Social Work Practice Family Treatment Thesis

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Social Work Practice: Family Treatment

The objective of this work is to compare at least three different theoretical models of family/systems therapy.

The work of Barker (2007) entitled: "Basic Family Therapy" states in Chapter 1: The Development of Family Therapy that family therapy "emerged during the second half of the twentieth century, as an often potent means of helping individuals and families with a variety of problems." Barker relates that before World War II "the response of psychiatrists to the difficulties their patients appeared to have in adapting to their family and social environments was often to remove patients from their families in order to ensure recovery in a setting away from the possible adverse effects of their family environments." (2007)

During the decade of the 1950s, "several groups embarked on the investigation and/or treatment of subjects with schizophrenia and their families." (Barker, 2007) During the 1960s the study of family treatment systems continued and Jackson (1961, 1965) "distinguished between family norms - rules that are not overtly acknowledged, but can be observed when the functioning of families is studied; 'values' - rules that are consciously acknowledged; and 'homeostatic mechanisms' - rules about how the family's norms and values are to be applied." These 'rules about rules' were dubbed by Jackson to be 'metarules'.

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The work of Murray Bowen expanded the range of the previous clinical work in treating families of children with problems, except the cases of schizophrenia." (Barker, 2007) the work of Singer (1994) states that the concept of triangles in family therapy was developed by Murray Bowen in 1955. Triadic-based family therapy was addressed in the work of Zuk (1981) who suggested that family therapy is "mainly dyadic-based because of the influence of psychoanalytic theory." (Singer, 1994) Bowen held that "in order to understand the emotional dynamics, the therapist must examine the triangle" and states specifically that "the triangle, a three-person emotional configuration, is the...basic building block of any emotional system, whether it is in the family or any other group." (Singer, 1994)

Thesis on Social Work Practice Family Treatment Assignment

The theories of Bowen "provide the basis for the study of triangles in family therapy."(Singer, 1994) According to Bowen (1978), all emotional systems can be understood through triangles. Two variables were identified by Bowen (1978) which are important in the determination of why triangles are existent in a relationship: (1) differentiation; and (2) anxiety. Differentiation "...refers to the degree to which individuality is maintained in a system" and anxiety "refers to the amount of emotional tension in a system." (Singer, 1994)

Family therapy is stated of Singer (1994) to have come of age in the 1970s and that it was increasingly accepted in major psychiatric centers. Family therapists began to address themselves to a wider range of disorders" than only schizophrenics and their family members. During this time there were many new study centers and developmental therapies for family and the work of Peggy Papp (1977) Family Therapy: Full Length Case Studies" made a presentation of "the work of 12 prominent family therapists including herself." (Singer, 1994) This work illustrates the diversity of the treatments used during the 1970s for family therapy. During the 1980s, family therapy is described to have been a form of "reapproachment" and meanwhile "new concepts and techniques continued to emerge." (Singer, 1994) Included is the narrative approach as well as "the technique of 'externalizing' problems." (Singer, 1994) During this time, there was also an interest in "brief solution-focused therapy. During the 1990s and in the first part of the new millennium family therapy is stated to have now "...a well established place among the psychotherapies." (Singer, 1994) Furthermore, interest has increased in "the application of cognitive behavioral methods of family therapy." (Singer, 1994) Family therapy is stated to also be presently applied."..to an ever-widening range of family types and ethnic groups." (Singer, 1994)

I. FUNCTIONAL FAMILY THERAPY

The work of Sexton and Alexander (2000) entitled: "Functional Family Therapy" states that Functional Family Therapy (FFT) is a "family-based prevention and intervention program that has been applied successfully in a variety of contexts to treat a range of...high risk youth and their families." Family Functional Therapy is stated to draw on "multisystemic perspective in its family-based prevention and intervention efforts." (Sexton and Alexander, 2000) Functional Family Therapy is a combination of the following elements and combines and integrates these "into a clear and comprehensive clinical model":

1) Established clinical theory;

2) Empirically supported principles; and 3) Extensive clinical experience. (Sexton and Alexander, 2000)

This model enables intervention that is successful in various complex and multidimensional problems "through clinical practice that is flexibly structured and culturally sensitive - and also accountable to youth, their families, and the community." (Sexton and Alexander, 2000) Sexton and Alexander state that Functional Family Therapy enables the identification of the primary focus of intervention and reflects "an understanding that positive and negative behaviors both influence and are influenced by multiple relational systems." (2000) Functional Family Therapy is a "multisystemic prevention program" with a focus on "the multiple domains and systems within which adolescents and their families live." (Sexton and Alexander, 2000) Functional Family Therapy first works in developing the inner strengths of the family members as well as improving their belief "of being able to improve their situations - even if moderately at first." (Sexton and Alexander, 2000) Functional Family Therapy "at the level of clinical practice...includes a systematic and multiphase intervention map - Phase Task Analysis that forms the basis for responsive clinical decisions. This map gives FFT a flexible structure by identifying treatment strategies with a high probability of success and facilitating therapists' clinical options." (Sexton and Alexander, 2000)

Functional Family Therapy has three stages of intervention:

1) Engagement and motivation;

2) Behavior and change; and 3) Generalization. (Sexton and Alexander, 2000)

Each of these stages of intervention are "interdependent and sequentially linked. (Sexton and Alexander, 2000) Each of these stages has clear goals and objectives for assessment and each focuses on different risk factors and different protective factors and "each call for particular skills from the interventionists or therapist providing treatment." (Sexton and Alexander, 2000) the first stage of intervention is referred to as the 'Engagement and Motivation' and is a stage in which the primary focus is on maximization of the factors "that enhance intervention credibility" and minimization of the factors "likely to decrease that perception" including difficult locations, insensitive referrals, personal or cultural insensitivity and inadequate resources. This is a stage of treatment in which the therapist "apply reattribution and related techniques to address maladaptive perceptions, beliefs and emotions." (Sexton and Alexander, 2000)

During stage two of FFT treatment, "clinicians develop and implement intermediate and ultimately long-term behavior change plans that are culturally appropriate, context sensitive and tailored to the unique characteristics of each family member." (Sexton and Alexander, 2000) Assessment during this stage of treatment is inclusive of "cognitive, interactive, and emotional components." (Sexton and Alexander, 2000) the provision of the therapists during this stage of treatment is "concrete behavioral intervention to guide and model specific behavior changes." (Sexton and Alexander, 2000) a special emphasis is placed on the use of individualized techniques and techniques which are developmentally appropriate and that "fit the family relational system." (Sexton and Alexander, 2000)

During the third stage of FFT treatment, positive change is applied to the situation or problem areas within the family. During this stage, the FFT therapists assist the family in maintaining change and in the prevention of relapse. During this stage, the family is connected to community resources, which may assist them or provide necessary intervention. Assessment in Functional Family Therapy is "ongoing, multifaceted" and is a process in which the focus is placed on "understanding the ways in which behavioral problems function within family relationship systems." (Sexton and Alexander, 2000)

Sexton and Alexander state that the assessment in Functional Family Therapy is focused on the principles as follows:

1) the ways that family relational systems are related to the presenting behavior problems - in both adaptive and maladaptive ways;

2) Should identify risk and protective factors through clinical and formal assessment toward the identification of family, individual as well as contextual issues that may become treatment targets;

3) Should be multilevel, multidimensional, and multimethod;

4) Assessment of the functioning of the family is preferred rather than diagnostic assessment in order to identify the most appropriate treatment options and approach;

5) Clinical, outcome and adherence assessment are critical to successful implementation of the FFT model. (Sexton and Alexander, 2000)

Sexton and Alexander relate that Functional Family Therapy has "identified formal and clinical tools for model, adherence, and outcome assessment. These tools are incorporated into the Functional Family Assessment Protocol - a systematic approach to understanding families - and the Clinical Services System (CSS) - an implementation tool that allows therapists to track the activities essential to successful implementation." (Sexton and Alexander, 2000)

II. BRIEF STRATEGIC FAMILY THERAPY

The work of Szapocznik (nd) entitled "Brief Strategic Family Therapy" states that BSFT is a "short-term problem-focused therapeutic intervention targeting children and adolescents 6… [END OF PREVIEW] . . . READ MORE

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