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Unit 16 Initial Phase

1. List the common contexts in which a family therapist sees clients.

The common contexts in which a family therapist sees clients are families with concerns about children or adolescents, families reporting that members have problems in relating to each other, one of the family members has a chronic illness and the family members want to understand how to cope with it better, and families with difficulty in transition from one stage to the next.

2. Name the important things to be covered during the initial phase of therapy.

The important things to be covered during the initial phase of therapy are establishing rapport, alteration of problem perception, motivating the family for change and setting of tentative goals.

3. List the basic assumptions of systems theory regarding presenting concerns of families.

The basic assumptions of systems theory regarding presenting concerns of families are:

• Serve a function or purpose for the corrective maladaptive/deficient family pattern.
• Maintain homeostasis in the family.
• Be a function of the family's inability to operate productively especially during developmental transitions.
• Be a symptom of dysfunctional patterns handed down across generations.

4. What are the common goals of family therapy? 

The common goals of family therapy are: reduction of presenting problem behaviour, improving the family or couple relationship, helping the family members improve autonomy and individuation, improving the ability of the family to interact effectively with important larger social systems, increasing the awareness and understanding of how couples' and families' patterns of interaction influence the everyday effectiveness in living. 

5. What are process goals? 

Process goals can be defined as short term goals that help the family in the process of achieving their own or the therapist's objectives. 

6. What are the important steps in constructing a genogram?

The important steps in constructing a genogram are:

• Decide who to include in the genogram
• Decide who will construct the genogram
• Collect the details
• Draw the genogram
• Note the developmental stage of therapist during the genogram construction
• Include all family members to get their perspectives

7. Name the six dimensions assessed in the Structural Family Systems Rating Scale.

The six dimensions assessed in the Structural Family Systems Rating Scale are: family structure, resonance, flexibility, developmental stage of family, identified patienthood, and conflict resolution.

8. What is circularity? 

Circularity is the ability of the therapist to ask questions based on the feedback given by the family members in response to her or his own questions about the family

9. What is neutrality? 

Neutrality can be defined as the technique where the therapist has successive alliances with every member of the family and is allied to everyone and no one at the same time. 

10. What is refrarning?

Reframing is changing the family's perspective of a problem such that the meanings of behaviours associated with the problem are viewed in a way that modifying the behaviours becomes easier for the family. 

11. What are the main aspects of a family formulation? 

The main aspects of a family formulaiton are brief description of presenting concern and expectations from therapy; genogram; therapist's understanding of current family functioning; family's strengths and weaknesses and family's relationship with the supra-system. 

12. What is the main theme and assumptions of Initial stage of family therapy.

• The main theme of the initial stage of family therapy is to establish a working relationship with the family, gather information about their concerns and dynamics, and begin to formulate a hypothesis about the family's functioning. This stage is crucial for setting the foundation for subsequent work.
• The assumptions of this initial phase are rooted in systems theory, which views the family as an interconnected unit. These assumptions include: that the presenting concern serves a purpose within the family system, that the family seeks to maintain stability (homeostasis), and that problems often arise from difficulties during developmental transitions, and that dysfunctional patterns can be passed down through generations.

13. Describe the various processes used in assessment in your words.

The assessment process involves several key elements:

• Initial Contact: This is where the therapist begins to "join" the family and establish rapport with all members.
• Observation: Observing the family's interactions during the session is important, noting their communication patterns, emotional expressions, and power dynamics.
• Questioning: The therapist asks questions to gather information about the family's history, presenting problems, and perspectives, using both direct questions and circular questions that explore relationships and patterns.
• Genograms: Creating a genogram (family tree) helps in understanding intergenerational patterns and family history.
• Defining goals: The therapist and the family work together to define goals for what they would like to achieve through therapy
• Feedback: The therapist gives the family feedback and information, and collaborates with other professionals if needed

14. What do you mean by SFRS? Explain the common techniques used in this.

SFRS stands for the Structural Family Systems Rating Scale. It is a tool used to assess a family’s functioning across six dimensions:

• Family structure: The way the family is organised in terms of hierarchies and boundaries.
• Resonance: The extent to which family members respond to one another's communications and needs.
• Flexibility: The family's ability to adapt to changes and new situations.
• Developmental stage of family: The stage of life cycle that the family is experiencing.
• Identified patienthood: The roles that family members take on in relation to the presenting problem.
• Conflict resolution: How the family deals with conflicts.

Common techniques used with SFRS include:

• Observation of interactions between family members during the session to assess different dimensions of family functioning
• Circular questioning helps the therapist understand family dynamics

15. Discuss the main signs of successful completion of initial phase.

Successful completion of the initial phase of family therapy is indicated by a few things:

• Rapport: The family and therapist have established a comfortable and trusting working relationship.
• Problem perception: The family's view of the problem is altered as they begin to see it as a systemic issue and not just as a problem with one family member.
• Motivation for change: The family is motivated to engage in the therapy process and work towards positive changes.
• Tentative goals: The family has defined some initial and realistic goals for therapy.
• Agreement: The family and therapist have come to an agreement about the next steps of therapy, and what the focus will be.