The Process of Family Counseling

The Process of Family Counseling
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  • 1:42 Behavioral Therapy
  • 2:50 Psychodynamic Therapy
  • 3:54 Brief Strategic Therapy
  • 4:54 Structural Therapy
  • 5:46 Solution Focused Therapy
  • 6:30 Transformational Systemic
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Lesson Transcript
Instructor: Jade Mazarin

Jade is a board certified Christian counselor with an MA in Marriage and Family Therapy, and a certification in Natural Health. She is also a freelance writer on emotional health and spirituality.

Counseling a family requires understanding of both individual and family patterns. This lesson explains several theoretical approaches that guide counselors in assessing family problems and treating them.

Family Systems Theory

Let's say you have a background in family therapy. This means that you are going to have a certain perspective about clients. For example, a teenage girl has just started seeing you for counseling. Her parents made the appointment, telling you she was getting into all kinds of trouble and causing problems for everyone else as well. But unlike her parents, and perhaps some other counselors, you may not believe this girl is the whole problem. You wonder if she is just a symptom of other issues going on in the family.

According to family systems theory, which was developed by Murray Bowen, every member of the family is interrelated and affects the others, so we cannot be treated as separate individuals. Our behaviors arise from our interactions with others, and then our behaviors cause other interactions.

Getting back to this family, perhaps the parents in this scenario are somewhat absent. The father drowns himself in work because his marriage is failing. The mother is depressed and distracted. The daughter's problem might look more obvious, since she may skip school or not come home until morning. But it is only one part of the equation. It results from family issues, while it inevitably causes more problems as well.

Counselors trained in family systems come from this basic perspective of interrelatedness, but they can also draw from various theoretical approaches while counseling. Here are some of the most common approaches for family therapy: behavioral, psychodynamic, brief strategic, structural, solution focused, and transformational systemic.

Behavioral Therapy

Let's say a child is with her mother in the grocery store, and she starts crying because she wants a cookie. If her mother gives her that cookie, she will continue to cry every time she shops with her mother in the future. This is because her behavior has been reinforced by the cookie.

The premise of behavioral theory is that we act in certain ways for the end result. If we are rewarded with what we want, we'll continue the behavior. If we are punished, we are deterred from it. The focus of therapy, therefore, is on fixing problematic behavior by identifying and changing its reinforcement.

For example, Lucy is 28 years old, but she has just moved back in with her parents since she is out of a job. This is the third time she has returned home for this reason. They have paid for everything she has needed, and now they are realizing she expects food for bills and any luxury she feels she 'needs.' She has even used their credit card without permission. A behavioral counselor would work with her parents to try to change her behavior by severely limiting or stopping their financial support as well as creating rules and punishment.

Psychodynamic Therapy

You know when you see someone dragging luggage around an airport? Well, that is to some extent how a psychodynamic therapist would see a family. It's almost as if each member of the family is dragging around different luggage, albeit invisibly. This luggage includes things like old emotions from the past and problematic relationships from childhood. Even past generations that had poor family interactions can pass on their dynamics to the present family.

For example, Sonya did not have a healthy relationship with her mother, and her mother had a poor one with her own. Today, Sonya cannot get emotionally close to her daughter. She has trouble telling her she loves her and can't get herself to show any physical affection. Psychodynamic therapy comes from Freud's psychoanalytic theory, which emphasizes the role of childhood issues and unconscious issues affecting our present. In order for Sonya to move past this, she has to be directed to bring up unconscious issues from her own childhood (perhaps through dream analysis, for example) and move through them.

Brief Strategic Therapy

Let's say Bob has a daughter who is doing drugs. The pressing goal is for the child to change her ways and become drug free. If the parent takes his child to a counselor who practices brief strategic theory, this is her focus, too. Rather than thinking about unconscious motivations, the brief strategic therapy practitioner will be concerned only with targeting problem behavior and teaching tools to stop it. The therapy is designed to be to the point, precise, and focused on measuring observable behaviors. As the title states, it is designed to be brief in duration. It is a key therapy used with teens, delinquency, and drug and alcohol interventions.

When Bob brings Cynthia in for counseling, he can expect the therapist will assess the relationship strengths and difficulties in the family to see what is contributing to his daughter's behavior. The therapist will try to give Cynthia and her parents practical strategies for different behaviors and how to maintain them.

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