Understanding Systems Perspectives in Family Therapy
On May 30 and 31, 2013 An Giang University
held a Social Work and Public Health Conference. Susan Newfield and Neal
Newfield, two well-known professors from West Virginia University, presented
the core principles of family therapy and how to help couples and families
increase their problem solving abilities through systems theories.
Both professors stated that a family is
similar to a system in which are interwoven relationships regarding
consanguinity and enactment along with sharing common interests, duties, and
family history. To apply systems perspectives to solve problems in the
family requires a counselor to understand the family as a system that can be
both closed or open and is divided into sub-systems having boundaries, roles,
hierarchies, influence, alignment, and rules.
To counsel successfully, a counselor has to
master perspectives on systems, communication, change, cybernetics, role, and
development in order to coin appropriate interventions. The views of these
schools are interdisciplinary in nature and can apply into research, a specific
case and other social issues regarding the fields of biology, psychology,
gender, physics, and chemistry.
This paper highlights the theoretical systems
perspectives: change theory, particularly linear causality versus circular
causality; communication theory; family assessment via genogram and ecomap; and
some basic rules when working with families.
First ─ The perspective of
systems theories
A System is defined as a set of complex
objects with relationships between objects and their attributes. The concept of
systems provides us with an organizing framework consisting of several elements
and parts that interact with each other in a social environment. For example,
in terms of biology, if one becomes ill affecting one of our organs (e.g.,
pneumonia, heart attack, diabetes, toothache, or injuries), the person’s physician
will review the illness progress of that organ in connection with other organs
as well as the entire body. Thus, if there is a change in one organ, it may
have an impact on other organs throughout entire body and on circular
causality. Therefore, in family therapy “the whole is greater than its parts”
as family is an interactional system that is best understood as a system of
relationships.
The above example does not end there because
the family is a system with multiple levels and interactions between members.
If an individual is ill, it impacts not only psychology and affection of that
individual, but also those of the other members in the family. All family
members have an impact on others. Exacerbation of an illness can help the
family. This change in one family member will affect all the members in the
family both in a positive or negative manner. However, social workers need to
coordinate with other agencies in order to support and aid couples or families
balance these changes. At the same time, counselors need to determine whether
the family belongs to a closed or an open system, whether they are disengaged
or enmeshed types and whether the family has positive or negative feedback with
boundaries divided by roles and rules in the family.
A Closed System means that families do not
communicate well with each other or have limited communication within and
outside the family. They also create walls between family and environment and
do not ask for assistance from outsiders. For example, a family has a child
studying at a secondary school who has recently not done well at the school. A
school counselor comes to meet his family but the parents refuse to talk with
the counselor. His parents excessively pamper, protect, and care for him
and they are still proud of him as a good child and the best student at the
school.
An Open System is similar to our social and
biological organism. This system helps the family members have autonomy and
interdependency along with mechanisms to maintain individual identity in the
family. It is also flexible to adapt and able to change with the surrounding
environment. This is stability in change through feedback, boundaries, and
rules.
Feedback could be positive or negative.
Positive feedback increases the ability to change, improve self-regulation and
development. In contrast, negative feedback discourages individuals, they lose
enthusiasm, and reduce their ability to change and the possibility of
self-regulation.
The family
is also a system, the family includes many sub-systems, each subsystem is an
individual carrying out particular functions to sustain and defend the system
as a whole unit. Subsystems can be formed based on hierarchy, such as parents,
spouses, siblings, or according to gender, such as father and son, mother and
daughter. The sub-systems are separated by boundaries. Boundary protects and
impacts sub-systems. There are three types of boundaries - rigid, open, and
healthy.
A rigid boundary shows distance between family members, communication is often
clogged or controversial and problems still exist and at times escalats between
the family members. An open boundary refers to an unclear boundary, the loss of
personal privacy, the loss of personal identity and attachment leading to
difficulties in defining what is private and what is general.
Healthy boundaries are flexible and clear.
Everyone in the family can communicate openly, show respect and trust each
other. All family members feel attached, yet there is room for making choices,
independent development, participation, self-determination, privacy, and
maturity.
Depending on the stage of family development,
boundaries can either be rigid, open, or healthy. Typically, an individual's
problem may be triggered when families have rigid boundaries. Conversely, if
the family has open boundaries, the family may fall into a state of chaos. If
these states happen frequently and have no tendency to change for the better,
it will form family problems. At that time, family members go to see counselors
because they cannot function well as a unit.
Rules are regulations that allow individuals
to perform the tasks of daily life. In addition to consanguinity and enactment,
individuals are bound by the rules, hierarchies, and roles in the family. There
are written rules (e.g., division of household chores) but there are unwritten
rules. For example, who sleeps on what side of the bed or, in the classroom we
often sit in one place with friends or acquaintances and hardly ever change our
seats. In general, healthy families will have basic, consistent, flexible, and
common rules, which can be changed to fit with other situations.
Second ─ The theory of change in
family therapy
Prof. Susan and Neal Newfield stressed that a
person's behavior refers to not only characteristics of the individual, but
also refers to the social environment in which an individual lives.
There are two models - linear causality
versus circular causality. Traditionally, when having a problem, people usually
only see it as a linear causality, from A> B> C. For example, an
alcoholic husband blames his wife for her whining. He gets bored with her
nagging and uses alcohol as a solution to reduce his stress. It is her fault,
therefore, she must change her behavior, not her husband.
Circular causality emphasizes the behavior of
an individual is affecting others in the family. The family’s problems go back
and forth as circular and escalating via time and frequency of problems.
For example, the husband drinks, so the wife nags him. The wife is always nagging
the husband so he continues drinking. This together with other causes
influences their problems. However, if the wife changes but the husband does
not it will create a pressure that hinders the the wife from changing.
Therefore, change is a process and the levels of change can be varied depending
on each individual and the context of the problem. Change theory emphasizes an
equilibrium level of change between individuals in the family and creates
conditions for change through open communication, expectations of each
individual, the co-goals, and barriers identified before they plan changes
together. It is important to note that a circular causality is opposite from a
circular causality manner of problem evaluation. To employ a circular method
can help a counselor find the clients’ patterns of behavior, the causes, and
appropriate remedies to make the clients’ situation better.
When working with couples and families,
counselors must remain neutral, show curiosity but not be critical, listen to
all perspectives, work based on relationships, create conditions so that each
person is able to share thoughts and ideas, and help strengthen their
self-worth. For example, during the first session the counselor focuses on
introducing him-or-herself and invites everyone to introduce themselves, rather
than beginning to work on problems immediately. Then, the counselor
invites each person to talk about expectations, positive things and issues that
they want to change for themselves and for the whole family. Thereby, the
counselor can find out the differences in each person's perception of the
problems, needs and expectations of each individual. The counselor tries
to avoid tension or argument between spouses. To do this, the counselor can
facilitate their communication through listening techniques, seating
arrangement, time limits for each person to share their experience and eye
contact while they are talking. If they have small children the counselor has
to prepare for provision of caregiving in therapy sessions. Before ending
the first therapy session, the counselor needs to summarize key and positive
points for each person and common ground between individuals, along with
outlining specific goals and tasks for each individual, arranging and planning
what to do, how to do it, and what they want to achieve prior to the next
session.
Third ─ Communication perspective
in family therapy
Prof. Neal Newfield provided a hypothetical
example, "You are given a roundtrip ticket reward so that you may go to
any country in the world you wish. When you are on the airplane, you sit in
First Class with people sitting around you who are the ones you hate and do not
want to communicate with, however, they keep talking to you". What
should you do to avoid the situation that you do not want to communicate but
cannot?
The participants offered many solutions such
as pretending to sleep, pretending to listen, reading a book, however, showing
courtesy by briefly greeting them, or telling them straight out that you do not
wish to communicate.
According to Prof. Neal Newfield nonverbal
communication accounts for 75% of our daily communication in life and often
times people misunderstand and misinterpret messages. The most important thing
is that we must see whether words and actions are relevant or not. Therefore,
communication is very important in family therapy because it enhances
interactions among individuals in the family. Refusing to communicate with
someone is one kind of communication. However, if we refuse to talk with people
and we hate or talk about our problems, difficulties remain unresolved. When
working with this couple and families counselors need to help them identify
their unhealthy interactions which affect their behavior.
Digital and analogical
communication
Both the professors said that there are
digital and analogical communication styles which associate with the
differences in world views of individuals and that we can relate these concepts
to the displays of clocks, or watches. An analogical communication style refers
to time with hands that point to hours, minutes that move around a clock-face
on a continual basis. We can read the time by observing the positions and
relationship of the hands. That means when we use analogical communication that
both sender and receiver understand facts, figures of speech, emotions, and
experiences. Music, poetry, painting, and text messages with emotional icons
are nonverbal analogical communication. In contrast, a digital clock has
numbers ranging from 0 to 9 that are coded to indicate the time. Digital
communication refers to fact, accuracy, logicality, complexity, and the
abstract. For example, we use the cell phone to check the time. The watch in
the cell phone has no hands pointing to hours and minutes on the clock face. It
is difficult to receive or decode a sender’s message and it may be easily
misinterpreted which may lead to damage to the relationship between
communicators. Good communicators have both digital and analogical
communication.
Symmetry and complementary
communication style
When coming to a symmetrical relationship, a
husband and wife behave equally. They may make equal decisions, have equal
values, or make equal observations towards certain issues. This common ground
helps their communication smoothly because both look in the same direction or
come to the same consensus. Vice versa, complementary interaction means that
the husband and wife supplement each other. For example, if a husband is good
at communication, he is in charge of answering the phone in the family and
deals with outsiders. Meanwhile the wife excels in financial issues in the
family, therefore, she will manage the family budget. A healthy relationship
has both symmetry and complementary characteristics which helps the family to
develop harmoniously and sustainably. Therefore, when working with families, a
counselor needs to use communication perspectives to clarify the problem and
avoid vague messages and misunderstanding between family members.
Fourth ─ Family assessment
To assess a family, the three following main
points are to be considered:
·
Understanding the family structure,
·
Identifying the stages of family development, and
·
Exploring the functions of the family
To understand the family structure in the relationships of internal, external, and contextual aspects are the first step. In terms of internal aspects, counselors should determine who is the most powerful? Who are the most influential? How is the family organized? What is the boundary between individuals? In terms of the external aspect, we need to identify larger systems including the extended family relationship with relatives and community. In terms of context, counselors need to learn about their clients’ ethnicity, social class, religion, and environment.
Secondly, to identify which stage the family is in will be critical. According
to the family life circle, there are six stages: Single, new couple without
children, couple with children, teenagers, adult children, and old stage.
Regarding the family function, counselors
must detail instrumental activities of each member in the family, such as the
division of labor, their affection towards individuals in the family,
attitudes, verbal and non-verbal language, roles, hierarchy, values, coalition,
and alignment.
Finally ─ The basic rules when
working with families
The role of counselors is to help family
members become more positive through restructuring of the family organization
and highlighting their strengths, and personal and family values. More
importantly, it is essential to create open and clear communications between
individuals in order to work on family problems, along with assisting them in
having a mechanism and ability to dynamically change depending on the stage of
development and family issues. When the family structure is stable and healthy,
signs and symptoms of mental, emotional and physical health of the identified
individual will be decreased and recovered.
Therefore, professional counselors should
keep in mind the following points when working with families:
1. Work
with the family’s definition of the problem to keep them connected
2. Look at the entire system, including other agencies involved with the family
3. Remember circular causality when listening to c/o
4. Align with something in everyone’s position - be friendly to all, don’t take
sides
5. Be active and interrupt dysfunctional interactions
6. To reduce intensity, have the family communicate their message to you
otherwise work with them to direct messages to one another
7. Get perceptions from everyone about the problem
8. Discourage blame and labeling and you messages
9. Watch and monitor interactions (who talks for whom, who takes up for whom,
alliances)
What do you think of the
following illustrated case?
"A 10-year-old boy, whom I have been
working with, has violent outbursts toward his mother. The child has one
younger sibling and he is from a solid home. This child is very concerned with
what he does not have in comparison to everyone else. Hoe does not go without.
He is extremely up and down with his moods, one moment being the most gentle
child you’d ever want to meet the next tearing his mothers’ heart out with his
mouth. He sees a counselor who feels he is very angry and continues to
encourage the mother to stay on the same course, giving unconditional love and
encouragement. Although she has not verbalized it to me, I feel she is
beginning to fear for her other child’s safety because of the outbursts. Dad is
in the home but often threatens to leave because of the volatile situations. He
has been known to have a bad temper and, although he has not done anything
physically, he does verbalize his dislike of the situation, probably more than
you or I would allow. If this child sees a cousin, for example, get a hug, he
reacts in a way that leaves one feeling that he needs four hugs to match what
the other has. He doesn’t seem to want for anything from what it appears in the
home and it has been reported that mom is extremely involved with both
children. No diagnosis has been made, limit setting works on occasion, but we
have a long way to go. Do you have any suggestions? By Laurel
By Doan Thi Ngoc
