Comparison Chart of Models of Marriage & Family Therapy

Bowen

Contextual

Object Relations

MRI Brief

Strategic Haley

Milan Systemic

Structural

Experiential

Emotional - Focused

SolutionFocused
* Clinical focus on solutions. * Co-construction. De-emphasis on history and pathology. Deconstruct * Exception. Finding when the problem is not a problem. Focus on future. * Problem and cause are con structions of real ity. Scaling. * No absolute reali ty. Do not impose view of normal.

Narrative

Collaborative

CBT

Psychoeducational

Anxiety. Differentiation. * Emotional cutoff. * Emotional system. Family projection process. * Functional level of differentiation. Fusion. * Multigenerational transmission process. Nuclear family promotional system. Sibling position. Triangulation.

* Destructive entitlement Entitlement Exoneration. Justice / fairness. Ledger. Legacy. * Loyalty (filial & invisible). Merit Multidirectional partiality. * Parentification. Relational determinants (facts,individ. psychology, behavioral transactions, relational ethics. Revolving slate. Trustworthiness.

Projection of internalized, repressed ego objects. Internal objects built from experi ence and expecta tion. Interpersonal view of individual & family develop ment Negative aspects of internalized object Current relating based upon expectations formed in early experience. Societal norms &

Communication theory (levels, rules & congruence). First vs. second order change. Cybernetics/posi tive feedback loops. Focus on the pre senting com plaint Most motivated person in family is used. Unit of treatment can be one per son. Primary determinant of behavior is other peoples

Problems stem from the dilemma between love and violence (Madanes). Clear rules should govern the hier archy. * Flexibility. Influenced by Bateson, Erickson & Minuchin. Symptoms are communicative acts embedded in a pattern of inter actions. * There needs to be a large repertoire of behaviors for problem resolu tion and life cycles. Focus on presenting problem.

Family system is constantly evolv ing. Hypothesizing. Circularity. * Neutrality. Double Bind. Invariant pre scription. * Homeostasis. Attend to beliefs rather than behavior. Positive Connotation.

Alliances. * Boundarie * Coalitions * Disengage * Detouir^g Enmeshrj * Parentif* * Restricts Structure. * Structura * Subsy stem * Triangles.

* Alienation. Battle for Structure. Battle for Initiative. * Communication. Use of crazi ness. * Creativity. * Experiential. * Family recon struction. * Growth thru immediate shared experience. * Intergenerational themes. Self worth.

* Negative interac tion cyde. * Core Conflicts Secondary reac tive emotions. * Primary Emotions * Separateness-connectedness Dependence-independence.

* Co-construction. * Flexibility and creativity Language is all important emphasis on meanings. * Dominant story. Hermeneutics. Objectification. Problem creates the system. Re-authoring. Subjugated story. * Symptoms are in the relationship, not in the person. Beliefs about an event are insepa rable from how it is experienced. Unique outcomes. You cannot know objective reality.

Dialogical conver sation. * Languaging. Multiversatile. * Non-pathologizing perspective. Philosophical stance. Postmodern theory. * Problem-deter mined system. Problem-organiz ing and problemdissolving system. Socially con structed knowl edge. Stuck system.

Baseline. Behavioral exchange theory. Classical condi tioning. Cognitions. * Discriminative stimulus (cue). * Extinction. Functions. Modeling. * Negative & posi tive reinforce ment * Operant condi tioning. Punishment. * Redprocal inhibi tion. Reciprocity. Successive approximation (shaping). Time-out

Maximize \ , ; func tioning and cop ing ability of all family members. Establish collabo ration among family members. Support Structure. Coping mecha nisms. Learning from the family. Belief that the family can help the patient

values, unconscious behavior. forces and personal Life cycle transition points are significant values. Unresolved family of origin issues. Negative aspects of repressed, introjected early objects are pro jected onto the spouse or children. Attempts at solu tions become the problem. Vicious cycles of mishandled attempts to solve the problem. Family engages in more of the same, maintain ing the problem.

Lack of differenti ation results in marital conflict dysfunction in a spouse, or symp toms of dysfunc tion in one or more children.
-

The trustworthi ness of relation ships breaks down because fairness, caring and accountabili ty are absent

Symptoms main tained by familys unsuccessful problem solving efforts. Inability to adjust to life cycle tran sitions. Dysfunctional hierarchy. Triangulation or coalitions. Increase flexibility. Strategies for developmental change. * Reassert hierar chy. Eliminate prob lem coalitions & triangles.

Family caught up in unacknowl edged dirty game. Problems main tained by behav ioral sequences. Familys old epistemology does not fit its current pattern of behavior. Develop alterna tive episteraology by creating an environment in which new infor mation is intro duced into the family.

* Inflexible structure adapt to i mental m uational i lenges. Rigid or < boundari * Enmesbe engaged ships.

Scapegoat pro vides relief from anxiety. * Difficulty in toler ating interperson al stress. Role and commu nication rigidity. * Intolerance for differences. Symptoms are nonverbal mes sages. Desperation signals readiness for change. Shared experi ence leads to growth. Creativity, spon taneity & play.

Couples hide their actual emo tions and exhibit defensive or coercive emotions leading to nega tive interactions.

The meanings attributed to behavior puts limits on the range of alterna tives that can be applied to the solution. Excessive focus on the problem and limited set of behaviors. Generate solu tions. Creative expan sion of solution behaviors. Learn from exceptions.

Family members partidpation in the problem. Internalization of the problem. Family unable to distinguish prob lem in time.

* Problems are maintained in language by a problem-deter mined system. The view of the problem hampers any successful means of resolu tion.

Maladaptive, symptomatic behaviors are learned respons es, involuntarily acquired and reinforced.

Family has beea hurt by insensi tive professionals. Need for informa tion and educa tion. Learn different coping strategies. Anxiety and grief render the lamah dysfunctional.

Increasing the ability to distin guish between thinking and feeli. ing within self and others. Use f this skill to direct | ones life and V solve problems.

A preventative plan for current and future gener ations. Restore peoples capacity to give thru fair relating and trust.

Expression of repressed objects. Resolution of neg ative aspects of repressed objects. Individuation. Detachment from the bad object

Change the complimentarity, interdependent nature of the symptoms. Change sequences by identifying the viscious cyde.

* Reorgaa family s* * Clear aa booadac berweea tems. * Funcboa tive pata assist di

Helping the cou ple to access their actual emotions, altering negative interactional sequences, and enhancing the emotional bond.

Family members realize partidpa tion in the prob lem. Time is col lapsed. Finding alterna tive solutions.

Generate new meaning about the problem. Family takes new action to resolve the problem.

Modify spedfic behavior patterns. Rewarding appropriate, adaptive behavior. Change contin gencies of social reinforcement

With edncascc and attention to family needs. family members may learn new strategies to cope with the problem. Change ideas about (leafing with paftrwt.

Bowen

Contextual

Object Relations

MRI Brief

Strategic Haley

Milan Systemic

Structural Experientia l

Emotional - Focused

SolutionFocused

Narrative

Collaborative

CBT

Psychoeducational

* Emphasize extended family. * Entire family need not be present * Use of genogram. * Reduce anxiety Increase differentiation. * Open communication, resolve triangles. Neutral. * Objective. * Coach.

* Unit of treatment is chosen by therapist * Engagement * Cognitive exploration of fam. history. * Alter perceptions. * Expand trust to increase options.*

* Engagement * Projective identification. * Confrontation. * Termination. * Often long terra.

* Setup and definition of the problem. * Identify & interrupt behavior maintaining the problem. * Set goals. * Intervention. * Termination. * Short-term therapy. * Active. * Clients are viewed as customers. * Attend to process over content. * Team and one way mirror often used.

* Initial interview: 1. Social. 2. Problem ident 3. Interactional. 4. Goal setting. * Observation. * Intervention. * Termination. * Short-term therapy.

* Entire family seen. * Pre-session. * Session interview. * Hypothesis testing. * Team discussion. * Therapist presents conclusions. * Post-session. * Short-term theapy.

* Entire family present * Join from p of leaders * Map underb structure. * Interventio n transform ti structure. * Short-term * Active. * Involved. * Leadership.

* Active. * Personal. * Co-therapy. * Relational balances. * Catalyist * Advocate for all.

* Non-directive^ * Observer. * Insight and understanding.

* Active and deliberate. * Join with the family. * Responsible for therapy. * Presenting problem. * Use language of the family. * Observer. * Directives, direct and paradoxical. * Enactment * Feedback. * Pretending. * Ordeals. * Reframing.

* Mixed gender treatment teams. * Neutrality. * Ways to think differently. * Generate hypotheses.

* Gather information. * Increase affect and expressiveness. * Expansion of self. * Termination upon achieving goals. * Satir: making contact, chaos, integration.* Pretreatment, middle, late phases. * Involved & active. * Self-disclosing, warm, responsive, positive. * Consultant * Alternating between provocation and support

* Delineate * Identify

core the negative interaction cycle. * Access underlying interactional positions. * Redefine the problem. * Promote identification with disowned needs and aspects of self * Promote acceptance of each partners experience. * Restructure the interaction. * Generate new solutions. * Consolidate new positions. Unconditional positive regard.

* Initial session: previous solutions, exceptions, goals, tasks. * Later sessions: feedback on tasks, perception of change, exceptions. * Termination: upon reaching goals. * Brief therapy. * Directive. * In control. * Engage in solution oriented con versation.

* Externalizing the problem. * Relative influence. * Collapsing time. * Raising dilemmas. * Setting experiments. * Short-term therapy-

* Therapy is a continuous process. * Focus on language. * Dialogical conversation. * Termination col Iaboratively determined.

* Identification of problem behavior. * Behavioral goals. * Behavioral interventions & homework. * Sympto m removal. * Termination. * Brief therapy.

* Initial interview. * Information star ing. * Other resources. * Assigning tadi. * Respond to prob Iems in family structure.

* Co-create system with the family. * Neither direct nor indirect * Clients have voice in treatment process.

* Multipartial. * Not knowing. * Honor clients reality. * Listener. * Responsive. * Compassionate. * Egalitarian partnership; coexplorer.

* Directive. * Teacher. * Coach. * Model. * Reinforcer.

Active. * Learn from faash. * Direct & empathic. * Provide information. * Brief therapy.

* Process over content * Genogram. * I position. * Detriangulation. * Create therapy triangle. * Often long term.

* Multidirectional partiality. * Listening. * Observing. * Responding to unconscious material. * Therapist decides whom to see. * Couple therapy is not separate modality. Focus on family resources. * Observations made on aO 4 dimensions. * Assessment is an ongoing process. * Developmental stage and interpersonal Ioy allies lead to beliefs. * Triangles assessed.

* Listening. * Observing. * Responding to unconscious material. * Interpreting. * Developing insight

* Self-reports. * Level of differentiation use of scale. * Degree of cut-off. * Level of family anxiety and reactivity. * Triangles.

* Self-report * Family of origin history. * Defensive system of the family. Individuation. * Intrapsychic material.

Most motivated person in system. * Symptom-focused. Tasks. * Paradox & reframe. Encourage interaction. Observe sequences. Define maladaptive sequences. * Problem resolution. * Non-historic. * Symptomfocused. * Sequence of symptom-main taining behaviors. Instances of circu lar causality.

* Hypothesizing. * Circularity. * Neutrality. * Invariant prescription. * Rituals. * Paradox. Positive Connotation.

* Joining/acc t dating. * Diagnosing. * Modify intes tions. * Boundary * Unbalancing * Challenging * Enactments * Reframing. * Tasks. * Paradox. Family stra System flerij Family maf Enmesh me disengages Family life < Family dew mental staf Observatia session.

Metaphor. In-session interaction. Sculpting (Satir). Family reconstruction. Parts Party (Satir). Temperature reading.

Changing interactional positions.

Complimenting. Formula first-session task. Scaling questions. Miracle question. More of the same.

Non-historic. Family life cycle transition points. Self-report Observing family ineractions.

Information learned before meeting is used in formulating the hypothesis. Hypothesis leads directly to interventions.

Degree of anxiety. Battles for Initiative & Structure. * Therapists own feelings. * Degree of separateness; ability to play. Intergenerationa l themes & life cyde. Desire for change.

Delineate the issues presented by the coup and assess how these issues express core conflicts in the areas of separateness-connectedness and depen denceindependence. Identify the negative interaction cyde. Access unacknowledged fedings underlying interactional positions

* Identify solutions. * Can family identify exceptions? * How does the family answer the miracle question? * Can family follow thru on interventions? * Degree of focus.

Questions and summaries. Externalizing problems. Dilemma questions. Escape meetings. Note taking/sharing. Landscape of action & meaning questions. Certificates. Therapeutic letters. * Familys experience of the problem. * Language of the family. * Ways that family members participate in the problem.

* Conversational questions. * Not-knowing approach. * Reflecting Team. * Shared inquiry.

* Shared inquiry. * Presentation of problem by client system. * Conversational questions utilized in assessment.

* Operant techniques (shaping, token economy, contingencies) * Respondent con ditioning (desen sitization, assertiveness, aversion). * Cognitive affective (thoughtstopping, rational emotional). Function of * Parenting training maladap tive and contracts. behaviors. Sequences with embedded problems. Interview/self-report Observation of problem-solving & communication. Functional analysis of behavior.

* Remo e Miw * FjiwinrapF * Contracting. * Survival Sk3b Workshop. * Training with family. * Lowering expectations.

History of the problem

* Evaluate fiat's understands^ :/ * Evaluate bash i needs for iafor maticn. Evaluate attempts at