Marriage and Family Therapy Supervision Models Term Paper

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¶ … 21st century, the term marriage and family therapy (MFT) seems as if it was long available as a principle means of treatment. In the timeline of psychotherapy, however, it is relatively young. During its brief tenure, the field has undergone a number of changes that continue to this day. In fact, several experiential family therapy modalities are resulting in significant results in outcome studies. One of these newer couples therapies, developed by Susan Johnson and Leslie Greenberg, is called emotionally focused therapy (EFT). It is based on an attachment model of adult intimacy and addresses essential emotional responses and interactions to enhance relationships. In contrast to the traditional "emotion contrast therapy," EFT regards many unpleasant emotions as sources of useful information. Furthermore, EFT is being recognized for its integrative approach. It adds to cognitive therapy with a focus on the constructive aspects of specific emotions; to the psychoanalytic therapies through an emphasis on the present day rather than the past as well as on how problems are produced in addition to why; and to interpersonal psychotherapy with a stress on the self and the importance of past interpersonal relations. Lastly, EFT is gaining in support by both clinicians and patients due to its emphasis on productive means of training and supervision. It is in the process of developing a supervision model, which, unlike those developed by other MFT therapies in the past will be based on efficacy of supervision in addition to the degree of instruction on the specific therapy.

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Marriage and family therapy (MFT) arose after the establishment of two separate schools of thought: Sigmund Freud's psychoanalysis and Carl Rogers' client-centered therapy, which were both predicated on the basis that psychological problems arise from unhealthy interactions with other individuals and could thus be resolved with private relationships between patient and therapist.

TOPIC: Term Paper on Marriage and Family Therapy Supervision Models Assignment

Broderick and Schrader's (1981, 1991) classic tracing of the history of marital counseling identified four distinct phases; Phase I (1929-1932), the "Pioneer" stage, dominated by a small handful of forward-lookng practitioners; Phase II (1934-1945), the "Establishment" stage, signaled by the formation of the American Association of Marriage Counselors (AAMC); Phase III (1946-1963), the "Consolidation" stage, leading to the first legal recognition of the marriage counseling profession (in California, in 1963); and Phase IV (1964-1978), the "Formative" stage, marked by the building of a professional literature, an occasional effort at scientific study, and what L'Abate and McHenry (1983, p. 3) called "intense growth and clarification of standards and competencies" for training and practice.

Despite appearing interested in the emotional welfare of partners, early marriage counselors infrequently met in what is now considered the usually preferred format of conjoint interview. In 1963, 30 years after the supposed beginning of the profession, Michaelson estimated from the case records of the three major marriage and family clinics in the United States that, in the 1940s, only 5% of marriage counselors' cases met conjointly, rising to 9% during the 1950s and to only 15% in 1960. By the mid-1960s, clinicians who primarily identified themselves as marital therapists normally used the conjoint format in couple cases, while those who practiced marital therapy in other mental health disciplines still were divided between conjoint and individual approaches (Alexander, 1968). It was not until the end of the '60s that Olson (1970), in the field's first comprehensive analytical review, identified the "predominant use of the technique of conjoint therapy" (p. 503).

Although MFT had agreed on the conjoint approach of therapy, the field was "seriously lacking in empirically tested principles, and it is without a theoretically derived foundation on which to operate clinically" (Olson, p. 503). Likewise, Broderick and Schrader (1981) found a "lack of clear commitment to any particular clinical philosophy" (p. 12). And Manus (1966) clearly stated that marriage counseling was a mere "technique in search of a theory" (p. 449).

From the 1960s, MFT evolved from a psycholanalytic into a clinical perspective. The list of these early therapists included Jay Haley, Salvador Minuchen, Virginia Satir, Carl Whitaker, Murray Bowen, Nathan Ackerman, Ivan Boszormenyi-Nagy and James Framo. Training institutes and academic programs through established marital organizations and universities also began developing at this time. Changes in the field continued throughout the 1980s and 1990s (Locke, 184).

One of the major pioneers in MFT, who had particular impact on the development of the emotionally focused therapy was Murray Bowen. Similar to other founders of family and marital therapy, Bowen was a psyschiatrist who specialized in schizophrenia. More so, however, he emphasized theory in his practice that made a major impact on the philosophy of MFT. Bowen's major interest was mother-child symbiosis, which led to his concept of "differentiation of self." This was the act of being autonomous from others and independence of thought from feeling. If parents rear emotionally healthy children, those children will develop a strong differentiation of self. This concept is defined as the ability to balance emotional and intellectual influences in cognitive functioning, as well as intimacy and autonomy in relationships (Bowen, 1978). A related concept is that people will tend to select a partner with a level of differentiation of self similar to one's own. It follows that if the relationship is to change, both partners will need help in achieving an increase in their level of differentiation. He expanded the mother-child symbiosis to include fathers, leading to the idea of "triangulation" or diverting conflict between two people by involving a third (Nichols 42).

At first, Bowen provided individual therapists for each family member, but found that this approach divided families (1976). He thus began treating families together and thus came about family therapy. Bowen was struck by the family members' intense emotional reactivity, where feelings completely overwhelmed indiviudals over objective thought. It was Bowen who introduced the therapist's own genogram as part of the training as a need to reflect on the person of the therapist in interaction with the client. For psychotherapy.

Bowen's basic concepts of theory were organized into eight interconnected variables: the emotional system with its variation in the counterbalance between togetherness and individuality; levels of differentiation of self; mechanisms of reactivity in the nuclear family; triangles; multigenerational transmission process; sibling position; anxiety, chronic and acute; and emotional cut off. No one concept could be explained by another. No one concept could be eliminated or isolated from the theory. Clinical families, Bowen's own family system, and all of human society were studied within the framework of theory.

Partners therapy in general and emotionally-focused therapy in specific also is based on the work developed 50 years ago by John Bowlby. As a psychiatrist, Bowlby worked with the World Health Organization to study the psychological adjustment of babies and children orphans for World War II. Based on studies from worldwide cultures, Bowlby concluded that humans have an innate desire for attachment or personal trust and security. Children have needs for attachment with at least one parent, and adults have these needs with a romantic partner. When children do not have the ability to get attachment figures to respond to them and their needs, they will do whatever possible to get that response. Children who do not feel their parents care, for instance, will become rebellious or withdrawn and depressed.

Related to the attachment theory were the relationships between adults that developed in the 1970s with bereavement studies (Bowlby and Parkses, 1970) and marital separation (Weiss, 1973 and 1977) (see Goldberg 71). This grew into a larger idea of marital relationships (Weiss, 1982 and 1991).

Johnson has found that attachment distress in couples might arise when one partner is unsupportive or emotionally unavailable, causing the other to experience insecurity. In emotionally focused therapy, any attachment ruptures between "distressed" partners are called "attachment injuries," If one partner withdraws after the other gets fired from a lucrative position and cannot help support the family, it can lead to attachment injury and a break in trust that could damage the marriage relationship.

Up to this point, this paper has dealt with the development of therapy modalities for the patients. Hand-in-hand with these models came frameworks for the training and supervision of the MFT professionals. It was recognized early on that the therapists had to understand and be immersed in the particular form of therapy. According to Liddle, early in the history of family therapy, training was fairly homogeneous (1988, 3). It was not characterized by clearly articulated curricula and objectives. In the 1970s to 1980s, training and supervision grew, with each approach having its own educational specifics, conferences, books, and so forth.

There was a tremendous heterogeneity of goals and objectives due to who was being trained, in what context and the specific modality being studied. The characteristics of the individuals conducting the training and those being trained also impact the type of family therapy training. Presently, the concept of training is all the more complex because of the increased complexity of the Western society and the role that potential marriage disillusionment occurs.

When Liddle's book was written in 1988, he noted,… [END OF PREVIEW] . . . READ MORE

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