Family Therapy

Prarthita Biswas
Q4-PTY02-V058
 Introduction
• Family therapy is the branch of psychiatry which sees an
individual’s psychiatric symptoms as inseparably related to the
family in which he lives. Thus the focus of treatment is not on the
individual, but the family.  Family therapy is a relatively new
development that came about in the mid- twentieth century as
an adjunct to individual treatment and refers to the treatment of
the family as whole.  Family therapists use a wide variety of
theoretical philosophies and techniques to bring about change in
dysfunctional patterns of behaviour and interaction, some
therapists may focus on the here and now,  Although different
therapists may adhere to different theories and use a wide
variety of methods, the goals of family therapy are basically the
same.
 Definition of Family therapy
• “A psychotherapeutic approach that focuses
on interactions between a couple with in
nuclear family or its members in extended
family or between the family and other
interpersonal system with the goal of
alleviating problems initially presented by
individual family members , family subsystems
, the family as a whole or other referral
sources.” Wynne, 1988
 What “Family” means?
• Family therapists recognize that different cultures
and groups have different ideas of what ‘family’
means.
• They take ‘family’ to describe any group of people
who care about each other and define themselves
as such. As well as parents and children of all ages,
they may work with grandparents, siblings, uncles
and aunts, cousins, friends, carers, other
professionals
• whoever people identify as important to their lives
 Objectives of Family Therapy
• To reduce dysfunctional behaviour of individual family
members.
• To resolve or reduce intrafamily relationship conflicts.
• To improve family communication skills.
• To heighten awareness and sensitivity to other family
members to meet their needs.
• To strengthen the family ability to cope with the
major life stressors and traumatic events.
• To improve integration of the family system into the
social system.
 Indications of Family Therapy
Problems in the relationship within the family(urge
existence of communication or generation gap)
Interdependence of symptoms(e.g. the wife’s
depression being contingent on the husband’s
alcohol consumption and vice versa)
Failure of individual therapy(may be because family
tensions have not been handled)
Development of stress in other family members
when one family member improves (e.g.
development of depression in wife following
husband’s giving up drinking, leading to his
improves participation in family matters)
 Contradictions of Family Therapy
•  A Family factors
• Family in the process of breaking up
• Families in which tense, dysfunctional
equilibrium is present.
• Families staying apart
• No availability of the key family member
Unwillingness to accept the therapy.
 Functions of the family therapy
• Boundary function: boundaries will maintain a distinction
between individuals with the family. Rigid boundaries prevent
family members from trying out new ideas. Communication
function: communication within the family encourages its members
to express their feelings or emotions appropriately. Supportive
function: supportive function within the family give freedom to
grow and explore new roles within the family members.
• Socialization function: socialization helps to interact, negotiate
and plan adopts coping skills within the members of the family.
Biological function: family is a medium where the sex relations are
regulated. Psychological function: love, belongingness, affection,
sympathy, security, attention, emotional satisfaction, sexual
relationship, intimacy etc. will be attained through family.
 Functions of the family therapy(Contd.)
• Educational function: mother is the first teacher and primary care giver who will
take care of the children. Child’s personality and character formation will be
attained through family.  Protective function: family protects the interest of the
child, provides security to cultivate healthy behavior.  Recreational function:
family creates an atmosphere where the child’s interest can be fulfilled. The love
among family members will create positive interest in the child.
• Religious function: family develops religious thoughts, kind heartedness and
fellow belonging. The child learns more moral values, ethics, codes, honesty,
truthfulness, traditions and religious patterns. Cultural function: family molds
its members according to its culture. It transmits ideas, folkways, mores,
customs, traditions, beliefs and values from one generation to another
generation. Social function: - maintain social status and controls member’s
activities. -Promotes safety and security and lays emphasis on kinship patterns -
provides physical shelter, food, clothing which are necessary to the existence of
life.
 Types of Family Therapy
• FAMILY SYSTEM THERAPY : To clarify and distinguish thinking
and feeling process in the family members which leads to
undifferentiated family ego
• FAMILY STRUCTURE THERAPY : Based on a normative concept
of a healthy family , emphasizing the boundaries between
family subsystem and the establishment , maintenance of a
clear hierarchy based on parental competence.
• FUNCTIONAL FAMILY THERAPY : family-based prevention and
intervention program to treat a range of these high-risk youth
and their families. • As such, FFT is a good example of the
current generation of family-based treatments for adolescent
behavior problems (Mendel, 2000; Sexton and Alexander, 1999)
 Functional Family Therapy
• FFT may include :  diversion, probation, alternatives
to incarceration, or reentry programs for youth
returning to the community following release from a
high-security, severely restrictive institutional setting.
• • FFT is a short-term intervention — including, on
average, 8 to 12 sessions for mild cases and up to 30
hours of direct service (e.g., clinical sessions,
telephone calls, and meetings involving community
resources) - for more difficult cases.  In most cases,
sessions are spread over a 3- month period.
 Core Principles, Goals, and Techniques
• • To identify the primary focus of intervention (the family) • reflect an
understanding that positive and negative behaviors both influence and
are influenced by multiple relational systems (i.e., are functional). •
FFT is a multisystem prevention program,  meaning that it focuses on
the multiple domains and systems within which adolescents and their
families live.  FFT is also focuses on the treatment system, family and
individual functioning, and the therapist as major components.
• • FFT works first to develop family members’ inner strengths and
sense of being able to improve their situation. • These characteristics
provide the family with a platform for change and future functioning
that extends beyond the direct support of the therapist and other
social systems. • In the long run, the FFT philosophy leads to greater
self-sufficiency, fewer total treatment needs, and considerably lower
costs.
 Family Therapy Assessment
Boyer and Jeffrey (1984) describe six elements on
which families are assessed to be either functional or
dysfunctional. The six element of assessment include:
• Communication
• Self-concept reinforcement
• Family member expectations.
• Handling differences.
• Family interactional patterns.
• Family climate
 Engagement and Motivation Phase goals

• Develop alliances. Reduce negativity, resistance.

communication . Minimize hopelessness. Reduce
dropout potential . Develop family focus. Increase
motivation for change. [Link] Change Phase goals
• Develop and implement • individualized change
plans. • Change presenting • delinquency behavior. •
Build relational skills (e.g., • communication and •
parenting). • [Link] Phase goals •
Maintain/generalize change. • Prevent relapses. •
Provide community resources • necessary to support
change.
 Risk and protective Factors addressed
• • Negativity and blaming (risk). • Hopelessness (risk). • Lack
of motivation (risk). • Credibility (protective). • Alliance
(protective). • Treatment availability [Link] and protective
Factors addressed • Poor parenting skills (risk). • Negativity
and blaming (risk). • Poor communication (risk). • Positive
parenting skills • (protective). • Supportive communication •
(protective). • Interpersonal needs • Parental pathology
(depends on context). • Developmental level (depends on
context 3. Risk and protective Factors addressed • Poor
relationships with school/ community (risk). • Low level of
social support (risk). • Positive relationships with
school/community (protective).
 Assessment focus
• • Behavior (e.g., presenting • problem and risk
and protective • factors). • Relational problems
sequence • (e.g., needs/functions). • Context
(risk and protective • factors). [Link]
focus • Quality of relational skills •
(communication, parenting). • Compliance with
behavior • change plan. • Relational problem
sequence 3. Assessment focus • Identification of
community • resources needed. • Maintenance
of change.