Family Systems Intervention

Family Systems Interventions Intervention skills: Facilitating family change Change skills 1. Break maladaptive interaction patterns 2. Clarity problematic consequences 3. Alter affective blocks 4. Initiate cognitive restructuring 5. Implement new adaptive patterns 6. Mobilize external resources as required Break Maladaptive Patterns †¢ Intervene to control maladaptive patterns by restructuring family interaction verbally or physically †¢When appropriate, facilitate the adaptive expression of anger of one family member in order to block the recurrent problematic behavior of anotherClarify problematic consequences †¢Confront family members on the problematic consequences of their own behaviors †¢Provide verbal or nonverbal support before and after direct confrontation whenever possible Alter Affective Blocks †¢Convey the importance of expressing and clarifying affective experience in order to better comprehend the maintenance of overt behavior patterns. †¢Remove inappropriate affective blocks by encouraging open discussion of the emotional turmoil of family members; validate their experience, clarify the content, and provide support Initiate Cognitive Restructuring Call into question collective beliefs, values, or goals that appear to be problematic and initiate open discussion and reevaluation of relevant issues. †¢To prevent new affect from blocking further progress, encourage the expression and discharge of emotion (especially through laughing or crying) while modifying a previous cognitive set. †¢Provide appropriate new information or a reformulation as required to develop more adaptive comprehension †¢Encourage family members to consider new ideas further and to continue to discuss specific issues at home in order to reach a reality-based consensus.Implement New Adaptive Patterns †¢Using behavioral principles, apply social reinforcements to strengthen appropriate behaviors at any ti me during the sessions an d encourage family members to do the same. †¢Elicit family member’s willingness to be receptive to suggestions and invite specific behavioral suggestion from other family members (or offer some). †¢Coach the family in implementing changes that are compatible with appropriate development tasks for the whole family as well as individual family members. Introduce adaptive changes in behavior during the interview by redirecting interaction patterns and altering spatial and seating arrangements to rearrange subsystems. Mobilize External Resources as Required †¢Openly admit to lack of progress as explore possible inhibiting factors both inside and outside the family. Effective Assessment and Intervention First, workers must develop an attitude that values the potential of families to change.Assessment and mobilization of family strengths should focus on the positives related to many areas, including †¢Family relationships: caring for members, gender roles that a re respected and valued, parental-child relationships based on the best of the child, physical and emotional self-care, the presence of positive family events and successes, supportive couple relationships, family history of previous successes in conflict management, a strong family identity †¢Individual family member skills: cognitive and intellectual abilities, a positive attitude, competent parenting, positive role-modeling, ability to build and access supportive social environments †¢Personal qualities: motivation, goal directedness, self-esteem and competence, an ability to laugh at oneself, inner strengths and resources, strong relational, abilities, nondefensiveness, willingness to work on issues despite challenges †¢Availability of community resources: friends and caring other outside the family, supportive relatives, health care, education, recreation, spiritual community, social services, the skills to navigate in these community resources †¢Seeing and learning: the ability to recognize difficult life experiences and to learn from these experiences Key Strategies in working with strengths †¢ The strength’s perspective capitalizes on the power and will of the family to self-correct with the help of appropriate environmental supports. †¢Words have the power to build up or tear done discourage or encourage. Pathology-based words darken the vista by imposing problems while strength-based words impose solutions and hope. Use a dictionary of helping, a dictionary that includes the use of such words as empowerment, skills, hope, support, ability, and knowledge Assessment and intervention will be more effective if the family social worker keeps the following considerations in mind: †¢Be keenly attuned to culture and adhere to culturally sensitive practices †¢Focus on family needs †¢Respect client autonomy †¢Avoid fostering unnecessary dependency †¢Reassess and re-interpret client resistance as avo idance of pain †¢Keep healthy professional boundaries while remaining emotionally available Culturally Sensitive Practice †¢ We advocate for cultural competence for all workers-competence that avoids the application of stereotypical checklists to families from minority cultures. Suggesting that a single program model or intervention can meet the needs of all cultural families risks stereotyping an reducing each culture to a single entity. †¢Not all members of a cultural group are connected in the same way to their cultural heritage placater †¢Some groups will have blended traditional and nontraditional practices in their daily living. †¢Acculturation can be seen as a mosaic, blending traditional native ways with dominant cultural ways. Five program structures that can be incorporated into family social worker in order to work appropriately with families from different cultures. 1. Workers must have a sincere interest in learning and accepting different cultu res. 2. Workers can learn to challenge their ethnocentric beliefs as a n integral part of family social work. 3.Family social workers can be open to collaboration with traditional cultural healers and leaders and support family choices about traditional sources of help that parallel, supplement, or replace interventions that are more common. 4. Family social workers should be familiar with and be prepared ti use existing client support systems, following the appropriate cultural protocols. 5. The intervention skills used by family social workers can adapted to specific cultures 6. Family social workers can seek specific cultural knowledge, which includes awareness of communication patterns, worldviews, belief systems, and values 7. Knowing how to gain entrance into a cultural community is important if a worker were to access culturally appropriate resources for a family.Reassess Clients’ Resistance Resistance may be a message from the client that the family social worker is o verstepping the boundaries of the relationship. Resistance can also signal that the issues being discussed are sensitive to the client. Set Realistic Expectations A sixth guideline for family social workers is to foster families’ feelings of competence, rather than inadequacy. Hepworth and Larsen (1993) list the following ecological interventions that family social workers can perform for families: †¢Supplementing resources in the home environment †¢Developing and enhancing support systems †¢Moving and enhancing support systems †¢Moving clients to a new environment Increasing the responsiveness of organizations to people’s needs †¢Enhancing interactions between organizations and institutions †¢Improving institutional environments †¢Developing new resources The way a problem is defined often depends on †¢How the family initially defines the problem †¢The theoretical perspective the family social worker uses †¢The mandate of the agency and how the agency views problems. For example, some agencies embrace solution-focused counseling and define problems to fit theory †¢How the problem is defined jointly between the family and worker in a way that both feel offers the most opportunities to create positive change. Unique ways of viewing a problem 1.A traditional analytic view is that symptomatic person in the problem. 2. The social systems assumption is that the family is the problem – problems evolving from relationship patterns within the family 3. The attempted solution is the problem. This is an interesting view that could be simplified by saying, â€Å"if what you are doing does not work, stop doing it and try something different! † Circular Patters †¢ The term patterns mean that the same behavior happens repeatedly and becomes predictable. †¢When a family is mired in problems, it may be because their repetitive patterns have produced gridlock without providing an adequ ate response to the issue at hand.In this way, the solution becomes the problem. Because the patterns are habits, family members feel secure in the stability they provide. The habitual patterns might be hurtful to individuals and harmful to the family system, but because family members are unaware of or unskilled in other ways of responding, they are unable to change, and the family is described as being stuck. †¢A pattern is a circular sequence of communication that occurs three times. †¢Alternatively, the worker may set the stage to encourage family members to play out their usual family patterns. ? 1. Clarify with the family these patterns, pointing out the relationship between affect, or feelings, and behavior.For example, father scolds child, child feels hurt, child pouts, father feels frustrated, father scolds, and around and around the pattern goes. It is helpful for a family to see how they go around in theses maladaptive circles. 2. When this is done, help clarify any family rules or myths that perpetuate these patterns, for example, a myth that the only way a child will listen to a parent is when the parent yells at the child. 3. When clarifying a circular pattern with a family, it is necessary to explore underlying feelings and any additional behaviors. 4. Point out evidence of emotional distress and get members to label specific feelings. When feelings are out in the open.Particularly fears and hurts, they can be directly faced 5. Encourage the family to provide each member with reassurance and support 6. Help the family develop understanding of each other by bringing their circular patterns out in the open and including underlying feelings. 7. After the dysfunctional patterns have been identified, the worker should then get the family to think of helpful adaptive patterns to deal with problem situations. 8. Help the family negotiate simultaneous change 9. Reinforce family member’s constructive suggestions 10. Coach family members in trying out new adaptive behaviors and assign realistic tasks explicitly as homework.Lineal Circular, strategic and reflexive question †¢Lineal questions ask for basic information and assume a cause-and –effect sequence. †¢Circular questions, on the other hand, are based on circular causality and the connections among family members. Circular questions help the family social worker to learn about ongoing patterns of family interaction and the effects that family members’ behaviors have on one another. †¢Circular questions are intended to create change, whereas lineal questions are intended to draw out information. †¢Strategic questions are directed at change, on the basis of the family social worker’s assessment of the situation.The underlying intent of strategic questions is to correct behavior. †¢Reflexive questions ask clients to become self-observers. Detriangulation Detriangulation involves developing strategies through which the family worker disrupts one triangle and opens up the family members to new, more functional alliances or triangles. Four possible methods of detriangulation are available for the family social worker. 1. One way of detriangulatiojn is to point the triangle out to the three people. 2. Another method of detriangulation is ensuring that family members interact as dyads. 3. Another method is through reversal, or getting one person in the triangle to do the opposite of the pattern. 4.Detriangulation also can occur by shifting alliances that is who does what with whom. If the mother is always the one trying to get a child to comply with a command, change can be accomplished by having the father gain the child’s compliance. Working with Involuntary clients Clients usually look for on of two outcomes from family social work. Some just want to eliminate the pain created by the problem, and in the process want to be nurtured. These clients may be satisfied once the initial stress has b een alleviated, and they may avoid making difficult or lasting changes. Other clients want to change their lives in concrete ways. They are willing to work hard to achieve needed changes in their lives.These are the most rewarding clients for family social workers. Many involuntary clients are precontemplators. In other words, they do not believe they have a problem. Others may acknowledge they have a problem but are not prepared to work on it. Families need to know that participating in family social work is their choice. The family social worker should emphasize that freedom from unwanted agency intervention will occur when the conditions of the court order or contracted work are met. Work with involuntary clients begins by finding out what it is like for them to be ordered into family work. This question is one way of showing empathy and starting where the client is.When clients are court ordered, they should be informed that some conditions of the work are not negotiable and the y need to understand the specific conditions for termination. When clients do not want work, the family social worker can print out that the family has a right not to participate but that nonparticipation involves some consequences. Motivation is the flip side of resistance. Direct confrontation about responsibility for problems during the assessment phase is likely to produce defensiveness rather that lead to change. Instead, using empathy and rolling with resistance might be most productive. The single most important skill for working with family resistance is being able to identify when it may be counterproductive to push an issue with the family.