FIU Family Week 4 Therapy Case Conceptualization Worksheet

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Please find the instructions and material attached.

Book: Handbook of Social work with groups 2nd edition (Garvin, Gutierrez, & Galinsky

Satir’s Human Growth Model Case Conceptualization
Based upon your readings and the case example, create a
Case Conceptualization (Template) from an empowerment
perspective for this family. Consider the children’s trauma
and abuse history and Betty’s lack of experience with
children, especially abuse survivors.
In Chapter 4, An Empowerment Perspective (Garvin, Gutierrez and Galinsky, 2017), the
author discusses the purpose of group work from an empowerment perspective. The
purpose of groups, from an empowerment perspective, is to “change oppressive
cognitive, behavioral, social and political structures or conditions that thwart the control
people have over their lives, that prevent them from accessing needed resources, and
that keep them from participating in the life of their community” (p. 56).
Satir’s Human Growth Model posits that the client possess the natural inclination toward
growth and the resources for growth. It is the role of the therapist to activate these
tendencies and act as a guide to the process of becoming more fully human.
Case for Satir Human Growth Model Case Conceptualization:
You are a therapist working with a blended family of four, including; Bob and his
pregnant wife Betty, ages 36 and 27 respectively; Bob’s two biological sons with his exwife Marsha 34. Aaron is four and Robbie is three years old. Bob currently has custody
of the two boys related to allegations of abuse by their mother. Bob, Betty, Aaron, and
Robbie have been a family unit for only about a year. While Bob is determined that the
blended family include his two boys, Betty would prefer to leave the family rather than
risk Robbie and/or Aaron harming her unborn baby.
Bob and Marsha were married after dating about 6 months because Marsha became
pregnant with Aaron. Their first year of marriage was hectic with settling in together and
new baby. Neither of their families were very supportive but did live in neighboring
towns. After Aaron’s birth Marsha suffered from post-partum depression. She began
drinking daily while on anti-depressants. After the birth of Robbie, her drinking further
increased and Bob would return from work to find her passed out. It was unclear how
much the boys were cared for and they began to have bruises.
Marsha refused help and Bob filed for divorce and was ultimately given custody of the
boys. However, they were initially living with Marsha until the divorce was finalized. Bob
met Betty about a year later. Betty was 26 and Bob 35 when they moved in together
and now have a baby due in 6 months. Betty is an only child and has supportive
parents. However, this is her first significant relationship and baby. She was fine with
the boys when they were 2 and 3 but as they are getting older and acting out more she
is nervous.
Bob and Betty were raised Christian protestant but do not attend church but are
considering it because of the children. Currently, they both work full time and have not
established a social network for themselves or the boys. Betty’s parents want to be
helpful with the baby but are nervous around Bob’s boys.
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
Chapter 8: Satir’s
Human Growth Model
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
Introduction to Humanistic
Family Therapies




The Satir growth model
Symbolic-experiential therapy
Emotionally focused couples therapy
Internal family systems
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Diane R. Gehart
• Experiential family therapies include four
approaches:
Theory and Treatment Planning in Family Therapy
Lay of the Land:
Humanistic Family Therapies
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Diane R. Gehart
• Targeting emotional transactions
• Warmth, empathy, and the therapist’s use of
self
• Individual and family focus
Theory and Treatment Planning in Family Therapy
Common Assumptions and
Practices
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
SATIR’S HUMAN GROWTH MODEL
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Theory and Treatment Planning in Family Therapy
THE JUICE: SIGNIFICANT
CONTRIBUTIONS TO THE FIELD
• Congruent
• Placator
• Blamer
• Superreasonable
• Irrelevant
• Stances acknowledge or minimize three realities:
self, other, and context
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Five communication stances:
Theory and Treatment Planning in Family Therapy
Juice #1: Communication Stances
• Minimizes self
• People-pleasing tendencies
• Needs less directive therapy methods
Blamer
• Minimizes other
• Needs to increase awareness of others’ thoughts and
feelings
• Direct confrontation often strengthens therapeutic
relationship
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Diane R. Gehart
Placator
Theory and Treatment Planning in Family Therapy
Survival Stances
• Minimizes self and others
• Logic and rules reign supreme
• Therapists must refer to context to gain validity
Irrelevant
• Minimizes self, others and context
• No consistent grounding in self, other, or context
• Must increase ability to recognize thoughts and
feelings of self and others
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Superreasonable
Theory and Treatment Planning in Family Therapy
Survival Stances (cont.)
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Theory and Treatment Planning in Family Therapy
RUMOR HAS IT: THE PEOPLE AND THEIR
STORIES
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• Virginia Satir
• John Banmen
• Maria Gomori
Theory and Treatment Planning in Family Therapy
Significant Contributors
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Theory and Treatment Planning in Family Therapy
THE BIG PICTURE: OVERVIEW OF
TREATMENT
• Status quo
• Introduction of foreign element
• Chaos
• Integration of new possibilities
• Practice
• New status quo
therapy involves going through stages several times
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Stages:
Theory and Treatment Planning in Family Therapy
Six Stage Model of Change
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Theory and Treatment Planning in Family Therapy
MAKING CONNECTION: THE
THERAPEUTIC RELATIONSHIP
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• People naturally tend toward positive growth
• All people possess the resources for positive growth
• Everything impacts and is impacted by everything
else
• Therapy is a process involving interaction between
therapist and client; each person is responsible for
him/herself
Theory and Treatment Planning in Family Therapy
ASSUMPTIONS OF SATIR’S GROWTH MODEL
Therapeutic presence: warmth and humanity
Making contact
Empathy
Conveying hope
Establishing credibility
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Diane R. Gehart





Theory and Treatment Planning in Family Therapy
The Therapeutic Relationship
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Theory and Treatment Planning in Family Therapy
THE VIEWING: CASE CONCEPTUALIZATION
AND ASSESSMENT
• Symptom has a role in the family system
• Example: child’s exaggerated acting out may
serve to reduce tension in marriage by getting
parents on same page.
• If the therapist can understand how symptom makes
emotional sense, it will be easier to help find ways to
interact successfully
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Diane R. Gehart
Emotional Role of Symptom
Theory and Treatment Planning in Family Therapy
Role of the Symptom in the System
• Power struggles
• Parental conflicts
• Lack of validation
• Lack of intimacy
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Diane R. Gehart
Problematic family dynamics typically involve
Theory and Treatment Planning in Family Therapy
Family Dynamics
• Each person’s role in family is assessed to understand
the function of the problem
• Possible roles:





The martyr
The victim or helpless one
The rescuer
The good child or parent
The bad child or parent
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Diane R. Gehart
Roles
Theory and Treatment Planning in Family Therapy
Family Roles
• Births and deaths
• Important family events: marriages, moves, tragedies,
major illnesses, job loss
• Important historical events: wars, natural disasters,
economic downturns
• Gives both therapist and client insight into the
context of the problem as well as strengths and
resources might exist
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Diane R. Gehart
• Timeline that includes major events in individual’s or
family’s life
Theory and Treatment Planning in Family Therapy
Family Life Chronology
• When the child is experiencing difficulty, the therapist
considers how the nurturing function of these relationships
can be improved
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Diane R. Gehart
• Child, mother, and father and quality of relationship
between them
• In this primary triad a child learns how to be human
• The triad should serve as nurturing system for child
Theory and Treatment Planning in Family Therapy
Survival Triad






Behavior
Coping
Feelings
Perceptions
Expectations
Yearnings
• Helps clients transform their feelings about
feelings to make change
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• Layers of the iceberg:
Theory and Treatment Planning in Family Therapy
Six Levels of Experience: The Iceberg
• Better indicator of happiness than self-esteem
• As self-compassion and self-worth rise
• Become more realistic and tolerant of their own and
others’ weaknesses
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• Consider aspects of the self that the client values and
aspects of which he/she is ashamed
• Self-compassion
Theory and Treatment Planning in Family Therapy
Self-Worth and Self-Esteem
• The way the body is used indicates a person’s
communication stance:





Congruent communication: open and relaxed body postures
Placating: timid and reserved postures
Blaming: pointing, angry, and stiff postures
Superreasonable: cold and distant postures
Irrelevant: hyper and distracted
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• How emotional issues may be manifesting in the
body, either symbolically or functionally
Theory and Treatment Planning in Family Therapy
Mind-Body Connection
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Theory and Treatment Planning in Family Therapy
TARGETING CHANGE: GOAL SETTING
• Achieve optimal realization of a person’s full
potential
• Two sets of practical goals for treatment
planning:
• Relationally focused goals: congruent
communication
• Individual focused goals: self-actualization
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• The goal is transformation
Theory and Treatment Planning in Family Therapy
Targeting Change: Goal Setting
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Theory and Treatment Planning in Family Therapy
THE DOING: INTERVENTIONS
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• Therapist’s self
• Ingredients of an interaction
• Facilitating emotional expression
• Softening family rules
• Communication enhancement
• Sculpting or spatial metaphor
• Touch
Theory and Treatment Planning in Family Therapy
Interventions
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Theory and Treatment Planning in Family Therapy
INTERVENTIONS FOR SPECIAL
POPULATIONS
• Group psychodrama; used to allow clients to
safely explore unresolved family issues and life
events
• Parts party
• Group activity similar to family reconstruction,
involves client identifying group members to
represent aspects of the self
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• Family reconstruction
Theory and Treatment Planning in Family Therapy
Interventions – Special Populations
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Theory and Treatment Planning in Family Therapy
WORKING WITH DIVERSE
POPULATIONS
• Used commonly in the LGBTQ community
• Focus is on the burden of societal rejection when
being the authentic self
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• Cultural, ethnic, and gender diversity:
• The therapist must be aware of cultures that
have different attitudes towards emotional
expression
• The therapist adjusts to the clients’ level of
intimacy
• Sexual diversity:
Theory and Treatment Planning in Family Therapy
Working with Diverse Populations
• Targeting emotional transactions from the
interactional patter
• Therapists use warmth, empathy, and self to
facilitate desired change
• Communication stances
• Give the therapist sense of how to most effectively
communicate with the client
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Diane R. Gehart
• Combined main ideas from systemic and
Humanistic theories
Theory and Treatment Planning in Family Therapy
In Conclusion
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Diane R. Gehart
• Internal Family Systems: www.selfleadership.org
• Satir Global Network (formerly AVANTA). Includes links to
training institutes in Asia, Europe, and South America:
www.avanta.net
• Satir Institute of the Pacific (John Banmen:)

Homepage


• Satir Institute of the Rockies:
http://www.satirtraining.org
• Satir Institute of the Southeast:
http://www.satirinstitute.org/
• Satir Training Centre Ottawa:
http://www.satirottawa.ca/main/
Theory and Treatment Planning in Family Therapy
Online Resources
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Theory and Treatment Planning in Family Therapy
Chapter 9:
Symbolic-Experiential &
Internal Family Systems
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Theory and Treatment Planning in Family Therapy
SYMBOLIC-EXPERIENTIAL THERAPY
• “Therapy of the absurd,” highlighting
unconventional and playful wisdom
• Focused on emotional process and family
structure
• Adamant about balancing strong emotional
confrontation with warmth and support
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• Developed by Carl Whitaker
Theory and Treatment Planning in Family Therapy
In a Nutshell: The Least You Need to Know
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Theory and Treatment Planning in Family Therapy
THE JUICE: SIGNIFICANT
CONTRIBUTIONS TO THE FIELD
• Should be won by the therapist, who sets
boundaries and limits for therapy
• Battle for Initiative:
• Needs to be won by the client
• Therapists should never work harder than their
clients
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• Battle for Structure:
Theory and Treatment Planning in Family Therapy
The Battle for Structure and the Battle for Initiative
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Theory and Treatment Planning in Family Therapy
RUMOR HAS IT: THE PEOPLE AND
THEIR STORIES
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Diane R. Gehart
• Carl Whitaker
Theory and Treatment Planning in Family Therapy
Significant Contributors
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
THE BIG PICTURE: OVERVIEW OF
TREATMENT
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Diane R. Gehart
• Known as “therapy of the absurd”
• Employs specific form of absurdity for specific purpose
• Absurdity used to perturb the system in a compassionate
and caring way
• Sometimes “caring” means speaking a truth no one else
will, but the therapist conveys caring behind brutally
honest comments
Theory and Treatment Planning in Family Therapy
Therapy of the Absurd
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Theory and Treatment Planning in Family Therapy
MAKING CONNECTION: THE
THERAPEUTIC RELATIONSHIP
• Therapist strives to be authentic
• Doesn’t follow professional pretenses or follow what is
considered appropriate boundaries
• Personal Integrity
• Willingness to stand up for personal beliefs
• Therapist’s Responsibility
• Pushes clients to accept full responsibility for their own lives
• Stimulating Mutual Growth
• The therapist and client grow together through authentic
encounter
• Use of Co-therapists
• Provides a balance of support and challenge
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• Therapist’s Authentic Use of Self
Theory and Treatment Planning in Family Therapy
The Therapeutic Relationship
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Theory and Treatment Planning in Family Therapy
THE VIEWING: CASE
CONCEPTUALIZATION AND ASSESSMENT
• Relies on in-the-moment authentic encounters to
directly experience the other in a holistic way
• Therapists focus primarily on family’s emotional
system rather than behavioral interactions
• When sensing triangles, they focus on emotional exchange
between parties rather than actions
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Authentic Encounters
Theory and Treatment Planning in Family Therapy
Authentic Encounters and the Affective System
• Observing how the family responds to the therapist’s
interventions and interactions
• How It Works
• Understand person’s preferred family roles, values,
developmental/family histories, and interactional patterns
• Two broad patterns:
• Structural organization of family
• Emotional processes and exchanges within the family
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• What It Is
Theory and Treatment Planning in Family Therapy
Trial of Labor
• Permeable boundaries within the family
• Clear boundaries with extended family and larger
systems
• Role flexibility
• Flexible alliances and coalitions
• Generation gap
• Gender-role flexibility
• Transgenerational mandates
• “Ghosts”
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Structural Organization
Theory and Treatment Planning in Family Therapy
Assessing Structural Organization









Differentiation and individuation
Tolerance of conflict
Conflict resolution and problem solving
Sexuality
Loyalty and commitment
Parental empathy
Playfulness, creativity, and humor
Cultural adaptation
Symbolic process
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Emotional Process
Theory and Treatment Planning in Family Therapy
Assessing Emotional Process
• Emphasize strengths, competencies, and resources for
change
• Families viewed as highly resilient and resourceful
• The therapists’ focus is on activating these resources
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Assessing Families
Theory and Treatment Planning in Family Therapy
Focus on Competency
• Symptoms develop when dysfunctional structures and
processes persist over time
• Healthy families experience periods of dysfunction but do not
become chronic
• Persistence of dysfunction can occur over generations
• Offspring feeling obligated to adhere to family myths and legacies
or make up for prior losses
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How It Works
Theory and Treatment Planning in Family Therapy
Symptom Development
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Theory and Treatment Planning in Family Therapy
TARGETING CHANGE: GOAL SETTING
• Increase family cohesion
• Promote personal growth
• Expand the family’s symbolic world
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Three Long-term Goals:
Theory and Treatment Planning in Family Therapy
Goal Setting
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Theory and Treatment Planning in Family Therapy
THE DOING: INTERVENTIONS
• Confusion and disorganization breaks family out of rigid
interaction patterns
• Can be created with:
• Absurd comments
• Role reversals
• Appealing to universal principles at odds with family beliefs
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How It Works
Theory and Treatment Planning in Family Therapy
Creating Confusion and Disorganization
• Therapists use present-moment interactions and their
own affect to promote change
• “Nothing worth learning can be taught”
• Immediacy is used to highlight and redirect structural
change and confront dysfunctional patterns and beliefs
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How It Works
Theory and Treatment Planning in Family Therapy
Here-and-Now Experiencing
• Redefine symptoms as ineffective efforts toward growth
• Uses specific reframe of striving for growth and
authenticity
• Example: Child’s refusal to do homework is redefined as fear of
failing at a new level of challenge at school.
• Expands symptom from an individual matter to a family
matter
• Often extending this to an intergenerational problem
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How It Works
Theory and Treatment Planning in Family Therapy
Redefining and Expanding Symptoms
• Play builds strong therapeutic relationship, allowing
honest confrontation of clients without resistance
• Playfulness helps reframe problems that have been
unrealistically magnified
• Use of humor and play often goes against common
stereotypes about therapists and therapy
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Use of Spontaneity and Fun
Theory and Treatment Planning in Family Therapy
Spontaneity, Play, and “Craziness”
• People don’t know how to allow personal autonomy while also
being intimately connected with others
• How It Works
• When clients are unreasonably demanding, therapist help sort
out where spheres of influence should begin and end
• Example: If a parent is demanding a child play certain instrument or sport
that child clearly does not enjoy, the therapist will confront the family about
where parenting ends and the child’s autonomy begins.
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• The Problem
Theory and Treatment Planning in Family Therapy
Separating Interpersonal from Personal Distress
• Uses affective confrontation to interrupt rigid patterns
• Goals may be:
• Raise clients’ awareness when they don’t know how they contribute
to problem
• Raise taboo subject that client and others have been avoiding
• Increase motivation to make changes when there is cognitive
awareness but no change in action
• Examples
• “When did you divorce your husband and marry your son?”
• “You are aware that you have abandoned the family to advance
your career”
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How It Works
Theory and Treatment Planning in Family Therapy
Affective Confrontation of Rigid Patterns and Roles
• Used with unrealistically hopeless clients
• Exaggerates the client’s symptom so they can see how
out of proportion the negative assumptions are with
reality
• Can be done in a playful way or a more direct and literal
way, depending on what would be most useful to client
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How It Works
Theory and Treatment Planning in Family Therapy
Augmenting Despair and Amplifying Deviation
• Invite clients into absurd fantasy scenarios to shake them out
of patterns and make realistic solutions more palatable
• Designed to increase family’s flexibility and openness to new
behaviors
• Gets clients out of habits by playfully perturbing the system so
new symbolic meanings, ideas, and perspectives can emerge
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How It Works
Theory and Treatment Planning in Family Therapy
Absurd Fantasy Alternatives
• Reinforce parental hierarchy and establish generational
boundaries between parents and children
• Involves:




Supporting parental requests
Parents manage child’s behavior in session
Beginning with parents
Greeting parents first
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• Maintaining the Hierarchy
Theory and Treatment Planning in Family Therapy
Reinforcing Parental Hierarchy
• Therapists share stories, free-associate, and offer
metaphors to provide powerful images and examples to
inspire clients to change
• Clients often receive a message more easily through a
fictional story or metaphor
• Metaphor is about somebody else -less resistance or debate
about details
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How It Works
Theory and Treatment Planning in Family Therapy
Stories, Free Associations, and Metaphors
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Theory and Treatment Planning in Family Therapy
INTERNAL FAMILY SYSTEMS THERAPY
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• People have healthy core self that therapy aims to
restore
• Each person’s inner life has multiple parts forming a
system
• Goal of therapy is to have Self provide inner
leadership to various parts
• Three basic roles parts assume: exiles, managers,
firefighters
Theory and Treatment Planning in Family Therapy
In a Nutshell: The Least You Need to Know
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
THE JUICE: SIGNIFICANT
CONTRIBUTIONS TO THE FIELD
• Each part must be understood in context of other parts
• Parts have boundaries and form coalitions
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• Individuals have an internal system of self parts
• Three types of parts: exiles, managers, and the
firefighters
• Parts work together to maintain homeostasis
and handle crisis
Theory and Treatment Planning in Family Therapy
Juice #1: Individuals as Systems
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• Transference and Countertransference
• Transference: how clients may relate to
therapists as if they were someone from their
past
• Countertransference: how therapists may
respond to clients based on another past
relationship
Theory and Treatment Planning in Family Therapy
Juice #2: Transference and
Countertransference
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Theory and Treatment Planning in Family Therapy
RUMOR HAS IT: THE PEOPLE AND
THEIR STORIES
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• Richard Schwartz
Theory and Treatment Planning in Family Therapy
Significant Contributors
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Theory and Treatment Planning in Family Therapy
MAKING CONNECTION: THE
THERAPEUTIC RELATIONSHIP
• Therapist Parts
• Must have knowledge of their parts and know how to
guide themselves
• Use the Self rather than more reactive parts
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• Collaboration
• Use collaborative approach to build relationship with
the client
Theory and Treatment Planning in Family Therapy
The Therapeutic Relationship
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Theory and Treatment Planning in Family Therapy
THE VIEWING: CASE CONCEPTUALIZATION
AND ASSESSMENT
• The seat of consciousness and natural leader of internal family
system
• Boundless state of consciousness and active, compassionate
inner leader
• When Self leads, experience inner balance and harmony
• Parts serve to protect the Self
• In trauma or crisis, parts will remove Self from leadership to
safeguard it
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How It Works
Theory and Treatment Planning in Family Therapy
The Self
• Exiles
• Managers
• Firefighters
• Due to trauma or other burdens, parts take on extreme roles
and become imbalanced
• All parts are considered valuable and having potential to be
constructive
• Goal of therapy is to help bring parts into balance by enabling
Self leadership
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Internal System and Parts
• Three types of parts or subpersonalities:
Theory and Treatment Planning in Family Therapy
Parts: Exiles, Managers, and Firefighters
• The more they are repressed, the more they want to get out
• Frozen in painful memories of the past
• Will do anything for small amounts of love and
acceptance
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• The parts that are closeted away due to burdens of
shame, guilt, or fear of not being lovable
• This group is kept from conscious mind at any cost
Theory and Treatment Planning in Family Therapy
Exiles
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• Keep exiles locked up so they do not flood the person
with strong, painful emotions
• Work to protect rest of system from exiles and to protect
exiles themselves
• Common Management Styles:
• Controller
• Evaluator
• Dependent One
• Passive Pessimist
• Caretaker
• Worrier/Sentry
• Denier
• Entitled One
Theory and Treatment Planning in Family Therapy
Managers
• Have very different methods, often causing conflict between the
two
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Diane R. Gehart
• Rescuers that contain dangerous images, emotions, and
sensations
• Automatically triggered when exiles are activated;
respond forcefully
• Strategies involve extreme behavior: cutting, binging,
substance abuse, or risky sexual behavior
• Firefighters and managers have same goal: containing
the exiles
Theory and Treatment Planning in Family Therapy
Firefighters
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Diane R. Gehart
• Parts assume leadership in order to protect the self
• As one part shifts to an extreme position the other parts
must oppose or take a counter role
• Tends to self-confirming: the more vulnerable one feels,
the more one needs to take extreme protection measures
Theory and Treatment Planning in Family Therapy
Polarization





Traumatic
Environmental
Legacy
Development
Tangible
• Imbalances
• Family harmony
• Leadership
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Diane R. Gehart
• Burdens and constrained development
Theory and Treatment Planning in Family Therapy
External Family System Imbalances




Manager-manager polarizations
Manager-exile polarizations
Manager-firefighter polarizations
Enmeshment between parts
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Diane R. Gehart
Patterns of polarization and enmeshment
Theory and Treatment Planning in Family Therapy
Parts Patterns Between Two People
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
TARGETING CHANGE: GOAL SETTING
Self organizes parts of the internal system
Parts don’t disappear, they just don’t take polarized roles
Parts less rigid and work together to help problem solve
When parts do conflict the Self is able to step in and
mediate
• Parts less noticeable to individual because they operate
harmoniously
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Diane R. Gehart




Theory and Treatment Planning in Family Therapy
Self Leadership
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
THE DOING: INTERVENTIONS
• Summarize and reflect what client is saying
• “So, it sounds like there is a part of you that wants to stay in the
relationship and a part that isn’t so sure if it is what you really
want.”
• Most clients like identify with having different parts that don’t
always agree
• Once clients are comfortable with parts language, therapist
offers more detailed explanation of the model
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Diane R. Gehart
How It Works
Theory and Treatment Planning in Family Therapy
Introducing the Language of Parts
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Diane R. Gehart
• Therapist helps map the client’s internal
relationships:
• Assessing the relationship between Self and
parts
• Assessing the relationship between parts
• Working to change parts
Theory and Treatment Planning in Family Therapy
Assessing Internal Relationships
• Fear that exiles will take over the system; blend with the Self
• Work with exiled parts, blending must be controlled so managers
and firefighters don’t activate
• How It Works
• Asks client’s Self not to let managers interfere and then approach
the exiles
• Therapist can help client’s Self engage the child-like exiles to learn
about why they hurt and how to help them feel safer
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Diane R. Gehart
• What It Is
Theory and Treatment Planning in Family Therapy
Controlling Blending
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Diane R. Gehart
In-sight
• Client develops an image of the part
• Visual image often helps client further externalize and
better relate to parts
• Therapists help clients in identifying images for their
parts
Theory and Treatment Planning in Family Therapy
In-sight and Imagery
• A type of boundary making
• How It Works
• Client puts part in a separate room, closes the door, and observes
the part from a window
• Used when client first encounters a part that is overwhelming
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Diane R. Gehart
• What IT IS
Theory and Treatment Planning in Family Therapy
The Room Technique
• Therapist directly talks with parts, often by having client switch
chairs as they speak from various parts
• Approach particularly useful with clients who have difficulty with
imagery
• How It Works
• Therapist interacts directly with parts
• Direct access can be used in conjunction with in-sight or withoutinsight work
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Diane R. Gehart
• What It Is
Theory and Treatment Planning in Family Therapy
Direct Access
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
RESEARCH AND THE EVIDENCE BASE
• Better coping abilities, greater optimism and hardiness, and
better physical health
• Core variables of symbolic experiential therapy:






Generating an interpersonal set
Creating a suprasystem
Stimulating a symbolic context
Activating stress within the family
Creating symbolic experience
Moving out of the system
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Diane R. Gehart
• Find best empirical support from common factors research
• Study found that Self-leadership is correlated to psychological
functioning
Theory and Treatment Planning in Family Therapy
Research on Humanistic Principles
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Diane R. Gehart
Theory and Treatment Planning in Family Therapy
TAPESTRY WEAVING: WORKING WITH
DIVERSE POPULATIONS
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Diane R. Gehart
Cultural Diversity
• Therapist must find out the family’s symbolic meaning to
ensure understanding
African-Americans and Biracial Individuals
• IFS used to explore internalized parts that are informed by
their experience of race
• Also used for victims of sexual abuse: look at power, privilege
and oppression
Theory and Treatment Planning in Family Therapy
Cultural, Ethnic, and Gender Diversity
© 2016. Cengage Learning. All rights reserved. For classroom use only.
Diane R. Gehart
• Be mindful of the unique symbols and meaning related to
marginalization
• Explore the contradictory parts of the Self to develop greater
understanding and acceptance
Theory and Treatment Planning in Family Therapy
Sexual Identity Diversity
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Diane R. Gehart
Symbolic-Experiential Therapy
• Theory of the absurd
• Look at emotional process and family structure
• Confrontation balanced with warmth and support
Internal Family System Therapy
• Goal of therapy increase power of the Self
• Three basic roles parts assume: exiles, managers,
firefighters
Theory and Treatment Planning in Family Therapy
In Conclusion
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Diane R. Gehart
• Internal Family Systems: www.selfleadership.org
Theory and Treatment Planning in Family Therapy
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