Abnormal Psychology

Foundations of Treatment 137

Family and Systems Therapy

Some therapies target family functioning in order to change maladaptive patterns of

interaction and to increase the support family members provide to each other.

Family Therapy

Family therapy is a treatment that involves either an entire family or some portion

of a family. What constitutes a “family”? For our purposes, a family is any group of

people that functions as a family: an extended family that includes several genera-

tions, a blended family of children and parents originally from different households,

any other nontraditional family, as well as a traditional nuclear family that consists

of mother, father, and their children (Carter & McGoldrick, 1999). Family therapy

can be performed using any theoretical approach; the main focus is on the family,

rather than an individual patient.

Systems Therapy: A Different Way of Thinking

About the Family

The most prevalent theoretical orientation in family therapy is systems therapy

(sometimes referred to as family systems therapy), which is designed to change the

communication or behavior patterns of one or more family members. According to

this approach, the family is a system that strives to maintain homeostasis, a state

of equilibrium, so that change in one member affects other family members.

Systems therapy is guided by the view that when one member changes (per-

haps through therapy), change is forced on the rest of the system (Bowen,

1978; Minuchin, 1974).

To a systems therapist, the “patient” is the family, and the individual

member with a psychological disorder is referred to as the identifi ed patient.

Systems therapy focuses on communication and power within the family.

The symptoms of the identifi ed patient are understood to be a result of that

individual’s intentional or unintentional attempts to maintain or change a

pattern within the family or to convey a message to family members.

The Goals of Systems Therapy

The goals of systems therapy are to identify and then change maladap-

tive patterns of interaction and communication among family members

(Gurman, 2000). For instance, had Leon and his parents participated in

systems therapy when he was younger, perhaps the therapist might have

found that Leon’s parents didn’t mind the fact that Leon didn’t socialize

with others; he was a good companion and having him around more meant

that the parents spent less time alone as a couple. The therapist might have

reframed the problem as one in which Leon needed to spend more time with

others so that his parents could have more opportunities to practice spend-

ing time alone as a couple before Leon went off to college and they were

alone all the time.

Methods of Systems Therapy

A systems therapist normally begins by interviewing family members about

the history of the family. This interview establishes which family members are

close to and distant from each other and determines how feelings, issues, and

confl icts tend to be handled within the family. The systems therapist might dis-

cover, for example, that one parent is underinvolved (doesn’t interact much

with his or her child, for instance), and the other is overinvolved (spending

inordinate amounts of time with the child, perhaps fi nishing his or her sen-

tences). In addition, the parents may have a confl icted relationship. Treatment

might then focus on rectifying such imbalances in the family system. The pat-

terns and confl icts are often illustrated graphically; Figure 4.5 illustrates an

angry, antagonistic relationship between parents, which infl uences the child’s

behavior (Kitzmann, 2000).

Figure 4.5

4.5 • Graphing the Family

System Systems therapists may

graphically illustrate the predominant

family dynamic. This fi gure shows confl ict

in the parents’ relationship with each

other. It also shows that each parent tries

to be involved with and control the son

(overfunctioning, represented by the long

arrows), who has withdrawn from both

parents (underfunctioning, represented

by the short arrows). Part of the problem

in this family system may be that the

parents are constantly vying for attention

from the son as an extension of their

confl ict with each other.

Source: Adapted from Ackerman, 1980,

pp. 152, 154.

45 GhithFil

Son

Overfunctioning

Underfunctioning

Barricaded (open conflict)

Father Mother

Family therapy

The form of treatment that involves either the

family as a whole or some portion of it.

Systems therapy

The form of treatment that is designed to

change the communication or behavior

patterns of one or more family members in

the context of the family as a whole; also

known as family systems therapy.