Dulce Maria Perez Santeliz

FAMILY THERAPY COURSE

PROFESSOR: LUIS LEOPOLDO MORALES

Chapter 3

The evaluation in family therapy

The conception of the family in terms of a system with four properties

Fundamentals: the functioning of the system is something more than just the mere sum of
the partial functions of its elements, morphostasis: tendency towards equilibrium,
morphogenesis: tendency to adapt to external and internal changes, and causality
circular: a behavior A causes, or controls B and is caused or controlled by B.

understanding the symptom from the concept of unity implies understanding it within the
ecological framework of behaviors in which it is immersed. The symptom appears as a
need of the system, like in reality, any behavior of any member
familiar, not of the individuals.

A sequence is maintained by virtue of a concatenation of learned behaviors.

by trial and error, persisting because it requires minimal energy expenditure.

Understanding the symptom from circular causality implies knowing how it chains together.
with all the other family behaviors.

By being understood as a result of the overall functioning of the system, the disorder passes
to be the product of an interaction and not the condition of an individual. It has been pointed out

two immediate effects in the clinical practice of this position: the first is the
excusing the one who has the symptom. The second is the neutrality that is gained
therapist, regarding the family when the problem that arose within it does not
conceived in terms of victim and victimizers.

It is important to note the practical repercussions of understanding the evaluation.

clinic in terms of hypothesis. The advantages are of two types: for the patient it allows
overlook the problems labeled as resistances and facing the therapist allows for a
alternative, when after correctly applying an intervention.
DULCE MARIA PEREZ SANTELIZ
FAMILY THERAPY COURSE
PROFESSOR: LUIS LEOPOLDO MORALES

Intergenerational or transgenerational theory: it has been considered as a theory

genetics, although it can rather be judged as a theory of contagion of the
disease. It is suggested that the disease is transmitted through intimate contact between
father and children for generations. Increase the level of awareness apparently
It serves to remove toxicity from the pathogen. These theories were very popular.
during the fifties and early sixties.

Communication theory: its most conspicuous example is the double bind theory.
pathology comes from misinformation, from the lack of orientation and guidance. The
reasons why communication entanglements exist, imply the double bind
It has to do with the fear of losing children when they start to grow up.

Scapegoat theory: it has been used both by transgenerationalists

like through the communicational aspects. It presumes a clear awareness of the offenders with

regarding the conduct to which they are subjecting their victims, the same
consciousness is supposed to exist in the victims.

Levant, 1983

Process models: they are descriptive, deriving their evaluations from observation.
the interaction between family members. the symptom is considered as a part
from the interactional guideline. There are three procedural models:

The behavioral: based on contingent reinforcements that support a behavior.

The communicational: they seek repetitive sequences that provide an operational definition of
the rules of the family system.

The roles: describes the role configuration that family members play in
the interaction.

Structural models evaluate: the organizational structure underlying the models

procedural. The diagnosis stems from the therapist's experience of bonding with the
family. capacity for family change. resonance of the family to help that
DULCE MARIA PEREZ SANTELIZ
FAMILY THERAPY COURSE
Luis Leopoldo Morales

one of its members can be requested. As the PI maintains the dysfunctional pattern of the
family. the ecological context of the family (sources of support and stress) and its moment
evolutionary.

The model presents two problems: it views the family as static and does not account for the
relationships of the nuclear family with the extended one.

Historical models: they attempt to trace the development of family structure over time.
generations. Those guidelines are logically inferred. The symptoms are seen as part
of an interactional pattern and maintained by an organizational structure. Structure that
has been established through generations.

Hypothesis: hypotheses are formulations that the therapist and the team make about the
Family functioning. A hypothesis is an assumption and a starting point. It is a
assumption because it does not intend to be the truth about family functioning, if not
It's just a theoretical construction whose value depends on enabling a vision.
clear enough about what is happening in the family and of its ability to
guide the intervention.

Circularity: it is the therapist's ability to lead their assessment of the problem.

based on the family's response to the information requested.
information is truly relevant if it makes a difference and if the difference
It is a relationship or a change in a relationship. In terms of differences, these remain.
better reflected when one is asked to talk about how they see the relationship between others
So, what I say will be more sensitive information.

There are a series of principles that are useful when questioning families:

Specific interactive behaviors are requested, not in

terms of feelings or interpretations.

Information is requested in terms of behavior differences rather than assumptions.

intrapsychic.
DULCE MARIA PEREZ SANTELIZ
FAMILY THERAPY COURSE
PROFESSOR: LUIS LEOPOLDO MORALES

Information is requested establishing classifications of family members in

relationship with a specific behavior or a specific interaction.

Information is collected in terms of behavioral changes that reveal a change in

the relationships before or after an event.

Information is collected in terms of difference concerning circumstances.

hypothetical.

Neutrality: it is said in relation to the family game. The therapist should not allow themselves
to consistently entangle oneself in the family game because it would lead to self-cancellation
as an agent of change. Neutrality is not an intrapsychic disposition of
therapist who tries not to get caught in the game, but rather the result of
a series of strategic moves executed throughout the entire interview, by virtue of
which the family can talk about how warm or not one is as a person.

Levels of neutrality:

Regarding people

Regarding the ideas, beliefs, values, and goals of the family.

Regarding the result of the therapy. Neutrality regarding the outcome.

the same as the therapy. Neutrality regarding specific behaviors to achieve
as a therapeutic goal.

Territoriality: all communication is characterized by its own territoriality,

understanding by this, the group of people for whom a message makes sense or
are affected by it. The discrepancies between communicators can be due to
both understanding and discrepancies between territories.

Timeliness: defines the time interval during which a communication makes sense
within a territory N, a context X, and a relationship Y.
DULCE MARIA PEREZ SANTELIZ
FAMILY THERAPY COURSE
PROFESSOR: LUIS LEOPOLDO MORALES

Strategies: the therapist's work during the interview should also be oriented
to the definition of strategies. They are fundamentally related to short-term goals.
deadline (what the therapist aims to achieve) and long-term goals (what the
family and the therapist have set themselves as the purpose of the therapy.

Evaluation elements in systemic family therapy

Symptomatic behavior
2- Minimum change and final goal
3- Type of patient cooperation strategies that helped to solve the
problem.
4- Attempted solutions.
5- Symptomatic sequence
6- Family relationship maps
7- Family game
8- Moment of the family evolutionary cycle.
9- Sources of support and family stress.

Personal opinion

I believe it is important to recognize that for the training of a therapist in therapy

Systemic family, the techniques and programs, rites that are going to be clear must be understood.

strategically directed and that allow for a clearer overview of

conduct an evaluation. Interview, obtain information, create hypotheses, have a
greater and more tempered knowledge of the terms of circularity, territoriality,
temporality, neutrality, which are undoubtedly very useful in practice; likewise
DULCE MARIA PEREZ SANTELIZ
FAMILY THERAPY COURSE
Luis Leopoldo Morales

the ability to combine that intervention strategies are fundamentally related to

with goals whether short, medium, or long-term, without underestimating concepts
like circularity, different theories that enrich learning for
to be able to approach the practice with confidence.

Elements that allow for an estimation of the problem. What is presented by the
patient understood as the diagnosis, aiming for a baseline and a
final goal of the treatment.
Recognizing the minimal change and final goal. Which are aimed at planning.
of the change, as well as establish a completion criterion.
Likewise, the type of cooperation of the patient and the family in therapy for
evaluate the change in the patient, also how to design the type of change depending
of the family in particular.
It is vital to recognize strategies that were useful and contribute to solving the problem.
which were effective for the patient and contributed to bringing about the change. Without

to underestimate the solutions attempted that the patient or the family has tried, to
resolve the problem that troubles them and has not worked for them, giving an opportunity to the

therapist, to stop trying them.

Regarding the symptomatic sequence, it is important to highlight that it is a chain of
behaviors of all family members within which the symptom appears,
aiming at which behavior is susceptible to change, try to
identify the congruences in which each family member is involved.
Regarding the family relationship map that aims to identify who is who.
more directly involved in the patient's problem, defining the type of relationship,
likewise evaluate the pressure exerted by the family of origin, define intra and extra limits
relatives.
The family game aims to determine the system of relationships, beliefs, and values.
family histories, in which the symptom appears.
Without a doubt, being able to identify the moments of the evolutionary cycle, identify the
nature of the evolutionary task and its problems in which it is involved
family, identifying the resources and skills of the family, as well as the phases of
DULCE MARIA PEREZ SANTELIZ
FAMILY THERAPY COURSE
Luis Leopoldo Morales

family evolutionary cycle considering it of great importance.

Reflecting on the program based on a mourning ritual, starting from the
evaluation of family members or system members, continuing with the phase
preparatory phase, phase of reorganization, phase of completion, considering that the
patient may have a follow-up session.
Regarding relationships with institutions and sources of support and stress, it is important.
to know to what extent support is being provided to the family or to the member of the system and

to what extent the family is receiving support and if it is being addressed apart
family doctor, social worker, etc.
Very useful in training is to know the usage rules to define the
problem, to understand how the family defines a problem, always preserving the
therapist the freedom to evaluate. Just like the evaluation (feedback) having as
Objective to evaluate the degree of compliance with the recommended task, in order to make recommendations.

new tasks. In evaluating the change, consider whether the change has been made,
very minimal it may seem, considering that a small change can give rise to
other changes in climbing or snowball.
Returning to the evaluation methodology, the questions in Family Therapy
Systemic ones are of great importance, as they contribute to having a greater amount of
information about the functioning of the family system, with different categories
such as linear, circular, strategic, reflective questions.