A CLINICAL GUIDE TO SYSTEMIC FAMILY THERAPY
AN INTRODUCTION
By Bradford Keeney
Systemic Family Therapy is a tradition of family therapy that treats the systemic context rather than the isolated behavior and/or individual that is regarded as problematic. The systemic context of experience is seen as embedded in multiple layers of organization that primarily include: (1) the circular interaction of problems and their attempted solutions and (2) the social choreography of coalitions that involve the participation of at least three people.
In the history of family therapy, the first level is associated with the work of Watzlawick, Weakland, and Fisch in their “interactional” approach to brief problem solving therapy. A variation of this orientation is represented by De Shazer’s soultion focused therapy which prescribes an interactional way of disrupting problem-solution interaction by exploring past and imagined future types of solutions that are successful (a specific way of changing the “class of solution”).
The second level of systemic organization is found in the work of Haley’s problem solving therapy and Minuchin’s structural family therapy. While both of these approaches focus on interrupting social behavioral sequences that hold inappropriate triadic relations, the contribution of the Milan model suggests an interpretive approach that paradoxically prescribes the problem with an explanation that highlights its positive contribution to the social organization of the family.
A third level of organization was proposed by Keeney and Ray’s resource focused therapy (RFT). It side stepped working with problems, solutions, and systemic hypotheses and instead focused on bringing forth resourceful performances of experience. Whereas other family therapies attempt to disrupt vicious circles, RFT dealt with initiating and feeding virtuous circles of interaction.
The Family Systems Institute model of SYSTEMIC FAMILY THERAPY utilizes the contributions of all the major orientations to systemic family therapy with a special emphasis upon the interactional view (Watzlawick, et al.), problem solving/structural family therapy (Haley & Minuchin), and resource focused therapy (Keeney & Ray). The techniques and strategies we use are directed by the presenting communications of the family. If clients request that we focus on problems, we organize ourselves to draw upon the technical contributions of problem focused therapies. If the family does not emphasize problems, we draw upon a more resource-focused approach. In this regard our overall approach is improvisational (see Keeney, Improvisational Therapy) and its exact form in a session is a creative collaboration between therapist and client (see Keeney, The Creative Therapist).
Change is most readily brought about by a focus on interactional patterns and triadic relations - the systemic context of an individual’s behavior. If a problem behavior is presented, look for the interactional patterns that maintain it and the social choreography that holds the interactions. We may choose to interrupt vicious circles of interaction (problem and solution focused therapies) or we may initiate and nurture virtuous circles of resourceful interaction (resource focused therapy). Systemic therapy treats the interactional patterns and social choreographies that hold individual experience. We do so improvisationally, that is, what we do is called forth by the particular nature of the client-therapist interaction. The exact form of each session is a creative collaboration between the client and therapist.
CORE PRAGMATICS OF SYSTEMIC FAMILY THERAPY
1. Systemic therapy utilizes:
a. Problem and solution talk: whenever a client presents communication about a problem, we only explore systemic information about it in terms of assessing what attempted solutions maintain it, what social coalitions and triadic relations contextualize it, and what frames of meaning are associated with it, especially in the interactional and social domains. This includes an exploration of past and imagined solutions in other situations.
b. Resource talk: whenever a client presents communication about a resourceful experience, we explore and bring forth more discussion of resourcefulness.
2. Systemic therapy sees the basic structure of a session as moving through three stages: initial complaints, transition to a resourceful emphasis, and a homework assignment to keep the momentum going.
3. The goal is to move therapeutic conversation from problem talk to solution talk, and then to resource talk, doing so in order to disrupt the vicious circles of problem behavior maintenance by inappropriate solutions. We do so to initiate and feed the construction of virtuous circles of behavior that bring forth resourceful experience that is healthy to the individual, family, and relevant social settings.
4. The first challenge is how to address the presenting problem without contributing to its maintenance or escalation. The second challenge is determining whether to disrupt a problem interactional cycle, realign a social triadic pattern, or instigate a new resourceful pattern of expression in the system. Sometimes, all can be done simultaneously or sequentially.
5. There are systemic ideas and practices that help bring forth a successful session of systemic family therapy.
By Bradford Keeney
Systemic Family Therapy is a tradition of family therapy that treats the systemic context rather than the isolated behavior and/or individual that is regarded as problematic. The systemic context of experience is seen as embedded in multiple layers of organization that primarily include: (1) the circular interaction of problems and their attempted solutions and (2) the social choreography of coalitions that involve the participation of at least three people.
In the history of family therapy, the first level is associated with the work of Watzlawick, Weakland, and Fisch in their “interactional” approach to brief problem solving therapy. A variation of this orientation is represented by De Shazer’s soultion focused therapy which prescribes an interactional way of disrupting problem-solution interaction by exploring past and imagined future types of solutions that are successful (a specific way of changing the “class of solution”).
The second level of systemic organization is found in the work of Haley’s problem solving therapy and Minuchin’s structural family therapy. While both of these approaches focus on interrupting social behavioral sequences that hold inappropriate triadic relations, the contribution of the Milan model suggests an interpretive approach that paradoxically prescribes the problem with an explanation that highlights its positive contribution to the social organization of the family.
A third level of organization was proposed by Keeney and Ray’s resource focused therapy (RFT). It side stepped working with problems, solutions, and systemic hypotheses and instead focused on bringing forth resourceful performances of experience. Whereas other family therapies attempt to disrupt vicious circles, RFT dealt with initiating and feeding virtuous circles of interaction.
The Family Systems Institute model of SYSTEMIC FAMILY THERAPY utilizes the contributions of all the major orientations to systemic family therapy with a special emphasis upon the interactional view (Watzlawick, et al.), problem solving/structural family therapy (Haley & Minuchin), and resource focused therapy (Keeney & Ray). The techniques and strategies we use are directed by the presenting communications of the family. If clients request that we focus on problems, we organize ourselves to draw upon the technical contributions of problem focused therapies. If the family does not emphasize problems, we draw upon a more resource-focused approach. In this regard our overall approach is improvisational (see Keeney, Improvisational Therapy) and its exact form in a session is a creative collaboration between therapist and client (see Keeney, The Creative Therapist).
Change is most readily brought about by a focus on interactional patterns and triadic relations - the systemic context of an individual’s behavior. If a problem behavior is presented, look for the interactional patterns that maintain it and the social choreography that holds the interactions. We may choose to interrupt vicious circles of interaction (problem and solution focused therapies) or we may initiate and nurture virtuous circles of resourceful interaction (resource focused therapy). Systemic therapy treats the interactional patterns and social choreographies that hold individual experience. We do so improvisationally, that is, what we do is called forth by the particular nature of the client-therapist interaction. The exact form of each session is a creative collaboration between the client and therapist.
CORE PRAGMATICS OF SYSTEMIC FAMILY THERAPY
1. Systemic therapy utilizes:
a. Problem and solution talk: whenever a client presents communication about a problem, we only explore systemic information about it in terms of assessing what attempted solutions maintain it, what social coalitions and triadic relations contextualize it, and what frames of meaning are associated with it, especially in the interactional and social domains. This includes an exploration of past and imagined solutions in other situations.
b. Resource talk: whenever a client presents communication about a resourceful experience, we explore and bring forth more discussion of resourcefulness.
2. Systemic therapy sees the basic structure of a session as moving through three stages: initial complaints, transition to a resourceful emphasis, and a homework assignment to keep the momentum going.
3. The goal is to move therapeutic conversation from problem talk to solution talk, and then to resource talk, doing so in order to disrupt the vicious circles of problem behavior maintenance by inappropriate solutions. We do so to initiate and feed the construction of virtuous circles of behavior that bring forth resourceful experience that is healthy to the individual, family, and relevant social settings.
4. The first challenge is how to address the presenting problem without contributing to its maintenance or escalation. The second challenge is determining whether to disrupt a problem interactional cycle, realign a social triadic pattern, or instigate a new resourceful pattern of expression in the system. Sometimes, all can be done simultaneously or sequentially.
5. There are systemic ideas and practices that help bring forth a successful session of systemic family therapy.
