Transcript for:
MFT 598: YouTube video 1

hello welcome to beh 229 family counseling today we're going to be discussing systems theory and systemic thinking so let's talk about families families are organized units with members living in continuous interactive patterned relationships with one another that expend standover time and space a change in any one component inevitably changes any other related components so when the oldest child goes off to college or moves out on their own that changes things if parents get divorced that changes things radically so these changes affect all the members of the family beyond the relationships of its constituent members the family itself is continuously and bi-directionally linked to a larger system so you can't just look at a family without understanding the culture of the family the community in which the family in their socioeconomic status etc the interplay between families and those social systems that tells us a great deal about the level of family functioning in this PowerPoint we present a systemic framework or paradigm for understanding the reciprocal interaction between the parts of a system that includes the family system by describing several key characteristics of symptom systems we try to help you shift from understanding concepts alone to really thinking systematically as a Family Therapist we explore the need for family therapists to help families manage their interactions across multiple settings such as school in health care issues a systemic perspective greatly broadens the context for understanding family functioning by tending to the numerous social systems with which it functions in this multi-dimensional view attention is directed beyond the family to external factors that may be influencing family funding beyond helping families improve their coping skills clinicians with this outlook help empower them to make more effective use of available social and community services so let's talk about the systems model this model provides a basic mental construct for the Family Therapist to consider in assessment treatment planning and intervention a variety of models have been introduced to facilitate system conceptualization they all attempt to demonstrate the complex narrative reciprocal nature of systems one mote model notes the dynamic reciprocity between individual factors into personal factors and environment or macro systemic factors over time individual factors such as things as personality psycho biology gender age ethnicity sexual identity attachment cognitive process and intelligence beliefs values and more so all of these things work together when you think of a system of a person interpersonal factors include family development family lifecycle family diversity couple relations parent-child relations family strength and social network relations contextual factors include politics culture healthcare religion and religious organizations media national ideology socioeconomic conditions physical environment and more so when you're looking at this kind of system you have to look at multi mentions of the system so this is all leading up to the system that we're going to be looking at and that has been really acknowledged as the ultimate in terms of developing a social system or in ecology bronfenbrenner Yuri is this first name in case you wanted to know that he created this model where individuals and families are nested within multiple but independent social systems that influence how they behave rather than viewing the family as an isolated encapsulated system the systemically oriented therapist is able to intervene at any level to improve family functioning bronfenbrenner proposed a theory of social ecology in which five levels of influence exist each level containing and influencing the prior level so if you look over on to the right-hand side in the middle of the picture you see the individual and then outside of the individual is the micro system this is your family your church your play area your peers your school then the next level which is the mezzo system talks about the interaction of all of these groups and how they interact so for example if your family is heavily invested in the church they may also interact at school so you might be going to a faith-based school your neighborhood play area is going to be heavily impacted by your peers then we move on to the exo system which is the friends of the family mass media social welfare services legal services neighbors these are the people who are a couple of systems removed from you then the macro system is the attitudes and ideologies of the culture in which you live in so for example in the United States we prize independence we prize freedom we look at life as an opportunity so we have a very you know proactive perspective finally this fifth system here at the bottom which is the Chronos system reflects the time or the socio-historical conditions in time since we've been born so depending on how old you are you may remember life before the internet you may have a good understanding of what it was like during 9/11 when the United States was attacked by Al Qaeda so again you know what happens during our lifetime has a serious impact over our entire family system so just to kind of summarize the five systems micro system this is the system with which the individual has direct association such as schoolwork relationships and the therapist may dress problems to improve the relationship among members in the mezzo system this is the connection that allows one system to directly affect another the therapist can work to improve a partner's relationship with extended family members or a community organization the exo system in this system the individual is affected by the system indirectly and does not have an active role in the molding of it a therapist can work on behavior problem children's child's parents losing their job the macro system again the ideology of the culture for example being born to a poor family often makes a person work harder every day they do more manual labor so their perspective is that sitting behind a desk isn't hard work and then finally the Cronus system which is the transitions and shifts in one lifespan this may involve the social historical context so over the past 10 year social media has become a strong influence on today's families the concepts of organization and wholeness are keys to understanding how systems operate if a system represents a set of units that stand in some consistent relationship to one another then we can infer that the system is organized around those relationships no system can be adequately understood or fully explained once it has been broken down into its component parts and no element within the system can ever be understood in isolation says it never functions independently a family like a human body is a system in which the components are organized into a whole that transcends the sum of its separate parts so you know as you can never really know a person even a person cannot know themselves it's the same situation with a family the family can describe its experiences it can describe its interactions but to truly understand and know itself is virtually impossible the relationships among the family members are complex and factions alliances coalition's and tensions exist causality within the family system as circular and multi-directional well and we all know that because we blame everything on somebody else in the family who ate the last cookie daddy wanted it he did she did sister did the dog did you blame everybody and it's just the circular thing focusing on the functioning of one element or member becomes secondary to understanding the connections or relationships among family members and the overall organization of the system so it's really about how each person has their own relationship family with two children does not simply add a member when a baby is born instead the family becomes a new entity with accompanying changes in family interactive patterns so for example you know that baby the youngest child when the baby's born now becomes a middle child and that has a whole set of issues that go along with that having two children and a mom and a dad is challenging having that third baby so now that the children outnumber parents makes it even more difficult adopting a systems view calls from reviewing the family constellation in isolation systems theory suggests that a family is a rule oriented entity the interaction of family members typically follows organized established patterns based on the family structure these patterns enable each person to learn what is permitted or expected of him or her as well as of others in family transactions usually unstated such rules characterize regulate and help stabilize how and how well families function as a unit they underlie family traditions and reveal family values help set up family roles consistent with these values and in the process provide dependability to relationships within the family system so for example you might have an unstated rule that if you want you're one of your parents to agree to let you go out on a Saturday night you talk to mom or if you want to borrow the car you have to talk to dad these are unstated rules but the family all understands these some rules may be negotiable while others are not rigid families may have too many rules chaotic families often have too few all members also learn the family's medals literally the rules about the roles which typically take the form of unstated family directions offering principles for interpreting rules enforcing rules and changing rules so if you're your dad and ask him for something and he says go ask your mother then she knows that your mother will know that your father has literally passed the book some rules are stated overtly such as children hang up their own clothes parents decide on a bedtime younger children earlier than older ones or our family does not marry outside of our religion so those overt rules are easier to interpret most family rules however are covert and unstated they are inferences that family members draw from the repetitive patterns in their relationships they observe at home for example father is distant do as frequent absences so approach mom if you have a problem or we don't have crybabies in our family so you know people resist the urge to weep stay away from their room on Sunday morning they'd like to be alone if mommy and daddy's bedroom door is closed you cannot bother them on a Sunday morning go eat some cereal in a well-functioning family rules are clearly communicated to help maintain order and stability while at the same time allowing for adjustments to changing circumstances dawn Jackson is a pioneer in family therapy and he first observed these patterns Jackson adopted the still helpful concept of marital quid-pro-quo to describe a relationship with well formulated rules in which each partner gives something and receives something else in return and quid pro quo literally means in Latin something for something so you know mom and dad a deal you know mom might make dinner three or four nights a week and dad grills on the weekend or mom cleans up after dinner because dad cooks dinner Jackson also hypothesized that a redundancy principle operates in family communication so a family interacts in repetitive behavioral sequences so you know there's always somebody in the family who gets teased a lot whether it's mom dad or one of the kids and as soon as the teasing starts all the other family members kind of jump on and start teasing that family member and you know the reality is that person likes to be teased they like the attention they can take it they don't get upset and angry and we as a family then have a common activity that we per you know conduct together to have fun Virginia cetera argued that dysfunctional families followed dysfunctional rules she attempted to help such families become aware of those unwritten rules that delay or prevent growth and maturity once identified she believed the family could revise or discard rules that are outmoded inappropriate or irrelevant in order to improve the individuals self-esteem of members as well as overall family functioning here are some examples of dysfunctional family roles we have the hero is typically the oldest child and is often described as trustworthy dutiful mature helpful and organized and the more feedback they get about their behavior they will continue to do that because they love being the hero in the family the play cater is typically a girl and may also be the oldest child she is often described as caring compassionate giving and a good listener on the negative side this person probably doesn't get a lot of support or help from others in the family because she is the person who does the supporting the scapegoat is typically the second child and is often described as irritating defiant deceitful hostile and disobedient that traditional middle child issues where you know they don't seem to have the ability to be as good as the oldest child but also doesn't have that affection the baby of the family has the lost child seems to fall through the cracks almost disappearing at times they are often described as quiet shy lonely solemn and passive this is a gift that spends all their time alone they don't want to interact with their family because they may not feel like they're part of the family the mascot is typically the youngest child and is often described as outgoing entertaining excitable cheerful and playful you know the mascot is loved as the mascot is beloved by everyone in the family and everybody sees them as the person who brings joy to the family homeostasis was a cybernetic concept applied to the family by early family theorists the idea was that family self-regulate to maintain maintain stability and resist change family stability is actually rooted and changed for example a well-functioning couple dealing with Parenthood for the first time may strengthen their partnership and intimacy as the family expands to accommodate the new arrival on the other hand a less well-functioning couple may grow apart after the birth of their child with one or the other or both feeling neglected angry and resentful and keep in mind that most divorces occur within the first five years of marriage oftentimes because you've added a child to the relationship most family therapists today adopt a living systems approach that moves beyond cybernetics to argue that helping families return to previous balanced States shortchange them by failing to credit them with the resiliency resourcefulness to adapt to a more highly functioning level as children grow up they usually put pressure on the family to redefine their relationships so homeostasis isn't as functional as adoption you know we don't want to be the same we want to continually adapt and move forward in a more positive way the children growing up puts challenges on family values customs and norms they insist on being on treated as equals all this can cause dis equilibrium in the family system so when you know the children start to leave home and begin their own families you can't force them to live the way you lived when you were a young couple with your spouse they are adapting to their new experience and as a grandparent you oftentimes have to adapt as well in poorly functioning families demands for modest changes can be met with increased rigidity as the family stubbornly attempts to retain familiar rules moving on to feedback feedback refers to reinserting into a system the results of its past performance as a method of controlling the system thereby increasing the system's likelihood of survival so in a feedback loop you'll see on the right-hand side in the picture you do something you measure it you analyze it you correct any areas that could be improved upon and then you repeat it and you are in a consistent loop where you're constantly trying to improve and that's the key here is feedback loops are circular mechanisms whose purpose is to introduce information about a systems output back into its input in order to alter correct and ultimately govern the fan the system's functioning and insurance viability this makes things better whether it's an athlete who is changing their stride or their way they carry a ball or pitchers how they throw a ball it is this constant desire to be better and when you get feedback it can be very challenging people don't like to be critiqued even if it's not done negatively or in a positive way it's just hard and people need to learn that this is how they grow and how they improve feedback loops help MIT again mitigate against excessive fluctuations thus serving to maintain and extend the life of a system so a family that respects feedback incorporates feedback and tries to adapt and improve is going to have a more functional system in the long run and the family will maintain their closeness over time as an example of the feedback loop think of a person entering a room in which she smells gas a moment before the air smelled fresh and now it doesn't the person takes action by going to the stove and shutting off the gas and opening the window these events and actions restore the system to a normal state to avoid the trap of homeostasis and reflect on adoption this person should then check to see if there's a problem with the stove why did the gas why was the gas on who shut it off you have to adapt also so it's not just about restoring that homeostasis feedback loops and families occur constantly and in far greater number than most of us realize they occur both negatively and positively negative feedback or reducing feedback loops helps to maintain the system steady state new information is fed back into the system and triggers changes that serve to put the system back on track positive feedback or amplifying feedback loop are all about chaining the system so negative feedback basically says everything is going well we're gonna stay on track everything's going well positive feedback is about changing and moving and growing systems require both negative and positive feedback the negative feedback to maintain the status quo and the positive feedback to accommodate changing conditions within a marriage feedback helps maintain equilibrium as disturbing or annoying patterns are adjusted and new stabilizing patterns evolve a misunderstanding can be corrected and minimized what we call an attenuating deviation or escalated amplifying deviation with the negative feedback loop and married couple engaged in a fight becomes increasingly vicious and the couple reaches a point where neither spouse can or no longer wants to move forward with their relationship they just stop talking to each other whereas the conflict can be resolved through positive feedback as the couple strives for a new level of understanding and behavior and again you know when couples fight sometimes there is no way to resolve it and move forward so sometimes you just let it go because there is no way to change it Bateson's information processing is fundamental to the operation of any system it is faulty if it is faulty the system is likely to mat malfunction according to Bateson's definition information is a difference that makes a difference by this he means new or different information that affects change within this system so it's not the same old argument about the same old thing a word a gesture a smile a scowl these are differences or changes in the environment comparable to a temperature drop as environmental input these differences in turn make a difference when the receiver of the new information alters his or her perceptions of the environment and modifies subsequent behavior one of the things that those of us who had teenagers understand very well is the fact that you know your cute little seven-year-old will turn into a snotty annoying fourteen-year-old who rejects any and all positive affirmation or information one of the big arguments is about tone of voice oral expression and the kid will oftentimes reject this information and then it becomes a big fight because they don't see what's going on with their facial expression or their tone of voice a system isn't organized into a more or less stable set of relationships subsystems are those parts of the overall system assigned to carry out particular functions or processes within the system as a whole each system exists as part of a larger Supra system and contains smaller systems and subsystems a family commonly contains a number of coexisting subsystems the husband and the wife constitutes a subsystem of the family as a whole so does the mother and child the father and child and then if you have more than one child the child and other child in a family subsystems can be formed by generation ie the parents by gender moms and daughters fathers and sons by interest so if one part of the family really likes to read or another group likes to play video games or by function parental caretakers within each subsystem each different level of power is exercised different skills or learn different responsibilities assigned for example the oldest child may have power within the sibling subsystem but must give up that power when interacting with his or her parents because each family member belongs to several subsystems simultaneously a person enters into different complementary relationships with other members for example a woman can be a wife a mother or a younger sister an older sister anis a granddaughter and so on so we have a lot of titles in our lives but that doesn't negate any of the other titles that we hold the most enduring subsystems are the executive parental and sibling subsystems the executive subsystem which is the husband and wife is basically any dysfunction and this is basic any dysfunction in this subsystem reverberates throughout the family as children are scapegoated or co-opted into alliances with one parent against the other whenever the parents engage in conflict a viable spousal subsystem one in which the marital partners have worked out a fulfilling relationship with one another provides both spouses with the experience of intimacy support mutual growth and an opportunity for personal development the parental subsystem which may include grandparents or older children assigned to parental roles has the Majoris panse ability for proper child-rearing nurturance guidance limit setting and discipline the sibling set represents a child's first pair group sibling relationships are typically the longest lasting connections we make extending over our entire lifespan spousal parental and sibling subsystems stand in an overall dynamic relationship each simultaneously influencing and being influenced by one another a boundary is a metaphoric line of demarcation that separates an individual a subsystem or a system from outside surroundings within a family system boundaries determine who is an insider and who remains outside the family boundary may act as a gatekeeper controlling information flow in and out of the system we don't care if your friends parents allow her to stay out until 2 a.m. in our family your curfew was midnight whatever you hear at home you are expected to keep private and not discuss with outsiders so you know that boundary is set up so that the members of the family understand the rules so to speak such divisions must be sufficiently well defined to allow subsystem a members to carry out their tasks without undue interference while at the same time open enough to permit contact between members of the subsystem and others an important issue here involves the permeability of the boundaries since boundaries vary and how easily they permit information to flow to and from the environment not only must the boundaries within families be clearly drawn but the rules must be apparent to all if boundaries are too blurred or too rigid they invite confusion or inflexibility increasing the family's risk of instability and dysfunction so for example if dad allows you to drink beer at home before you're 21 but mom doesn't want you to and you create this dynamic where around dad you're drinking beer but around mom you're drinking soda you know this becomes an issue and then when you're 21 and you start drinking beer in front of mom she really can't say anything because that boundary of legal issue changes a system in continuous interaction with the outside is considered an open system while one whose boundaries are not easily crossed is considered a closed system open systems do more than adapt to their surroundings their social transactions are bi-directional they initiate activities that permit an exchange within the community because their boundaries are permeable closed systems on the other hand have impermeable boundaries thus they fail to interact with the outside environment lack feedback corrective mechanisms become isolated and resist change an example of a closed system is a religious cult or a totalitarian country that doesn't permit foreign newspapers radio or television or access to the Internet so for example North Korea is a closed country it is run by a dictator and their information that they're allowed to see basically puts North Korea as the center of the world their perspective is that all the great inventions have come out of North Korea the car the telephone telephone the internet all were created in North Korea their internet is basically an intranet where the only information people are allowed to search his information that takes place within North Korea so they're closed off from the rest of the world in family terms no system is fully open or closed if it were totally open no boundaries would exist between it and the outside world and it would cease to exist as a separate entity if totally closed there would be no exchanges with the outside environment and it would ultimately die off so you have families that really married within each other's you know this this idea of you know families marrying each other's cousins and you saw this especially in Europe at the beginning of the 1900s a lot of the royal families had a lot of children Bert with birth defects because they had just kept married cousins married cousins so they had to open it up and start marrying some outside blood or everybody would be born with you know a hand sticking out of their head rather systems exist along a continuum according to the flexibility or rigidity of their boundaries families that function effectively develop a balance between being open and being closed tuned to their outside world to achieve appropriate change and adaptation while resisting changes that threaten the survival of the system so it's not a black-and-white situation there is a continuum where some families are more open some families are more closed this is called negentropy or a tendency towards maximum order such families increase their chances of becoming more highly organized in developing resources to repair minor or temporary breakdowns in efficiency closed systems run the risk of entropy they are prone to eventual disorganization particularly under prolonged stress so for example recent immigrants or ethnic groups that live in relative isolation communicating only among their own ethnic group suspicious of outsiders and fostering dependence on the family hold on to tradition and avoid change acting as a relatively closed system parent-child relationships and such families may encounter problems due in part to culture conflict that may lead to the development of an entropic family this our college is in Pennsylvania and we have a large population of Amish people and the Amish have an interesting tradition where they allow their young person who turns 18 or 19 to go off for a year and it's called room spring off to explore the world and see if they want to live amongst the what they call the English or the the Society or if they want to stay with the ought the the Amish people and a lot of the young people do return to the Amish lifestyle but a fair number leave the Amish lifestyle and the sad part is they are often not allowed to interact with their diet their family of origin and so they will leave and they leave permanently and this can cause a lot of strife in these family units all families interact with and are influenced by one or more of society's larger systems be it health care church welfare probation schools the legal system family interventions may involve a case management approach which typically includes counseling and Family Advocacy to link them to available community resources and services ie medical care job training legal services and then monitor their progress the family the school in the community are all part of this ecosystem the delivery of Family Services within a school setting at his example of the interlocking nature of systems not only is a child a part of a family that has its own unique structure in relationship patterns but the family itself is embedded in its culture ethnic group socioeconomic status and social history the two major systems in the child's life home and school interact and form a new larger system with its own characteristics objectives priorities and language of the adopted land and encourages its children to adapt in a similar manner can be considered to be acting as an open system so basically you know your little 4 year old is a perfect example of your family and their culture and then that little girl or a little boy goes off to school and now they're surrounded by other little boys and girls who come from different cultures and you may see them coming home with different language that you're used to hearing or they like music that you've never played in your house there's all kinds of influences that occur especially in the first few years of school and then again later when they hit puberty so as a family you have to adapt the school may often be the first to detect a child's emotional or behavioral problem in the cases of many low-income immigrant or otherwise closed families who have difficulty accessing mainstream agencies school-based Family Services may open the gates to needed psychological medical or other social services oftentimes you'll see a child who is got a problem with their anger or they have hygiene issues and the school has to deal with these things and it's very touchy depending on the family's culture the family consultant called upon to help assess and treat a school child's behavioral problem whether it be truancy dropout low level of commitment violence or drug use needs to adopt a systemic approach taking into account the interaction of the two systems ie home in school before attempting to sort out whether the child is having difficulties in one or both and deciding how best to proceed he or she must not only remain aware of the child in the family system but also be familiar with the culture of the school school law regarding children with special needs how the school reaches decisions and the role of the school board and so forth so it is a vast number of influences that affect you know how you work with this child lust ermine urges the concept of mapping the ecosystem evaluating both the school and family before deciding whom to include ie children teachers school counselors parents grandparents and so on in the treatment plan in his view it is necessary from the outset to make clear that the therapists task is not an advocacy for one group or the other but rather helping create conditions for change a systems perspective facilitates this process if it is carried out successfully neither party is targeted as causing the presenting problem and the interactive process between participants becomes the focus of the joint meetings school related difficulties are conceptualized as a result of a reciprocal interaction between the school child and the major social systems in which he or she is embedded Finley peer school and the neighboring community several promising school related intervention programs carefully research and evidence-based have been developed illustrating the emerging social ecological viewpoint for example multi-system systemic therapy has assessment which helps pinpoint the characteristics of the school child's ecology calling that fit factors that are contributing to the maintenance of the problem behavior how much of the school problem is associated with characteristics of the child the family the peers the fifth school family link and the community and identifying strengths discovered during the assessment which can be applied in the subsequent interventions so kind of going back to that positive psychology movement so this is a standard ecomap symbol what you see here and the box on the left a straight line with solid is positive dotted is tenuous stressful is that wavy line the arrows indicate energy flow and the line thickness indicates the intensity so system B and C stress each other out system B ristretto so receives positive energy and so on and so forth this is a little hard to understand so I'm going to show you the next slide which is an actual eco map of a person named Juan so one is sixty years old his major illness is diabetes and here is his social ecology his daughter which is his extended family provides emotional and economic support and she has a thick positive line with the energy flowing to one his daughters that our extended family provide economic support and one daughter provides his food so that's positive church is tenuous maybe he's a lapsed Catholic his brother is extended family and he provides positive support and energy going both ways the neighbor provides transport so that's positive doctor health care provider positive so you see a lot of positives in Juan's life and church being the one that's tenuous now if he had no health care no insurance and he had a very problematic system with his health care provider then you would see a dotted line if he did not get along well with his brother you would see a stressful or a wavy line another example of interlocking systems is the relationship between families and healthcare medical family therapy an integrated approach to care aims at increasing self-efficacy and meaningful communication for everyone involved meaning the patient significant others and the healthcare team family therapists may conduct brief interventions crisis counseling or intensive therapy for patients and families while also facilitating healthcare team interaction with patients and families coaching physicians providing in-service education for professionals and health programs for patients and families and conducting program evaluation substance abuse and chronic mental illness often involve the intersections of family therapy and community agencies models have been developed that help families identify resources and support marsh and left Lea described the social service agency deficits that create significant stressors for the families of those with serious mental illness which we know at this point there a serious need in the United States for more resources for people with mental health issues family needs their own treatment at times for the challenges they face and help in serving the many roles they must fulfill around the treatment of the family member with serious mental illness so for example if you have a child who a teenager or someone in their early 20s who's schizophrenic you know there's a lot of issues to deal with if they're paranoid they may have issues with violence they may be hallucinating they may have delusions they may be unable to work so then you have to get the welfare people involved or Social Security involved so then you end up with a lawyer and it becomes a much bigger situation than just a reg are all pain-in-the-butt teenager systemic problems finally in some cases it is incumbent upon family therapists to look beyond the dysfunctional family itself to a broader view of the social systems around the family otherwise therapists arrive at solutions for the family that no matter how therapeutically elegant are short-sighted because they fail to consider cultural political and institutional issues so somebody who belongs to a family where you know religion plays a huge part and they want to come out to their family as gay or lesbian you know you can have every single idea in the world on how to do this but the family itself who are more than likely going to reject that person you know you have to deal with those issues and you can't just say well this is how it worked for this person so it's going to work fine for that person so assessment should also reflect systemic thinking systemic thinking is the foundation for the practice of family therapy it informs essential features of therapeutic process such as the creation and maintenance of the therapeutic alliance family assessment and case conceptualization the understanding of change in family therapy and the selection and delivery of effective interventions eco maps are frequently used by social workers and others to map out and coordinate the helping services a family is receiving an eco map is a drawing of the family social environment diagramming a family's connection to larger social issues illustrating its simultaneous connections to different agencies a family receiving child welfare services for example might be in contact at the court system medical services church neighbors police attorneys the school system foster parents in various child care agents the Eco map offers a snapshot of these relationships at any given time and you know as the therapist this helps you identify opportunities and strengths these interlocking programs if not coordinated may at times work at cross purposes and result in conflict between specialized helping systems Eco maps help organize and clarify both the stresses and supports inherent in the families network to coordinate the most workable solution to the family's current predicament and that's really the key in family therapy is finding workable solutions for a particular family because every family is going to be different so that's it for today's presentation if you have any questions please feel free to email or text the instructor if you do not attend our school please feel free to leave a comment and we will return any questions with hopefully effective answers have a great day