MARRIAGE & FAMILY COUNSELING:Systems Theory, Postwar changes

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Theory and Practice of Counseling - PSY632

Lesson 40

MARRIAGE & FAMILY COUNSELING

"It is the relationship that heals" Yalom (1989)

Factors Affecting Marriage/ Family Counseling

Developments in psychoanalysis

Psychoanalytic therapists began to extend their approach to include a family orientation in the late

1960s. Ackerman applied psychoanalytic practices to the treatment of families.

Systems Theory

All family members are part of interacting system. Identified "patient" may not be locus of

problem. It is generally assumed that we can't change one without changing others, so we

shouldn't try.

Dysfunctional roles (e.g., making one person black sheep in the family)

Mis-alliances (e.g., conflicts across generations)

Secrets ("don't tell") and secret rules (double bind, in the form of double messages)

Schizophrenia and families

Two main teams of researchers conducted pioneer studies in the area of family dynamics and the

etiology of schizophrenia: the Gregory Bateson group. Theodore Lidz group. They found out that

in families where there is some schizophrenic patient, often there is conflict between parents. Also

there is an inordinate intrusiveness between parents and disturbed offspring. Regarded

Schizophrenia, a Palo Alto research group (Bateson, Jackson, Harley, Satir, et al.,) approached the

problem of communication. All observed how couples and families functioned when a family

member was diagnosed as schizophrenic.

Among the most important concepts to emerge were double bind, and material schism and

skewness. The last two concepts attracted a lot of researchers at that time.

In a double bind, a person receives two contradictory messages at the same time and is unable to

follow both.

Marital schism is overt marital conflict; marital skewness is a pathology in marriage in which one

partner dominates the other. The latest research in the area concentrates on the expression of

negative emotions in families and relapse in schizophrenic relative.

Focus on marriage relationship

The pioneers' focus on the marriage relationship, rather than just the individuals involved, was

important. The new emphasis meant that three entities were considered: two individuals and one

couple. Early marriage counseling set a precedent for seeing couples together in conjoint sessions.

Growth of the Child Guidance Movement

Early research in this area tended to focus on parental behavior such as maternal over-

protectiveness, clinicians and counselors eventually began to concentrate on the family as a whole.

Emphasis on Group Work

First T-group was conducted at the National Training Laboratories in Bethel, Maine (USA) in 1947.

Experiences in group settings showed the powerful influence of groups on individuals. Techniques

developed in psychodrama and Gestalt therapy further influenced work in marriage and family

counseling.

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Postwar changes

At the end of World War II, the United States experienced an unsettling readjustment from war to

peace that manifest itself in three trends that had an impact on the family:

About 50-60% of couples dissolved their marriages.

Half of the work force was comprised of women

Expansion of the life span.

Multicultural Counseling

The most recent trend to influence marriage and family counseling is multiculturalism. Before the

early 1980s, little attention was given to culture and ethnicity in family life. The multiculturalism of

the 90s went beyond encouraging individuals to rediscover their roots. Instead, it was aimed at

exposing the link between peoples' culture and their behaviors within families and society.

Associations, Education and Research

Research studies summarized by Wohlman and Stricker (1983) report a number of interesting

findings. First, family counseling interventions are at least as effective as individual interventions for

most clients' complaints and lead to significantly greater durability of change. Second, some forms

of family counseling (such as using structural-strategic family therapy with substance abusers) are

more effective in treating problems than individual counseling approaches. Third, the presence of

both parents, especially noncompliant fathers, in family counseling situations greatly improves the

chances for success. Similarly the effectiveness of marriage counseling when both partners meet

conjointly with the counselor is nearly twice that of counselors working with just one spouse.

Finally, when marriage and family counseling services are not offered to couples conjointly or to

families systematically, the results of the intervention may be negative and problems may worsen.

Marriage/ Family Organizations

Early pioneers in marriage counseling were instrumental in establishing the American Association

of Marriage Counselors in 1942. That fledging organization grew in time to become the American

Association of Marriage and Family Therapists (AAMFT).

The pioneers' focus on the marriage relationship, rather than just the individuals involved, was

important. The new emphasis meant that three entities were considered: two individuals and one

couple. Interest in marriage and family counseling had grown rapidly since the 1970s, especially in

regard to the number of individuals receiving training in this specialty. Different professional

associations attract these specialists.

Family Life Cycle

The family life cycle is the name given to the stages a family goes through as it evolves over the years.

It is considered the heart of marriage and family counseling

Becvar and Becvar's 9-stage cycle (1993):

Becvar and Becvar (1993) outline a nine-stage cycle that begins with the unattached adult and

continues through retirement. Regardless of timing all families have to deal with cohesiveness

(emotional bonding) and family adaptability (change and flexibility). Families very high and low on

both are dysfunctional.

Unattached adult

Newly married

Childbearing

Preschool-age child

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School-age child

Teenage child

Launching center

Middle-aged adult

Retirement

Marriage Counseling

Reasons for counseling?

Couples seek marriage counseling for a wide variety of reasons, including finances, fidelity,

communication and compatibility, and children. It is crucial to see both members of the couple

from the beginning

Format?

If a counselor does not structure counseling in this way and starts to treat one spouse alone for

even one or two sessions, it increases the other spouse's resistance to counseling. Moreover, if one

member of a couple tries to change without the knowledge or support of the other, conflict is

bound to ensue.

Different Marital Therapy Approaches

Psychoanalytic

Social learning

Behavioral

Bowen family systems

Structural-strategic

Rational-emotive

Psychoanalytical Theory

Psychoanalytical based marriage counseling is based on the theory of object relation which

addresses how relationships are developed across the generations.

Counseling Process and Techniques:

Transference

In the process, the counselor uses the process of transference where each partner restructures

internally based perceptions of, expectations of, and reactions to self and others and projects them

onto the counselor.

Individual histories of each partner of relationship:

Objects are significant others in one's environment, such as a mother with whom children form an

interactive emotional bond. Preferences for certain objects as opposed to others are developed in

early childhood in parent-child interactions. Individuals bring these unconscious forces into a

marriage relationship.

Dream work

Analysis of resistance

Catharsis: Catharsis, the expression of pent-up emotion, is a must.

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Goal:

The goal of this approach is for individuals and couples to gain new insights into their lives and

change their behaviors.

Social Learning Theory

Social learning theory is a form of behaviorism that stresses learning through modeling and imitation.

According to this approach, marriage partners-either have -a deficit or excess of needed behaviors.

A deficit may be the result of one or both partners' never having witnessed a particular skill, like

how to fight fairly. An excess may come as a result of one or both partners thinking that just a little

more of a certain behavior will solve problems. For examples, telling every negative or positive

feeling to the other partner or what one likes and does not like in the marriage in the hope that

honest communication will be beneficial. While such honesty may be admired, research shows that

marriages grow more through positive reciprocity than negative feedback. Selective communication

and interaction with one's spouse seem to work best.

The focus of social learning theory is on skill building in the present.

Techniques:

Within the treatment process, counselors may use a wide variety of behavioral strategies to help

couples change, such as:

Self-reports

Observations

Communication-enhancement training exercises

Contracting

Homework assignments

Much of social-learning theory is based on linear thinking, that A is the likely cause of B.

Behavioral Marriage Counseling

In behavioral marriage counseling, the behavior is maintained or eliminated by consequences. It is

based on direct, careful assessment and intervention. The focus is on presenting problems.

Treatment process: The treatment process in Behavioral Marriage Counseling is based on patient

training, marriage relationship and couple communication, and the treatment of sexual

dysfunctions, and the emphasis is on dyadic interactions.

Role of Counselor

The counselor plays roles as teacher, expert, and reinforcer.

Techniques

Systematic desensitization

Positive reinforcement

Generalization

Extinction

Modeling

Reciprocity

Punishment

Token economies

Psychoeducational methods

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Bowen Family Systems Marital Theory

The focus of Bowen family system marital theory is on differentiation (distinction) of one's

thoughts from one's emotions and of oneself from others.

When there is a great deal of friction within a marriage, the less mature partners tend to display a

high degree of fusion (undifferentiated emotional togetherness) or cutoff (physical or psychological

avoidance). They have not separated themselves from their families of origin in a healthy way nor

have they formed a stable self-concept. When they are stressed as persons within the marriage, they

tend to triangulate (focus on a third party). The third party can be the marriage itself, a child, or

even a somatic complaint. Regardless, it leads to unproductive couple interactions.

Techniques

To differentiate oneself from family of origin

Assessment of self and family through Genograms

Structural Strategic Theory

Structural Strategic Theory is based on the belief that when dysfunctional symptoms occur in a

marriage, they are an attempt to help couples adapt.

The job of a structural-strategic marriage counselor is to help couples try new behaviors because

their old behaviors are not working.

How to learn new behaviors:

Relabelling: Giving a new perspective to a behavior.

Paradoxing: Insisting on the opposite of what one wants.

Prescribing the symptoms: Having the couple display voluntarily what they had previously

manifested involuntarily, like fighting.

Rational Emotive Therapy (RET)

The premise behind RET is that couples, like other individuals, often become disturbed because of

what they think rather than because of specific actions that occur in relationships. That is "highly

exaggerated, inappropriately rigid, illogical and absolutist" is what leads to neurosis and relationship

disturbance.

The focus is on helping individuals first and marriages second.

The RET counselor works with them separately and together in the ABC method of RET.

Goal:

The goal is to understand the illogical beliefs, otherwise they tend to catastrophize and awfulize and

the emphasis is on particular problems like jealousy, sexuality, etc.

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