Couple &Family Therapy An Integrative Map of the Territory Jay L Lebow

Introduction  Text is about the essence of working with systems in counseling  System  an assemblage of things or parts forming a complex whole  Examples of Systems  Homeostasis (Lebow, 2014)

History of Family Therapy  Beginning of Psychology  Decontextualized people  Individual as locus & focus of change  Systems Theory Emerges  Bold Declarations  Individuals exist only in context  Either / Or  Both / And (Lebow, 2014)

Current Status of Family Therapy  Marginalized  What programs exist in your community for Family Systems?  Culture  How does our culture effect FT?  Realities of Conjoint Therapy  What makes FT difficult?  Limitations of Training  How well were you trained to work with families? (Lebow, 2014)

Family Therapy  Actually more cost effective  It meets multiple people’s needs  Helps the system to change together  All therapists/counselors should be comfortable with systematic approaches  Who works with families? A study of American psychotherapists found the following percentages…  Couples – 50%  Families – 36%  Exclusively Couples & Families – 7% (Lebow, 2014)

Family Centered Therapies  Still consider cognitions, affect, biology, Etc..  “underlying assumption that families can and should solve problems together” (p. 9)  Even individual problems can be solved by family or with family support  Families are often forgotten (Lebow, 2014)

Types of Family Treatment  Couple/ Family Assisted  Focus is on one individual and helping that person create/maintain positive change with family help  Disorder Specific  Addresses specific problems known to be associated with a certain disorder  Ex: a family program for people with schizophrenia to reduce level of expressed emotion in the home  Couple/Family Focused  The family or couple is the identified patient (Lebow, 2014)

History  WWII Lack of Resources & Severe Psychopathologies  Systems Theory & Cybernetics  Technology  Business/ government  Families & Societies  Biology  Causality is Circular – “Identified Patients” (Lebow, 2014)

History (cont.)  70’s & 80’s  Competition between approaches  Family Therapy entered mainstream discussions  90’s  Feminists  Multicultural Approaches  “Family Resilience”  A positive language shift toward recognizing family strengths rather than failings (Lebow, 2014)

Who to Involve in Therapy  What differentiates a case most appropriate for couple and family therapy from those that have a best fit with another therapy format?  How do you decide?  What limitations exist? (Lebow, 2014)

Answers according to Lebow  All clients are best served through couple and family therapy  Pragmatics  Problem  Availability of Family  Acceptability of Family Therapy  Therapist Skill (Lebow, 2014)

Therapist Skills  Contact with all family members from the time of the first call  Attentiveness to ways of increasing family members interest  Continual vigilance about keeping members involved & participating  All family members are stakeholders  Do we do this?  How do you do this? (Lebow, 2014)

Conclusion  Systems should be a part of everyone’s practice with clients  Family therapy has grown over the last 100 years  Work with systems is “best viewed in the context of pursuing one of many pathways rather than a single method for couple and family therapy” (p. 21) (Lebow, 2014)

How will you integrate a systems perspective or a systems component into your PDE? (Lebow, 2014)

Reference Lebow, J. L. (2014). Couple and family therapy: An integrative map of the territory. Washington, DC: APA books. (Lebow, 2014)