Family Therapy Theories
Working with families involves education, guidance, and counseling to help in coping with various health issues. Families always need education to help in understanding the health problems faced and how to effectively manage them. Family therapies are based on theories that describe the structure and the process of providing treatment. The goals of family therapy using these theories include solving family problems, handling special family situations, and creating a better functioning home environment (Varghese et al., 2020). This discussion analyzes modern and postmodernist family therapy theories and their impact on families.
Relevant Concepts of Theories
Bowenian Family Systems Theory
Bowen family systems theory is a theory that sees the family as an emotional unit and uses the system’s thinking to describe its complex interactions. The theory is based on eight interlocking concepts used to manage anxiety through the facilitation of awareness in the family. The first concept is the emotional fusion and differentiation of self whereby the emotions of an individual are set aside to achieve harmony in the family (Erdem & Safi, 2018). Bowen acknowledged that it is difficult to achieve emotional differentiation in one’s lifetime.
The second concept describes triangles in the family to represent the smallest stable relationships observed during anxiety. For instance, a two dyad may exist in a family but can become unstable when anxiety is present. In such circumstances, a third party is required to help in reducing overall anxiety in the family. The third concept focuses on the family projection process where anxiety can be transferred to the child due to unstable relationships (Ahluwalia et al., 2018). Another concept is the multigenerational transmission process which causes behaviors to be passed to lower levels.
The emotional cutoff is a concept that represents conflict or anxiety management in the family through distancing from other members. Bowen described that this approach can be used to reduce tension and stress in relationships. Sibling position is a concept that describes the role of the oldest family members to assume specific roles when family issues arise. For example, older children may be forced to act like adults or role models when conflict arises. The last concept is the nuclear family emotional process which describes conflict levels in the family. Bowen demonstrated that problems exist in four main areas including intimate partner conflict, problematic behaviors or concerns in one partner, emotional distance, and impaired functionality in children.
Narrative therapy is a psychological approach that seeks to adjust stories about one’s life to bring about the better mental health of an individual. The theory was developed by Michael White and David Epston to help individuals to adjust to positive changes in their lives (Monk & Zamani, 2019). Narrative therapists believe people are shaped by the stories they tell about their lives. The therapy is based on four concepts well known as principles that guide one’s story. The first principle is that reality is socially constructed. It is observed that the way we interact with people influences what is perceived as reality.
The second concept of the therapy is that reality is influenced by language. The interpretation of reality is dependent on how people communicate and sometimes people make different interpretations of the same event. The third principle is that having a narrative can help one maintain and organize reality. People are more likely to make sense and meaning in life when a story exists. The last concept in the narrative theory is that objective reality does not exist. People are observed to have different realities from the same experience and what might be true for one person can be false for someone else.
Historical Impacts of Theorists
Bowenian Family Systems Theory
Bowen’s model of family therapy is recognized as the most distinctive for its depth of evaluation beyond symptoms. The theory has been adopted and developed by many prominent therapists in an attempt to solve problems in families. Bowen provided therapists with a platform to engage families in counseling using various steps that are used to date. According to Bowen, stage one of therapy provision aims at reducing the client’s anxiety about symptoms (Rodríguez-González et al., 2019). The therapist encourages the patient and the family to learn about symptoms to promote acceptance. This approach has given modern therapists a platform to begin counseling and management of family issues. Secondly, Bowen describes that therapy should focus on adult clients to enable them to deal with self issues to promote togetherness in the family.
Bowen’s concepts have also helped in designing conflict management without involving children. The detriangling maneuver has been adopted to ensure adults take the place of children in conflict to promote understanding. Bowen’s theory has been used since the early 1980s by the likes of Carter and McGoldrick to include attention to the family life cycle (Rodríguez-González et al., 2019). Therapists have also learned to acknowledge the impact of gender, race, and ethnicity on the family’s progression through life cycle stages. This means that families are now able to critique the roles they occupy in relationships to promote better understanding.
The narrative therapy theory was developed by Michael White, an Australian social worker and family therapist. Throughout the construction of the theory, the theorist explained various techniques used to solve problems that are even used today. For instance, constructing a narrative is a technique where the therapist enables the client or the family to describe the story in their own words. The re-storying process helps individuals make new meanings from their stories. Secondly, white enabled therapists to engage in a critique of situations to come up with an understanding of their happenings. The approach has turned out to be effective in managing patients with conditions such as depression to achieve unique outcomes.
Narrative therapy focuses on dominant stories that seem to get into an individual’s way of life. These stories are used to define relationships and understanding them helps individuals to get a sense out of it. Michael White introduced to the medical field how post-structural ideas could practically be applied to therapeutic conversations. Through his text on ‘Maps of Narrative Practices’ and ‘Narrative Means to Therapeutic Ends’ Michael’s work brought forward a new wave of ideas that revolutionalized family therapy (Suddeath et al., 2017). Another contribution of Michael White was on the issue of identity whereby he was interested in people telling a story about themselves. This part led to the concept of externalizing the problem which is used by therapists to separate the problem from the person.
Role of Family Therapist
Family therapists help families during the management of mental disorders by assuming an array of functions. These therapists meet with individuals or the entire family members to assist in establishing functional relationships. The primary role of the family therapist is to meet and discuss the family issues interfering with their lives (Messina et al., 2018). While addressing these issues, the therapist understands that the goal is to address emotional and mental issues affecting the family. The roles of the family therapist can sometimes differ depending on the family therapy theory in use.
Bowenian Family Systems Theory
The Bowenian theory explains how families develop and function through the balance of the individual and togetherness forces. Bowen believed that the development of a family occurs when family members are differentiated, feel little anxiety, and when they maintain healthy emotional contact. While providing care to the family, the therapist understands that the family patterns and emotions are important than the problem. Therefore, the therapist tries to lower anxiety to promote understanding in the family. Lowering the anxiety without focusing on the problem ensures that the issue is buried leaving less room for future conflicts.
A family therapist in Bowenian theory remains neutral and detriangulated during problem-solving. For example, conflict resolution between two parties in the family does not require taking sides but enabling the members to understand their differences. However, the therapist can help the family differentiate because a single member can spur changes in a larger family (Messina et al., 2018). While solving the family issues, the development of personal relationships is crucial to encourage forming of stronger bonds for effective control of the situation. Additionally, the therapist coaches and consults with the family and models skills to build the family for the future.
Narrative therapy seeks to adjust the stories one tells about one’s life to bring about positive change and better mental health. Narrative therapy sees families or individuals as experts on their own. People are viewed as separate from their problems and this makes it the central focus of the therapist. The position of the therapist is to help families work on their issues without blaming any party. Different approaches can be used by the therapist at this point including constructive narrative, externalization, and deconstruction. In the constructing part, the therapist’s role is to help the patient make new meaning in their stories.
Externalization is a technique that involves changing the client’s perspective of issues. During therapy, the therapist’s role is to ensure that individuals no longer see themselves as problematic. The therapist works to separate the personality of the individual from the problems observed. Lastly, the therapist works to challenge the family and individuals to establish unique outcomes through the utilization of opportunities. There is an encouragement to utilize small opportunities to make great changes in their stories.
Bowen family system’s theory is an approach to family therapy that emphasizes the importance of understanding relationships and family backgrounds. The theory views the family as an emotional unit where a change in one’s behavior affects the functioning of others. Narrative therapy is another approach to problem-solving that describes people as experts in their lives. The theory is mainly based on the idea of separating the problem from an individual. These two theories portray differences in the counseling approach and the changes made to an individual during problem-solving.
Bowen’s theory is the most common and widely used approach to problem-solving in families. The theory is observed to involve two main forces; togetherness and individuality which determine the course of therapy. On the other hand, Narrative therapy is based on three main components that determine the establishment of relationships with clients. The components include respect for the client, non-blaming during counseling, and seeing the client as an expert (Monk & Zamani, 2019). Regarding these concepts, the narrative therapy approach views the family or individual as a collaborative partner. The therapist’s role is to explore the challenge and help the family achieve positive outcomes.
The second difference between the two theories can be observed in the key concepts stressed. Bowen’s theory discusses eight key concepts including differentiation of self, triangles, nuclear family emotional process, the family projection process, multigenerational transmission process, sibling position, emotional cut-off, and societal emotional processes (Monk & Zamani, 2019). These processes link the purpose of therapy to the evolution of society. They closely emphasize the role of relationships in the family in promoting emotional and mental health. Narrative therapy, on the other hand, has four key concepts including the social construction of reality, the role of language in influencing reality, having a narrative and objective reality. All these concepts revolve around the idea of stories and how they are interpreted by individuals.
The Bowenian theory is a suitable approach to family therapy when individuals do not want to involve other family members. The theory explains how learning to become less emotionally reactive in family relationships helps in solving family issues. Narrative therapy differs in this approach because, in its deconstruction approach, people gain clarity in their story sharing. This also means that narrative therapy is dependent on sharing of information and can be effective in solving psychiatric problems such as depression, anxiety, and anger (Jafari et al., 2016). However, failure of the patient to share information or discuss their stories will lead to unproductive sessions. Bowen’s approach is observed to be more applicable in issues originating from a family. Studies demonstrate that the theory is effective with families, couples, and individuals.
There is a difference observed in the type of individuals involved when using the narrative and Bowenian therapy theories. The Bowenian theory tends to keep children away from the process of problem-solving. The adults are more involved because they are more influential in the family (Erdem & Safi, 2018). The narrative theory does not exclude any individuals from therapy. It stresses the importance of telling stories and separating the problem from the person. Another difference observed is the role of the therapist in realizing change when using the two therapies. The Bowenian therapist gives less attention to specific problems and focuses on family patterns of emotions. The narrative therapist works to help individuals challenge their problems and also considering alternative stories to their problems.
Bowenian Family SystemsTheory
Bowen’s family systems therapy theory focuses on relationships and their networks in a family. The therapy appears to be effective in managing issues that have family origins alongside other personality issues. The theory has proved to be important in promoting teamwork because individuals work together to find solutions affecting a family. For example, Bowen’s approach has helped to heal broken relationships and solving long-standing problems through the use of different techniques. Another impact of the theory is that it has helped to shape behavior in children. For example, substance use disorder in families is handled using family therapy. The therapist allows the individual to come into reality with the causes and effects of the substance. The family members also reckon on how they have influenced the negative behavior and mutually agree to solve the problem.
Narrative family therapy has proved to be effective in improving outcomes for families and individuals through the idea of telling stories. The basic mechanism involves guiding the individual to put together stories and guiding them to find different meanings from the narratives (Jafari et al., 2016). For example, narrative therapy has proven effective in improving self-esteem among family members or individuals. The therapist allows affected individuals to tell stories and find meaning in their problems. The individuals can understand the unique outcomes that result from changing their stories.
Narrative therapy promotes the use of skills, talents, and strengths of individuals to bring about change. The patients or families are encouraged to look at the upsides of a perceived problem and determine how the problem can be overturned. For example, individuals with marital issues are advised to view the effects of the problem on their marriage rather than the problem itself. The spouse can understand the cause of the problem and consequently rectify the situation. Additionally, narrative therapy allows the family to heal and express anger or hatred (Varghese et al., 2020). Using approaches like the positive psychology program, narrative therapy enables spouses to discover their purpose and value in the problematic marriage.
Family therapy is a form of treatment used to address specific issues affecting the functioning and health of families. The provision of this treatment is guided by theories including Bowenian family systems therapy theory and the narrative therapy theory alongside others. The Bowenian theory holds that individuals are inseparable from their networks or relationships. Eight interlocking concepts are observed to explain family development and functioning in this theory. The narrative theory helps people become experts in their own lives by focusing on the person rather than the problem. It provides a way that individuals share their stories to help in creating new perspectives on their issues. These two theories exhibit differences in their applicability and how problems are perceived and solved by families. The Bowenian theory becomes more effective when solving family and marital issues while the narrative theory is best suited for managing individual problems
Ahluwalia, H., Anand, T., & Suman, L. N. (2018). Marital and family therapy. Indian Journal of Psychiatry, 60(Suppl 4), S501–S505.
Erdem, G., & Safi, O. A. (2018). The cultural lens approach to Bowen family systems theory: Contributions of family change theory. Journal of Family Theory & Review, 10(2), 469-483. https://doi.org/10.1111/jftr.12258
Jafari, L., Hashemian, K., & Mohammadi, A. Z. (2016). The impact of narrative therapy with creative drama on orphan children self esteem. European Psychiatry, 30(S1), 1-1. https://doi.org/10.1016/S0924-9338(15)31272-4
Messina, K. C., Kolbert, J. B., Bundick, M. J., Crothers, L. M., & Strano, D. A. (2018). The impact of counseling on Bowen’s differentiation of self. The Family Journal, 26(2), 150-155. https://doi.org/10.1177/1066480718776197
Monk, G., & Zamani, N. (2019). Narrative therapy and the affective turn: Part I. Journal of Systemic Therapies, 38(2), 1-19.
Rodríguez-González, M., Martins, M. V., Bell, C. A., Lafontaine, M. F., & Costa, M. E. (2019). Differentiation of self, psychological distress, and dyadic adjustment: Exploring an integrative model through an actor–partner analysis. Contemporary Family Therapy, 41(3), 293-303. https://doi.org/10.1007/s10591-019-09493-x
Suddeath, E. G., Kerwin, A. K., & Dugger, S. M. (2017). Narrative family therapy: Practical techniques for more effective work with couples and families. Journal of Mental Health Counseling, 39(2), 116-131.
Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family Interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62(Suppl 2), S192–S200. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_770_19
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