instructor’s manual and test bank for the essentials of family therapy 7th edition by michael p nichols
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Instructor’s Manual and Test Bank
For
The Essentials of Family Therapy
Seventh Edition
Michael P. Nichols, College of William and Mary
Sean D. Davis, Alliant International University
Prepared by
Michael P. Nichols, College of William and Mary
ISBN-10: 0-13-517097-4
ISBN-13: 978-0-13-517097-7
,Table of Contents
Introduction. Becoming a Family Therapist 1
Chapter 1. The Evolution of Family Therapy 7
Chapter 2. Basic Techniques of Family Therapy 19
Chapter 3. The Fundamental Concepts of Family Therapy 28
Chapter 4. Bowen Family Systems Therapy 40
Chapter 5. Strategic Family Therapy 53
Chapter 6. Structural Family Therapy 69
Chapter 7. Experiential Family Therapy 81
Chapter 8. Psychoanalytic Family Therapy 93
Chapter 9. Cognitive-Behavioral Family Therapy 106
Chapter 10. Family Therapy in the Twenty-First Century 117
Chapter 11. Solution-Focused Therapy 136
Chapter 12. Narrative Therapy 143
Chapter 13. Comparative Analysis 152
Chapter 14. Family Therapy Research 172
Answer Keys 181
iii
,Introduction. Becoming of Family Therapist
Learning Outcomes
1. Explain how unresolved family conflicts can complicate an identified patient’s problems.
2. Describe how the culture emphasis on individual achievement may obscure our fundamental
connectedness to each other.
3. Compare the value of individual therapy to family therapy.
INTRODUCTION
Family therapy isn’t just a new set of techniques; it’s a whole new approach to
understanding human behavior -- as fundamentally shaped by its social context.
SUMMARY OF KEY POINTS AND ISSUES
The Myth of the Hero
While our culture celebrates the uniqueness of the individual and the search for an
autonomous self, we cannot deny our inescapable connection to our families. We do many
things alone, but we are defined and sustained by a network of relationships. Yet when we think
about families, it’s often in negative terms. Talk of “dysfunctional families” often amounts to
little more than parent bashing. People feel controlled and helpless not because they are victims
of parental failings, but because they don’t see past individual personalities to the structural
patterns that make them a family.
Psychotherapeutic Sanctuary
The two most influential approaches to psychotherapy, Freud's psychoanalysis and Carl
Rogers's client-centered therapy, were predicated on the assumption that therapy should be
conducted in private, isolated from stressful relationships. Problems were thought to arise from
interactions with others and were best alleviated in a confidential relationship between patient
and therapist. In some ways, psychotherapy displaced the family’s function of resolving the
problems of everyday life.
Family versus Individual Therapy
Individual therapy helps people face their fears and learn to become more fully
themselves. Treatment is directed at the person and his or her individual make-up. In contrast,
family therapists believe that the dominant forces in our lives are located externally, in the
family. Therapy based on this framework is directed at changing the organization of the family.
Family therapy influences the entire family because every family member is changed -- and
continues to exert synchronous changes on each other.
A family approach is often preferable for treating problems with children, complaints
about relationships, or symptoms that develop around the time of a major family transition.
Individual therapy may be more useful in cases where people identify something about
themselves that they’ve tried in vain to change while their social environment remains relatively
stable.
, Although psychotherapy can succeed by focusing on either the psychology of the
individual or the organization of the family, both perspectives -- psychology and social context --
are useful for a full understanding of people and their problems. Once, therapists were
encouraged to learn models of treatment that focused on either the individual or the family,
because they were considered different enterprises. Today, family therapists treat individuals,
recognize the impact of psychopathology, and see family therapy as an orientation rather than a
technique. Individual therapists recognize the importance of family dynamics and direct their
efforts to understanding and changing patterns of relationships. In short, a good therapist looks
at the whole picture -- barriers in the environment as well as those in a patient’s mind.
The Power of Family Therapy
The power of family therapy derives from including people with a significant impact on
the identified patient and influencing their interactions. Instead of relying of a client's account of
relationship problems, those relationships are brought into the consulting room. Moreover, when
changes are initiated in family therapy, the fact that all family members are included means that
positive changes in each of them can continue to reinforce progress. The downside of this is that
the inclusion of other family members may allow individuals to blame each other for problems
and to quarrel about who is responsible for what. Getting past blame in order to help family
members recognize their own role in family problems is part of the art of family therapy.
Mental illness has traditionally been explained in linear terms, either medical or
psychoanalytic. Emotional distress is treated as a symptom of internal dysfunction with
historical causes. Such linear explanations take the form of A ® B. Recursive, or circular,
explanations take into account mutual interaction and mutual influence, A ¨ B. The illusion
of unilateral influence, or linear thinking, often biases therapists, especially when they only hear
one side of the story. But once they understand that reciprocity is the governing principle of
relationship, therapists can help people get past thinking in terms of villains and victims.
Learning to think in circles rather than lines empowers individuals to look at the half of the
equation they can control. The power of family therapy derives from bringing family members
together to transform their interactions. Instead of isolating individuals from the emotional
origins of their conflict, problems are addressed at their source.
SUGGESTED LEARNING ACTIVITIES
Videos/Films
Salvador Minuchin: Unfolding the Laundry Distributor: AAMFT
Minuchin demonstrates his structural approach with a large blended, recently married, dual-
career family with five stepchildren. The IP is the youngest son (age 11) who is acting out.
Minuchin defocuses attention on the IP, relabels the sibling behavior, and focuses his attention
on the couple. Approximately 147 minutes.
Paul Watzlawick: Mad or Bad? Distributor: AAMFT
In his consultation with a family whose 25-year-old son presents with chronic somatic
symptoms, Watzlawick employs the strategic use of Ericksonian-style questions. The systemic
function of symptoms in protecting the family from other problems is highlighted.
Approximately 136 min.
Luigi Boscolo and Gianfranco Cecchin: What to Call It? Distributor: AAMFT
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,This Milan team consults with a couple and their 27-year-old daughter who has a history of
hospitalizations for delusions and manic depressive symptoms. Pre-, inter-, and post-session
hypothesizing includes beliefs about genetic origins, double binds, incest, and hopes of
priesthood. Therapists demonstrate therapeutic neutrality through a range of historical and
circular questions. Approximately 138 min.
Virginia Satir: Of Rocks and Flowers Distributor: Golden Triad Films
Satir works with a blended family in which the couple has been married for a year. The husband,
a recovering alcoholic, is the father of two boys, ages 4 and 2, who were repeatedly abused by
their biological mother. The children are highly active and violent on occasion. The wife,
abused by her previous husband who was also alcoholic, is pregnant and afraid the boys will
abuse her own child. In a moving segment, Satir interacts only with the two young children--she
has them touch her face gently, reciprocates, and then asks if they would like to do the same with
their parents. Then she gently coaches the parents how to touch and respond to the children.
Following the session, Virginia comments on her use of touching, both in this session and
generally.
Carl Whitaker: Usefulness of Non-Presented Symptoms Distributor: AAMFT
Whitaker consults with a grandmother, mother, and two pre-adolescent sons. The women are
recent widows and the boys were abused by their deceased, alcoholic father. The
intergenerational rules that hypnotize people to act in destructive ways are searched out, as the
family is challenged to deal with issues in a healthier fashion. Approximately 93 min.
Internet Resources
Have students look up two or three of the web sites listed below that feature the field of
family therapy. Instruct students to write a one-page reaction paper outlining the purpose,
nature, and activities of the national organizations in family therapy, major family therapy
training institutions, and publishers in the field of family therapy. Several suggested sites
include:
American Association for Marital and Family Therapy (www.aamft.org): provides resources for
family therapy practitioners, training videos for purchase, instructions on how to become a
student member, licensing requirements, announcements for AAMFT sponsored conferences,
and information on how to make local referrals to AAMFT-licensed practitioners, etc.
American Family Therapy Academy (www.afta.org): provides resources to practitioners, seeks
to promote research and teaching in family therapy, lists information on how to become a
member, etc.
Ackerman Institute for the Family, 49 East 78th St, New York, NY 10021-0405
(www.ackerman.org): lists training conferences, continuing education opportunities, training
materials for rent or for sale, etc.
You might also have students search the Internet and compile a list of the most useful
web sites devoted to family therapy, and distribute the list to each class member for their
resource files.
3
, Discussion Questions
1. What do you believe is necessary for real therapeutic change to occur: a brief but decisive
intervention in a family system or long-term exploration of personality? Some argue that
changes initiated via family therapy are lasting because change is exerted throughout the
entire system--each family member changes and continues to exert synchronous change on
each other. Others assert that long-term, insight-oriented therapy is necessary to prevent a
patient's personality problems from reasserting themselves.
2. The choice of individual versus family therapy can be based on technical considerations
(which approach works best for a given problem--marital conflict, school phobia,
alcoholism) or philosophical point of view (one's understanding of human nature and
behavior, and the therapist's role in treatment). Discuss how your own views of therapy are
shaped by each of these factors.
3. Have students interview a few people and ask them what strategies, successful and
unsuccessful, they have used to try to improve their relationships with important others. As a
class, have students discuss responses to their inquiries and attempt to extract characteristics
of successful vs. unsuccessful relationship strategies.
4. In a family like Holly's, when conflict develops between a child and a stepparent, what is
gained by seeing the problem as triangular (rather than as a result of personalities)? What is
gained by seeing the problem as transitional?
5. Does the myth of the hero (the ideal of heroic individual accomplishment) have a greater
influence on men than on women? To what extent is this changing? What are some cultural
narratives (including novels, television shows, movies) that still support the myth of the
hero? Are certain story lines that feature women as action-oriented heroes opening space for
women or simply casting them into masculine myths?
6. Have the class generate a list of problems for which students believe families typically enter
family therapy. Categorize each problem on the list with respect to locus of the problem
using a scale ranging from 1 (linear causality) to 7 (circular causality). Divide the class into
smaller groups and have each group take a portion of the “presenting problems” and
brainstorm creative ways to translate linear explanations of the problems into circular or
systemic explanations. Reconvene the class and review students’ ideas about how to shift
family members’ constructions of presenting problems from linear/intrapsychic to
systemic/interpersonal.
7. How could a family systems perspective be incorporated into the treatment offered at a
college counseling center?
8. Ask students what is “a family”? Hopefully what will emerge is something about a group of
people organized is such a way that the properties of the whole go beyond a collection of
individuals. Then ask what is “psychotherapy”? What should emerge is some notion that
psychotherapy (as opposed to counseling) involves some kind of transformation. Family
therapy, therefore, is a process that considers the family as a group with superordinate
properties and attempts to produce change in the organization.
4
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