How to Coach Yourself and Others Coaching Families | Page 171

DEFINITIONS
The identified patient
The identified patient (IP) is the family member with the symptom that has brought the family into
treatment. Children and adolescents are frequently the IP in family therapy. The concept of the IP is used by
family therapists to keep the family from scapegoating the IP or using him or her as a way of avoiding
problems in the rest of the system.
Homeostasis (Balance)
Homeostasis means that the family system seeks to maintain its customary organization and functioning
over time, and it tends to resist change. The family therapist can use the concept of homeostasis to explain
why a certain family symptom has surfaced at a given time, why a specific member has become the IP, and
what is likely to happen when the family begins to change.
The extended family field.
The extended family field includes the immediate family and the network of grandparents and other
relatives of the family. This concept is used to explain the intergenerational transmission of attitudes,
problems, behaviours, and other issues. Children and adolescents often benefit from family therapy that
includes the extended family.
Differentiation
Differentiation refers to the ability of each family member to maintain his or her own sense of self, while
remaining emotionally connected to the family. One mark of a healthy family is its capacity to allow
members to differentiate, while family members still feel that they are members in good standing of the
family.
Triangular relationships
Family systems theory maintains that emotional relationships in families are usually triangular. Whenever
two members in the family system have problems with each other, they will "triangle in" a third member as
a way of stabilizing their own relationship. The triangles in a family system usually interlock in a way that
maintains family homeostasis. Common family triangles include a child and his or her parents; two children
and one parent; a parent, a child, and a grandparent; three siblings; or, husband, wife, and an in-law.
Multisystemic Therapy
In the early 2000s, a new systems theory, multisystemic therapy (MST), has been applied to family therapy
and is practiced most often in a home-based setting for families of children and adolescents with serious
emotional disturbances. MST is frequently referred to as a "family-ecological systems approach" because it
views the family's ecology, consisting of the various systems with which the family and child interact (for
example, home, school, and community). Several clinical studies have shown that MST has improved
family relations, decreased adolescent psychiatric symptoms and substance use, increased school
attendance, and decreased re-arrest rates for adolescents in trouble with the law. In addition, MST can
reduce out-of-home placement of disturbed adolescents.
Calibration:
Setting of a range limit (bias) in a system, like a thermostat in a room. The limit of how much change a
family will tolerate. (Bias: a family's emotional thermostat. The therapist needs to look into who has the
power to reset it.)

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