Family integrative psychotherapy to help you and your family

is one of the youngest psychotherapeutic schools developing recently. This approach arose after the Second World War, it developed in close collaboration with cybernetics, and this is its significant difference from other psychotherapeutic approaches. In this approach, a person is not an object of influence and a client. The client is the entire family, the entire family system, and it is she who is the object of psychotherapeutic influence.

This is a psychotherapeutic direction that considers systemic connections and interpersonal relationships in a group as the basis for diagnosis and treatment of mental disorders and interpersonal conflicts. This form of therapy and its effectiveness are scientifically recognized in Germany. In Austria and Switzerland, recognition occurred already in the 1990s. The following non-therapeutic areas are based on theoretical principles similar to systemic therapy - social work, systemic consulting, systemic coaching.

Story

Unlike classical psychoanalytic schools, each of which had one center and founder (Freud, Adler, Jung, Frankl), systemic therapy has several centers and founders. The basis of the systems approach is considered to be general systems theory and constructivism (see also Ernst von Glasersfeld as the founder of radical constructivism). Biologist Ludwig von Bertalanffy, the founder of general systems theory, sought a model that was universally applicable to various systems and developed a metatheory for this purpose. His point of view was based on observations of general patterns and their fundamental foundations. According to Bertalanffy, a system is a unity consisting of elements that is much more than just their sum. Elements interact both with each other and with other systems. Family therapeutic thinking began to develop in the 70s. XX century, relying on new scientific fields: cybernetics and systems theory. Over time, the methodological approach and basic assumptions separated from each other, which made it possible to distinguish several schools: structural and strategic family therapy, as well as intergenerational family therapy (Milan model, Heidelberg School), narrative approaches (Michael White, Harold A. Gulishian), family sculpture (Virginia Satir), integrated family therapy (Hans-Werner Gessmann - Psychotherapeutic Institute Bergerhausen - Duisburg) and solution-oriented approaches (Milwaukee School). The main hypotheses of the last decades of the 20th century. (the double bind theory of Gregory Bateson and Paul Watzlawick; the original identification of family and system) retained their influence only at the initial stage of development of systemic therapy. Now systemic therapists consider them obsolete. At the moment, the theory is strongly influenced by the biological systems theory of the Chilean scientists Maturana and Varelo, which was then expanded and strengthened by the sociological theory of systems by Nicolas Luhmann. [ source not specified 698 days

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USA. Origins

A group of researchers led by Gregory Bateson (John Wikland, Jay Haley, William Fry, Don Jackson) studied the paradoxes of communication. In doing so, they focused on three main aspects: communication theory, change methodology, and appropriate therapeutic practice. In 1956, a research article mentioned the historically important term “double bind theory.” An important prerequisite for this was the developments of Norbert Wiener in the field of cybernetics. On this basis, a new concept of family therapy began to develop. The solution-oriented approach to family therapy originated in the 1950s at the Mental Research Institute (MRI) in Palo Alto, California, by Don Johnson, Gregory Bateson, John Weakland, and Richard Fish. Many prominent family therapists were subsequently inspired by this, such as Virginia Satir, Jay Haley, Paul Watzlawick, Steve de Shazer and Mara Selvini Palazzoni. Salvador Minujin also played a decisive role in the historical development of family therapy. As a leading family therapist of the 1960s, he influenced the understanding of the meaning of family structure and boundaries for many subsequent generations of therapists and educators. Together with Jay Haley, Braulio Montalvo and Bernice Rosman, he developed a training program for family therapists in which video surveillance and monitoring methods were already standard. In 1988, Together with Family Studies Inc. He founded the Institute for the Training of Family Therapists in New York.

Milanese model

An example of an important theoretical and practical approach to systemic family therapy is the Milan Model, created by Mara Selvini Palazzoli, Luigi Boscolo, Gianfranco Cecchin and Giuliana Prata. For a long time they enjoyed the support of Paul Watzlawick, who regularly visited Milan and discussed the results of the work of this family therapy center with therapists. In a short time, the Milan Group achieved success in working with schizophrenic family members and clients with eating disorders. Currently, the main role is played by the following method of work - the two-room method: the therapist and client are in the same room and are separated from fellow therapists who observe the treatment through a one-way mirror or by video surveillance. The treating and supervising therapists discuss the concept of the therapy session (discussion of hypotheses). The conversation is led by the treating therapist. If necessary, the therapist and observers provide consultations during breaks. At the end of the conversation, the clinical team decides on the optimal final intervention (eg, homework or symptom clarification), which is immediately communicated to the client. The purpose of this intervention is first to eliminate patterns of interaction in the system (family members and/or significant others) and, second, to change the symptoms of which the client complains.

Virginia Satir, Tom Andersen

Virginia Satir is considered the mother of systemic therapy. She expanded the repertoire and methodology of systemic therapy, had a decisive influence on its development, introducing, firstly, the concept of “family sculpture”, secondly, “family reconstruction”, and thirdly, “Parts Party” " Thanks to this, biographical patterns and transgenerational problems can be discovered, for example, in the third case, one's own parts of the personality become visible and integrated. The American Virginia Satir conducted many seminars in Europe and influenced not only the family therapy community, but also the introduction of neurolinguistic programming and family system constellation, although she was skeptical about this. Norwegian social psychiatrist Tom Andersen expanded the therapeutic approach to so-called team reflection. In it, the therapist and client typically switch places with a team of fellow therapists at the end of the therapy session. The therapist and client(s) observe a team of fellow therapists reflecting on current events from their perspective with the goal of helping and supporting the client. Increasing effort (multiple therapists) brings greater variety of therapy perspectives, reduces therapeutic errors, eliminates subjectivity, and pays off in high effectiveness (usually few sessions required).

Heidelberg School

German psychoanalyst and pioneer of family therapy[1] Helm Stierlin was the head of the department of psychoanalytic basic research and family therapy at the University of Heidelberg from 1974 to 1991. Around him gathered a group of young interested therapists, the so-called Heidelberg School, which promoted the narrative approach, the intergenerational perspective, the genogram and couples therapy. Stierlin's colleagues include Arnold Retzer, Günter Schmidt, Fritz B. Simon and Günthard Weber. Influenced by Michel Foucault and drawing on a cultural anthropological background, Australian social worker Michael White, together with his New Zealand colleague David Anstone, created the narrative approach. He encourages his clients to engage in new patterns of storytelling, often solution-oriented, such as encouraging them to write letters to themselves, and develops therapeutic exercises to develop oral language skills in a constructivist tone.

Systemic family constellations

Main article: Systemic-family constellations

Systemic-family constellations, or systemic constellations, are widespread in modern systemic therapy of the German-speaking space and represent a further development of the family sculpture technique of Virginia Satir. This method is supported by Insa Sparrer, Matthias Varga and Günthard Weber. Very controversial, however, is the version of the family constellation of Bert Hellinger, who strongly polarized the system community in Germany with his categorical manner and categorical statements. The method of systemic constellations is applied not only to groups of people (families, teams, companies and their departments), but also, by some systemic psychotherapists, to groups of subpersonalities. [ source not specified 2067 days

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Milwaukee School

Insoo Kim Berg and Steve de Shazer began using solution-oriented or solution-focused therapy (solution-oriented approach). Formed under the decisive influence of the Austrian philosopher Ludwig Wittgenstein, this approach assumes that the problem and the solution are completely different. The formulation of the problem fades into the background, as does the family as a system (with family members as elements). The entire “therapeutic event” is modeled as a process of development and problem solving. The most important tools of this approach are respect, scaling and the so-called “miracle question”.

Goals and objectives

Unhealthy relationships within the family, lack of correct understanding of the role of this cluster and its members, increasing divorce statistics - all this became the reasons for the emergence of family psychotherapy. Based on this, we can highlight the main goals and objectives of the industry :

• general improvement in relationships between family members;
• developing feelings of mutual respect;
• cultivating mutual support in difficult situations and empathy;
• elimination of tyranny, a more rational distribution of roles between family members and distribution of their responsibilities;
• overcoming conflicts, finding ways to solve current problems;
• eliminating the “scapegoat” complex, moving away from shifting the blame for ongoing misunderstandings onto one person;
• searching for the true causes of conflicts and problems in relationships;
• training in self-analysis and rational self-criticism;
• developing a sense of tolerance for other people’s mistakes and missteps;
• awareness and acceptance of differences of views;
• developing a sense of independence;
• cultivating the ability to listen to other people’s opinions;
• developing the ability to express your feelings to your partner;
• maintaining a healthy balance between all of the above.

If you have problems of this kind, you should contact a family psychotherapy center. Many people find it difficult to admit that they need help, much less go to the session itself. The lack of trust in specialists in this industry played a role here. To ensure the effectiveness of such activities, it is worth looking at reviews of family psychotherapists. They helped save thousands of families from destruction and allowed them to finally find happiness.

Mutual respect in the family and general improvement of relationships between all its members is one of the main goals of psychotherapy

Development of the theory

The foundations of systemic therapy are based on the work of Gregory Bateson (the double bind model), the philosophy of radical constructivism (Heinz von Foerster, Ernst von Glaserfeld), the work of Paul Watzlawick and the approaches of Steve de Shazer as the founder of the solution-oriented approach. Since the 90s. XX century one can also trace the influence of the biological systems theory of Umberto Maturana (main work: “The Tree of Knowledge”[2]) and the sociological-communicative systems theory of Niklas Luhmann (main work: “Social Systems”[3]).

Child psychotherapy

Special techniques aimed at working with children deserve special attention. Reasons to visit a child psychotherapist include the following situations:

• excessive activity, inattention;
• neuroses, attacks and other symptoms of nervous disorders;
• difficulties in communication and being in society;
• intrafamily conflicts between parents and children;
• suspicion of developmental disabilities;
• strange behavior;
• aggressiveness;
• disobedience;
• behavioral disorders;
• autism;
• unreasonable fears, anxiety;
• emotional shocks, for example, against the background of parental divorce, etc.

If specific movements, facial expressions, or peculiar rituals are identified, a course of family psychotherapy is conducted to correct the child’s tics. Its essence lies in identifying the causes of such a reaction and performing special gymnastic exercises. It is important to teach the child to resist, that is, to block the desire to carry out this or that action, which is a tic.

It is important to take into account the characteristics of the child’s psyche. Children are characterized by emotional instability and are easily suggestible. In addition, at an early age, those behavioral foundations are laid that influence the rest of a person’s life and shape his personality.

Child psychotherapy involves various approaches and methods aimed at and influencing the child and his environment

Therapeutic approach

A further development of family therapy, this approach views the family system or organizational system as a resource from which both the abilities and strengths and behavioral disorders of an individual member of the system can develop. If a group member exhibits mental or behavioral disorders, then he is considered to be a carrier of a symptom of the entire system. This may manifest itself, for example, in typical personality conflicts with a partner or in recurring problems with clients or colleagues. The further development of systemic therapy to date has been marked by the absence of a clear teaching about disorders, for example, the diagnosis of “disorders” or even “mental illnesses”, together with traditional psychopathological concepts, has been largely rejected as inadequate. On the one hand, this leads to a therapeutic affinity for solution-oriented approaches, and at the same time may be the largest, most difficult to overcome disagreement with the main directions of psychotherapy and the identity of the German health care system, which operates in a largely disease-oriented and theoretically oriented way. to a behaviorist or psychoanalytic approach. Social or mental abnormalities are not designated as “diseases” or “pathologies,” but as fundamentally understandable responses to problems or demands that may themselves be problematic.

Methods and techniques

The Society of Family Consultants and Psychotherapists annually expands its arsenal of methods and techniques used for treatment. With their help, it is possible to find difficult situations much more effectively and influence key aspects of the problem.

Psychoanalytic family psychotherapy involves a thorough analysis of the problem situation, the emotions and actions of each family member, as well as their interaction. The following methods of family psychotherapy are used at different stages:

• Non-directive technique - full concentration of attention on the patient, his experiences, the relationship between the true manifestations of behavior and the inner “I”.
• Supervision – observation, control and analysis. Supervision in family psychotherapy is used in combination with audio and video technologies.
• Empathy is empathy, insight into the feelings of others.

It is important to concentrate your attention on the patient, his experiences, relationships with other family members

The following techniques are used in various family psychotherapy techniques:

• free associations;
• free discussions;
• interpretation;
• modeling and elaboration of situations;
• directive;
• paradoxical reaction;
• analysis of video recordings;
• intervention;
• clarification;
• confrontation;
• reflection of feelings;
• informing;
• Feedback;
• question;
• dream interpretation;
• encouragement;
• repetition;
• use of silence, etc.

Other approaches

The starting point for systemic therapy is to clarify the contract between therapist and client as precisely as possible (the word “patient” is rejected in most cases). Once treatment goals are specific and acceptable to both therapist and client, therapy itself can begin. If therapy lasts several sessions, a new clarification of the contract is permitted, since the goals of therapy may change over time. The preferred form is considered to be a small number of sessions, if possible, with maximum intervals between them, during which the client tries to try out the new knowledge acquired during the sessions in life and (or) performs so-called homework. In this regard, the systemic therapeutic approach is characterized by economy, which emphasizes the personal initiative of clients. Techniques used, types of therapeutic interventions, methods:

• Circular questions, the purpose of which is to find out the possible position of a third party (including those present);
• Scale questions to clarify differences and progress in therapy;
• Positive assessment and development of a positive aspect of the problematic order of things;
• Reframing the order of things is necessary to stimulate changes in meaning or interpretation;
• Paradoxical intervention is usually the description of problem behavior in order to change automatisms;
• Homework of various, individually oriented nature is completed between sessions;
• Metaphors, parabolas and stories as a technique for working with possible “resistance”;
• Questioning exceptions to the problematic order of things in order to clarify the variability of the statistically considered order of things;
• Using the subjunctive mood to focus on options and possibilities;
• The sculpture is a depiction of family relationships from the client’s point of view;
• Sociogram is a graphic representation of social relations;
• Group reflection - see the article about Tom Andersen;
• Inviting family members or friends to participate in a particular session or phases of therapy;

and many others.

Stages of therapy

Today, a wide variety of family psychotherapy techniques are used. Their selection and combination are carried out in accordance with the stages of therapy. As a classical model, the following distribution can be represented:

• Diagnostic stage. An acquaintance with the family is made, the problem and an accurate diagnosis are determined.
• Overcoming conflict. Using the selected technique of family psychotherapy, the causes of controversial situations are clarified and true positions are transmitted from one family member to another through an intermediary - a psychotherapist. The behavior and emotions of patients are analyzed in the context of a specific situation.
• Reconstruction of relations. It is necessary to learn to solve problems collectively, without unnecessary emotions, and to build a constructive dialogue.
• Supporting stage. The psychotherapist consolidates the skills acquired by patients with a view to their further use in resolving conflicting family situations. Simulation of situations is carried out to assess the behavior of family members and further correct it.

Worth seeing: Orthodox and Christian psychotherapy

Research and international recognition

Systemic (family) therapy is recognized in the USA and most European countries (Finland, Italy, Poland, Switzerland, Hungary and Great Britain [4]) at the state level as a therapeutic method. In Austria, recognition took place after a thorough study carried out by the Federal Ministry of Health in 1993. On December 14, 2008, the Scientific Advisory Board of Psychotherapy decided to consider systemic therapy scientifically recognized in Germany[5]. Shortly before this, two leading organizations, the German Society for Systemic and Family Therapy (DGSF) and the Systems Society (SG), presented the results of a joint study to the Scientific Advisory Board of Psychotherapy, the purpose of which was to help in the official recognition of this therapeutic direction in Germany. About 80 randomized and controlled studies have been able to confirm that systemic and family therapy is an effective and cost-effective method of psychotherapy with very good long-term effects[6]. A year later, in December 2009, the training of specialists in the field of systemic psychotherapy for adults was allowed[7]. Since November 2010, the first direction of training has opened in the specialty “Children and Youth Psychotherapy” in the field of systemic therapy[8].

What is it, key features

Family psychotherapy is a separate area. The object of influence in this case is the family as a whole, as well as its individual representatives.

Internal relationships are not always built properly. As a result, sooner or later conflicts begin to arise that cannot be resolved in the usual way. The atmosphere of the relationship deteriorates, which is fraught with a constant feeling of emotional tension, loss of mutual respect and trust, and divorce. To prevent such situations, family counseling and family psychotherapy were created. A specialist is able to provide assistance in overcoming a crisis situation and lead family members in the right direction.

Child psychotherapy deserves special attention. It is children who find themselves in the “center of fire” during family scandals. Their psyche suffers when the family is inferior, when one of the parents does not take part in the process of raising their child. The worst thing to bear is the breakdown of the relationship between mother and father, as well as the use of incorrect parenting methods and lack of trusting communication.

In family scandals, it is often the children who suffer, who find themselves in the “center of the fire.”

Criticism

The main criticism of systemic psychotherapy is that, unlike, for example, psychoanalysis, it has neither a widely accepted theory of the psyche, nor a widely accepted pathological concept, nor a specific theory of disorders. Therefore, it should be noted that methods of systemic therapy, despite their effectiveness, most often have an eclectic character. In addition, there are several leading systemic therapy organizations, and the views of educational institutions on this issue do not always coincide.

Examples of exercises

Let's look at a few simple family psychotherapy exercises that can be used even at home.

Exercise 1. Listening skills. For 5 minutes, one person in the couple should listen to their partner and not interrupt. You can only ask clarifying questions to better understand the situation. Then the roles are exchanged. This way you can delve into the essence of the conflict and consider it from the point of view of both partners, learn to speak out and listen.

Exercise 2. Distribution of roles. Make two identical lists with the responsibilities that family members must perform and the roles they play in this system. On a scale of 1 to 3, rate how often you and your partner perform these items (1 – rarely, 2 – often, 3 – constantly). You need to complete the task independently, focusing on your perception of the situation. Then you can fill out a similar list in relation to the performance of duties by your partner. At the end, compare the results.

Exercise 3. Complete the sentence. You need to complete the sentence you started and compare your version with the real one. For example:

• I get angry when...
• I need my husband/wife's help in...
• Most often we quarrel because...

Such exercises can be performed not only to clarify the relationship between husband and wife, but also for children and parents.

Notes

1. Stumm, Pritz.
   Psychotherapy. Encyclopedia of personalities. - 2005. - P. 458.
2. Maturana, Humberto and Varela, Francisco.
   Tree of knowledge. Biological roots of human cognition. — 1987.
3. Luhmann, Niklas.
   Social systems. Frankfurt am Main. — 1984.
4. Jochen Schweitzer, Stefan Beer, Kirsten von Sydow, Rüdiger Retzlaff.
   Systemic/family therapy.
5. Dietmar Schulte, Gerd Rudolf, Berlin.
   Decision of the Psychotherapy Scientific Advisory Board regarding family therapy. — 2008.
6. Bernard Schorn.
   Scientific research proves effectiveness and long-term success.
7. Ministry of Labour, Social Development, Health, Family and Women of the Federal State of Rhineland-Palatinate.
   Recognition of the specialty “Systemic therapy of adults”. — 2009.
8. Permission to open the specialty “Children and Adolescent Systemic Psychotherapy”. The specialty “Child and adolescent systemic psychotherapy” was admitted in November by the examination bureau of the federal state of North Rhine-Westphalia.

Individual and group lessons

At the family psychotherapy center you can get help in solving a wide variety of problems. In this regard, both individual and group lessons are used. The best option is a combination of both approaches.

Individual sessions are characterized by closer interaction between the doctor and the patient. In family practice, individual practices include sessions for couples, that is, specifically for each family. It is possible to analyze in more detail the problem that exists at the moment, to trace the development of the situation, the peculiarities of the relationship between family members.

In some cases, the group technique of family psychotherapy is more effective. Classes are held simultaneously for several couples. This allows you to compare the reactions of different people to the same situation and better reveal the essence of the problem. In this case, it is necessary to take into account the characteristics of each patient and select families with similar problems, equal social status, level of education, etc.

Some trainings are conducted separately for men and women. This is a kind of preparation before the main therapy, helping to get rid of defensive reactions that provoke conflicts.

Worth seeing: Types of psychotherapy

Literature

• Andrea Brandl-Nebehay et al. (Hrsg.): Systemische Familientherapie. Grundlagen, Methoden und aktuelle Trends. Facultas, Wien 1998, ISBN 3-85076-439-7
• Jürgen Hargens: Aller Anfang ist ein Anfang. Gestaltungsmöglichkeiten hilfreicher systemischer Gespräche. Göttingen: Vandenhoeck & Ruprecht, 2004
• Jürgen Kriz: Systemtheorie für Psychotherapeuten, Psychologen und Mediziner. Eine Einführung. 3. Auflage, Facultas, Wien, Stuttgart 1999, ISBN 3-8252-2084-2
• Rudolf Klein, Andreas Kannicht: Einführung in die Praxis der systemischen Therapie und Beratung. Erste Auflage, Carl-Auer Verlag, Heidelberg 2007, ISBN 978-3-89670-571-6
• Kurt Ludewig: Systemische Therapie, Klett-Cotta, Stuttgart 1992, 1997 4. Auflage, ISBN 3-608-91648-2
• Klaus Mücke: Probleme sind Lösungen. Systemische Beratung und Psychotherapie - ein pragmatischer Ansatz. 3. Auflage, Potsdam, 2003, ISBN 978-3-9806094-4-9
• Arist von Schlippe, Jochen Schweitzer: Lehrbuch der systemischen Therapie und Beratung I.Vandenhoeck & Ruprecht, Göttingen 2012, ISBN 978-3-525-40185-9
• Arist von Schlippe, Jochen Schweitzer: Lehrbuch der systemischen Therapie und Beratung II. Vandenhoeck & Ruprecht, 4. Auflage 2012. ISBN 978-3-525-46256-0
• Kirstin von Sydow, Stefan Beher, Rüdiger Retzlaff: Die Wirksamkeit der Systemischen Therapie/Familientherapie. Hogrefe-Verlag, Göttingen 2006, ISBN 3-8017-2037-3
• Christiane und Alexander Sautter: Alltagswege zur Liebe. Familienstellen als Erkenntnisprozess. Eine Einführung in die systemische Arbeit nach Virginia Satir. Schwerpunkt: Systemaufstellung mit Familiensystemen. (hat nichts mit Familienstellen nach Bert Hellinger zu tun), überarbeitete Auflage, Ibera Verlag, Wien 2006, ISBN 3-85052-026-9.
• Günter Schiepek: Die Grundlagen der Systemischen Therapie, Vandenhoeck & Ruprecht, 1999
• Insa Sparrer: Wunder, Lösung und System, Heidelberg: Carl Auer 2004 (3. Auflage)
• Varga A. Ya. Systemic family psychotherapy. — Speech, 2001.
• Gessmann H.-W. Textbook on integrated systemic family therapy / Russian adaptation by Elena Oladova. - Duisburg: Publishing House of the Psychotherapeutic Institute Bergerhausen, 2011. - ISBN 978-3-928524-67-4.
• Systemic family therapy: Classics and modernity / Ed. A. V. Chernikova. - Class, 2005. - ISBN 5-86375-130-4, ISBN 978-5-86375-130-6.
• Ludewig K. Systemic therapy. Fundamentals of clinical theory and practice. - Verte Publishing House, 2004. - ISBN 5-94866-001-X, ISBN 978-5-94866-001-1.

Course content

Section I. Basic principles and emergence of family systemic therapy

Topic 1. Definition of family systemic therapy

Family as a system of interacting elements. Symptom in the context of the functioning of the family system. The family system as an object of influence by the therapist.

Topic 2. Methodological prerequisites for the formation of family systemic therapy

Functional method in sociology and anthropology. Bronislaw Malinowski and Margaret Mead. Male and female roles in the family in the studies of Talcott Parsons. Systematic approach - Ludwig von Bertalanffy. Cybernetics - Norbert Wiener. Circular causality.

Topic 3. Empirical prerequisites for the formation of family therapy

Research by Julian Lef and Christine Vaughn. The “Symptom Walks Through the Family” effect in the observations of psychoanalysts. Attempts by psychotherapists, psychiatrists, psychoanalysts to work with families.

Topic 4. Historical situation of the emergence of family systemic therapy

Institutional factors. Conceptual barriers. Gregory Bateson and the beginnings of the Palo Alto group. Its main participants. Various areas of family systemic therapy.

Topic 5. Family systemic psychotherapy and psychoanalysis

Theoretical differences. History of relationships. Current situation. Integrative approach. Cases in which family systemic therapy is the number one remedy of choice.