Family Therapy

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Family therapy is a kind of communicational therapy. It has a goal to harmonize family relationships and solve conflicts among relatives. Family counseling is a category of psychotherapy that provides counseling for couples and family members. Such therapy considers tight interfamily connections as an important factor for psychological health. Williams (2003) stated that:

In the field's early years, many clinicians defined the family in a narrow, traditional manner usually including parents and children. As the field has evolved, scholars define the concept of the family in terms of strongly supportive, long-term roles and relationships between people who may or may not be related by blood or marriage. (p. 471)

This methodology is relatively new. “By the mid-1960s, a number of schools of family therapy had emerged. From the groups that experienced the greatest influence of cybernetics and systems theory is MRI Brief Therapy. Later, strategic therapy, Salvador Minuchin's Structural Family Therapy, and the Milan systems model appeared” (Margolin, Gordis, & John, 2001, p. 4). It is more than simply another method of treatment as it is a new way of conceptualizing human problems, understanding their behavior, tracing the development of symptoms and finding an appropriate solution. Various approaches of family therapy have their understanding of the process. They claim that regardless of the nature of the problem, the fact that the family is involved may be beneficial for both sides. Family is a powerful system that has a great impact on an individual. Family relationships are everlasting, dynamic and complex.

Family membership is a kind of relationship that remains for the whole life. Sometimes certain family members are far away for a long time, but they still feel attached to their family. Despite the fact that modern nuclear families often live on their own, far from extended family members, they are still part of the larger multigenerational system, intertwined in their past, present, and anticipated future relationships (McGoldrick & Carter, 2003, p. 3). The feeling of alienation often occurs between relatives. However, even not fully realizing the family membership, individuals understand their particular place in the family structure. Alienation may happen because people feel lonely; they experience incomprehension and rejection from the members of their family (Hagen & DeVries, 2004, p. 88). Moreover, even after the divorce, when a couple decides to live apart, they still have mutual co-parenting (Hirschberger, Srivastava, Marsh, Cowan, & Cowan 2009, p. 412).

When growing  up, family members develop their own identities and begin their development as independent people. However, all of them remain a part of the family group. Family members are dependent on one another. This dependence comprises not only such basic needs as mutual home, food, and clothing, but also include various spiritual assets, for instance, love, care, duty, commitment, loyalty among others. Every family has its history. Some call it ‘family story’ and value every moment in pictures and home videos. Some retell legends about their grandparents. Others  remember only certain parts of memorable moments (Lyons & Sayer, 2005, p. 1051). Every family has its unique past and precious memories to remember.

It is important to understand the behavior of the individual in the context of the family system. Many scholars are too concentrated on personal psychological analysis and underestimate the great impact of the environment (McGoldrick & Carter, 2003, p. 382). The influence of large systems such as race, gender, ethnicity, social class, sexual orientation on the functioning of the family and individual members can be crucial for the process of problem identification and their solution finding. Postmodern thinking introduces us to the importance of language and belief systems in understanding how people construct their view of reality (Goldenberg, 2013, p. 3).

Family is a system in which people are born, grow up and become independent. Despite the fact that the system makes a great influence on individuals, it encourages their personal growth and realization of their potential (Margolin, Gordis, & John, 2001, p. 15). Family gives freedom for exploration and self-discovery.

Many families experience great influence of external problems such as poverty, illnesses, accidents, legal issues, etc. Sometimes when people experience hardships, members of the family can feel not self-sufficient but miserable. In such situation, eternal help may catalyze the problem solving within a family. For example, governmental aid may be much helpful for those families that experience financial hardship. Having enough money, the whole family may feel self-sufficient.

One of the most popular methods of family therapy is interactive. It involves family members into different activities that are going to strengthen interfamily relationships. For example, shared family rituals ensure the family’s identity and continuity (Goldenberg, 2013, p. 5). Various traditions, celebrations, and family activities unite and build relationships between those who belong to it.

It is important for the therapist to take into consideration the family origins of the couples. Although it may seem that problem is individual, the influence of unstated family rules may appear crucial in the development of marriage. Males and females grow up with different senses of entitlement, exercise different degrees of power and have different life experiences, gender shapes of individual identity and expectations (Goldenberg, 2013, p. 12). Men, traditionally, play more powerful roles in the most heterosexual families. Williams (2003) states that “the series of researches and theory on gender, marriage, and mental health suggest that marital status is more important for men's psychological well-being than for women's while marital quality is more important to women's well-being than that of the men. These beliefs rest largely on a theoretical and empirical foundation, established in the 1970s. However, despite those changes in gender and family roles, they have rarely been questioned” (p. 470). However, in the recent decades the role of the women increased greatly. This situation happened because of the increase of women’s employment and different feminist movements. There is a strong need to overcome the stereotypes of gender inequalities and those beliefs that limit stable psychological functioning of both sexes. As a result, gender changes made a great impact on the structure and functioning of the family. Couples redefined gender-linked home responsibilities and changed some sex-defined roles. Gender therapy may appear debatable in the light of different bias related with sex. Some therapists even raise a question whether the gender of therapist may influence the outcome of the therapeutic session. Clients select their therapists only after they have considered different criteria, such as their age, race, religion or sexual orientation. Thus, gender plays one of the most dominant roles. In most cases, gender of the therapist does not appear to influence clinical outcomes. However, other criteria may moderate or mediate the impact of gender (Blow, Tim, & Cox, 2008, p. 19)

For many years, therapists underestimated the role of cultural factors. However, with the increase of immigration, the notion of cultural diversity became essential in our society.  Different cultures have different values, rituals and patterns of behavior.  Sometimes even the definition of ‘family’ differs in meaning in the contexts of various cultures. For example, English definition of family typically focuses on the nuclear family while Italians usually perceive a family as a network of all relatives, including grandparents, aunts, uncles and cousins who are involved in decision-making (Goldenberg, 2013, p. 14). McGoldrick (2003) underlines the importance of taking into consideration all facets of ethnicity, cultural identity, and the heritage of the clients. Therefore, it is easier to distinguish their cultural prejudices and biases (Williams, 2003, p. 476).

Generations within a family have great impact on one another as they move through family cycle stages. Many scholars claim that the family cycle divides every family development into the different stages. People perform specific development tasks on each stage of the development. Ira Glick, Ellen Berman, John Clarkin, and D. S. Rait (2000) developed basic issues of interpersonal relationships, which determine the quality of relationship. The first one is power. This issue comprises different kinds of power from physical to custom. In most cases, couples share power in their relationships. There is general agreement in charge of decisions and whose needs come first in a family. How a couple resolves conflicts makes this factor most important after all. The second is closeness-distance (emotional intensity), the number of shared activities and values. Partners negotiate the type of emotional distance, the one that is close and intimate for them and the one that is too distant. Because different kinds of behavior may connote intimacy for one partner and not the other, they usually are agreed-on behaviors that represent a bid for closeness. The third one is inclusion and exclusion. The couple decides who else belongs to their marital system. This issue refers not only to relatives but also to time that spouses spend on the career and recreational interests. The fourth is marital commitment. Both partners need to feel that they and their spouse are completely committed to the relationship and take the primary position in each other’s lives. The last is intimacy. Partners often vary in their need for verbal sharing, but for most couples, it is an important or essential part of bonding (Glick, Berman, Clarkin, and Rait, 2000, p. 69).

In recent years, therapists have focused their attention on the multisystemic approaches that account for the interactions among the individual, the family and the surrounding cultural community. Families are organized units the members of with are living in continuous interactive, patterned relationships with one another. These relations get extended in time and space (Goldenberg, 2013, p. 90). A change in any component inevitably influences the whole system. The family itself interacts with the larger systems. In the late 1920s Ludwig von Bertalanffy introduced the general system theory. It focused on the relationships between the elements rather than on the elements themselves. The key concepts for understanding the operation of the system are organization and wholeness. The system consists of certain elements that interact with one another according to predictable patterns. A family is like a human body where everyone has particular function. Therefore, understanding dynamic relationships between the components is more important than simply summing them up.

Systems theory proposes that a family is a cybernetically rule-governed entity. Usually members of a family follow well-organized, established patterns, based on a family structure. Those rules characterize, regulate and help the family to function as a unity. In most cases, rules are unstated admissions or prohibitions, family traditions or patterns of behavior (Powers, Pietromonaco, Gunlicks, & Sayer, 2006, p. 613). First who noticed that family interactions follow certain patterns was Don Jackson (1965), a pioneer of family therapy. He observed some challenging situations that occurred after marriage, such as housekeeping, parenting, wage earning and lovemaking. Early in their relationship they begin to exchange their expectations and views regarding one another.

Therefore, family is one of the most crucial factors in the definition of psychological health. Family membership remains forever and modifies patterns of behavior as well as it introduces unstated rules of permission and prohibition. As a system, family has its structure and functions. Counselors should take into consideration cultural and individual facets while examining interfamily problems.

Hope-focused Marriage Counseling

During the last decades, there was a rapid growth of family counseling approaches. That happened due to the postmodern thinking and reevaluation of cultural and spiritual assets. Worthington E. developed a kind of Christian family therapy under the name of hope-focused counseling.

“The goal of hope-focused marriage counseling is to strengthen the marriages and reduce divorces. Hope-focused counseling is briefer than traditional. Although often used, none of the traditional approaches described is an optimal solution for missing values except for under specialized circumstances. These approaches can result in serious biases in a positive or a negative direction, increase behavioral errors, and underestimate correlations” (Acock, 2005, p. 1017). In traditional counseling, most changes occur during the sessions and the duration of such therapy is much longer. After this counseling, the improvement of the marriage either stops or begins to deteriorate slowly. Contrary to traditional families, hope-focused counseling lasts only for approximately ten sessions. In most cases, families who are more disturbed accept the changes faster while those who have minor problems need a long process of integration into the changes (Neff & Broady, 2011, p. 1050).

Hope-focused counseling has six major aspects. First, it is a key to successful and effective counseling. Its goal is to produce stronger, less-troubled marriages. This counseling promotes hope and corrects the weaknesses in valuing love, faith and work.  Its target is to provide change, based on assessment, selected from nine areas of marriage. Hope-focused counseling introduces sensible, powerful, planned interventions that are flexibly employed (Worthington, 2005, p. 28).

Hope-focused counseling searches for hope in the family relationships and encourages them to have enough desire for changes. Many critics of brief family counseling claim that it is impossible to explore deep problems of marriage in less than ten sessions. They state that lasting changes become efficient only when being practiced for a long time. However, hope-focused therapy does not change people by forming habitual behavior and modeling patterns. This methodology serves as a push for self-analysis and decision-making. Many serious changes appeared rapidly. If to take the life of Jesus as an example, we can see that he healed people by telling a few words. Many people believed in one moment, for example, when Peter spoke at Pentecost and over a thousand of people repented.  However, even after rapid changes couple needs a long process of spiritual growth. If to mention the disciples, Jesus taught them for three years before he left them. Marriage is like a life in Jesus, after repentance, you still need to make efforts and develop your relationships with God. The same happens with hope-focused counseling: after some changes had happened in their lives, couple needs to develop their relationships with each other. 

Worthington (2005) claims that hope-focused counseling is based on Scripture values. First, it focuses on love, faith, and work (Gal 6:5). Second, it promotes marital commitment, which is important because the marital bond is often used as a metaphor for our relationship with Christ (1Cor 6:16-17; Eph 5:23-35). Third, it promotes harmony and reconciliation of people who are in conflict (Mt 5:9). Fourth, it promotes love between Christians (1 Cor 13; Rom 12:9-21). The last, it promotes covenantal commitment: the Abrahamic covenant, the new covenant in Jesus’s blood and the marriage covenant. (Worthington, 2005, p.24) 

The author of Hope Focused Marriage Counseling decided to conceptualize the nature of marital troubles for better understanding and deep analyses of the problems. According to Worthington (2005), one of the main reasons of marital conflicts is failure to perform God’s will. Scripture says that each Christian has to make disciples of others (Mt 28:19). Failure to promote the partner’s spiritual maturity within the marriage relationship is a serious Christian problem. Often when one of the partners experience hurt, fear, or sadness, he or she usually does not think about the spiritual development of the other partner but concentrates on his or her own problem. The main task of Christian counselor is to move the partners closer to the Great Commission within their marriage. Another important part of family strategy is commitment. Commitment bases on contract or covenant. The partners’ understanding of their commitment has a profound effect on their marriage. People who treat commitment as contractual may be highly dedicated to their careers, families or friends. Their commitments may last as long as they hold a covenantal view of commitment. They might be willing to sacrifice for the partner.

Worthington (2005) suggests certain steps in counseling. Counselor performs an initial assessment and makes a couple complete an intake form before the first session is organized. This form contains information about the marriage, personal data, history and relationship status, the person’s evaluation of the marriage, the problems that person believes led them to counseling, things that each can do to improve their marriage. Then counselor asks about relationship status (married, engaged or cohabiting). One more issue that is important is marital satisfaction. A counselor may ask partners to indicate the level of their satisfaction with the relationships according to Dyadic Adjustment Scale: extremely unhappy, fairly unhappy, a little unhappy, happy, very happy, extremely happy, perfect. After that, partners list problems that brought them to counseling and identify what they consider as the most serious problem. A good idea is to suggest a couple to point out one thing each can do to improve their marriage regardless of what the partner does.

The first session looks rather an assessment than counseling. The couple describes their problems. During the first session, it is important for the counselor to let both sides speak up their minds and prevent any interruptions of the partners. Written reports of the therapist is an interesting approach of hope- focused counseling. Once investigated, the couple counselor writes a report that consists of several parts: personal data, presenting complaints, relationship, history, relationship strengths, relationship weaknesses, and recommended treatment goals. In such a way therapist involves himself or herself in the story of the couple and partners have an opportunity to not only discuss all the points at the session but also read them at home together. People tend to treat written conclusions more seriously than simple discussions. Practice shows that time spent on writing such reports is worth those changes that happen in families.

In hope-focused counseling therapist must respect the values of clients and reveal his or her important values. Then the counselor affirms the client’s desire to do what is good. After that, he or she encourages them to make good decisions. Then counselor identifies the problems that arise from the client’s values or behaviors. Therapist helps the client examine the evidence of the consequences that will ensue if the behavior continues, including the consequences to the person and to the spouse. Performing these steps, counselor should respect the client’s right to accept the consequences of his or her own value decisions.

Therefore, hope-focused counseling is a brief series of sessions that promote hope and willingness for changes. This method bases on the Scriptures and as a result uses Christian principles and Christian values.  The counselor identifies the nature of the problem and analyses the background and personal data. He interacts with the couple, distinguishes the most serious problems that led partners to counseling. After the series of sessions, therapist provides a written report with clearly stated information that contains beneficial suggestions and goals for the changes. Hope-focused counseling gives hope that strengthens the couple and enables them to make their relationships better. It provokes commitment and desire to work for the welfare of their family.

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