Critically consider the application of systemic family therapy to working with children.
Family Therapy-defining concepts
At first, family therapy was an experiment. In the post-World War II, many psychologists and psychiatrists strove to comprehend the multiple influences on human behaviour and adjustment. This is the common background of the biopsychosocial approach, the systemic approach, or family systems theory. Gurman, Kniskern, and Pinsof (1986) state that the ‘Family therapy may be defined as any psychotherapeutic endeavor that explicitly focuses on altering the interactions between or among family members and seeks to improve the functioning of the family as the unit, or its subsystems, and/or functioning of the individual members of the family’ (p.565). In other words, rather than focusing solely on the individual, family therapy is concerned with the person in his or her own right. The problem of an individual, therefore, is viewed by family therapists as stemming from the source larger than the person. The main advantage of this is the possibility of influencing the problem via a number of people (i.e. family members), instead of just one. Symptoms are changed through alterations of relationships in which people are involved. The varieties of family therapy practice and family systems theory range from those derived from psychoanalysis (psychodynamic family therapy of Ackerman, Bowen systems therapy, and object relations therapy); to those primarily centred around expressiveness and communications (Satir’s conjoint therapy); to those focused on organisation (structural family therapy of Minuchin); and to those derived from hypnotic practises of Milton Erickson. The unifying theme of the techniques employed is the identification of the family process as the targets for intervention and alteration. Beginning with Ackerman, one line of family therapists who work with young children concentrates on psychodynamics. Zilbach (1986) emphasises the important contributions of young children to the content and timing of emotional events. Scharff and Scharff (1987) show how, by providing a therapeutic environment and through the use of transference, countertransference and interpretation, they help families to identify the problem of the past. This allows the family to confront emotional difficulties and to master stress. Another line of work with children from Minuchin’s structural approach (Minuchin, 1974); in which family organisation is viewed as crucial to the experience of individuals in the family. In families, boundaries are the conceptual markers of differentiation between individuals and subsystems representing the family’s managements of both roles and proximity. Most problems in relational functioning can be described under one of three categories: disorders of membership (lack of clarity about who is in and who is out of the family), status (lack of clarity about roles), and proximity (over- or under-involvement of family members). Some forms of childhood difficulties are associated with diffuse boundaries characterised by a lack of role clarity and over involvement, and others are associated with disengagement, where boundaries separate individuals in the family too rigidly. In healthy families, the parent-child boundary marks the differentiation of parent and child functions, preserving functional family hierarchy, and separating the parental subsystem from the child system. Structural family therapists assist families to achieve a more functional organisation. A third application to children has evolved out of the strategic school and is described by Madanes (1984). A child’s symptoms are understood as metaphors about the family’s situation. Through playing out themes in which family members pretend to be in the relationships metaphorically represented by the symptoms, the family’s repertoire of interactions is expanded, increasing the flexibility and adaptation. Family therapy using...
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