Systemic Family Therapy
This is one model used in Hesed House and its underlying theoretical frameworks for therapy described as systemic, social constructionist, and narrative (Carr, 2000). These theoretical frameworks underpinned a style of practice in which clients are invited to tell their stories and therapists focus on shaping the conversational architecture to help clients re-author their personal and family narratives.
The aim of this style of therapy is to help clients construct more liberating personal narratives that empower them to resolve their presenting problems and concerns. Therapists used a range of general therapy interventions in their practice including the following:
- Utilising a systemic, network or relational approach in addressing problems and solutions
- Connecting client problems and strengths to their social systems and stories or narratives
- Connecting clients’ past and present, and looking for patterns related to problems and exceptions to these problems
- Using genograms and family of origin work to understand problems, exceptions to these, and family strengths
- Using drawings and stories in age-appropriates way to help children engage in therapy
- Externalising problems to help clients see themselves as separate from their difficulties
- Engaging in a collaborative approach and following client’s lead
- Maintaining a position of neutrality and respectful curiosity
- Examining the therapist’s own role in the therapeutic relationship when therapeutic progress stalls
- Inviting clients to complete therapeutic tasks between sessions
- Carefully managing the pacing of therapy, the frequency of sessions and the overall duration of therapy to fit with client needs
Specific Therapist Skills and Strengths
The therapists described a number of specific therapeutic skills and professional strengths that they applied in their clinical practice. These are presented below.
- Taking a collaborative respectful approach
- Taking a curious position in therapy of ‘not knowing’ about the fine-grained details of clients lives and really trying to fully understand the world from the clients’ perspective
- Having an up-to-date understanding of literature and research in systemic therapy as a basis for introducing new perspectives into the therapeutic conversation
- Having special expertise with particular client groups, such as couple work, working with middle-aged women, or adolescents.
- Connecting or engaging with clients and maintaining a strong therapeutic alliance
- Understanding and containing ambivalence and conflicting positions expressed by individual clients and by different family members
- Empowering clients to facilitating change
- Bringing a mixture of education and street credibility to the therapeutic process
- Using humour in therapy and engaging with clients at a warm or human level
- Getting ‘on the floor’ with children and engaging them in the therapy process
- Integrating therapeutic techniques from other types of therapy into systemic practice
- Creating a climate of openness in the therapeutic relationship
- Tailoring therapy to meet the unique needs of specific clients (Carr 2004)
The humanistic approach began in the 50s and 60s in the US and was a counter to the pathology-based view of the person, the determinism of Freudian psychodynamics & the mechanical nature of Skinner’s behavioural psychology.
It draws very much from the field of existential philosophy and holds that people are essentially free and responsible for their own condition. Therefore it believes people are neither driven by their unconscious nature as Freud would have said and neither were they merely a product of what they had learned which behaviourism mooted.
In essence this psychotherapeutic approach sees people as ‘agents’ of their own destiny, that we each have consciousness and it is this which enables us to determine our own path and to decide what is best for us. Therapists in this approach believe people strive for truth and are trustworthy, are resourceful, capable of self-understanding and self-direction and are able to make constructive changes. When the therapist provides the facilitative conditions and emotional climate then clients will be able to unravel the personal history which he/she has constructed around his/her own experiencing and then change can occur.
Humanistic psychotherapy acknowledges that an individual is strongly influenced by their ongoing inner processes and in their relationship with their external environment, specifically the society in which they live. Humanistic therapy holds a hopeful, constructive view of human beings and the individual’s substantial capacity to be self-determining and self actualising. By and large, this can involve working with any past events that are presented during a session as being still present and needing to be overcome therapeutically through fuller engagement with the present experience of them.
The humanistic therapeutic approach recognises that at the core of the growth and healing process is the ability for a client to experience him/herself in relationship with another in a safe and nurturing environment. So the core of Humanistic therapy is the provision of such ahealing relationship, where the client experiences a safety which permits them to remove their defences.
The focus here is in allowing the client to experience themselves in an authentic way and to go further by trusting themselves to determine the direction of their own healing, growth, and self-actualisation. This leads onto a client then learning to trust in their relationship with their external environment.
The work of the therapist in this is to provide a safe relationship which is sensitive enough to whatever woundedness makes itself present, and which is containing enough of whatever defensive behaviour manifests itself, and which is present enough to the true nature of the person of the client as this unfolds. This latter is understood in Humanistic therapy as appearing with no preceding blueprint but is always new and mysterious in its description with each new client, and even with each new client session.
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