Feminist, Postmodern & Family Systems Therapy

Feminist Therapy

The man, or the boy, in his development is psychologically deterred from incorporating serving characteristics by an easily observable fact: there are already people around who are clearly meant to serve and they are girls and women. To perform the activities these people are doing is to risk being, and being thought of, and thinking of oneself, as a woman. This has been made a terrifying prospect and has been made to constitute a major threat to masculine identity. 

~ Jean Baker Miller, MD

There is no one founder of feminist therapy.  This therapy has been an effort by many.

v Jean Baker Miller, MD – Clinical professor of psychiatry at Boston University School of Medicine and director of the Jean Baker Miller Training Institute at the Stone Center, Wellesley College.

v Carolyn Zerbe Enns, PhD – Professor of Psychology and participant in the Women’s Studies and Ethnic programs at Cornel College in Mt. Vernon, Iowa.

v Olivia M. Espin, PhD – Professor Emerita in the Department of Women’s Studes at San Diego State University and at the California School of Professional Psychology of Alliant International University.

v Laura S. Brown, PhD – Founding member of the Feminist Therapy Institute and a member of the theory workgroup at the National Con ference on Education and Training in Feminist Practice.

 

Key Concepts  

Ø  View of Human Nature – This theory is different from most other therapies.  Many of the other therapies came from historical periods where social arrangements were assumed to be rooted in a person’s biological base gender.  Because men were considered to be the norm they were the only ones who were studied.  The constructs of feminist therapy is fair, spans the entire life, is flexible, and multicultural.

Ø  Feminist Perspective on Personality Development – When a person is born the gender role expectations influence the identity of that person from birth and become ingrained in the personality.  Very young children develop gender schemas.  These schemas are internalized and they continue in a sexist society.

Ø  Principles of Feminist Therapy – The following core principles form the foundation for the practice of feminist therapy:

1.     The personal is political – Based on the assumption that the problems that clients bring to counseling starts in a political and social context.

2.     Commitment to social change – Feminist therapy not only focuses on change in the individual but also social change.  The goal is to free men and women from the constraints that come from gender-role expectations.

3.     Women’s and girl’s voices and ways of knowing are valued and their experiences are honored – Distress is identified when women’s perspectives are considered.

4.     The counseling relationship is egalitarian – In feminist therapy attention to power is central.  Feminist therapists believe all relationships should strive for equality or mutuality.

5.     A focus on strengths and a reformulated definition of psychological distress – Feminist therapists talk about problems in the context of living and coping skills rather than pathology.  If a diagnosis is given or used the client collaborates with the therapist in making the decision. 

6.     All types of oppression are recognized – Therapists acknowledge that social and political inequalities have a negative effect on all people.  Feminist therapists help the individual client make changes and also strive for social change.

Therapeutic Goals

Ø  Become aware of their own gender-role socialization process.

Ø  Identify the messages the client tells themselves and then how to replace those messages with self-enhancing beliefs. 

Ø  Understanding how sexist and oppressive societal beliefs and practices influence them in negative ways. 

Ø  Acquire skills to bring about change in the environment.

Ø  Restructure institutions to rid them of discriminatory practices.

Ø  Develop a wide range of behaviors that are freely chosen.

Ø  Evaluate the impact of social factors on their lives.

Ø  Develop a sense of personal and social power.

Ø  Recognize the power of relationships and connectedness.

Ø  Trust their own experience and their intuition.

Techniques Used

Ø  Self-Disclosure – The therapist chooses when to share personal experiences with the client.  This involves a certain quality of presence the therapist brings to the sessions.

Ø  Gender-Role Analysis – Therapist examines the outcome of gender-role expectations on the psychological well being of the client.  This begins with the client identifying the societal messages they received about how woman and men should act.

Ø  Gender-role intervention – The therapist reacts to the client’s concern by comparing it to society’s expectations for women.  The focus is to give the client insight into how social issues are affecting them.

Ø  Power Analysis – This is to help clients understand how too much or not enough access to power and resources can influence the client’s reality.  The therapist helps the client focus on the kinds of power that they can exercise and challenge the gender-role messages that might be getting in the client’s way of exercising the power. 

Ø  Bibliotherapy – This is non fiction books, autobiographies, psychology and counseling textbooks, self-help books, educational videos, films and some novels that can be used as a resource.  When reading material is provided it increases knowledge and decreases the difference in power between client and therapist.

Ø  Assertiveness Training – This is teaching assertive behavior.  Women benefit from this because they are more aware of their interpersonal rights, transcend stereotypical gender roles, change negative beliefs, and implement changes in their daily lives.  The client and therapist work together to deem what is culturally appropriate and then the client decides when to use what they have learned.

Ø  Reframing and Relabeling – This is a shift from blaming the victim to focusing on social factors and how they contributed to the client’s problem.

Ø  Social Action – Once clients are grounded in feminism the therapist will suggest that the client volunteers, educating society about gender issues, and lobbying lawmakers.  This is a way for the client to feel more empowered.

Ø  Group Work – Clients transition from individual therapy to a group format.  Clients share their experiences with others and this helps the client see that they are not alone in the way that they feel.

Check out this empowering video on Feminist Therapy:

Postmodern Therapy

In the 1970's and in early 1980's, a startling discovery was made that almost 

every problem contains an element of  solutions. ~ Insoo Kim Berg

In the 1970's and in early 1980's, a startling discovery was made that almost every problem contains an element of solutions. ~ Insoo Kim Berg

This therapy does not have a single founder.  There are several people who have had a major impact on this approach.

v Insoo Kim Berg (1935-2007) – Co-developer of the solution-focused approach.  She was the director of the Brief Family Therapy Center in Milwaukee, Wisconsin.

v Steve de Shazer (1940-2005) One of the pioneers of solution-focused brief therapy.  For many years he was the director of the research at the Brief Family Therapy Center in Milwaukee, where solution-focused brief therapy was developed.

v Michael White (1949-2008) Cofounder of the narrative therapy movement.

v David Epston (b 1944) Cofounder of the narrative therapy movement.

Key Concepts

Ø  Unique Focus of Solution-focused brief therapy – focusing on what is possible and not how the problem emerged.

Ø  Positive Orientation – Optimistic assumption that people are healthy and competent and have the ability to figure out solutions that can make their lives better.  Therapists assist clients in shifting from the problem to a world with new possibilities.

Ø  Looking for What is Working – The focus is not the problem but instead on what is working in the client’s life. 

Ø  Basic Assumptions Guiding Practice – Clients are capable of behaving effectively.  There are advantages to having a positive focus on solutions and on the future.  There are exceptions to every problem, or times when the problem was absent.  Clients often present only one side of themselves.  Clients are asked to look at the other side of the story.  Change is inevitable.  Clients desire change, they can change, and they are doing their best to make change happen.

Therapeutic Goals

Ø  Goals are implemented by the client with the assistance of the therapist.

Ø  Client expresses early on what they would like to see from their therapy.

Ø  Realistic goals are concentrated on.

Ø  Modest goals are viewed as the beginning of change.

Ø  Clients are encouraged to engage in solution talk, rather than problem talk.

Techniques Used

Ø  Pretherapy Change – Therapists asks the client what they have done since the initial call for therapy or since their last session.  They are encouraged to rely less on their therapist and more on themselves and their resources.

Ø  Exception Questions – Questions are asked about the times when problems did not exist.  This reminds clients that problems are not all-powerful and have not existed forever.

Ø  The Miracle Question – “If a miracle happened and the problem you have was solved overnight, how would you know it was solved, and what would be different?”  Changing the doing and viewing of the perceived problem changes the problem.

Ø  Scaling Questions – When changes in human experiences are not easily observed, and to assist clients in noticing that they are not completely defeated.

Ø  Formula First Session Task – Homework that is completed by the client in either the first or second session.

Ø  Therapists stop the session 5 to 10 minutes before it ends to do a summary for the client.

Ø  Terminating – From the very beginning of therapy the therapist mindful of working toward termination.  When clients develop concerns at a later date they can ask for more sessions.

Ø  Application to Group Counseling – Facilitators create opportunities for the members to view themselves as being resourceful.  The group leader works with members to develop well-formed goals as soon as possible.

References

Corey, G. (2012). Theory and Practice of Counseling and Psychotherapy (9th ed.). Belmont, CA:         

          Brooks/Cole.

Insoo Kim Berg Quotes (2012). Retrieved from:        

          http://www.goodreads.com/author/quotes/227781.Insoo_Kim_Berg

The Postmodern Approach doesn’t make room for focusing on problems.  If you are tired of people whining and complaining about their problems then whack Dr. Sigmund Freud with a mallet.  Play this fun game and let off some steam:

http://www.postmodernvillage.com/games/freud.html

Family Systems Therapy

In the investigation of a neurotic style of life, we must always suspect an opponent, and note who suffers most because of the patient's condition. Usually this is a member of the family. 

~ Alfred Adler

  

v Alfred Adler (1870-1937) was the first psychologist of the modern era to do family therapy using a systemic approach.

v Murray Bowen (1913-1990) was one of the original developers of family therapy.

v Virginia Satir (1916-1988) developed conjoint family therapy, a human validation process model that emphasizes communication and emotional experiencing.

v Carl Whitaker (1912-1995) is the creator of symbolic-experiential family therapy.

v Salvador Minuchin (b. 1921) began to develop structural family therapy in the 1960’s through his work with delinquent boys from poor families at the Wiltwyck School in New York.

v Jay Haley (1923-2007) and Cloe Madanes (b. 1941) founded the Washington School of strategic family therapy in the 1970’s.

  

Key Concepts

Ø  Communication within the family is the focus.  This includes verbal and nonverbal communication.

Ø  Relationship problems are likely to be passed on from generation to generation.

Ø  Adlerian Family Therapy – the development of children within the family constellation is heavily influenced by birth order.  All behavior is purposeful.  The parents and children engage in repetitive, negative interactions based on mistaken goals that motivate all parties involved. 

Ø  Multigenerational Family Therapy – 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.  The cause of an individual’s problems can be understood only by viewing the role of the family as a unit.

Ø  Human Validation Process Model – Promote growth, self-esteem, and connection. This model helps family communicate and interact in a positive way. 

Ø  Experiential Family Therapy – Choice, freedom, self-determination, growth, and actualization are focuses.  The relationship between the therapist and the family is important.  The goal was not to get rid of anxiety in the family unit but to maintain or enhance it.  The anxiety would be the motivation for change.

Ø  Structural-Strategic Family Therapy – An individual’s symptoms are best understood from the vantage point of interactional patterns, or sequences, within a family.  Changes must occur in a family before an individual’s symptoms can be reduced or eliminated.

Therapeutic Goals

Ø  Adlerian Family Therapy – Enable parents as leaders: unlock mistaken goals and interactional patterns in family; promotion of effective parenting.

Ø  Multigenerational Family Therapy – Differentiate the self; change the individual within the context of the system; decrease anxiety. 

Ø  Human Validation Process Model – Promote growth, self esteem, and connection; help family reach congruent communication and interaction. 

Ø  Experiential Family Therapy – Promote spontaneity, creativity, autonomy, and ability to play.

Ø  Structural Family Therapy – Restructure family organization; change dysfunctional transactional patterns,

Ø  Strategic Family Therapy -Eliminate presenting problem; change dysfunctional patterns, interrupt sequence.

Techniques Used

Ø  Adlerian Family Therapy – Family constellation, typical day, goal disclosure, natural/logical consequences.

Ø  Multigenerational Family Therapy – Genograms; dealing with family of origin issues; detriangulating relationships.

Ø  Human Validation Process Model – Empathy; touch; communication, sculpting; role playing, gamily-life chronology.

Ø  Experiential Family Therapy – Co-therapy; self-disclosure; confrontation; use of self as change agent. 

Ø  Structural Family Therapy –Joining and accommodating; unbalancing; tracking; boundary making; enactments.

Ø  Strategic Family Therapy – Reframing; directives and paradox; amplifying; pretending; enactments.

Alfred Adler Quotes, (2012). Retrieved from http://www.brainyquote.com/quotes/authors/a/alfred_adler.html

Corey, G. (2012). Theory and Practice of Counseling and Psychotherapy (9^th ed.). Belmont, CA: Brooks/Cole.

Check out this link to online flash cards.  Learn while you have fun:

http://quizlet.com/8284255/family-systems-therapy-flash-cards/

Cognitive Behavior and Reality Therapy

Cognitive Behavior Therapy

        

The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, the ecology, or the president. You realize that you control your own destiny. ~ Albert Ellis

•   Albert Ellis (1913-2007) – Psychologist that developed an approach to psychotherapy that he called rational therapy and later rational emotive therapy.  It is now known as rational emotive behavior therapy (REBT)
•   Aaron Temkin Beck (b. 1921) – He holds the position of University Professor (Emeritus) of Psychiatry.  He is an innovating figure in cognitive therapy and one of the most influential and validated approaches to psychotherapy.  He continues to be active and has published 21 books and more than 450 articles and book chapters.
•  Judith S. Beck (b. 1954) – Her and her father, Aaron Temkin Beck, opened the nonprofit Beck Institute for Cognitive Therapy.  The Institution is devoted to national and international training in cognitive therapy.  She is also the Clinical Associate Professor at the University of Pennsylvania.  She has written nearly a hundred articles and chapters on a variety of CT topics and authored several books on cognitive therapy.
•  Donald Meichenbaum (b. 1940) – He is the recipient of a Lifetime Achievement Award from the Clinical Division of the American Psychological Association for his work on suicide prevention.  He is also the research director of the Melissa Institute for Violence Prevention.  He has published extensively, lectured and consulted internationally, and presents workshops at professional conferences.

Key Concepts

Although psychological problems can stem from childhood they are bolstered by the way the client presently thinks.  The way a person believes is the main cause of disorders.  The things that a client says to himself or herself, (“I am worthless.”) plays a key role in their behavior.  Clients replace misconceptions about self with effective beliefs.

Ø  View of Human Nature – People are born with rational and irrational thinking.  People have predispositions for self-preservation, happiness, thinking and verbalizing, loving, communion with others, and growth and self-actualization.  The also have the propensities for self-destruction, avoidance of thought, procrastination, endless repetition of mistakes, superstition, intolerance, perfectionism, and self-blame, and avoidance of actualizing growth potentials.

Ø  View of Emotional Disturbance - People learn illogical beliefs from significant people in their childhood.  They have a tendency to recreate these beliefs throughout their life.  People reinforce their self-defeating beliefs through autosuggestion and self-repetition.  Because we behave in the way we believe about ourselves it keeps the dysfunctional attitudes active and operant within us.

Ø  A-B-C- Framework – A is the activating event.  B is the belief.  C is the emotional and behavioral consequence.  D is the disputing interventions.  E is the effect.  And F is the new feelings.  It is not the experience itself that causes the depressive reaction, but instead the person’s beliefs about the experience.  An emotional disturbance is fostered by the self-defeating sentences clients continually repeat to themselves.  Cognitive restructuring is the main technique of cognitive therapy that teaches people how to replace the illogical beliefs with the logical beliefs.  This involves assisting clients with learning to be aware of self-talk, identify illogical self-talk, and substitute logical self talk for their illogical self-talk.

Therapeutic Goals

Ø  To show clients how they created the irrational beliefs early in life.

Ø  To show clients how they are keeping their irrational beliefs and disturbances active.

Ø  To assist clients in modifying the way they think and how to minimize their irrational ideas. 

Ø  To achieve unconditional self-acceptance.

Techniques Used

Ø  Cognitive Methods – Disputing irrational beliefs-clients go over a must, should, or ought until they no longer hold that illogical belief or until it is diminished.  Doing cognitive homework- Clients make lists of their problems, look for illogical beliefs, and dispute the beliefs.  The REBT Self-Help Form is often used.  When doing this homework clients are asked to put themselves in situations that will challenge their self-limiting beliefs.  Clients are asked to take record and think about how their personal beliefs about themselves contributed to their problems.  Bibliotherapy- An adjunct form of treatment.  This is seen as an educational process because clients are asked to read REBT self-help books.  Changing one’s language- “Musts”, “oughts”, and absolute “should” can be replaces with preferences.  Language that reflects helplessness and self-condemnation can learn to incorporate new statements.  Psychoeducational methods- Clients are introduced to different educational material.  Therapists educate clients about how their problems and treatment will most likely proceed.

Ø  Emotive Techniques – Unconditional acceptance, role-playing, modeling, rational emotive imagery, and shame attacking exercises are used.  Clients are taught that putting themselves down is destructive.  The main goal of this technique is to dispute illogical beliefs about self.  Rational emotive imagery- Clients are asked to imagine one of the most horrible events that could happen to them.  Once the clients imagine themselves in the situation and the disturbing feelings arise they are shown how to train themselves to develop healthy emotions in place of unhealthy emotions.  Using humor- It is believed that if people take themselves too seriously that is when illogical thinking comes into play.  A better sense of humor is fostered and life is put into perspective.  It teaches client’s to laugh.  Role playing- Clients rehearse behaviors so that they can bring to surface their feelings.  Shame attacking exercises- This helps clients minimize shame and anxiety over acting certain ways.  Clients can refuse to be ashamed by telling self that it is not a big deal if someone thinks that they are foolish.  Clients are given homework that puts them in situations that they will act foolish on purpose.  These acts do not involve illegal activities or behaviors that result in people being harmed.

Ø  Behavioral Techniques – This includes operant conditioning, self-management principles, systematic desensitization, relaxation techniques, and modeling.  Clients are given homework assignments that will desensitize and give exposure in real situations.

Check out this video that can help your child feel confident and brave:

References

Albert Ellis Quotes. (2012). Retrieved from http://www.brainyquote.com/quotes/authors/a/albert_ellis_2.html

Corey, G. (2012). Theory and Practice of Counseling and Psychotherapy (9^th ed.). Belmont, CA: Brooks/Cole.

Reality Therapy

If you want to change attitudes, start with a change in behavior. ~ William Glasser

v William Glasser (b. 1925) He was initially a chemical engineer.  He then turned to psychology (MA, Clinical Psychology, 1948) and then to psychiatry, attending medical school (MD, 1953) with the intentions of becoming a psychiatrist.  In 1962 he began to give lectures on “reality psychiatry,” but there were few psychiatrists in the audience so he changed it to reality therapy.

v Robert E. Wubbolding, EdD (b. 1936) He received his doctorate in counseling and is licensed to counsel as well as a psychologist.  He is the director of the Center for Reality Therapy in Cincinnati and professor emeritus of Xavier University.  He is an internationally known teacher, author, and practitionaer of reality therapy.  He received the Gratitude Award (2009) for Initiating Reality Therapy in the United Kingdom and the Certificate of Reality Therapy Psychotherapist by the Erupean Association for Psychotherapy (2009).

Key Concepts

Ø  View of Human Nature – People are born with five genetically encoded needs that drives them their entire lives: survival, love and belonging, power, freedom, and fun.  Although all people have the five needs they vary in strength from person to person.  The brain acts as a control system.  It monitors feelings as to determine how the person is doing in the pursuit of satisfying these needs.  When a person feels bad then one of these five needs is not being satisfied.  Reality therapists teach clients choice therapy so that the client can identify and satisfy unmet needs.  Wants are called quality world.  This is at the core of the person’s life.  The picture album is specific wants and how those wants will be satisfied.

Ø  Choice Theory Explanation of Behavior – All humans do from birth to death is behave, rarely do they not choose their behavior.  Every total behavior is the pursuit to get what satisfies the need.  Total behavior teaches that all behavior is made up of four distinct components: acting, thinking, feeling, and physiology.  These components accompany all actions, thoughts, and feelings.  Behavior is on purpose because it fills the gap between the wants and what is perceived that the person is getting.  Because behaviors come from the inside we choose our destiny. 

Ø  Characteristics of Reality Therapy – Contemporary reality therapy focuses on the lack of or unsatisfying relationship.  This often is what causes the clients’ problems.  Reality therapy doesn’t allow for the client to blame others for causing them pain.  The reality therapist asks the client to consider their choices affect their relationships with the important people in their lives.  Emphasize Choice and Responsibility-What we choose, we must be responsible for that choice.  People are dealt with “as if” they have choices.  Therapists help clients focus on where they have choice and this helps get them closer to the people that they need.  Reject Transference- Whatever mistakes have happened in the past, they are not important in the presence.  The past contributed but it is never the problem.  Reality therapists will allow the client to talk a little about the past but there is not a lot of time spent on looking back.  Early on, therapists will tell clients, “What has happened is over; it can’t be changed.  The more time we spend looking back, the more we avoid looking forward.”  Avoid Focusing on Symptoms- The reality therapist spends very little time on symptoms.  Symptoms last as long as they are needed in order to deal with an unsatisfying relationship or the frustration of basic needs.  Going back to the past or focusing on symptoms causes lengthy therapy.  Therapy can be shortened if present day problems are focused on.

Therapeutic Goals

Ø  To help the client get connected or reconnected with the people they have chosen to put in their quality world.

Ø  To assist clients in learning a better way of fulfilling their needs.  This includes achievement, power, or inner control, freedom or independence, and fun.

Ø  To assist clients in making better and more responsible choices when related to their wants and needs.

Ø  To get connected with involuntary clients. (i.e. individuals who are violent and living with addictions)

Techniques Used

Ø  Creating the Counseling Environment – a challenging and supportive environment allows clients to begin making changes in their life.  The client/therapist relationship is the base for the therapy to be effective.  Therapists avoid behaviors such as arguing, attacking, accusing, demeaning, bossing, criticizing, finding fault, coercing, encouraging excuses, holding grudges, instilling fear, and giving up easily.  Clients learn how to create a satisfying environment that leads to successful relationships. 

Ø  Procedures That Lead to Change – Therapists begin by asking what the client wants from therapy.  They take any mystery out of therapy at the beginning.  They ask about how the client’s relationships are and what choices are they making in them.  The first session the wants are identified.  Then the therapist looks for unsatisfying relationships.  Initially, the question, “Whose behavior can you control?” is asked often.  The therapist encourages the client to look at their own behavior and to focus on what they can control.  Once the client realizes that they can only control self is when therapy starts.  The remainder of the therapy sessions focus on helping the client learn to make better choices.  When clients make a change it is their choice.  Through reality therapy clients can obtain and maintain healthy and successful relationships. 

References

Corey, G. (2012). Theory and Practice of Counseling and Psychotherapy (9^th ed.). Belmont, CA: Brooks/Cole.

William Glasser (2012). Retrieved from: http://www.quotesdaddy.com/quote/276087/william-glasser/if-you-want-to-change-attitudes-start-with-a-change

Test your knowledge and learn more about reality therapy:

http://quizlet.com/2551613/reality-therapy-flash-cards/