Family Therapy Family therapy is increasingly recognised as one of the evidence based psychotherapies.Incontemporarytherapeuticpractice,familytherapyis helpful across the age span and for distress caused by family conflict, traumaandmentalhealthdifficulties.Becauseofthis,manypsychother- apistsintegrateelementsoffamilytherapywithintheirapproaches. Family Therapy: 100 Key Points and Techniques provides a concise andjargon-freeguideto100ofthefundamentalideasandtechniquesof this approach. Divided into helpful sections, it covers: • Family therapy theory • Essential family therapy practice • Using family therapy techniques • Common challenges in family therapy • Contemporary debates and issues • Self issues for family therapists. FamilyTherapy:100KeyPointsandTechniquesisaninvaluableresource forpsychotherapistsandcounsellorsintrainingandinpractice.Aswell as appealing to established family therapists, this latest addition to the 100KeyPointsserieswillalsofindanaudiencewithothermentalhealth professionals working with families and interested in learning more aboutfamilytherapytechniques. MarkRivettisaUKCPregisteredfamilytherapistandSeniorLecturer and Director of Family Therapy Training at Bristol University. He is the current editor of the Journal of Family Therapy. EddyStreetisaCharteredClinicalandCounsellingPsychologist(BPS) and having spent most of his professional career in NHS Child and Adolescent Mental Health Services he is now working independently. HeisapasteditoroftheJournalofFamilyTherapy,andhaspublished widely on this subject. 100 Key Points Series Editor: Windy Dryden ALSO IN THIS SERIES: Cognitive Therapy: 100 Key Points and Techniques Michael Neenan and Windy Dryden Rational Emotive Behaviour Therapy: 100 Key Points and Techniques Windy Dryden and Michael Neenan Family Therapy 100 key points and techniques Mark Rivett and Eddy Street Firstpublished2009 byRoutledge 27ChurchRoad,Hove,EastSussexBN32FA SimultaneouslypublishedintheUSAandCanada byRoutledge 270MadisonAvenue,NewYork,NY10016 RoutledgeisanimprintoftheTaylor&FrancisGroup,anInforma business This edition published in the Taylor & Francis e-Library, 2010. To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk. Copyright(cid:216)2009MarkRivett&EddyStreet Allrightsreserved.Nopartofthisbookmaybereprintedor reproducedorutilisedinanyformorbyanyelectronic,mechanical, orothermeans,nowknownorhereafterinvented,including photocopyingandrecording,orinanyinformationstorageor retrievalsystem,withoutpermissioninwritingfromthepublishers. Thispublicationhasbeenproducedwithpapermanufacturedto strictenvironmentalstandardsandwithpulpderivedfrom sustainableforests. BritishLibraryCataloguinginPublicationData AcataloguerecordforthisbookisavailablefromtheBritishLibrary LibraryofCongressCataloging-in-PublicationData Rivett,Mark. Familytherapy:100keypointsandtechniques/MarkRivett& EddyStreet. p.;cm. (100keypoints) ISBN978-0-415-41038-0(hbk.) ISBN978-0-415-41039-7(pbk.) 1.Familypsychotherapy.I.Street,Eddy.II.Title.III.Series:100key points. [DNLM:1.FamilyTherapy–methods.WM430.5.F2R624f2009] RC488.5.R5862009 616.89'156–dc22 2009003867 ISBN 0-203-92980-2 Master e-book ISBN ISBN:978-0-415-41038-0(hbk) ISBN:978-0-415-41039-7(pbk) To Leonard who would have told me which were the best points and With heartfelt gratitude to all my teachers Contents Preface xii Part 1 SYSTEMS THEORY 1 1 What is a system? 3 2 The family as a system 7 3 Individuals and systems 11 4 Circularity and interconnection 13 5 Structures and contexts 17 6 Family rules, contexts and meanings 21 7 History and development 23 8 Meaning and time frames 27 9 The life cycle and transitions 31 10 Transitions and stress 33 Part 2 COMPLEXITIES AND MISUNDERSTANDINGS 37 11 Doesn’t systems theory make it sound as if people are ‘things’? 39 12 Doesn’t family therapy ignore the individual? 41 13 What about the ‘self’ of the therapist? 43 14 Doesn’t family therapy ignore the social contexts of families? 45 vii CONTENTS 15 Is family therapy sexist? 47 16 Does family therapy promote what it sees as a ‘normal family’? 49 17 Is there such a thing as one ‘family therapy’? 51 Part 3 BEGINNING THERAPY 55 18 Collaborative integrative ethical therapy model 57 19 Who is the customer? 59 20 Contacting and convening 61 21 Meeting the individuals 65 22 Explaining the process 67 23 Listening to the story 69 24 Capturing everyone’s perspective 73 25 Asking and empathy 75 26 The therapeutic alliance 77 27 Neutrality and the curious position 81 28 Reflection of feeling 83 29 Reflection of interaction 85 30 Tracking interactions 87 31 Establishing the family ideology 91 32 Children and play 95 33 Observation of interaction in the room 97 34 Establishing the family’s position regarding therapy 99 35 Feedback and providing summaries 101 36 Considering external systemic pressures 103 37 Family resilience 105 38 Investigating the family supportive network 107 39 Setting the therapy agenda 109 Part 4 THE THERAPIST’S TECHNIQUES 111 40 Hypothesising and formulating 113 41 Expanding contexts 117 42 Talking about difficult subjects 119 43 Working with blaming interactions 121 viii CONTENTS 44 Constructing a family history narrative – a genogram 123 45 Reframing and positive connotation 127 46 Assessment in family therapy 131 47 Building motivation to change 133 48 Encounter moments and process change 137 Part 5 DEVELOPING INTERVENTIONS 139 49 Circular questions 141 50 Using questions to clarify and expand 145 51 Using questions to open communication 149 52 Using questions to break repetitive patterns 151 53 Using questions to link time – the past and present 155 54 Using questions to link time – the future and present 159 55 Asking questions to place behaviour in a normative context 163 56 Investigating problem-solving solutions 165 57 Making suggestions within questions 167 58 Enactment 169 59 Homework tasks 171 60 Working with family scripts 173 61 Letters to clients 175 Part 6 TECHNIQUES FROM SCHOOLS OF FAMILY THERAPY 179 62 Techniques from the strategic school of family therapy 181 63 Techniques from structural family therapy 185 64 Techniques from solution-focused family therapy 189 65 Techniques from narrative family therapy 191 66 Techniques from attachment-based therapies 195 67 Techniques from psycho-educational approaches 199 ix