Supporting someone who is in a one-down position, thus changing
• hierarchical position.

• Putting the presenting problem in a perspective that is both different from what
• the family brings and more workable.

• The actualization of transactional patterns under the control of the therapist.
• It allows the therapist to observe how family members mutually regulate their behaviors,
• and to determine the place of the problem behavior within the sequence of transactions.

• Special case of enactment, in which the therapist defines areas of interaction that he rules open to certain members but closed to others. Example: a son is asked to leave his chair (in between his parents) and go to another chair on the opposite
• side of the room, so that he is not “caught in the middle”.

• Join with family; both accommodate to and challenge rules of family system;
• assessment/mapping of hierarchy, alignments, and boundaries; reframing of problem to include
• whole system.

• Highlight and modify interactions; utilize enactments of issues to challenge participants
• and unbalance the system.

Review progress made; reinforce structural change; provide tools for future.

• Change happens through self-awareness and improved communication. A humanistic
• approach.

• ● Active facilitator
• ● Resource detective
• ● Therapist is genuine and warm
• ● Honest and direct

• The goal is for clients to increase congruent communication, improve self-esteem/confidence
• and personal growth.

• Incongruent Communication
• Styles of Communication
• Placater
• Blamer
• Computer
• Distracter
• Leveler
• Modeling Communication
• Family Life Chronology
• Family Sculpting
• Take Responsibility
• Metaphors and Storytelling
• Transforming Rules

Discrepancies between verbal and non-verbal cues.

• The rules that govern family interaction function as a method
• of ensuring the maintenance and preservation of the family’s current functioning level.
• Communication styles are:
• ○ Placater: Apologizing, never disagreeing, trying to please.
• ○ Blamer: Attacking others, fault finder, dictator, boss.
• ○ Computer: Super reasonable, intellectual, distant, always correct.
• ○ Distracter: Seeking approval by acting out, irrelevant.
• ○ Leveler: Congruent in their beliefs about self and others.

• Therapist uses “I” messages; expresses thoughts and
• feelings directly; avoids statements about what others are thinking or feeling; is honest.

• Gathering history as far back as possible. Include: ideology,
• values, rules, disruptions, moves, and major events. What the family has been through
• and how those events impact the family. How past events and unresolved issues are
• carried out presently.

• Put people into a spatial metaphor – a physical representation of
• family members characterizations.

• Encouraging clients to take responsibility for how they felt, what
• they experienced, what meaning they made, what feelings they had about their feelings.

Used to help clients understand their roles.

Assisting clients to create more functional, less rigid guidelines.

• Establish rapport, a sense of equality and hope. Assess communication patterns,
• stances, and concerns. Identify treatment focus and goals.

• Increase the family’s congruent communication. Support and strengthen each
• individual’s sense of uniqueness and self-esteem.

Help family practice, implement, and integrate changes and increase awareness of larger familial patterns.