Using Strategies and Techniques
Approaches to Family Therapy
Approaches to Family Therapy
Cognitive-Behavioral Approach to Family Therapy (Dattilio, 2000)
A cognitive-behavioral approach considers the family schemata of the system. This approach seeks to understand the varying family members’ beliefs about the issues they face together. The subsequent strategies and techniques attempt to address those beliefs and bring them in line with healthy and productive ways the family can address their problems. Dattilio (2000) cites the work of Miller, Keitner, Epstein, Bishop, and Ryan (1993) describing a series of steps addressing members’ thoughts and behaviors. The following list provides modified strategies and techniques:
- Define the current problem or crisis.
- Actively and directively introduce the change that will take place.
- Explore the family history and intergenerational patterns.
- Examine ways that intergenerational schemata are present in the current family system.
- Assess the automatic thoughts and behaviors that each of the members currently enact as they attempt to address the problem.
- Discuss the automatic thoughts and behaviors that contribute to the current interaction patterns. Explore members’ options for alternative behaviors.
- Develop a behavioral contract that provides measurable goals and expectations for the new schemata and corresponding alternate behaviors.
- Assist the members to develop communication skills to facilitate the new behaviors and interactions between members.
- Address ways the new skills and interactions can be generalized to address future issues and crises.
Intergenerational/Strategic Approach (Kagan & Schlosberg, 1989)
Kagan and Schlosberg (1989) address the work with families that have experienced repeated crises. They address the needs of working with family interactions that are embedded in cycles of crises that make work with a current issue even more difficult. They suggest that the therapist must follow the “clues to the basic patterns” (p. 43). They suggest examining the intergenerational aspects of a crisis. By viewing the current crisis through an intergenerational lens, the therapist can address the family’s current status within in a larger frame that can help to inform the family members’ current responses.
Generally, families who have experienced repeated crises appear to be resistant to change and anyone who suggests that they should change. Integration of a strategic approach assumes that resistance is a normal and adaptive response to the prospect of change. Furthermore, the family’s resistance is better understood as a preservative effort that defines and protects the family despite the unresolved outcome of such efforts. Kagan and Schlosberg suggest discussing the functional aspects of the resistance with the family. By exploring the varied ways the resistance serves the family, the therapist signals a respect for their concerns and perceived vulnerabilities. Continued discussions can help the family to discover the varied ways that their efforts actually maintain the cycle of crises. Making the cycle overt, the family will have a better opportunity of changing those patterns.