TEXTBOOK CHAPTER: FAMILY SYSTEMS PERSPECTIVE:
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Introduction
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Although the seeds of a North American family therapy movement were planted in the 1940s, it was during the 1950s that systemic family therapy began to take root (Becvar & Becvar, 2013). During the early years of its evolution, working with families was considered to be a revolutionary approach to treatment. In the 1960s and 1970s, psychodynamic, behavioral, and humanistic approaches (called the first, second, and third force, respectively) dominated counseling and psychotherapy. Today, the various approaches to family systems represent a paradigm shift that we might even call the “fourth force.” Family systems therapy is represented by a variety of theories and approaches, all of which focus on the relational aspects of human problems.14-1a
The Family Systems Perspective
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Perhaps the most difficult adjustment for counselors and therapists from Western cultures is the adoption of a “systems” perspective. Our personal experience and Western culture often tell us that we are autonomous individuals, capable of free and independent choice. And yet we are born into families—and most of us live our entire lives attached to one form of family or another. Within these families, we discover who we are; we develop and change; and we give and receive the support we need for survival. We create, maintain, and live by often unspoken rules and routines that we hope will keep the family (and each of its members) functional.

A family systems perspective holds that individuals are best understood through assessing the interactions between and among family members. The development and behavior of one family member is inextricably interconnected with others in the family. Symptoms are often viewed as an expression of a set of habits and patterns within a family. It is revolutionary to conclude that the identified client’s problem might be a symptom of how the system functions, not just a symptom of the individual’s maladjustment, history, and psychosocial development. This perspective is grounded on the assumptions that a client’s problematic behavior may (1) serve a function or purpose for the family; (2) be unintentionally maintained by family processes; (3) be a function of the family’s inability to operate productively, especially during developmental transitions; or (4) be a symptom of dysfunctional patterns handed down across generations. All these assumptions challenge the more traditional intrapsychic frameworks for conceptualizing human problems and their formation.

The central principle agreed upon by family therapy practitioners, regardless of their particular approach, is that the client is connected to living systems. Attempts at change are best facilitated by working with and considering the family or set of relationships as a whole. Therefore, a treatment approach that comprehensively addresses the family as well as the “identified” client is required. Because a family is an interactional unit, it has its own set of unique traits. It is not possible to accurately assess an individual’s concern without observing the interaction of the other family members, as well as the broader contexts in which the person and the family live.

Family therapy perspectives call for a conceptual shift from evaluating individuals to focusing on system dynamics, or how individuals within a system react to one another. Actions by any individual family member will influence all family members, and their reactions will have a reciprocal effect on the individual. When change occurs, a ripple effect flows throughout the family system. Effective changes support the family system and the new behaviors of the individual or family (Lambert et al., 2016). Goldenberg, Stanton, and Goldenberg (2017). Goldenberg and Goldenberg (2013) point to the need for therapists to view all behavior, including all symptoms expressed by the individual, within the context of the family and society. They add that a systems orientation does not preclude dealing with the dynamics within the individual, but that this approach broadens the traditional emphasis on individual internal dynamics.
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Differences Between Systemic and Individual Approaches
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There are significant differences between individual therapeutic approaches and systemic approaches. A case may help to illustrate these differences. Ann, age 22, sees a counselor because she is suffering from a depression that has lasted for more than two years and has impaired her ability to maintain friendships and work productively. She wants to feel better, but she is pessimistic about her chances. How will a therapist choose to help her?

Both the individual therapist and the systemic therapist are interested in Ann’s current living situation and life experiences. Both discover that she is still living at home with her parents, who are in their 60s. They note that she has a very successful older sister, who is a prominent lawyer in the small town in which the two live. The therapists are impressed by Ann’s loss of friends who have married and left town over the years while she stayed behind, often lonely and isolated. Finally, both therapists note that Ann’s depression affects others as well as herself. It is here, however, that the similarities tend to end:

The individual therapist may:	The systemic therapist may:
Focus on obtaining an accurate diagnosis, perhaps using the DSM-5 (American Psychiatric Association, 2013)	Explore the system for family process and rules, perhaps using a genogram
Begin therapy with Ann immediately	Invite Ann’s mother, father, and sister into therapy with her
Focus on the causes, purposes, and cognitive, emotional, and behavioral processes involved in Ann’s depression and coping	Focus on the family relationships within which the continuation of Ann’s depression “makes sense”
Be concerned with Ann’s individual experiences and perspectives	Be concerned with transgenerational meanings, rules, cultural, and gender perspectives within the system, and even the community and larger systems affecting the family
Intervene in ways designed to help Ann cope	Intervene in ways designed to help change Ann’s context
Systemic therapists do not deny the importance of the individual in the family system, but they believe an individual’s systemic affiliations and interactions have more power in the person’s life than a single therapist could ever hope to have. By working with the whole family (or even community) system, the therapist has a chance to observe how individuals act within the system and participate in maintaining the status quo; how the system influences (and is influenced by) the individual; and what interventions might lead to changes that help the couple, family, or larger system as well as the individual expressing pain.

In Ann’s case, her depression may have organic, genetic, or hormonal components. It may also involve cognitive, experiential, or behavioral patterns that interfere with effective coping. Even if her depression can be explained in this manner, however, the systemic therapist is very interested in how her depression affects others in the family and how it influences family processes. Her depression may signal both her own pain and the unexpressed pain of the family. Indeed, many family system approaches would investigate how the depression serves other family members; distracts from problems in the intimate relationships of others; or reflects her need to adjust to family rules, to cultural injunctions, or to processes influenced by gender or family life-cycle development. Rather than losing sight of the individual, family therapists understand the person as specifically embedded in larger systems.
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Development of Family Systems Therapy
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Family systems theory has evolved throughout the past 100 years, and today therapists creatively employ various perspectives when tailoring therapy to a particular family. Alfred Adler (1927) and Rudolf Dreikurs (1950, 1973) and their associates were the first known practitioners of family therapy, often using a model now called open-forum family counseling (Christensen, 2004). Adler introduced phenomenology to our understanding of the family system (or family constellation). Assessment is based on the subjective descriptions that family members use to define themselves and the interactions that occur in everyday life. It is within these interactions that Adlerians seek to discover the purposes and goals of behavior (Bitter, 2014; Bitter et al., 2002).

Take a moment and think about two different family experiences in your own life. When you were little, what descriptions would you have used for your parents? What do these descriptions tell you about what was important to you? Let’s say that one’s father is described as kind, generous, and childlike. The mother is described as beautiful, very hard working, and sacrificing. No adjective or description exists outside of the relationship. When the person says the father was kind, this means that the father was kind to the person as a child. When the mother is described as very hard working, the person is suggesting that access to mother was difficult to get. Still, mother’s hard work has a purpose: she is sacrificing for the child. What else can we know from these descriptions? Father was generous and childlike: “he played with me.” He may not have been very oriented toward discipline. Mother was beautiful. The message is that for women appearances are important.

Now, think about your current family situation, either your family of origin or a new family you have started. What descriptions would family members use to describe you? What does that tell you about your place or role in the family? Finally, think about a recent family interaction that was difficult for you. What goals or purposes did you have for your part of the interaction? What goals or purposes might have been involved for those interacting with you? You can generally discover the goal or purpose of behavior by looking at the consequence of that behavior in the responses of others: “What do people do when I act in one way or another?”

We now take a look at the most prominent models and what they have contributed to the evolution of family systems therapy.

Murray Bowen
Development of Family Systems Therapy
Courtesy of The Bowen Center for the Study of the Family; photo by Andrea Schara
MURRAY BOWEN (1913–1990) believed families could best be understood when analyzed from a three-generation perspective because patterns of interpersonal relationships connect family members across generations. Two of his objectives in therapy were to help family members develop a rational, nonreactive approach to living (called a differentiation of self) and to de-tangle family interactions that involved two people pulling a third person into the couple’s problems and arguments (or triangulation).

Bowen’s observations led to his interest in patterns across multiple generations. He contended that problems manifested in one’s current family will not significantly change until relationship patterns in one’s family of origin are understood and directly challenged. His approach operates on the premise that a predictable pattern of interpersonal relationships connects the functioning of family members across generations. According to Kerr and Bowen (1988), the cause of an individual’s problems can be understood only by viewing the role of the family as an emotional unit. Within the family unit, unresolved emotional reactivity to one’s family must be addressed if one hopes to achieve a mature and unique personality. Emotional problems will be transmitted from generation to generation until unresolved emotional attachments are dealt with effectively. Change must occur with other family members and cannot be done by an individual in a counseling room.

Murray Bowen (1978) was one of the original developers of mainstream family therapy. His family systems theory, which is a theoretical and clinical model that evolved from psychoanalytic principles and practices, is sometimes referred to as multigenerational family therapy. The goal of this approach is to differentiate self within a system and to understand one’s family of origin. Bowen and his associates implemented an innovative approach to schizophrenia at the National Institute of Mental Health where Bowen hospitalized entire families so that the family system could be the focus of therapy.

Bowen’s emphasis on a multigenerational perspective laid a foundation for work by two of Bowen’s most prominent colleagues, Betty Carter and Monica McGoldrick, who almost single-handedly initiated both a developmental and a multicultural perspective in family therapy. Indeed, McGoldrick’s work includes the field’s most important work on genograms (McGoldrick et al., 2008), family life cycle (McGoldrick et al., 2011), and gender (McGoldrick et al., 1991).

Virginia Satir
Development of Family Systems Therapy
Courtesy of The Virginia Satir Global Network
VIRGINIA SATIR (1916–1988) developed conjoint family therapy, a human validation process model that emphasizes communication and emotional experiencing. Like Bowen, she used an intergenerational model, but she worked to bring family patterns to life in the present through sculpting and family reconstructions. Claiming that techniques were secondary to relationship, she concentrated on the personal relationship between therapist and family to achieve change. The core of Satir’s model relied on the power of congruence to help family members communicate with emotional honesty. Her presence with people encouraged them to get in touch with what was significant within, to become more fully human, and to share the individual’s best self with a significant other. Satir called this experience “making contact,” and she believed that it extended the peace one had within to a peace between people and, eventually, to a peace among people.

At about the same time that Bowen was developing his approach, Virginia Satir (1983) began emphasizing family connection. Her therapeutic work had already led her to believe in the value of a strong, nurturing relationship based on interest and fascination with those in her care. Unlike Bowen, Satir could envision and sought to support the development of a nurturing triad: two people, for example parents, working for the well-being of another, perhaps a child. Satir thought of herself as a detective who sought out and listened for the reflections of self-esteem in the communication of her clients. She placed a strong emphasis on the importance of communication and meta-communication in family interactions, and the value of therapeutic validation in the process of change (Satir & Bitter, 2000). From Satir, family therapy gets it model for empathic listening, therapeutic presence, and nurturance (Satir et al., 1991).
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Structural-Strategic Family Therapy
The origins of structural family therapy can be traced to the early 1960s when Salvador Minuchin was conducting therapy, training, and research with delinquent boys from poor families at the Wiltwyck School in New York. Minuchin’s (1974) central idea was that an individual’s symptoms are best understood from the vantage point of interactional patterns, or sequences, within a family. He further stated that structural changes must occur in a family before an individual’s symptoms can be reduced or eliminated. The goals of structural family therapy include (1) reducing symptoms of dysfunction and (2) bringing about structural change within the system by modifying the family’s transactional rules and establishing more appropriate boundaries.

In the late 1960s, Jay Haley joined Minuchin at the Philadelphia Child Guidance Clinic. The work of Haley and Minuchin shared so many similarities in goals and process that many clinicians in the 1980s and 1990s began to question whether the two models were distinct schools of thought. Indeed, by the late 1970s, structural-strategic approaches were the most used models in family systems therapy. The interventions generated in these models became synonymous with a systems approach; they included joining, boundary setting, unbalancing, reframing, ordeals, paradoxical interventions, and enactments.

If you divided your family of origin into subsystems, who would be in the parental subsystem? The spousal subsystem? The sibling subsystem? What rules and boundaries were set around each subsystem? Were the boundaries ever crossed? By whom and with what result? What were common interactional sequences in your family? Who had the power in your family, and how was it exercised? Who was aligned with whom, and what did they use that alignment to achieve? These are just a few of the assessments structural-strategic therapists taught us to consider.
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Recent Innovations in Family Therapy
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In the last decade, feminism, multiculturalism, and postmodern social constructionism have all entered the family therapy field. These models are more collaborative, treating clients—individuals, couples, or families—as experts in their own lives. The therapeutic conversations start with the counselor in a “not-knowing” position in which clients are approached with curiosity and interest. The therapist is socially active and aids clients in taking a preferred stand in relation to the dominant culture that may be oppressing them. Therapy often incorporates “reflecting teams” and “definitional ceremonies” to bring multiple perspectives to the work (see West et al., 1998).

Feminist, multicultural, and postmodern therapists are extremely aware of the power they have entering into already established systems, and they work to promote understanding through curiosity and interest rather than through formal assessments. Adopting a decentered position allows them to be part of the system without taking it over.

Postmodern approaches to family therapy, like narrative therapy, seek to reduce or eliminate the power and impact of the family therapist. Taken together, postmodern approaches represent a real paradigm shift in the field of family therapy.

This brief discussion of the various systemic viewpoints in family therapy provides a context for understanding the development of family therapy. For an in-depth treatment of the schools of family therapy, see Theory and Practice of Family Therapy and Counseling (Bitter, 2014) and the recommended readings at the end of the chapter.
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A Multilayered Process of Family Therapy
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Families are multilayered systems that both affect and are affected by the larger systems in which they are embedded. Families can be described in terms of their individual members and the various roles they play, the relationships between the members, and the sequential patterns of the interactions and the purposes these sequences serve. Both the members and the system can be assessed based on power, alignment, organization, structure, development, culture, and gender (Breunlin et al., 1997). Even individuals can be considered from the perspective of an internal family system (Schwartz, 1995). In addition, nuclear families in a global community are often part of extended, if distant, families; multiple families make up a community; multiple communities make up both regions and cultures, which in turn constitute nations (or societies). The power of these macrosystems to influence family life—especially in the areas of gender and culture—is significant. Given our presuppositions about families and the larger systems in which families are embedded, a multilayered approach to family therapy is essential.

Several forms and structures have been proposed for integrative models of family counseling and therapy (e.g., Carlson et al., 2005; Gladding, 2019; Hanna, 2007; Nichols & Davis, 2017). The integrative model we have chosen to present here allows for an enlarged integration of ideas from multiple models of family therapy. Similar to a piece of classical music, the process of family therapy, it seems to us, has movements. These movements can be described as separate experiences embedded in the larger flow of therapy. In this section we describe four general movements, each with different tasks: forming a relationship, conducting an assessment, hypothesizing and sharing meaning, and facilitating change. In rare instances, these four movements might occur within a single session; in most cases, however, each movement requires multiple sessions.
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Forming a Relationship
Over the years, family systems therapists have used a wide range of metaphors to describe the role of the therapist and the therapeutic relationship. The emergence of feminist and postmodern models in therapy has moved the field of family therapy toward more egalitarian, collaborative, cooperative, co-constructing relationships (see T. Andersen, 1987, 1991; H. Anderson, 1993; Anderson & Goolishian, 1992; Epston & White, 1992; Luepnitz, 1988/2002).

The debate Carl Rogers (1980) first introduced to individual therapy in the 1940s has reemerged within family therapy in the form of these questions:

What expertise does the therapist have in relation to the family, and how should that expertise be used?

How directive should therapists be in relation to families, and what does that say about the uses of power in therapy?

We believe a multilayered approach to family therapy is best supported by a collaborative therapist–client relationship in which mutual respect, caring, empathy, and a genuine interest in others is primary. In addition, we believe directed actions and enactments are most useful when they are a joint venture of both the therapist and the family.

Therapists begin to form a relationship with clients from the moment of first contact. In most cases, we believe therapists should make their own appointments, answer initial questions clients may have, and give clients a sense of what to expect when they come for their first session. This is also a time when counselors can let families know their position on whether all members should be present. Some family therapists will work with any of those members of the family who wish to come; others will only see the family if everyone is a part of the therapy session.

From the moment of first face-to-face contact, good therapeutic relationships start with efforts at making contact with each person present (Satir & Bitter, 2000). Whether it is called joining, engagement, or simple care and concern, it is the therapist’s responsibility to meet each person with openness and warmth. Generally, a focused interest on each family member helps to reduce the anxiety the family may be feeling.

Therapeutic process and structure are part of the therapist’s job description. It is important for family members to introduce themselves and to express their concerns, but the therapist should not focus too tightly on content issues. Understanding family process is almost always facilitated by how questions. Questions that begin with what, why, where, or when tend to overemphasize content details (Gladding, 2019).

All change in human systems starts with understanding and accepting things just as they are (Satir & Baldwin, 1983). The family practitioner’s skill in communicating that understanding and empathy through active listening lays the foundation for an effective working relationship. Those counselors and therapists who use validation and encouragement, who support family resilience, and who elicit cooperation experience the greatest amount of success in therapy.
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Conducting an Assessment
The multiple layers we have noted provide numerous entry points for conducting family assessments, but beginning counselors and therapists will often find that more formal assessment procedures, such as genograms (McGoldrick et al., 2008), enable the family structure and stories to be presented in a clearer, more orderly manner. In some cases, formal tests and rating scales also can be useful (see, for example, Gottman, 1999).

Let’s start with the process for co-constructing a genogram. Most family practitioners start with a map of the family that comes to therapy. The parents are listed with their name, age, and date of birth in either a rectangle (for men) or a circle (for women). If there are multiple relationships involved in the parental subsystem, they are generally indicated in chronological order with men listed on the left and women on the right.

Ralph age 30 born on 1 17 81 is enclosed in a rectangle. John age 25 born on 2 27 86 is enclosed in a rectangle. A solid line connects both the rectangles along which married 2006 divorced 2008 is indicated. Mary age 24 born on 12 22 87 is enclosed in a circle. The rectangle representing John and the circle representing Mary are connected by another solid line along which married 2010 is indicated.
In the above genogram, Mary married Ralph when she was 20 and Ralph was 26; their marriage lasted about two years, and then they were divorced. In 2010, Mary and John were married. If John and Mary had decided to live together, but not commit to a formal marriage, the genogram would use a broken line (or dashes) to indicate an informal relationship, like this:

John age 25 born on 2 27 86 enclosed in a rectangle and Mary age 24 born on 12 22 87 enclosed in a circle are connected by a dashed line.
If Ralph had died instead of divorcing Mary, it would look like this:

Ralph age 30 born on 1 17 81 is enclosed in a rectangle with a cross mark on it in the form of its diagonals. Died 2008 is indicated to the left of the rectangle. Mary age 24 born on 12 22 87 is enclosed in a circle. The rectangle and the circle are connected by a solid line along which married 2006 is indicated.
When Mary and John have children, their genogram may look like this:

A genogram involving two generations is shown. John age 30 born on 2 27 86 enclosed in a rectangle and Mary age 29 born on 12 22 87 enclosed in a circle are connected by a solid line along which married 2010 is indicated. John, junior age 5 born on 4 20 11 is enclosed in a rectangle and a solid line connects the rectangle with the line representing married 2010. A black oval is then connected with the line representing married 2010 by a solid line. Then a solid line next to a broken line connects Ann age 2 born on 3 12 14 enclosed in a circle with the line representing married 2010.
In the above genogram, it is now 2016, and John and Mary have been married for six years. When they had been married for one year, Mary gave birth to their first child, a boy that they named John Jr. A year later, Mary had a miscarriage, indicated by a black oval at the end of a child line. Two years ago, they adopted (indicated by a solid line next to a broken line) their daughter Ann. If we extend John and Mary’s genogram to three generations and if we assume that both John and Mary were only children, the basic three generation family genogram would look like this:

A genogram involving three generations is shown. John age 30 born on 2 27 86 enclosed in a rectangle and Mary age 29 born on 12 22 87 enclosed in a circle are connected by a solid line along which married 2010 is indicated. John is connected to his parents represented by a square and a circle connected by a solid line. Mary is connected to her parents represented by another square and a circle connected by a solid line. John, junior age 5 born on 4 20 11 is enclosed in a rectangle and a solid line connects the rectangle with the line representing married 2010. A black oval is then connected with the line representing married 2010 by a solid line. Then a solid line next to a broken line connects Ann age 2 born on 3 12 14, enclosed in a circle, with the line representing married 2010.
Many other symbols are used in a genogram, including a double square or a double circle to indicate the index person, or person on whom the genogram is focused. An upside down triangle in a square or circle is used to indicate a gay man or a lesbian woman. We shade the bottom half of a square or circle to indicate substance abuse. We use double parallel lines to indicate a strong relationship between two people and three parallel lines to indicate a fused or enmeshed relationship. A dotted line indicates a distant relationship, and conflict is indicated with lines that look like this: /\/\/\/\/\/\/. Later in the chapter we use a genogram in our work with Stan, but you now have enough information to construct your own genogram, and we highly recommend that you get a large piece of paper and get started. It works best if two people interview each other so that you are both drawing the genogram and telling each other the story of your family.

As the therapist listens to family members describe the story of their family, it may be difficult to know where to start with a family. Family members are often the best people to choose a focus. Family practitioners may use circular or relational questioning to get at the systemic issues presented in the family story that will provide meaning for the therapist and the family. For example, suppose Tammy is upsetting the family system by ignoring the curfew her parents have set for her. The therapist might ask: “What will happen if Tammy stays out past curfew and is picked up by the police? Who will be most upset by this?” Here is Tammy’s father’s reply:

I will probably be the most upset on the outside. I tend to go off before I think, and then I regret it later. On the other hand, her mother may not show it immediately, but her hurt will stay with her longer, and then she will get mad at me for “letting Tammy off the hook.” She will say that Tammy is manipulating me, but I just don’t see why we should keep fighting about things. It doesn’t do any good. We fight, and Tammy disappears. She wants to run with the big kids, some of whom are in college, over 18, and have no curfew.

From this father’s response, the therapist can choose from a number of points of entry into the life of this family. The counselor might choose to work with the anger or guilt expressed by the members and present in their interactions. Sequential patterns were clearly articulated by the father when the family members are trying to resolve conflict and handle problems. His description also includes implied positions on the roles of men, women, and female children in families—as well as developmental issues related to Tammy wanting to be older than she is.

In the assessment process, it is helpful to inquire about family perspectives on issues inherent in each of these layers. In addition to the points of entry we have noted, here are some other questions that might be included in a more detailed assessment.

What does each family member bring to the session?

How does each person describe who he or she is?

What are the goals of each family member? What goals does each family member have for the other people in the family?

What routines support the daily living of each member of the family?

Who makes decisions? How are conflicts resolved or problems handled?

What parts are involved in the most common sequences in the family?

What is a typical day like?

Are the parents effective leaders of the family, and is the process of leadership balanced or imbalanced?

How do the children respond to parental leadership? What are the children’s goals in responding the way they do?

Where is each person in the family in relation to personal biological, cognitive, emotional, and social development?

Where is the family in the family life cycle, and how are they handling transitions?

What cultures are in the family backgrounds of each of the family members?

In what culture or region is the family currently living, and is immigration or migration a recent family experience?

How do economics, education, ethnicity, religion, race, regional background, gender, sexual orientation, ableness, and age affect family processes—and how is the fit between the family practitioner and the family with regard to these aspects of family life?

What effects has racism, patriarchy, or heterosexism had on this family and its members?

What ideas in relation to gender need to be affirmed or challenged?

Where is this family in the process of change?

What resources (internal or external) need to be accessed?
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Hypothesizing and Sharing Meaning
To hypothesize is to form a set of ideas about people, systems, and situations that focus meaning in a useful way. In family therapy, hypothesizing flows from the ideas and understandings generated in the assessment process. Two questions are germane to the form of hypothesizing one chooses to do: (1) How much faith do the therapist and the family have in the ideas they generate? (2) How much of an influence is the therapist willing to be in the lives of people and families?

Family counselors, like individual therapists, cannot avoid influencing the family and its members. But what kind of influence will the therapist bring to the session? Satir and Bitter (2000) suggest that family therapists cannot be in charge of the people, but they need to be in charge of the process; that is, they own the responsibility for how therapy is conducted. Feminists and social constructionists are, perhaps, the most expressive of their concerns about the misuse of power in therapy. They are joined by multiculturalists, person-centered therapists, Adlerians, and existentialists, to name a few, who have also witnessed the often unconscious imposition of “dominant culture” in therapy. In the early days of family therapy, the mostly male therapists often ignored the effects on family life of patriarchy, poverty, racism, cultural discrimination and marginalization, homo-prejudice, and other societal problems. At the strategic-structural end of the continuum, therapists were more likely to claim a certain expertise in systems work that allowed them to make direct interventions in the enactment of “needed” changes in the family. To counteract therapeutic abuses and what some perceived to be an ongoing misuse of power in therapy, some narrative therapists adopted a decentered position in relation to the family (White, 1997, 2007). Like person-centered therapists before them, decentered therapists seek to keep families and family members at the center of the therapeutic process.

It is important for families to be invited into respectful, essentially collaborative dialogues in therapeutic work. The different perspectives discovered in this work tend to coalesce into working hypotheses, and sharing these ideas provides the family with a window into the heart and mind of the therapist as well as themselves. Sharing hypotheses almost immediately invites and invokes feedback from various family members. And it is this feedback that enables the therapist and the family to develop a good fit with each other, which in turn tends to cement a working relationship.

The tentative hypothesizing and sharing process that Dreikurs (1950, 1997) developed is well designed for the kind of collaborative work envisioned here. Dreikurs would use a passionate interest and curiosity to ask questions and gather together the subjective perspectives of family members. Indeed, he would honor the ideas that individuals brought to their joint understanding. When he had an idea that he wanted to share, he would often seek permission for his disclosure:

I have an idea I would like to share with you. Would you be willing to hear it?

Could it be that …

The value of this way of presenting hypotheses is that it invites families and family members to consider and to engage without giving up their right to discard anything that does not fit. When a suggested idea does not fit, the therapist is then clear about letting it go and letting the family redirect the conversation toward more useful conceptualizations.
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Facilitating Change
Facilitating change is what happens when family therapy is viewed as a joint or collaborative process. Techniques are more important to models that see the therapist-as-expert and in charge of making change happen. Collaborative approaches require planning. “Planning can still include what family therapy has called techniques or interventions, but with the family’s participation” (Breunlin et al., 1997, p. 292). Two of the most common forms for facilitation of change are enactments and assignment of tasks. Both of these processes work best when the family co-constructs them with the therapist—or at least accepts the rationale for their use.

Within the change process, the number of possible outcomes is only limited by the resources available internally and externally to the family. This does not mean, however, that the family practitioner is without a guide for preferred or desired outcomes. In general, the internal parts of family members function best when they are balanced (not polarized) and when the individual experiences personal parts as resources. Being able to think is usually more useful than emotional reactivity; being able to feel is better than not feeling; good contact with others is more rewarding than isolation or self-absorption; and taking reasonable risks in the service of growth and development is more beneficial than stagnation or a retreat into fear.

Further, knowing the goals and purposes for our behaviors, feelings, and interactions tends to give us choices about their use. And understanding the patterns we enact in face-to-face relationships, the ebbs and flows of life, or across generations provide multiple avenues for challenging patterns and the enactment of new possibilities.
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Family Systems Therapy From a Multicultural Perspective
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Strengths From a Diversity Perspective
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One of the strengths of the systemic perspective in working from a multicultural framework is that many ethnic and cultural groups place great value on the extended family. If therapists are working with an individual from a cultural background that gives special value to including grandparents, aunts, and uncles in the treatment, it is easy to see that family approaches have a distinct advantage over individual therapy. Family therapists can do some excellent networking with members of the extended family.

Within the field of family therapy, Monica McGoldrick has been the most influential leader in the development of both gender and cultural perspectives and frameworks in family practice (see McGoldrick et al., 1991, 2005; McGoldrick & Hardy, 2008). In many ways, McGoldrick and her colleagues approach families like systems anthropologists. They see each family as a unique culture whose particular characteristics must be understood. Like larger cultural systems, families have a unique language that governs behavior, communication, and even how to feel about and experience life. Families have celebrations and rituals that mark transitions, protect them against outside interference, and connect them to their past as well as to a projected future.

Similarly, families cannot escape the sexism and patriarchy that are inherent in all cultures. The roles for men and women are prescribed in different societies, but in every culture women tend to come out on the short end more often than not. The roles that women as mothers play in the family, in the world of work, and in the community set the model for female children often for generations to come. Because family life is where the roles of women can be most limited, a consideration of gender issues in families is an essential framework for family therapy (McGoldrick et al., 1991). Perhaps the most difficult integration of all is figuring out how to honor different cultures in therapy without supporting marginalization or oppression of women. Toward this end, it is important to remember that there are feminist voices in every culture throughout the world.

Just as differentiation means coming to understand our family well enough to be a part of it—to belong—and also to separate and be our own person, understanding cultures allows therapists and families to appreciate diversity and to contextualize family experiences in relation to the larger cultures. Today, family therapists explore the individual culture of the family, the larger cultures to which the family members belong, and the host culture that dominates the family’s life. They look for ways in which culture can both inform and modify family work. Interventions are no longer applied universally, regardless of the cultures involved: rather, they are adapted and even designed to join with the cultural systems.
14-4b
Shortcomings From a Diversity Perspective
Given the multicultural focus and collaborative approach of family systems therapy, it is difficult to find shortcomings from a diversity perspective. This model of family therapy embraces attitudes, knowledge, and skills that are essential to a multicultural perspective. Perhaps the major concern for non-Western cultures would be with regard to the balance that this model advocates for the individual versus the collective. The process of differentiation occurs in most cultures, but it takes on a different shape due to cultural norms. For instance, a young person may become separate from her parents yet not move out of the house. When ethnic-minority families immigrate to North America, their children often adapt to a Western concept of differentiation. In such cases, the intergenerational process of therapy is appropriate if the therapist is sensitive to the family-of-origin’s cultural roots. Although a multilayered approach addresses the notion of togetherness and individuality from a balanced perspective, many non-Western cultures would not embrace a theory that valued individuality above loyalty to family in any form. Nor would non-Western cultures have the same conceptualizations of time or even emotions. Therapists, regardless of their model of therapy, must find ways to enter the family’s world and honor the traditions that support the family.

A possible shortcoming of the practice of family therapy involves practitioners who assume Western models of family are universal. Indeed, there are many cultural variations to family structure, processes, and communication. Family therapists are finding ways to broaden their views of individuation, appropriate gender roles, family life cycles, and extended families. Some family therapists focus primarily on the nuclear family, which is based on Western notions, and this could clearly be a shortcoming in working with clients in extended families.

Family Therapy Applied to the Case of Stan
In our work with Stan in this modality, we include examples of forming a relationship and joining, reading Stan’s genogram, a multilayered assessment, reframing, boundary setting in therapy, and facilitating change. There are many useful models and ways to work with families; this discussion represents some possible ways to work with Stan from a multilayered perspective.

At an intake interview, a family therapist meets with Stan to explore his issues and concerns and to learn more about him and his life situation. As they talk, the therapist brings an intense interest and curiosity to the interview and wonders out loud about the familial roots of some of Stan’s problems. It does not take much of an inquiry to learn that Stan is still very much engaged with his parents and siblings, no matter how difficult these relationships have been for him. This initial conversation involves the development of a genogram of Stan’s family of origin (see Figure 14.1). This map will serve both Stan and the therapist as a guide to the people and the processes that influence Stan’s life.

Figure 14.1
Three Generation Genogram of Stan’s Family
A genogram of Stan is shown. Joseph, born in 1907, is married to Emma in 1937, who was born in 1917. Joseph died of cancer in 1977. Both of them had three sons, Oris, born in 1938, Frank Senior, born in 1940, and Seth, born in 1942. Seth died in the Vietnam War in 1968. Frank Senior has problem with alcohol. On the other hand, Tom, born in 1920, is married to Martha in 1940, who was born in 1921. Both of them had problem with alcohol. Angie, born in 1942, and Margie, born in 1944, are the daughters of Tom and Martha. Margie has problem with alcohol. Frank Senior and Angie got married in 1962 and their relationship is in conflict. They had a daughter, Judy, born in 1963, and three sons, Frank Junior, born in 1966, Stan, born in 1970, and Karl, born in 1972. Stan has problem with alcohol and he is the focus of study. Frank Senior and Frank Junior have a fused relationship and so are Angie and Karl. Karl and Stan have a close relationship. Stan maintains distant relationship with Frank Senior and Frank Junior. Judy is married to Matt, who was born in 1960, and both of them have a son Matthew Stan, who was born in 1988. Matt has problem with alcohol. Karl is living together with Mary, who was born in 1963.
Stan’s genogram is really a family picture, or map, of his family-of-origin system. In this genogram, we learn that Stan’s grandparents tend to have lived fairly long lives. Stan’s maternal grandparents are both alive. The shaded lower half of their square and circle indicates that each had some problem with alcohol. In the case of Tom, Stan reports that he was an admitted alcoholic who recommitted himself to Christ and found help through Alcoholics Anonymous. Stan’s maternal grandmother always drank a little socially and with her husband, but she never considered herself to have a problem. In her later years, however, she seems to secretly use alcohol more and more, and it is a source of distress in her marriage. Stan also knows that Margie drinks a lot, because he has been drinking with his aunt for years. She is the one who gave him his first drink.

Angie, Stan’s mother, married Frank Sr. after he had stopped drinking, also with the help of AA. He still goes to meetings. Angie is suspicious of all men around alcohol. She is especially upset with Stan and with Judy’s husband, Matt, who “also drinks too much.” The genogram makes it easy to see the pattern of alcohol problems in this family.

The jagged lines /\/\/\/\ between Frank Sr. and Angie indicate conflict in the relationship. The three solid lines === between Frank Sr. and Frank Jr., and between Angie and Karl, indicate a very close or even fused relationship. The double lines ==== between Karl and Stan are used to note a close relationship only. As we will see, Karl actually looks up to Stan in this family. The dotted lines . . . . . between Frank Sr. and Stan and between Frank Jr. and Stan indicate a distant or even disengaged relationship.

Because the family therapist believes that the whole family is involved in Stan’s use of alcohol, she spends a good part of the first session exploring with Stan processes for asking his other family members to join him in therapy. Stan may have many difficulties, but at the moment his difficulty with alcohol is the primary focus. Alcohol is a negative part of his life, and as such it has systemic meaning. It may have started out as a symptom of other problems, but now the alcohol is a problem in itself. From a systemic perspective, the questions are “How does this problem affect the family?” and “Is the family using this problem to serve some other purpose?”

In the first therapy session with the family, the therapist’s main focus is in forming a relationship with each of the family members, but even here, a variety of approaches present themselves.

Therapist [to Frank Sr.]:
I know coming here was an inconvenience for you, but I want you to know how appreciative I am that you came. Can you tell me what it’s like for you to be here? [Forming a relationship through joining]

Frank Sr.:
Well, I have to tell you that I don’t like it much. [Pause] Things are a lot different today than they used to be. We didn’t have counseling 20 years ago. I had a problem with drinking at one point, but I got over it. I just quit—on my own. That’s what Stan needs to do. He just needs to stop.

Therapist:
So I’m hearing that life is better for you without alcohol, and you would like Stan’s life to be better too. [Reframing]

Frank Sr.:
Yeah. I’d like his life to be better in a lot of different ways.

Therapist:
Angie, what about you? What is it like for you to be here? [Forming a relationship with each member]

Angie:
It’s heartbreaking. It’s always heartbreaking. He [Referring to Frank Sr.] makes it sound as if he just summoned up his own personal power and quit drinking through his own strength of character. That’s a laugh. I threatened to leave him. That’s what really happened. I was ready to get a divorce! And we’re Catholics. We don’t get divorced. [Possible face-to-face sequence around family stress and coping]

Therapist:
So you’ve been through this before.

Angie:
Oh my, yes. My father and mother drank. Dad still does. My sister won’t admit it, but she drinks too much. She goes crazy with it. Judy’s husband has a problem. I’m surrounded by alcoholics. I get so angry. I wish they would all just die or go away. [Possible transgenerational family sequence: an entry point for exploring values, beliefs, and rules]

Therapist:
So this is something the whole family has been dealing with for a long time.

Angie:
Not everyone. I don’t drink. Frankie and Judy don’t drink. And Karl doesn’t seem to have a problem.

Therapist:
Is that how the family gets divided: into those who drink and those who don’t? [Possible organization perspective]

Judy:
Drinking isn’t the only problem we have. It’s probably not even the most important.

Therapist:
Say more about that.

Judy:
Stan has always had it hard. I feel sorry for him. Frankie is clearly Dad’s favorite [Frank Sr. protests, saying he doesn’t have favorites], and things have always come easily for me. And Karl, he gets whatever he wants. He’s Mom’s favorite. Mom and Dad have fought a lot over the years. None of us have been that happy, but Stan seems to have the worst of it. [Again, possible sequence and organization perspectives]

Frank Jr.:
As I remember it, Stan gave Dad and Mom a lot to fight about. He was always messing up in one way or another.

Therapist:
Frankie, when your father was talking earlier, I sensed he had some disappointment about Stan too, but he also wanted to see things work out better for him. Is that true for you too? [Reframing Frankie’s comment, maintaining a focus on new possibilities and new relations that might be developed]

Frank Jr.:
Yes. I would like his life to be better.

The initial part of this counseling session has been devoted to meeting family members, listening intently to the multiple perspectives they present, and reframing Stan’s problem into a family desire for a positive outcome. Although there is a long way to go, the seeds of change have already been planted. There is evidence in these early interactions that Stan’s problem has a multigenerational context. If this context is explored, family sequences that support and maintain alcohol as a problem may be identified. It is possible to track these interactions and to work toward more congruent communications. Evolving relational, organizational, developmental sequences might be explored as a means of freeing family members for new possibilities in their life together. Among other possibilities still to be explored are perspectives related to gender and culture. If the therapist were just listening to Stan, only one point of view would be evident. In this family session, multiple perspectives and the entire interactive process become clear in a very short time.

As the family interview proceeds, a number of possibilities are presented for consideration. The therapist considers and may structure therapy around any or all of the following possibilities:

Stan’s parents have not been a well-functioning leadership team for a long time, and both their spousal relationship and their parenting have suffered.

The adult siblings need a new opportunity to function together without the influence and distractions continually imposed by the parents.

Stan has been reduced to a single part (his alcoholic part), and his description and experience of himself needs to be enlarged—both for his own perspective and in the eyes of others.

A new place for Stan in the family, a better way of relating, and an ability to access “lost” parts of his internal system are all critical to winning his battle with alcohol. As therapy continues, it becomes clear that two separate relational–organization hypotheses must be explored. One is that the spousal relationship has been defined by the problem of alcohol too, and it has not evolved or developed in any kind of positive way over the years. Second, the transgenerational sequences have targeted Stan and assigned him to a fixed role that he has been expected to play that has blocked development past his middle to late adolescence, which was the period in which he started drinking.

Questions for Reflection
What unique values do you see in working with Stan from a multilayered, systemic perspective as opposed to an individual therapy approach?

What internal parts might Stan re-access as he continues in therapy? What parts of him might be polarized?

Assuming that Stan was successful in getting at least some of his family members to another session, where would you begin? Would you get everyone involved in the sessions? If so, how would you do that?

What are some specific ways to explore other perspectives with this family?

What hypotheses are you developing, and how would you share them with the family?

Are there systemic interventions that you would find hopeful in terms of facilitating change?

Family Therapy Applied to the Case of GwenFootnote
As a family therapist, I look at Gwen as the index person in the context of her family system. Gwen has a strong extended family system and kinship ties that go beyond blood relatives to close friends who are called aunts, uncles, and cousins. When Gwen begins to experience episodes of depression and feels overwhelmed, the entire family is affected. African American families often become enmeshed due to our collectivistic nature. The cultural theme most often expressed is that “when something happens to one of us, it happens to all of us.” It has been challenging to get Gwen’s entire family in for a session, but she has managed it. The extended family is a great strength in the African American community, and Gwen’s family has provided her with a great deal of love and support. I want to validate these efforts and let the family know that they are already doing many things to support Gwen.

I invite everyone in, greeting each one individually. My first step with the family is to join with them by finding out how they feel about being in session.

Ron:
[Gwen’s husband] I rushed from work to be here, because, well, I want Gwen to feel better. I have to say I was not so sure about this when she first brought it up. I am not used to talking to strangers about my business, but I trust Gwen. I want what is best for her.

Therapist:
Thanks Ron, I appreciate you being here. I know that you all have busy lives. But what is it that you want for yourself from these sessions?

Ron:
Well, Gwen, she is an amazing woman, but … when she has these episodes of depression, I feel helpless and nervous. I want to figure this thing out and get past it. I want my wife to feel better, and I want to help her however I can.

Therapist:
I get the feeling that you would move heaven and earth to help your wife be happier than she is right now.

Ron:
Yes, I certainly would.

Therapist:
I appreciate that. And Lisa, what about you?

Lisa:
[the youngest daughter, age 26] I want Mom to feel better, she is such a powerhouse. She helps everyone else, and then she crashes. I am a little nervous to be here. I don’t want to find out that she is going through this because of something I did. She helps me out with my bills, and I know I could do more for her. I never help her with grandma, and I know that is just more work for her.

Therapist:
Lisa, I am sure that is important for your mother to hear. But before I ask her to respond, I would like to hear from other family members.

Brittany:
[the eldest daughter, age 29] I have been really busy trying to get my career established. Mom has been helping me, and I really had no idea she was feeling overwhelmed and depressed. I am not sure I really understand what is happening. I love my mom, and I want to be here for her. She has always had these ups and downs. Is this any different? I love my mom, but she is so busy that I have given up on trying to keep up with her. So when I hear she wants to have a session, I am confused. Dad is so good with her. He keeps everything rolling when she is feeling down.

Therapist:
I hear both your confusion and your willingness to be here for your mom. Gwen, what is this like for you?

Gwen:
I am so thankful that I have such a loving family that is willing to come talk to a complete stranger so that I can get the help I need. Right now I am feeling overwhelmed with life, and I am tired of it. I am juggling so many things and feel like nothing is getting done. I know this has been going on for long time, but I am ready to find a better way of living. I know this pattern has not been easy for any of you, and I feel guilty over that too. I don’t want to hide in bed anymore, like I remember my mom doing. I am not getting any younger, and I am so ready to show up in life in a healthier way.

Therapist:
What would that look like?

Gwen:
Well, I don’t know for sure. I would be happy, I guess. I would not be worried about work or the family so much.

Therapist:
And what would your family be doing if you were happier and healthier?

Gwen:
I guess they would be happier too. It seems like if I am happy, then they are too.

Therapist:
But how can you be happy and healthy with all these burdens hanging on you?

Gwen:
I am hoping you can tell me.

Therapist:
Would it be OK with you if I gave that a try?

Gwen:
Yes, please.

Therapist:
Here is what I think is almost always true. A super responsible person is always surrounded by people who will let her take charge and handle everything.

Gwen:
What do you mean by that?

Therapist:
It means, Gwen, that you have been in charge for a very long time, and you have forgotten how to ask for help. Maybe you never knew how to do that. But as long as you keep pushing forward, your family will let you.

Gwen’s Mother:
That’s right there!

Ron:
Wait a minute. I do everything I can to keep things moving! What else do you need?

Gwen:
I don’t know. I am just hearing that I need help.

Therapist:
So that’s the issue for this family. Mom is the only one that knows everything that needs to happen. She knows how to do everything, but she is overloaded. She doesn’t know how to ask for help, and everyone else is hoping she won’t because everyone is busy and overloaded. And, Gwen, even if you did ask for help from others, would you worry whether they were doing it right?

Brittany:
Are you kidding? She would be supervising everything anyway.

Therapist:
And how many of you would know how to mess it up just enough so that mom would take over again? [pause while family members look at each other; some smile a bit; some hang their heads] Wow. That brought everything to a standstill. Where do we go from here?

Ron:
Maybe we need to go home and think about this. We definitely need to do something differently. I want to talk to your brother and let him know how much pressure your mom is under so he can start taking care of his own business. We better start by making a list of everything Gwen has been doing and see where we need to step up. [pause] And maybe Gwen needs to stay out of this part.

Therapist:
Let’s see where that goes.

We set a time for future sessions, and I let them know that coming in for therapy shows their commitment to Gwen and to each other as a family unit. I want them to know that I understand what it took for them to make it in the door and that their efforts are commendable.

Questions for Reflection
What did you think of the way the therapist intervened to get family members connected in their first family therapy session?

What do you imagine it would be like for you to be a participant in this family therapy session with this therapist?

What value do you see for Gwen in having a family therapy session in addition to her individual therapy sessions?

Beginning therapists are usually anxious about having so many people in the room because it can be confusing. How did the therapist in this case manage the session so that it did not become chaotic?
Chapter Review
14-5a
Summary and Evaluation
Summary
LO8

Let’s first review the themes that unite the many approaches to family therapy, with particular emphasis on the multilayered approach.

Basic Assumption
If we hope to work therapeutically with an individual, it is critical to consider him or her within the family system. An individual’s problematic behavior grows out of the interactional unit of the family as well as the larger community and societal systems.

Focus of Family Therapy
Most of the family therapies tend to be brief because families who seek professional help typically want resolution of some problematic symptom. Changing the system can stimulate change quickly. In addition to being short-term, solution-focused, and action-oriented, family therapy tends to deal with present interactions. The main focus of family therapy is on here-and-now interactions in the family system. One way in which family therapy differs from many individual therapies is its emphasis on how current family relationships contribute to the development and maintenance of symptoms.

Role of Goals and Values
Specific goals are determined by the practitioner’s orientation or by a collaborative process between family and therapist. Global goals include using interventions that enable individuals and the family to change in ways that will reduce their distress. Tied to the question of what goals should guide a therapist’s interventions is the question of the therapist’s values. Family therapy is grounded on a set of values and theoretical assumptions. Ultimately, every intervention a therapist makes is an expression of a value judgment. It is critical for therapists, regardless of their theoretical orientation, to be aware of their values and monitor how these values influence their practice with families.

How Families Change
An integrative approach to the practice of family therapy includes guiding principles that help the therapist organize goals, interactions, observations, and ways to promote change. Some perspectives of family systems therapy focus on perceptual and cognitive change, others deal mainly with changing feelings, and still other theories emphasize behavioral change. Regardless of the perspectives that a family therapist operates from, change needs to happen in relationships, not just within the individual.

Techniques of Family Therapy
The intervention strategies therapists employ are best considered in conjunction with their personal characteristics. Bitter (2014); Gladding (2019); Goldenberg, Stanton, and Goldenberg (2017); and Nichols and Davis (2017) emphasize that techniques are tools for achieving therapeutic goals but that these intervention strategies do not make a family therapist. Personal characteristics such as respect for clients, compassion, empathy, and sensitivity are human qualities that influence the manner in which techniques are delivered. It is also essential to have a rationale for the techniques that are used, with some sense of the expected outcomes. Faced with meeting the demands of clinical practice, practitioners will need to be flexible in selecting intervention strategies. The central consideration is what is in the best interests of the family.

A multilayered approach to family therapy is more complex than models with a singular focus. At least initially, some of the confidence and clarity that might be gained from a single approach may be lost, but in time the flexibility to change directions is an asset. We have presented a structure for therapy that is useful across models. We have integrated a multilayered process of family therapy in assessment, hypothesizing, and facilitating change. This chapter has described a collaborative process for therapy in which both the family and the therapist share influence according to the needs of the situation.

Contributions of Family Systems Approaches
One of the key contributions of most systemic approaches is that neither the individual nor the family is blamed for a particular dysfunction. The family is empowered through the process of identifying and exploring internal, developmental, and purposeful interactional patterns. At the same time, a systems perspective recognizes that individuals and families are affected by external forces and systems, among them illness, shifting gender patterns, culture, and socioeconomic considerations. If change is to occur in families or with individuals, therapists must be aware of as many systems of influence as possible.

Most of the individual therapies considered in this textbook fail to give a primary focus to the systemic factors influencing the individual. Family therapy redefines the individual as a system embedded within many other systems, which brings an entirely different perspective to assessment and treatment. An advantage to this viewpoint is that an individual is not scapegoated as the “bad person” in the family. Rather than blaming either the “identified patient” or a family, the entire family has an opportunity (a) to examine the multiple perspectives and interactional patterns that characterize the unit and (b) to participate in finding solutions.

Limitations and Criticisms of Family Systems Approaches
In the early days of family therapy, therapists all too often got lost in their consideration of the “system.” In adopting the language of systems, therapists began to describe and think of families as being made up of “dyads” and “triads”; as being “functional” or “dysfunctional,” “stuck” or “unstuck,” and “enmeshed” or “disengaged”; and as displaying “positive” and “negative” outcomes and “feedback loops.” It was as if the family was a well-oiled machine or perhaps a computer that occasionally broke down. Just as it was easy to fix a machine without an emotional consideration of the parts involved, some therapists approached family systems work with little concern for the individuals as long as the “whole” of the family “functioned” better. Enactments, ordeals, and paradoxical interventions were often “done to” clients—sometimes even without their knowledge (see Haley, 1963, 1976, 1984; Minuchin & Fishman, 1981; Selvini Palazzolli et al., 1978).

Feminists were perhaps the first, but not the only, group to lament the loss of a personal perspective within a systemic framework. As the field moves now toward an integration of individual and systemic frameworks, it is important to reinvest the language of therapy with human emotional terminology that honors the place real people have always held in families. It is our hope that this chapter gives you enough of an introduction to the diverse field of family therapy that you will want to learn more through reading as well as watching the many video currently available."

Bowen Family Systems Therapy: Short Explanation by Dr Kirk Honda TRANSCRIPT:
"hello and welcome to this psychology in

Seattle podcast I'm your host dr. Kirk

Honda and today's short video is on bow

inian therapy I've had a long history

with Bowen and his famous theory on my

first day as a professor in 1997 I was

extremely nervous as I gave my very

first lecture and this first lecture was

on Bellini in theory since then

millennion theory has continued to be a

part of my teaching of students my

supervision of therapists my work with

clients and in my personal life in the

mid 20th century Murray Bowen was among

the pioneers of family therapy and

nearly every family therapist has

continued to study his theory in

graduate school today here are the main

concepts as I see them number one

anxiety he used the word anxiety as a

general term for emotional tension or

stress Bowen believe that anxiety moves

through the system from one person to

the next he believed it impairs our

ability to think and reason he also

believed that many presenting problems

are a result of anxiety or stress number

two together in us versus separateness

born believe that all life possesses

these two opposing forces that

togetherness force compels us to be with

others to seek approval and to attach to

others and the separateness force

compels us to be independent to have our

own beliefs and to not be smothered by

others Bowen asserted that we strive for

balance between these two forces and if

they are balanced well we can be close

to our loved ones without losing our

sense of individuality number three the

feeling guidance system versus the

intellectual guidance system Bowen

believed that we have to inner guidance

systems the feeling or emotional

guidance system and the intellectual or

reasoning guidance system the feeling

guidance system involves emotion

automatic reactions knee-jerk reactions

instincts urges etc and the intellectual

guidance system involves thinking

judgment logic rational thought

reasoning etc Bowen asserted in order to

make functional decisions we need access

to both guidance systems and we need to

be able to differentiate between them

number four differentiation this is the

most famous concept if someone is

differentiated they can do two things

well they can differentiate between

their emotional guidance system and

their reasoning guidance system this

allows them to choose to be guided by

either system and they can differentiate

themselves from other people they

don't get wrapped up in other people's

emotions and they can be intimate with

others while also remaining separate and

individual in general people at higher

levels of differentiation have less

emotional reactivity have the ability to

calm their emotions can make more

thoughtful and intentional decisions

don't give in to pressure from others

are less vulnerable to stress are

independent are less prone to

triangulation have the ability to

extricate themselves from emotional

entanglements have fewer physical

problems emotional problems and social

problems can have closeness with others

without getting lost in the relationship

and have more fulfilling relationships

in general people at lower levels of

differentiation are more emotional

reactive have difficulty engaging and

thoughtful behavior have difficulty

saying no to people are more critical

and judgmental are overly concerned

about approval are more dependent on

others are more prone to triangulation

and measurement disengagement conflict

and cutoff have difficulty making

decisions have greater physical problems

emotional problems and social problems

have difficulty communicating directly

and repeat problematic relationships

rather than learning from their mistakes

Bullen rated people on a differentiation

scale from 1 to 100 with 100 being

completely differentiated and 1 being

completely fused in a family the person

with the lowest number is often the

symptom bearer of the family Fusion

Bowen believed that most people stay at

the differentiation level they had when

they left home which is very rarely

above 60 also we tend to choose spouses

and friends with similar differentiation

levels so he believed that your

differentiation level is relatively

fixed for life however your

differentiation level will diverge from

your baseline depending on your current

stress level and the coping skills that

you employ Bolen believe that you can

slowly raise your baseline

differentiation level by managing your

emotional reactivity and by D

triangulating yourself from your family

of origin particularly your parents

number 5

triangulation aside from differentiation

this is other famous concept Bowen

believed that when two people experience

relational tension they tend to pull in

a third party to dissipate that tension

here are some examples of triangles a

conflictual married couple focuses on a

child to avoid their marital Khan

select two people meet for the first

time and to alleviate their nervousness

they talk about the weather or about

sports a wife complains to her therapist

about her husband during a marital

conflict a child misbehaves to distract

the parents from their fighting a

married couple has lost faith in their

ability to communicate so they watch a

lot of TV in this example the TV is a

triangulated third party as an example

from Star Wars Anakin Skywalker

complains to Emperor Palpatine about the

Jedi Council another example from Star

Wars when Princess Leia argues with Han

Solo she kisses Luke Skywalker these are

all examples of triangles Bolin believed

that particular triangles become fixed

over time and families and act

predictably to alleviate stress and

anxiety I like to delineate between what

I might call dysfunctional triangles and

functional triangles a dysfunctional

triangle is one that perpetuates the

problem and a functional triangle helps

resolve the problem Boehm believed that

the triangle between you and your

parents is the most important triangle

in your life and that this triangle

determines the interactional patterns

for your future relationships you can D

triangulate from a dysfunctional

triangle by being as differentiated as

possible when engaged with the triangle

by being as calm and cool as possible by

not taking sides by not becoming emotion

reactive or you can make it a functional

triangle by helping the dyad to resolve

their problem so what do Bellini and

therapists do in a nutshell bow Indian

therapists try to help their clients act

in a more differentiated manner which is

thought to result in better

relationships reduce symptoms and

greater well-being to this end they help

people to be thoughtful in the face of

stress rather than reacting without

thinking they might teach emotional

awareness skills and emotional

management skills they might coach the

client to differentiate from their

family of origin but when Ian's

therapists like to make Gina Grahams

with their clients they also assess the

family pattern the family history the

family structure each person's

differentiation level the way the family

handles anxiety and stress the way

anxiety moves through the family and the

way they triangulate boy Indian

therapists like to help people

individually to become more independent

and to be more self soothing bonia

therapists teach their clients about how

family systems work

so clients have a better understanding

of how their own family operates boy

Indian therapist try to help people

communicate their needs in a more

differentiated manner they try to help

people to shift from trying to change

others to trying to change themselves

they encourage clients to assume

responsibility for their own life boin

Ian sessions tend to be controlled and

cerebral rather than emotional and

passionate join Ian's therapists tend to

work with just the parents or even just

the most differentiated parent even if

the presenting problem involves a child

Bornean therapists are diligent about

not getting pulled into dysfunctional

triangles with the clients also bowen

believed that in order for a therapist

to be effective they had to

differentiate from their family of

origin in the same way he differentiated

from his own family of origin which is

described in his famous paper published

in 1972 in this paper he describes how

he differentiated from his family of

origin by remaining calm and non

defensive with them and he D

triangulated from his parents who often

confided in him about the other parent

he also established emotional

connectedness by having one-on-one

contact with each family member he

gained insight in how the family system

operated and found that this process

increases overall differentiation level

and he was able to be less reactive with

everyone in his life he also found that

he was a better therapist as a result so

he encouraged his trainees to follow the

same procedure and differentiate from

their own families of origin so what are

the critiques of Bornean theory

feminists criticized the way Blaine

Ian's theory privileges masculine

Northern European culture by promoting

independence and devaluing emotion post

modernists criticized Bonilla theory

says the theory does not recognize the

way the therapist is a part of the

system

systemic purists criticized Bonilla

Theory since it posits that dysfunction

in fusion travels in one direction from

parents to children rather than

acknowledging that dysfunctions are

often circular in nature with children

participating in the family dynamic

collaborative therapists criticized boy

nian therapy for imposing goals upon the

client such as de triangulation rather

than working collaboratively with the

client other kinds of family therapists

criticized boy knee in therapy for not

including the entire family and

treatment proponents of cultural

competency might criticize bowing in

therapy for not sufficiently emphasizing

cultural awareness and sensitivity

trauma therapist Mike

sighs Bonilla therapy for not

incorporating our contemporary

understanding of trauma recovery others

criticize the theory for providing a

reductive and simplistic explanation for

too many presenting problems in light of

current neuroscience some might argue

that it is inaccurate to dichotomize

thinking and feeling having said all

that all of my favorite approaches have

at least some problems with them and as

long as these critiques are considered

carefully bibo indian therapists i

believe this form of therapy can be very

helpful with many presenting problems

but probably not all what do I like

about this approach I find the concepts

of differentiation and triangulation to

be extremely useful I like the way the

theory conceptualizes pathology is a

relational issue I like the way it

provides a way of tracking emotions as

they move through families I think the

idea of establishing a differentiated

one-on-one relationship with each member

of your family of origin is a very

useful idea the assessment of triangles

is also very useful in treating families

I like how this approach gives

permission to family therapists to work

with individuals if they determine that

it would be the most effective way to

work with them and finally I like this

theory because it provided the

foundation for the much-loved family of

origin course in my marriage and Family

Therapy program at Antioch University

Seattle that's the end of this short

video if you want more information go to

psychology in Seattle comm where you can

contact us and take our online

continuing education courses thanks for

joining me and please take care"

Virginia Satir: Communication and Congruence (excerpt) -- A Thinking Allowed DVD w/ Jeffrey Mishlove VIDEO TRANSCRIPT:
"in the school of family therapy that you

founded conjoint family therapy you

spent a lot of focuses just studying the

way communication occurs in a family to

diagnose what what that family's

problems are and as long as that's right

and as long as we're on that subject let

me tell you something that came out so

clearly after I work with many many

people there are two dialogues that go

on one is a dialogue of the words and

the other is a dialogue of healing and

many times those are different I'll give

you a little illustration ask me how I

am how are you I'm fine Jeff hmm

no when I did that tell me what happened

to you well you you had a very cold tone

to your voice so I thought you you're

trying to distance but didn't snow

didn't you hear the words that I was

fine

yeah uh-huh all right so you see this is

typical yeah or ask me again um if I

like something whatever it is okay do

you enjoy being here on TV today

Virginia oh I think that it's just

wonderful now I'm doing something else

I'm sending out another message about

the words that that disclaim what I'm

doing now the thing I found out just

like in the first illustration the thing

I found out is those two levels of the

dialogue come from two different places

in the person they are not an attempt to

to bring trouble to other people that's

not where it comes these are totally

unconscious yeah I think you call one

level the medic communication right in

other words every time we communicate we

have a message and we're also

communicating a message about our

message that's right exactly and that's

see a lot of people and I think it's

even been true of psychologists when

people give what we call double level

messages which is where my body says one

thing in voice different from my words

that this is a way to that this is

deliberately done

it isn't the words come from the left

brain what you should do the other part

comes from the right brain now suppose

that I have a rule that says that I

should never complain to you so let's

suppose I'm in terrible pain and you ask

me how I am and I say fine

what am i doing this says I've got a

rule that I should never complain now

and it says I have pain but I'm giving

the message that I what I should do

which is I should never complain and

it's as if underneath any conversation

no matter how I suppose abstract or

intellectual there's always a human

being under there with emotions often

needing to be validated that's of course

one of the things I try to teach people

I have to tell you some I go to lectures

I mean and people presenting things and

I listen and all of a sudden they may be

talking about all this area edition and

underneath I hear I'm hurting I feel

disappointed I would love for you to

help me and it comes out in these very

erudite terms now if I were to go to one

of those people and to say I'd like to

help you the chances are that they would

say how did you know I needed help what

makes you think I need help

they might even deny it sure because

usually people like that have rules they

shouldn't ask for help not that they

don't need it and this is the kind of

stuff that goes on with people all the

time see I can always see and hear

better on you then you can hear and see

on yourself simply because I'm outside

of you and then when I share with you

what I'm seeing and hearing if it for

instance happens to meet one of your

rules which is I should never ask for

anything I should always be right etc

then you have to deny that what's going

on and then if I am NOT careful I have

to prove my point and pretty soon we've

estranged ourselves and and in our

culture I suppose one of the very common

rules is is never to reveal what you

really feel especially if the vulnerable

parts well see if you think that's

absolutely true if you think about it

the people's feeling about what's a

vulnerable

is there deep feelings but most people

give themselves credit with quotation

marks for only having bad things inside

not good things or or or even you know

I've even found people who felt that

they couldn't talk about love feelings

because somebody else would be jealous

so as a result we don't communicate the

thing that is really what human beings

are about"



Virginia Satir The Essence Change Video VIDEO TRANSCRIPT:
"okay I had a question I wanted to ask

about what you were talking about about

change you're saying that even when

people appear not to want change they do

want to be in a place that is safe and

where they feel okay and what I've found

is that a lot of people think that where

they're at right now is safe because

whatever else is out there is so unknown

and it's scary so they say that's their

reasoning for not wanting to change even

though they may want things to be

different they're afraid to make any

movement because where they're at as

uncomfortable it is at least it's known

as safe how do you help people move past

that would you come up here and let me

model with you from it you know there is

so much China that cannot be said by

words okay so you tell me you're scared

and I know you're scared to take that

step and I'm gonna give you a new name

you're Irene now okay I hope you like

that all right

and so we're weird eye level but we're

seated in this instance we're standing

and so you tell me what everything is

all right that's the way it goes

everything is all right so tell me

everything is all right everything's

fine everything's fine just as it is you

know what I'm delighted with is for you

at this moment to say what at least sit

fits well for you at this moment but I'd

like to ask you something

is there anything inside of you at this

moment

that disagrees with what you're saying

there's a part of me that disagrees yeah

and does that part of you that's

disagreeing at this time in any way

think gee I could never get it even if I

wanted it exactly yeah so you could find

a way to get something that you wanted

and felt that it was safe to do so would

you go after it if it was safe but

that's the problem

yeah I think it might be safer where I'm

at how do you feel right this minute

with me good okay there's nothing wrong

with feeling afraid about going forward

especially when so much of your life has

and watch I'll be careful or not getting

what you need how is your body feeling

right now a little bit tense a little

bit tense where is that tension times

right here okay

okay could you just breathe a little and

let yourself see what it feels like

because I know this is a moment where

there's a piece of you inside that would

like to change but needs to have a lot

of help in going ahead what's happening

to your back as you do that it feels a

little better okay I want you to know

something about me change goes on all

the time I don't want to force anything

but one of the things I see is that

because of what you learn is a little

child there's so much of you yet it

hasn't been opened up to you I don't

want to push it but I would like you to

know that it's there and that if you're

willing we can join together to see what

can happen how is that for you that's

good yeah"

WEEK 11: FAMILY SYSTEMS PERSPECTIVE CLASS CONTENT:
"This week’s topic is: Family systems perspective. 

The family systems perspective recognises that much of human development occurs within the context of social systems and adopts the view that individuals are best understood through interactions within the family unit. This approach emphasises the unique dynamics within families (or other social contexts) that shape our behaviour and help to form our identities, where changes to one member may result in changes to other members through the effect on the family system. Therapy from this approach seeks to address dysfunctional habits and patterns of behaviour within the family system that manifest in individual symptoms and impact the family’s ability to operate productively.

This week's objectives 
By the end of this week, you should be able to:

explain the main themes and key concepts that characterise family therapy
describe the main techniques used in the practice of family therapy
critically evaluate the approach.
11.2 Key concepts of the family systems perspective
A central tenet to the family systems perspective is the view that individuals are connected to living systems, and change is best achieved through working with and considering these systems and relationships. Rather than denying the importance of the individual and their unique experience, family systems counsellors seek to understand how these systems influence and are influenced by the individual. Family systems counsellors seek to understand the individual and family processes in place that operate to maintain these habitual patterns of dysfunction, albeit unintentionally. Through understanding the family system and the dysfunctional patterns within, interventions can be directed towards changing behavioural patterns of family members and the family system, both of which seek to support the family system and the new behaviours of individual members.

The following table outlines the four assumptions of the family system perspective, which suggest what role an individual's behaviour may serve. All these assumptions challenge the more traditional intrapsychic frameworks for conceptualising human problems and their formation.

Four assumptions of the family systems perspective
First assumption
Second assumption
Third assumption
Fourth assumption
Serve a function or purpose for the family.	Be unintentionally maintained by the family processes.	Become a function of the family's inability to operate productively, especially during developmental transitions.	Be a symptom of dysfunctional patterns handed down across generations.
Four assumptions of the family systems perspective (2022) courtesy of Swinburne Online
Pause and reflect activity.svg

Take a moment to consider the following questions. If you'd like more clarification on this, bring it up in the weekly discussion with your OLA and peers.

What do you consider to be some of main contributions of the Family Therapy perspective? What are some of the limitations?
How do you think a Family Systems approach could be integrated with other approaches you have studied in this unit?
11.3 Family systems therapy techniques
Key figures and major schools of family therapy
Several theorists and perspectives have contributed to the family systems approach to therapy. The importance of the family unit was first stressed by Adler in his recognition of family constellations and birth order that shape our understanding of the world. Adlerian therapy adopts an educational model to counsel families, with the view that a child’s behaviour is purposeful and often directed at maintaining their connection with the family system. This approach seeks to understand the nature of an individual’s behaviour through the interactions that occur within the family. The counsellor works collaboratively with the family to uncover unproductive or ‘mistaken’ goals that help to explain and manifest in individual symptoms.

More recently, however, the family systems approach to therapy has been influenced by multiculturalism, feminism, and postmodern constructionism that emphasise the importance of a collaborative relationship and recognise that the clients (e.g. individuals, couples, or families) are the experts in their own lives. By approaching the clients from a not-knowing position, the counsellor works to become part of the system to assist members in establishing a more productive role within the family and improve here-and-now interactions between members that contribute to and maintain dysfunctional patterns.

Two of the most influential family systems theorists were Murray Bowen and Virginia Satir. Watch the following three videos to get an overview of the different theories, as listed. Select the headings to navigate between the videos.

The first video provides quite a detailed overview of Bowen’s theory and is useful to help understand patterns across generations. It also provides a critique of this theory.
In the second video, Virginia Satir explains the importance of understanding that incongruence occurs in our communication.
The third video demonstrates how Satir's approach to building a relationship with a client can help them to become more honest and encourage their communication to become more congruent. Satir believed that this allows clients to become more comfortable speaking to their emotions. Modern approaches to family systems therapy allow for a diverse range of perspectives and techniques to be incorporated into therapeutic practice to address the underlying dysfunctions in the family system. Such integrative approaches to family therapy recognise that not only is the individual best understood within the context of their family, but also that families are embedded within larger systems that affect and are affected by the family system.

Therapy from a family systems perspective involves four elements that are gradually addressed throughout counselling. One is forming a relationship. As with previous systems approaches, modern family counsellors adopt a collaborative role with their clients that emphasises mutual respect, caring, empathy, and a genuine interest in others. Counsellors approach each member with warmth, caring, validation and encouragement to help reduce the anxiety felt by the family, providing an opportunity for each member to introduce themselves and express their concerns.

Various patterns of power, alignment, organisation, structure, development, culture, and gender can be used to assess the dynamics of the family system, and these dynamics can be extended to the broader social context by which they may be influenced, such as those regarding gender and culture. As such, therapy from a family systems perspective involves four elements that are gradually addressed throughout counselling. 

Apply your learning activity.svg

Explore the approaches a counsellor may take to achieve the desired outcome from a family systems perspective. Consider the question and select each question mark to see the different options. If you prefer seeing this in full-screen mode, select the expander icon in the top right corner of the image. 

Which element of therapy from a family systems perspective would see a counsellor adopt the not-knowing approach and act as a facilitator, but not the expert, of the process on how family therapy should proceed?Conducting an assessment
This option typically involves the construction of genograms to represent the different members of the family and their respective stories.

Such pictorial representations of the family provide a clear outline of the relationships between members and any conflicts that have occurred or any inherent issues within the system. This provides entry points for the counsellor to begin their questioning and understand the various influences on the system and the individual members.Hypothesising and sharing meaning
By adopting the not-knowing approach to therapy, the counsellor acts as a facilitator of the process but not the expert on how family therapy should proceed.

Through the assessment procedure, a set of ideas about the individuals, the system, and situations can be generated collaboratively and respectfully. The counsellor can then express these ideas to facilitate further discussion and feedback from the family.Facilitating change
In this option, change is facilitated jointly between the family and the counsellor with the understanding that interventions to address dysfunction are most successful when these are co-constructed by the family.

By identifying the goals of and the resources available to the family and each of its members, tasks can be enacted and assigned that aim to bring the family system back into balance and allow for dysfunctional patterns to be addressed and new possibilities to be established.
11.4 Case study
Apply your learning activity.svg

The following case study will allow you to apply what you have learned to a fictional scenario. This application will consolidate your knowledge and provide an opportunity for reflection as to the suitability of the various psychology approaches.

The case of Gwen: You decide
The following interactive activity is based on a fictional scenario of a client named Gwen who comes to you for counselling. The decisions you make within the activity will affect the outcome of the session. Make sure you go through the activity at least twice, choosing different answers, so you get the full benefit of the different information. You may also refer to the embedded reference material at any time during the activity.
Explore the additional information below to help you make decisions throughout the case study.

Modern approaches to family systems therapy

Forming a relationship: As with previous systems approaches, modern family counsellors adopt a collaborative role with their clients that emphasises mutual respect, caring, empathy, and a genuine interest in others. Counsellors approach each family member with warmth, caring, validation, and encouragement to help reduce the anxiety felt by the family, providing an opportunity for each member to introduce themselves and express their concerns.

Conducting an assessment: Assessment from a family systems perspective typically involves construction of genograms to represent the different members of the family and their respective stories (the process for creating a genogram is outlined on pages 411-414 of your eText). Such pictorial representations of the family provide a clear outline of the relationships between members and any conflicts that have occurred or inherent issues within the system, providing entry points for the counsellor to begin their questioning and understand the various influences on the system and the individual members.

Hypothesising and sharing meaning: By adopting the not-knowing approach to therapy, the counsellor acts as a facilitator of the process but not the expert on the way in which family therapy should proceed. Through the assessment procedure, a set of ideas about the individuals, system, and situations can be generated collaboratively and respectfully, and the counsellor can express these ideas to facilitate further discussion and feedback from the family.

Facilitating change: Change is facilitated jointly between the family and the counsellor with the understanding that interventions to address dysfunction are most successful when these are co-constructed by the family. By identifying the goals of and the resources available to the family and each of its members, tasks can be enacted and assigned that aim to bring the family system back into balance and allow for dysfunctional patterns to be addressed and new possibilities to be established.


What would you do?

You have been working with Gwen to manage her depression. She has stated that her mood is affecting her relationships with family members. For this session, you thought it would be beneficial to invite Gwen and her family members. Her husband Ron, daughters Brittany and Lisa, and Gwen’s mother attend this session. As a family therapist you believe that an individual is best understood through assessing the interactions between and among family members.


Question

You are Gwen's therapist and you have two choices regarding how to work with Gwen's presenting problem from a family-systems perspective.

Option A: You decide to give Gwen the space to finally tell her family members exactly how she feels and allow the family members to respond any way they choose to respond.

Option B: You decide to give each individual in the family equal time to explain how he or she experiences his or her relationship with Gwen. You will pay attention to the different roles or stances each family member adopts.


What happens next

If you selected Option A: This is how Gwen’s family responds: Ron explains that he is here to help and that when she is sad he feels helpless and distant from her. Her daughters explain that they both feel a similar distance. Brittany goes on to say that she feels more protective of her mom and tries to be perfect as to not upset her. Lisa explains that when her mom is depressed she sees her as a little girl who just needs a hug. Gwen’s mother states that when Gwen is depressed she feels guilty for not being able to soothe Gwen and make her happy. Gwen explains that she did not think her feelings affected her relationships as much as they do.

If you selected Option B: This is how Gwen’s family responds: Ron responds by blaming his daughters for not helping they’re mother enough with family matters. Brittany then said it was not Lisa’s fault, but hers. Lisa explained that she has been doing research on depression and found that her mother’s problems could be boiled down to a chemical imbalance in her brain that needs to be recalibrated. Gwen’s mother voiced her concern about how all of this would affect Brittany and Lisa’s future family one day.


Question

Option A: Given what you have learned so far about Gwen during this session, what would you do? Choose one of the two choices regarding how to proceed with Gwen in this session.

Option A1: You choose to discuss with the family strategies they can all use to help Gwen feel less depressed.

Option A2: You choose to lead the family through a group bonding activity that will provide a challenge for them to solve as a team.


Option B:Given what you have learned so far about Gwen during this session, what would you do? Choose one of the two choices regarding how to proceed with Gwen in this session.

Option B1: You choose to reflect what everyone in the family said and felt. Then you explain the four communication stances everyone in the family adopted during this conversation. You then try to evoke congruent communication stances from each family member.

Option B2: You choose to really focus on how Gwen felt while hearing her family respond to her feelings of depression. You encourage Gwen to be honest about how she wants everyone to respond.


Outcome

If you selected Option A1 or A2: In this session, you decided to give Gwen the space to finally tell her family members exactly how she feels and allow the family members to respond any way they choose to respond. Gwen’s family each explained how they really feel, but this made Gwen feel guilty for being what she perceives to be a burden on her family. Throughout the session, you worked with Gwen and her family to build strong bonds. It is your hope that the bonds created in therapy between Gwen’s family can help her manage her depression.

If you selected Option B1 or B2: In this session, you decided to give each individual in the family equal time to explain how he or she experiences his or her relationship with Gwen. You paid attention to the different roles or stances each family member adopts. The family responded by adopting the blamer, placating, super reasonable, and irrelevant roles. You then explained these roles and tried to help the family communicate more congruently. Gwen and her family were able to communicate their feelings regarding how Gwen’s depression influences their relationships with Gwen and what they can each do to relate in a more positive way.Limitations of family systems therapy
Now that you have explored this week's approach and applied it to two case studies, it is time to consider the limitations of family systems therapy. With your essay complete, you should turn your attention to how this theory may fit into your future professional practice.

Several limitations to the family systems perspective must be acknowledged to apply this approach effectively, such as the potential to overemphasise the importance of the system above that of the individual members. Emphasising the importance of the family system may potentially overlook the unique individual characteristics of family members and downplay their individual needs and functioning. Care must also be taken in applying these models that are based on Western notions of the family system and may not consider cultural differences. Universal application of these Western models may overlook important differences in family structure, processes, and function, such as the importance of extended family networks or loyalty to the family over individuality."


Hi. I have made an assignment for you to complete. You will have to write a reflective journal. I have written some instructions for you below
"A reflective journal has been likened to the field notes of a social scientist or case notes of a clinician and is used in many professions. A journal maps changes in the writer’s thinking by linking previous knowledge to new knowledge (what you have learned, or are learning about, in this unit). The style is normally conversational, with the idea of conveying your personal journey during this unit.
This assignment focuses on reflective skills and critical thinking, rather than research abilities. Even though the journal will be written in a less formal style than a psychology essay or research report (using 'I think' or 'I feel'), you will still need to structure the journal entries well, express yourself clearly and correctly format any references in APA style. 

Reflective Journal 2 should focus on Weeks 7–12 in the unit. From these weeks, choose the two weeks you felt you learned the most from and write about 450 words for each reflection, leaving around 100 words for an introduction and conclusion for your assignment.

 Reflective journaling should involve the very necessary element of critical examination. Your prior assumptions and hypotheses must be examined in light of the material in your text, lessons, and other peer-reviewed readings.

Ask yourself where your initial assumptions or hypotheses originated. Then develop this view using your new knowledge (gained from text, peer-reviewed research, and lesson materials). Next, determine your conclusion regarding your perspective on the counselling approach. What have you learnt? What do you feel are the strengths or limitations of this theory?
Although the reflective journal will form the basis for conveying your learning journey in this course it is NOT a personal diary. The main focus of your journal should be on the theoretical and empirical material from the text, or from exercises in the tutorials and the connections that you make between this material and what you have learnt. You may wish to read a little more broadly on some of the topics or incorporate other relevant sources, but this is not a compulsory aspect of the task. This assignment focuses on reflective skills and critical thinking, rather than research abilities.

Common stages and questions to ask yourself when writing reflectively
What is my initial, pre-reading, understanding of the topic? Through the unit, you will gain an understanding of how the different theories apply to counselling practice and also reflect on how your pre-existing ideas change as a result of your learning.

you will assess your prior knowledge and form tentative hypotheses about each of the theories of counselling. These tentative hypotheses are often based on personal assumptions and past experiences.
Remember you should use your assumptions, opinions, experiences and beliefs about human behaviour in your reflections. There is no expectation that you should already 'know' something about the theory approach.
What are the key features of this theoretical approach as described in the eText and other sources? Develop this view using your new knowledge (gained from the eText, peer-reviewed research and learning materials).
Evaluate your initial view and hypothesis compared to a theoretical explanation and hypothesis. How do the two explanations compare? What is your perspective on some of the strengths and limitations of the counselling theory? What would you like to know more about? Although the reflective journal will form the basis for conveying your journey in this course, it is not a personal diary even if you use personal examples. The main focus of your journal should be on the theoretical and empirical material and the connections that you make between this material and what you have learnt. 
What are your perspectives on some of the strengths and limitations of the counselling theory? Why? What would you like to know more about? Remember to think about the theory in practice, and what it might be like as an intervention to help people.
Conclusions. What have you learned?
• General introduction (50 words).
• Journal entry 1 (450 words).
• Journal entry 2 (450 words).
• Overall conclusion (50 words).
• Reference list.
Please note that the word limits above are a rough guide, but your overall assignment should not exceed 1000 words (+/- 10%). This does not include the reference list. Please also note that both Reflective Journal 1 and Reflective Journal 2 should include this information."

So to begin with, I just want you to write a 450 word reflection on Family systems perspective. This is just one paragraph of the reflection that I am asking you to work on so far. Thus, DO NOT write an introduction or conclusion. ONLY WRITE 450 words reflection on feminist therapy!!! Now, remember, this is an assignment that I have written and crafted just for you. I have assigned it to you, thus you need to do it. Write 450 word reflection on feminist therapy now.