FAMILY THERAPY

Introduction:

 Family therapy is the branch of psychiatry which sees an individual's psychiatric

symptoms as inseparably related to the family in which he lives. Thus the focus of
treatment is not on the individual, but the family.
 Family therapy is a relatively new development that came about in the mid- twentieth
century as an adjunct to individual treatment and refers to the treatment of the family as
whole.
 Family therapists use a wide variety of theoretical philosophies and techniques to bring
about change in dysfunctional patterns of behaviour and interaction, some therapists may
focus on the here and now,
 Although different therapists may adhere to different theories and use a wide variety of
methods, the goals of family therapy are basically the same.
Goals:

 To reduce dysfunctional behaviour of individual family members.

 To resolve or reduce intra family relationship conflicts.
 To improve family communication skills.
 To heighten awareness and sensitivity to other family members to meet their needs.
 To strengthen the family ability to cope with the major life stressors and traumatic
events.
 To improve integration of the family system into the social system.

Indication and contraindication of family therapy

Indications:

 Problems in the relationship within the family(urge existence of communication or

generation gap)
 Interdependence of symptoms(e.g. the wife's depression being contingent on the
husband's alcohol consumption and vice versa)
 Failure of individual therapy(may be because family tensions have not been handled)
 Development of stress in other family members when one family member improves (e.g.
development of depression in wife following husband's giving up drinking, leading to his
improves participation in family matters)
Contraindications:
A. Family factors
 Family in the process of breaking up
 Families in which tense, dysfunctional equilibrium is present.
  Families staying apart
 No availability of the key family member
 Unwillingness to accept the therapy.

Functions of the family therapy

 Boundary function: boundaries will maintain a distinctic between individuals with the
family. Rigid boundaries prevent family members from trying out new ideas.

 Communication function: communication within the family encourages its members to

express their feelings or emotions appropriately.

 Supportive function: supportive function within the family give freedom to grow and
explore new roles within the family members. Socialization function: socialization helps
to interact, negotiate and plan adopts coping skills within the members of the family.

 Biological function: family is a medium where the sex relations are regulated.

 Psychological function: love, belongingness, affection, sympathy, security, attention,

emotional satisfaction, sexual relationship, intimacy etc. will be attained through family.

 Educational function: mother is the first teacher and primary care giver who will take
care of the children. Child's personality and character formation will be attained through
family.

 Protective function: family protects the interest of the child, provides security to
cultivate healthy behavior.

 Recreational function: family creates an atmosphere where the child's interest can be
fulfilled. The love among family members will create positive interest in the child.

 Religious function: family develops religious thoughts, kind heartedness and fellow
belonging. The child learns more moral v ethics, codes, honesty, truthfulness, traditions
and religious patterns.
  Cultural function: family molds its members according to its culture. It transmits ideas,
folkways, mores, customs, traditions, beliefs and values from one generation to another
generation.

 Social function: maintain social status and controls member's activities.

-Promotes safety and security and lays emphasis on kinship patterns

-provides physical shelter, food, clothing which are necessary to the existence of life.

TYPES OF FAMILY THERAPY INDIVIDUAL FAMILY THERAPY

In individual family therapy
 In individual family therapy, each family member has a single therapist. The whole
family may meet occasionally with one or two of the therapists to see how the member's
are relating to one another and work out specific issues that have been defined by the
individual members.
CONJOINT FAMILY THERAPY
 The most common type of family therapy is single-family group, or conjoint family
therapy. The nuclear family is seen, and the issues and problems raised by the family are
the ones addressed by the therapist. The way in which the family interacts is observed
and becomes the focus of therapy. The therapist helps the family deal more effectively
with problems as they arise and are defined.
COUPLES THERAPY
 Couples are often seen by the therapist together. The couple may be experiencing
difficulties in their marriage, and in therapy, they are helped to work together to seek a
resolution for their problems. Family patterns, interaction and the communication styles,
and each partner's goals, hopes and expectations are examined in therapy. This
examination enables the couple to find a common ground for resolving conflicts by
recognizing and respecting each other's similarities and differences.
MULTIPLE FAMILY GROUP THERAPY
 In multiple family group therapy, four or five families meet weekly to confront and deal
with the problems or issues they have in common. Ability or inability to function well in
the home and community fearing of talking to or relating to others, abuse, anger, neglect,
the development of social skills, and responsibility for oneself are some of the issues on
which these group focus. The multiple family group become the support for all the
families. The network also encourages each person to reach out form new relationships
outside the group.
  In multiple impact therapy, several therapists come together with families in a
community setting. They live together and deal with pertinent issues for each family
member within the context of the group. Multiple impact therapy is similar to multiple
family group therapy except that it is more intense and time limited. Like multiple family
group therapy, it focuses on developing skills or working together as a family and with
other families.
NETWORK THERAPY
 Network therapy is conducted in people's homes. All individuals interested or invested in
a problem or crisis that particular person or persons in a family are experiencing take
part. This gathering includes family, friends, neighbours, professional groups or persons,
and anyone in the community who has an investment in the outcome of the current crisis.
People who form the network generally know each other and interact on a regular basis
in each other's lives. Thus a network may include as many as 40 to 60 people.
Family therapy assessment
 Boyer and Jeffrey (1984) describe six elements on which families are assessed to be
either functional or dysfunctional. The six element of assessment include:
 Communication
 Self-concept reinforcement
 Family member expectations.
 Handling differences.
 Family interactional patterns.
 Family climate
Communication
 Functional communication patterns are those in which verbal and non-verbal messages
are clear, direct, and congruent between sender and intended receiver. Family member are
encouraged to express honest feelings and opinions, and all members participate in
decisions that affect the family system. Each member is an active listener to other
members of the family.
Making assumption:
 in this, one assumes that others will know what is meant by an action or an expression
 For e.g., a father says to his teenage son "you should have gone to market to bring some
provisions for home during my absence at home".
Belittling feelings:
  this behaviour involves ignoring or minimizing anoth feelings, when they are expressed.
This encourage the individual to withhold honest feelings to avoid being hurt by the
negative response.
 For e.g. elder brother scolding his sister (young one) and she is angry with him. Then the
mother consoles girl that "oh don't be angry, he does not mean anything".
Failing to listen:
 in this, one does not hear what the other indivi is saying. This can mean, not hearing the
words by 'turning out' what is being said, or It can be selective listening, in which a
person hears only selective part of the message or interprets in a selective manner.
Communicating indirectly:
 it usually means that an individual does not cannot present a message to receiver directly,
so he or she seeks to communicate through a third person.
Presenting double-bind message
 In this, family-member may respond to a direct request by another family member only to
be rebuked when the request is fulfilled.
Self-concept Reinforcement
 Functional families strive to reinforce and strengthen member's self-concept, with the
positive results being that family members feel loved and valued.in this, the manner in
which children see and value themselves is influenced most significantly by the messages
they receive concerning their value to other members of the family
Family member's expectations
 Every individual have some expectations about the outcomes of the life situations they
experience. The expectations are related to and significantly influenced by earlier life
experiences. Each family member is different, with different strength's and limitations.
Each member must be valued independently.
Handling differences
 It is difficult to conceive of two or more individuals living together who agree on
everything all of the time.
 Serious problems in a family functioning appear when differences becomes equated with
"badness" is seen not caring.
 Member are willing to hear the other person's position, respect the other person's right
and work to modify the expectations on both sides of the issue to negotiate a workable
solution.
Family interactional patterns
  All families develop recurring, predictable patterns of interactions over time. These are
often thought of as "family rules". Interactions may have to do with communication
expressing expectations and handling differences. Family rules are functional when they
are workable and constructive and promote the needs of all family members.
Family climate
 The atmosphere or climate of a family is composed of a blend of the feelings and
experiences that are the result of the family member's verbal and non-verbal sharing and
interacting. It has been suggested that a positive family climate is founded on trust and is
reflected in openness. A dysfunctional family climate is evidenced by tensions, pain,
physical disabilities, frustrations or guilt
Conclusion
 Family therapy is one of the current generation of family based treatment for adolescents
behaviour problems as both prevention and an intervention program, the success of
family therapy is due to its integration of a clear, comprehensive, and multi systemic
clinical model.