How to Coach Yourself and Others Coaching Families | Page 142
When treatment is complete, the therapist moves outside the family structure and leaves the family
intact and connected without the loss of individual family member identities.
Family member behaviour can be understood only in the family context.
The Structural Family Therapy is a type of family therapy, based on the assumption that family member
behaviour is ongoing and repetitive and can be understood only in the family context.
This therapy may be characterized by the highly active therapist who gives specific directives for behaviour
change that are carried out as homework assignments.
Paradoxical interventions are often used to harness the strong resistance clients have to change and to taking
directives.
Clients may be asked to intensify the problem as one way of using paradox.
Another way is for the therapists to take a "one-down" position, encouraging the client not to do too much
too soon.
Counselors must differentiate between first-order and second-order changes.
First-order changes are those that help the system stay at its current level of functioning. They occur when
the symptom is temporarily removed, only to reappear later because the family system has not been
changed.
Second-order changes restructure the system to bring it to a different level. They occur when symptom and
system are repaired and the need for the symptom does not reappear.
E.g.: Teaching family members how to use "I" statements and listen empathically demonstrate first-order
changes that enhance the family's current functioning. Coaching a widow through the loss of her husband,
helping a couple let go of the last child to leave the nest, and restructuring an alcoholic family to eliminate
drinking are second-order changes that alter the family fundamentally, bringing it to an entirely new
structure and psychological place.
Key concepts:
Enmeshment:
encourages somatisation, and disengagement, acting out. High resonance.
Ecological context:
the family's church, schools, work, extended family members.
Sick child:
family conflict defuser.
Common boundary problem: parents confuse spouse functions with parent functions.
Rules:
generic and idiosyncratic rules that regulate transactions govern structure.
Boundaries:
can be diffuse (enmeshed), rigid (disengaged), or clear.
Power:
determined by authority and responsibility for acting on it.
Coalitions:
can be stable or detouring.
Transitional anxieties:
Reaction to therapist probes: A family will either dismiss the therapist's probes, assimilate to
previous transaction patterns, or respond as to a novel situation, in
which case stress increases and the probe is restructuring.
Rigid triad:
where parents habitually use a child to lightning rod conflict.
Rigid boundary around the triad; common when the children have
severe psychosomatic problems.
Dysfunctional families:
A dysfunctional family is one that responds to inner or outer demands
for change by stereotyping its functioning.
Families are constantly in transition, and transitional anxieties and lack of
differentiation are sometimes mislabelled pathological.
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