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Instructor Solution Manual for Couple and Family Therapy: A Case Approach, 1st ed by Nancy L Murdock

Instructor's Manual D. Robert Casares, Jr., Wake Forest University

Couples and Family Therapy: A Case Approach 1st Edition

Nancy L. Murdock University of Missouri–Kansas City

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ISBN-10:

0-13-278027-5

ISBN-13: 978-0-13-278027-8

Chapter 3: Structural Family Therapy

CHAPTER THREE: STRUCTURAL FAMILY THERAPY CHAPTER OUTLINE Overview and Background Most commonly associated with Salvador Minuchin Minuchin developed the structural approach in partnership with Jay Haley and Braulio Montalvo SFT influenced the later development of Multisystemic Therapy Basic Philosophy Rooted in systemic thinking Individuals experience the twin pulls of belonging and being separate Families are constantly balancing the tension between belonging and autonomy Central Constructs Family Structure “The invisible set of functional demands that organize the ways in which family members interact” Repeated patterns of interaction are the family structure Subsystems Families differentiate into smaller groupings that have different functions (e.g., parental, partner, sibling, etc.) Boundaries Rules that specify who participates in a system or subsystem When boundaries are too rigid, the system is said to be disengaged When boundaries are unclear, or diffuse, it is said to be emmeshed Power and Hierarchy Typically, parent figures have the most power, placing them at the highest level with children in subsystems below Sometimes deviations in this hierarchy signify disfunction Theory of Development Four stages of family development: couple formation, families with young children, families with school-age or adolescent children, and families with grown children

Chapter 3: Structural Family Therapy

Becoming a couple requires partners to shift loyalties from their families of origin to their new entity, the partnership The arrival of children requires the system to undergo serious realignment Health and Dysfunction Something about the structure is not working; the problem can typically be seen in the ways in which the family relates Families tend to experience difficulties when old patterns of interaction stop working Dysfunction is discussed as enmeshment or disengagement Healthy families are those whose structures are clearly defined and flexible and up to the task at hand A healthy individual can maintain a good balance between individuation and belonging to the family Nature of Therapy Assessment No formal assessment; rather, a series of questions are considered Some contemporary structural therapists use genograms to explore and document a family’s history Overview of Therapeutic Atmosphere Structural therapists strive to “modify the present, not to explore or interpret the past” No one individual may be viewed as the problem Roles of Clients and Counselor Therapist is the expert—joins with the family but maintains a stance as a leader in the counseling process Goals Changing the structure of the family Solve the presenting problem Impede old patterns of thinking and relating Build on strengths to generate new patterns that lead to results Process of Therapy Therapist is both a leader and a member of the system Four steps: Opening Up the Presenting Complaint, Highlight Problem-Maintaining Interactions, Structurally Focused Exploration of the Past, Exploration of Alternative Ways of Relating Recognizing and acknowledging family strengths is critical 7 Copyright © 2022 Pearson Education, Inc. All Rights Reserved.

Chapter 6: Cognitive Behavior Therapy

Altering Selective Perceptions, Inaccurate Attributions, Inaccurate Expectancies, Unrealistic or Inappropriate Assumptions and Standards Evaluation of the Theory Research Support Outcome Research Theory-Testing Research Issues of Diversity Broad agreement exists that CBT can be adapted to a wide range of client diversity Some Western-based principles of CBT may conflict with the values and norms of other cultures CBT’s individualistic outlook may clash with the values of individuals and families from collectivistic cultures Summary CBT-CF offers a broad and flexible approach to working with individuals in relationships

Chapter 7: Solution-Focused Therapy

CHAPTER SEVEN: SOLUTION-FOCUSED THERAPY CHAPTER OUTLINE Overview and Background Key figures: Steve de Shazer, Insso Kim Berg, and Bill O’Hanlon Early on, solution-focused therapy (SFT) was referred to as solution-centered, possibility therapy and collaborative, competency-based counseling de Shazer and Berg met at the Mental Research Institute (MRI) in Palo Alto, California, and were married for 28 years SFBT incorporates ideas developed at MRI de Shazer and Berg later founded the Brief Family Therapy Center in Milwaukee, Wisconsin Basic Philosophy Rooted in optimism and believes in the power of language to create and define reality There are no absolute truths Humans create their realities through language and are capable of re-creating more helpful realities during times of trouble Clients are referred to as “customers” and problems are called “complaints” Key assumptions: (1) Clients have strengths and resources to resolve complaints; (2) change is constant; (3) the SF therapist’s job is to identify and amplify change; (4) it is usually unnecessary to know a great deal about the complaint to resolve it; (5) it is not necessary to know the cause or the function of a complaint to resolve it; (6) a small change is all that is necessary—a change in one part of the system can effect change in another part of the system; (7) clients define the goal; (8) rapid change or resolution of problems is possible; (9) there is no one right way to view things; and (10) focus on what is possible and changeable rather than on what is impossible and intractable Central Constructs Exceptions There are always times when the problem does not happen The presenting complaint is not always present—there are times when the client is successful and happy Oftentimes, clients have not paid attention to exceptions Change Talk Problems are discussed in ways that hold the potential to bring about change 21 Copyright © 2022 Pearson Education, Inc. All Rights Reserved.

Chapter 7: Solution-Focused Therapy

Complaints are discussed in terms of behaviors that are amenable to change rather than using negative labels Solutions SFT focuses on what clients would perceive as an acceptable solution to the problem Strengths and Resources Therapists in SFT emphasize client strengths and already accessible resources Theory of Development SF advocates do not postulate a theory of development A theory of counseling more than a theory of human nature Not interested in the history of the problem, except in very rare circumstances Health and Dysfunction Therapists in SFT are not concerned with notions of health and dysfunction Clients have complaints and therapists in SFT listen to the client’s construction of the problem, look for exceptions, and construct solutions One way of looking at dysfunction is that clients are stuck Nature of Therapy Assessment Do not believe in traditional assessment Therapists in SFT interview for solutions from the very start of counseling Overview of Therapeutic Atmosphere Clients typically complete four to five sessions, and most find their solutions in fewer than 10 sessions Counselors strive to promote respect and cooperation and avoid passing judgment and making interpretations about client wants, needs, or behaviors Roles of Clients and Counselor Therapists in SFT take full responsibility for what takes place in sessions Therapists take the lead and use a series of questions designed to elicit information about exceptions, solutions, and strengths Three types of clients: visitors, complainants, and customers Goals Three primary goals: (1) change the doing of the situation that is perceived as problematic; (2) change the viewing of the situation that is perceived as problematic; and (3) evoke resources, strengths, and solutions to bring to the situation perceived 22 Copyright © 2022 Pearson Education, Inc. All Rights Reserved.

Chapter 7: Solution-Focused Therapy

as problematic Process of Therapy First task is defining and redefining the problem Once a solid relationship is established, the counselor will introduce change talk Therapists in SFT focus on the present, not the past Therapists in SFT interrupt problem-focused talk and redirect discussion to what clients would like to happen instead The initial goal of the first session is to create a solvable complaint The remainder of the first session is devoted to finding exceptions to the complaint and constructing concrete, solvable goals Remaining sessions invite clients to take advantage of the “more of the same” principle—clients are encouraged to do more of what works and abandon what doesn’t Therapeutic Techniques Questions Normalizing the Problem Compliments The Miracle Question Scaling Questions Asking About the Problem Externalizing First Session Formula Task Generic Task Breaking Patterns Surprise Task Write, Read, and Burn Structured Fight Do Something Different Evaluation of the Theory Research Support Outcome Research Theory-Testing Research

Chapter 11: Conclusion

CHAPTER ELEVEN: CONCLUSION CHAPTER OUTLINE Where to Go from Here As a beginning couple and family therapist, it might be best (less confusing) to choose one theory to start with Which Theory Is Best? Some theories have more research supporting their theoretical explanations than others BFST, EFT, CBT, and the Gottman Method have been extensively researched Structural, strategic, and experiential approaches have not been studied as systematically Which Theory Fits? You do not want to risk choosing a theory based solely on the fact that it matches your personal beliefs Instead, you should be able to point to good quality evidence that supports your perspectives and practices Another factor to consider is how these theoretical ideas lead to what you actually do in therapy sessions Most theories require you to be active in sessions—some require teaching or coaching, other approaches have more structured techniques, whereas others require you to be inventive and more in the moment Preference for spontaneity versus structure may influence the theory you choose Integrative Approaches Sometimes called the “best of all worlds approach” Able to harness the strengths of major approaches and open to adding new techniques as they are developed Four general approaches: technical eclecticism, theoretical integration, assimilative integration, and common factors Common Factors Certain elements and mechanisms are proposed to operate in all effective therapies Common elements: trusting therapeutic relationship, establish expectation that help/change is possible, therapist and client agree on the goals and tasks of therapy

Chapter 11: Conclusion

In Conclusion It takes time to settle into a theoretical home, and part of the fun is the process

Instructor Solution Manual for Couple and Family Therapy A Case Approach, 1st ed by Nancy L Murdock