Homeostasis
In families, refers to the unique set of behavioral, emotional, and interactional norms that create stability for the family or other social group. Not static but dynamic and should be thought of as a “range of behaviors” that are “normal” within a family system.
e.g., expectations for showing affection, handling conflict, etc.
Nonpathologizing
Avoiding labeling, demeaning, or patronizing the client, focusing on the client’s strengths instead.
Systemic Therapy Conceptualization
They conceptualize families using two basic paradigms:
- family structure: boundaries, hierarchy, and subsystems, and
- systemic interaction patterns: repetitive interaction cycles related to the problem.
Family as System
System is autonomous; therapists can only “perturb” system; cannot directly reorganize or control it. No one person “controls” the system, but instead the system as a whole responds to treatment.
General Systems Theory
A theory used broadly in the physical and social sciences that includes the following concepts:
- The whole is greater than the sum of its parts.
- Systems can be viewed in terms of hierarchy, executive organization, and subsystems.
- Systems strive toward self-preservation and therefore its members work in service of the system as well as themselves.
Self-Correction
(general systems theory)
Refers to the systems ability to maintain homeostasis and stability. Negative and positive feedback is used to help the system self-correct to “get back to normal”.
Cybernetics
(general systems theory)
The study of information processing, feedback, and control in communication systems. Examines how systems self-correct to maintain homeostasis.
First-Order Cybernetics
(general systems theory)
The therapist is an objective, neutral observer describing the family as an outsider. Leans toward the modernist tendency to find a more objective form of truth.
Second-Order Cybernetics
(general systems theory)
Refers to applying the systemic model to the therapeutic system and describes how the therapist and client form a secondary system. From this perspective, the therapist and family form a system and therapeutic objectivity is not possible.
The treatment unit is a meaning system to which the treating professional is an equal and active contributor. The therapist’s own assumptions, worldviews, and beliefs shape what they see and their behaviors shape the behavior of the client.
Negative Feedback
(general systems theory)
These mechanisms kick in to try to bring things back to normal (homeostasis).
For example, when a child’s behavior is outside the expected norm, a parent may yell or criticize in an attempt to get the child’s behavior back to acceptable parameters.
Positive feedback
(general systems theory)
Involves escalating behavior that leads to a new homeostasis.
Example might be physical violence or involving a parent who is rarely involved or any other action that might lead to a new homeostasis.
First Order Change
(general systems theory)
Refers to when the system returns to its previous homeostasis after positive feedback. In first-order change, the roles can reverse (e.g., a former distancer could start pursuing), but the underlying family structure and rules for relating stay essentially the same: someone is pursuing someone is distancing.
Second Order Change
(general systems theory)
When a system restructures its homeostasis in response to positive feedback and the rules that govern the system fundamentally shift.
For example, second-order change would increase the amount of emotional intimacy the system is able to tolerate or fundamentally re-distribute power in the system (e.g, rather than one parent having more authority in system the couple equally shares authority).
Report/Command (Content/Relationship)
(general systems theory)
The “report” aspect of communication is the content: the literal meaning of the statement. The “command” is the metacommunication, or the communication about how to interpret the communication. The command aspect always defines the relationship between two people.
Example, the same piece of advice (content), such as “You might want to wear sunscreen today,” can be accompanied by a command that defines either a peer-peer relationship or a one-up-one-down relationship. This is where miscommunication, double-bind communication, and arguments come in.
Double binds
A double bind occurs when someone is presented with two conflicting statements or demands and is unable to successfully comment on it, making it impossible to satisfy both. Often there is a verbal command at one level (e.g., “requesting more affection”) but then contradicting themselves (e.g., pulling away when affection is shown).
Example: Asking your partner to show be romantic, but when they do, you are upset and say they only did so because you asked. Similarly, a parent can demand a child speak up, but then say they are being disrespectful when they do speak up.
Primary and Secondary Injunction (Double bind)
Primary level is the first command; secondary injunction contradicts the first request, usually at the metacommunication (non-verbal) level.
Symmetrical Relationships
(general systems theory)
The parties have “symmetrical” or evenly distributed abilities and roles in the system: an equal relationship. When in conflict, these relationships tend to have escalating tension.
Complementary Relationships
(general systems theory)
Each party has a distinct role that balances or complements the other. Conflict in these systems is less likely to escalate due to clearly defined roles.
System
An entity itself, with the whole greater than the sum of its parts.
Systemic Family Therapy Theories
Includes the Systemic Theories:
- Strategic Therapy
- Mental Research Institute (MRI) therapy
- Milan Systemic Therapy
Interaction Patterns (Symptom Cycle)
(Strategic theory/ MRI)
Track couple/family interactions related to the symptom.
Homeostasis to Symptom: Homeostasis > Rise of tension > Symptom at its worst > Return to normal
Report/Command
(Content/Relationship)
The report is the content: the literal meaning of the statement. The command is the metacommunication, or the communication about how to interpret the communication. The command aspect always defines the relationship between two people.
Example, the same piece of advice (content), such as “You might want to wear sunscreen today,” can be accompanied by a command that defines either a peer-peer relationship or a one-up-one-down relationship. This is where miscommunication, double-bind communication, and arguments come in.
Social Constructionism
Focuses on how people interact with their society and relationship. They emphasize how truth is generated at the local (immediate) relational level.
Constructivism
Focus on the construction of meaning within the individual organism, on how information is received and interpreted.
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DSM-5-TR Diagnosis129
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Mental Status and Clinical Assessment52
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Law, Ethics, and Crisis43
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General Treatment, Tx Planning, and Termination32
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Systemic and Cybernetic Foundations38
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Strategic and Systemic Theories35
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Structural Family Therapy35
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Intergenerational/Bowen Therapy31
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Psychodynamic and Contextual Family Therapist34
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Satir Family Therapy22
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Symbolic-Experiential Family Therapy17
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Emotionally Focused Couple and Family Therapy22
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CBT/CBFT41
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Gottman's Couples Therapy21
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Narrative, SFT, and Collaborative41
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Feminist Therapy22
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Rogers, Gestalt, and DBT49
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Family Development Theories35
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Research and Statistics39
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Genogram Symbols52
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Family Mapping (Structural Family Assessment)31
