Family psychotherapy: methods and main forms

Psychotherapy has many different forms, and above all, this process differs in the form of its conduct. There is individual, family and group therapy. However, many researchers believe that any kind of work is a work with a cell of society. After all, psychotherapy of an individual person is essentially a work with a fragment of a family.

The emergence of discipline

Family psychotherapy first appeared in the second half of the 50s of the last century. Its appearance was facilitated by the observation of psychotherapists on the problems and difficulties of individuals. Researchers have noticed that often psychological difficulties do not originate in the characteristics of an individual person, but have a family as their primary source. The development of this approach was also facilitated by the opinions of scientists from other fields of science - sociology, anthropology, methodology, and philosophy.

Definition

Family systemic psychotherapy (CCT) refers to a whole area that is united under one name. A psychologist who uses FTA in his practice works with family difficulties, but this is not the only area of ​​his competence. Often, individuals with life difficulties come to see such a therapist. A person is always perceived as part of a system of people interacting with each other. And the vital difficulty with which he has to deal is perceived as a common problem for all people. That is why the name "systemic" is present in the name of this type of therapy.

Main ideas

The system is a dynamic mechanism, consisting of constantly interacting individuals. In addition, it also comes into contact with the outside world. In other words, other systems also influence this system. She seeks to maintain her original condition, or homeostasis.

The second idea is that the system itself has an impact on the world around it. From this follows one of the most important concepts of systemic family psychotherapy - the idea of ​​feedback. Information about the behavior of a person as an element of the system or about the family as a holistic design is continuously reflected by the outside world and comes back.

The following concept, which is one of the central ones, is that the behavior of each of the elements of the system has a direct impact on the entire system. Multiple responses to these changes constantly arise in it, which support the structure itself and its functioning. A vicious circle arises - one action causes the second, the second - the third, etc. In the process of psychotherapy it is discovered that often the difficulty of one of the family members can be caused by the problems of the other.

Examples of work situations

Family counseling and family psychotherapy have accumulated during their existence a lot of samples that clearly illustrate the ideas of this approach. In this case, we can give some illustrative examples. The child suffers from panic attacks that are not amenable to drug therapy. When turning to a psychologist, it turns out that there is no normal relationship between parents, in the evenings they constantly quarrel. When a child begins a panic attack, this stops the quarrels - all the parents' attention is concentrated on the problem of the child. Thus, once a panic attack occurred in a child received positive feedback from parents, which reinforced this reaction. The roots of the baby’s problem were actually in the difficulties of the parents.

Another example is that a daughter cannot arrange her personal life. All her attempts in this regard end in failure, the relationship does not last more than a few weeks. When turning to a psychologist, it turns out that there are no problems in the girl’s behavior that would repel potential candidates for husbands. In fact, there is a problem in relations with the mother, who constantly demonstrates manipulative behavior, not wanting to “let go” the adult daughter from the family. The solution to the girl’s problem will be psychological separation from her mother, taking responsibility for her life, work on the development of independence - including financial.

Personalities

Russian psychologists made a significant contribution to the development of family psychotherapy - Varga Anna Yakovlevna, Moskalenko Valentina Dmitrievna, Edmond G. Eidemiller and others. Most of the domestic researchers, like their Western counterparts, adhere to the Freudian principle: "neurosis occurs on the threshold of the father’s house." At the same time, some scientists rely in their work on concepts from the field of neurology. For example, this is a model of the analytic-systemic family psychotherapy of Eidemiller - Alexandrova, which emphasizes the importance of creating the concept of medical psychology.

Scientific base of FTA

Adherents of each approach avoid concentrating on causal relationships, focusing on the features of complex family relationships. At every moment in time, they are both a consequence and a cause. Family psychotherapy matured in the following areas:

• The methodological foundations of the general theory of systems (L. Bertalanffy).
• Concepts of group dynamics K. Levin and his followers.
• The study of the characteristics of relationships in the family of people suffering from schizophrenia (in particular, the study of the characteristics of family ties in patients with a group of scientists in Palo Alto under the guidance of G. Bateson).

FTA Methods

In accordance with the methods used in the treatment process, the following types of FTAs ​​are distinguished:

• strategic;
• structural;
• Milanese approach;
• the concept of M. Bowen;
• various types of postclassical CCT.

The last item includes narrative psychotherapy, short-term methods, neurolinguistic programming, etc. Studies in the framework of these approaches are carried out in various institutes of family and group psychotherapy. For example, this is the Moscow Institute of Psychoanalysis, the Caucasus Institute of Gestalt Therapy and Family Psychotherapy, etc. The first four approaches are the main types that are used by most psychologists. Let's consider each of them in more detail.

Strategic FTA

This method of systemic family psychotherapy is primarily aimed at solving family difficulties. It has other names - “short-term therapy”, or “problem-solving”. Among the representatives of this approach, such personalities as Jay Helly, Clu Madanes stand out. In the course of their work, they incorporated the experience of G. Bateson and M. Erickson.

The strategic approach of family psychotherapy focuses not on the individual characteristics of family members, but on the development of specific strategies to solve existing problems. The reasons for these situations are not taken into account. The most important thing in this type of therapy is a change in habits, behavior, decisions. Strategic therapists are convinced that even small changes can influence the outcome of a situation. The intervention of a therapist following this approach is high in intensity. However, it is most often short-lived.

Psychotherapists in this area are not focused on those root causes that triggered the pathological process in the family (similar to how they focus on them, for example, psychoanalysts). Rather, they study the factors that contribute to maintaining negative behavior.

Structural approach

The very name of this method of family therapy contains a definition indicating the use of the concept of the family as a single system. Special emphasis by psychotherapists in this area is on family unity. Just as a living organism consists of organs, or an amoeba consists of organelles, a cell of society includes several members. They form a unity among themselves.

The theory of the structural approach is based on three main points:

• The family is the main human system that ensures the development of its members, or, conversely, negatively affects it.
• Each of these structures has its own subsystems.
• The interfering behavior of other members of the system has a particular effect on each individual.

If the family subsystem lends itself to external actions of other members, this indicates the permeability of its borders. For example, when parents argue about something, children often try to intervene in the disagreement. Parents, as a rule, immediately respond to the presence of a child, his requests, etc. As a result, their dispute remains unresolved. Since the matrimonial subsystem has weak, permeable boundaries, this incident will affect subsequent events - unresolved issues during the dispute will be felt in the form of aggression, further quarrels.

Milan school

It arose in the 70s of the last century. This approach is based on the following assumptions:

• The family is a self-regulatory system.
• Any action of each of its members is a form of communication.
• Its non-verbal aspects are more important than verbal.
• The main regulator of interactions are the rules taken in the family.
• In his work, the psychologist adheres to neutrality with respect to each of the members of the system. The impact is primarily directed towards behavioral patterns.

Methodological concept of M. Bowen

Murray Bowen is the author of one of the most complex ideas of FTA; his work is still conducted research in many institutes of family psychotherapy. It includes 8 interconnected concepts:

1. A provision describing the level of autonomy or merger of the "I" of each member of the family.
2. The idea of ​​triangulation, in the framework of which, in each of the cells of society, connections are formed according to the pattern of triangles.
3. Provisions on the interaction of family members within one generation.
4. The idea that pathogenic factors are passed down from generation to generation.
5. Family members project their own complexes on surrounding relatives.
6. The idea of ​​an emotional break.
7. The importance of sibling position.
8. The idea of ​​social regression.

Positive exchange method

As an example of one of the practical interventions of FTA used by psychologists, the above method can be cited. Many couples in their family life tend to show helpless behavior, complaining about each other. One of the goals of behavioral family psychotherapy is to fundamentally change this situation: so that the couple adjusts to interact with each other, practice cooperation. This method consists of three aspects:

• First you need to clearly define each other's desires.
• Desires must be formulated in a positive way. Couples should not think about what each partner does not want.
• Further, each of the spouses should regularly surprise the partner with their positive behavior.

This technique was first proposed by therapists Jacobson and Margolin in 1979. The psychologist should ask each spouse to write a list of three main activities that he can carry out and thereby give pleasure to the other partner. These activities should be formulated in a positive manner. As a homework assignment, the therapist asks partners to fulfill at least three of these desires. A similar method can be used in cases where the spouses are reluctant to participate in psychotherapy or are inclined to compete with each other.

Forms of family therapy

Among psychotherapists, there is still a debate about how the process of working with the family should take place. Some researchers insist that the whole cell of society should take part in therapy, while others are convinced that it is first necessary to work with the individual problems of its members. However, all researchers are convinced that regardless of the form of family therapy, it is always necessary to see a group of relatives as a whole. Thus, the alignment of forces among them becomes apparent. Also considered axiomatic is the provision that for real changes in the nature of communication, the rules that are adopted among those living under the same roof, it is also necessary to work with all family members.

Often, forms of therapy are combined to achieve the optimal effect - in other words, group family therapy is combined with individual work with some members. This approach is most effective when it is necessary to work out the behavior of the most infantile relative. In addition to sessions in which a psychologist and other family members are present, he must also attend group or individual therapy. For example, it may be a meeting of parents whose children have schizophrenia, or wives of alcoholics. In the process of group therapy, a family member gets the opportunity to adjust their inappropriate behavior, which also affects the situation in the family.

One of the popular methods is the so-called stereoscopic psychotherapy, in which each spouse visits a separate specialist, but all the results of the meetings are subsequently discussed.

Conclusion

A distinctive feature of most approaches in family psychology and family psychotherapy is the position according to which the cell of society is regarded as a single organism. In the course of work, analyzes are made of the way family members react to certain events, family rules, myths are considered. The true causes of difficulties become apparent, customer problems are resolved. Methods of family psychotherapy have proven effective in dealing with problems such as difficulties in marital relationships, loss of a loved one, impaired child behavior, psychosomatics, and deviant behavior of adolescents.