Instructor’s Resource Manual and Test Bank
for
Family Therapy: History, Theory, and
Practice
Sixth Edition
Samuel T. Gladding
Wake Forest University
PR
O
FD
O
C
,Contents
Prologue Rationale For Family Therapy ................................................................................................................. 1
Chapter 1 The History of Family Therapy: Evolution and Revolution .................................................................... 2
Chapter 2 The Theoretical Context of Family Therapy .......................................................................................... 10
Chapter 3 Types and Functionality of Families ..................................................................................................... 17
Chapter 4 Working with Single-Parent and Blended Families ............................................................................... 24
Chapter 5 Working with Culturally Diverse Families ............................................................................................ 36
Chapter 6 Ethical, Legal, and Professional Issues in Family Therapy .................................................................... 49
PR
Chapter 7 The Process of Family Therapy ............................................................................................................. 63
Chapter 8 Couple and Marriage Therapy and Enrichment ..................................................................................... 74
Chapter 9 Transgenerational Theories: Psychodynamic Family Theory and Bowen Family Systems Theory ...... 86
O
Chapter 10 Experiential Family Therapy .................................................................................................................. 94
Chapter 11 Behavioral and Cognitive-Behavioral Family Therapies ..................................................................... 102
FD
Chapter 12 Structural Family Therapy ................................................................................................................... 111
Chapter 13 Strategic Family Therapies................................................................................................................... 118
Chapter 14 Solution-Focused Brief Therapy and Narrative Family Therapy ......................................................... 126
O
Chapter 15 Working with Substance-Related Disorders, Domestic Violence, and Child Abuse ........................... 134
C
Chapter 16 Research and Assessment in Family Therapy ...................................................................................... 144
Answer Key .............................................................................................................................................................. 152
ii
, Prologue
• Approximately 19% of the U.S. population is seen by marriage and family therapists each year at a cost of more
than $300 million
• Despite these statistics, marriage and family therapy is relatively new with its theoretical and clinical beginnings
starting in the 1940s and its real growth occurring from the 1970s until today
• Family therapy differs from individual and group counseling in its emphasis and clientele
❖ Individual counseling is more intrapersonal
❖ Group counseling is more interpersonal
❖ Family therapy for the most part focuses on making changes in the family system
• Family therapy is connected to the influence of creative, innovative, and assertive mental health practitioners
who devised and advocated new ways of providing services to clients
The Rationale for Family Therapy
• Family therapists believe that most life difficulties stem from and can best be addressed within the family
system
PR
• Family therapy is an effective treatment approach, particularly in cases of:
❖ adolescent anorexia nervosa
❖ adolescent drug abuse
❖ adult alcoholism and drug abuse
❖ adult hypertension
❖ adult obesity
❖ adult schizophrenia
O
❖ aggression and noncompliance in children with ADD and ADHD
❖ childhood and adolescent anxiety disorders
❖ childhood autism
❖ childhood conduct disorders
FD
❖ chronic physical illness in adults and children
❖ couple distress and conflict
❖ dementia
❖ depression in women in distressed marriages
• Client satisfaction is high, with 97% satisfaction rates and high percentages of clients stating they received the
help they wanted from marriage and family therapists
O
Reasons for Working with Families as Opposed to Working with Individuals
• Provides flexibility in conceptualizing cases from both linear and circular causality perspectives
C
• Provides for increased complexity and treatment options for clients
• Involves other real, significant people in the treatment process and brings the action into the room
• All family members receive treatment interventions simultaneously
• Family therapy tends to be briefer than individual counseling
• Family therapy focuses on the interpersonal rather than the intrapersonal which creates new and unique ways of
resolving problems
1
, Chapter 1
The History of Family Therapy: Evolution and Revolution
Chapter Overview
Family Therapy Through the Decades
• Prior to the development of marriage and family therapy as a profession, older family members assisted
younger members and adult family members cared for the very young and the very old
• Before 1940
❖ focus in the United States was on the individual
❖ society utilized clergy, lawyers, and doctors for advice and counsel
❖ prevailing individual theories were psychoanalysis and behaviorism
• Catalysts for the growth of family therapy
❖ courses in family life education became popular
❖ establishment of marriage and family training programs (e.g., Marriage Council of Philadelphia in
1932)
PR
❖ founding of the National Council on Family Relations in 1938 and the journal Marriage and Family
Living in 1939
❖ county home extension agents educated and promoted understanding family dynamics
• Family therapy: 1940 to 1949
❖ establishment of the American Association of Marriage Counselors in 1942
❖ first account of concurrent marital counseling published in 1948 by Bela Mittleman
❖ research on families with a schizophrenic member by Theodore Litz
O
❖ National Mental Health Act of 1946 funded research on prevention, diagnosis, and treatment of mental
health disorders
• Family therapy: 1950 to 1959
❖ individual leaders dominated the profession
FD
❖ Nathan Ackerman used a psychoanalytical approach to understand and treat families
❖ Gregory Bateson studied communication patterns in families with a schizophrenic member and
developed the double bind theory
▪ double bind theory - two seemingly contradictory messages may exist simultaneously and lead to
confusion
❖ Mental Research Institute was created by Don Jackson in Palo Alto, CA
O
▪ changed problem conceptualization from a pathology oriented individual perspective to a more
relationship based orientation
▪ brief therapy developed at MRI as one of the first new approaches to family therapy
❖ Carl Whitaker pushed the conventional envelope by seeing spouses and children in therapy
C
▪ set up the first family therapy conference at Sea Island, GA
❖ Murray Bowen studied families with schizophrenic members
▪ held therapy sessions with all family members present
▪ pioneered theoretical thinking on the influence of previous generations on the mental health of
families
❖ Ivan Boszormenyi-Nagy developed contextual therapy focusing on the healing of human relationships
through trust and commitment
• Family therapy: 1960 to 1969
❖ An era of rapid growth in family therapy
❖ Increase in training centers and academic programs in family therapy
❖ Jay Haley, expanding on the work of Milton Erikson, developed strategic family therapy
▪ emphasis on the therapist gaining and maintaining power during treatment
▪ strategic therapy uses directives to assist clients to go beyond gaining insight
▪ edited Family Process from 1961 to 1969, providing a means for to keep professions linked and
informed
▪ Haley joined with Salvador Minuchin at the Philadelphia Child Guidance Clinic in the late 1960's
2
for
Family Therapy: History, Theory, and
Practice
Sixth Edition
Samuel T. Gladding
Wake Forest University
PR
O
FD
O
C
,Contents
Prologue Rationale For Family Therapy ................................................................................................................. 1
Chapter 1 The History of Family Therapy: Evolution and Revolution .................................................................... 2
Chapter 2 The Theoretical Context of Family Therapy .......................................................................................... 10
Chapter 3 Types and Functionality of Families ..................................................................................................... 17
Chapter 4 Working with Single-Parent and Blended Families ............................................................................... 24
Chapter 5 Working with Culturally Diverse Families ............................................................................................ 36
Chapter 6 Ethical, Legal, and Professional Issues in Family Therapy .................................................................... 49
PR
Chapter 7 The Process of Family Therapy ............................................................................................................. 63
Chapter 8 Couple and Marriage Therapy and Enrichment ..................................................................................... 74
Chapter 9 Transgenerational Theories: Psychodynamic Family Theory and Bowen Family Systems Theory ...... 86
O
Chapter 10 Experiential Family Therapy .................................................................................................................. 94
Chapter 11 Behavioral and Cognitive-Behavioral Family Therapies ..................................................................... 102
FD
Chapter 12 Structural Family Therapy ................................................................................................................... 111
Chapter 13 Strategic Family Therapies................................................................................................................... 118
Chapter 14 Solution-Focused Brief Therapy and Narrative Family Therapy ......................................................... 126
O
Chapter 15 Working with Substance-Related Disorders, Domestic Violence, and Child Abuse ........................... 134
C
Chapter 16 Research and Assessment in Family Therapy ...................................................................................... 144
Answer Key .............................................................................................................................................................. 152
ii
, Prologue
• Approximately 19% of the U.S. population is seen by marriage and family therapists each year at a cost of more
than $300 million
• Despite these statistics, marriage and family therapy is relatively new with its theoretical and clinical beginnings
starting in the 1940s and its real growth occurring from the 1970s until today
• Family therapy differs from individual and group counseling in its emphasis and clientele
❖ Individual counseling is more intrapersonal
❖ Group counseling is more interpersonal
❖ Family therapy for the most part focuses on making changes in the family system
• Family therapy is connected to the influence of creative, innovative, and assertive mental health practitioners
who devised and advocated new ways of providing services to clients
The Rationale for Family Therapy
• Family therapists believe that most life difficulties stem from and can best be addressed within the family
system
PR
• Family therapy is an effective treatment approach, particularly in cases of:
❖ adolescent anorexia nervosa
❖ adolescent drug abuse
❖ adult alcoholism and drug abuse
❖ adult hypertension
❖ adult obesity
❖ adult schizophrenia
O
❖ aggression and noncompliance in children with ADD and ADHD
❖ childhood and adolescent anxiety disorders
❖ childhood autism
❖ childhood conduct disorders
FD
❖ chronic physical illness in adults and children
❖ couple distress and conflict
❖ dementia
❖ depression in women in distressed marriages
• Client satisfaction is high, with 97% satisfaction rates and high percentages of clients stating they received the
help they wanted from marriage and family therapists
O
Reasons for Working with Families as Opposed to Working with Individuals
• Provides flexibility in conceptualizing cases from both linear and circular causality perspectives
C
• Provides for increased complexity and treatment options for clients
• Involves other real, significant people in the treatment process and brings the action into the room
• All family members receive treatment interventions simultaneously
• Family therapy tends to be briefer than individual counseling
• Family therapy focuses on the interpersonal rather than the intrapersonal which creates new and unique ways of
resolving problems
1
, Chapter 1
The History of Family Therapy: Evolution and Revolution
Chapter Overview
Family Therapy Through the Decades
• Prior to the development of marriage and family therapy as a profession, older family members assisted
younger members and adult family members cared for the very young and the very old
• Before 1940
❖ focus in the United States was on the individual
❖ society utilized clergy, lawyers, and doctors for advice and counsel
❖ prevailing individual theories were psychoanalysis and behaviorism
• Catalysts for the growth of family therapy
❖ courses in family life education became popular
❖ establishment of marriage and family training programs (e.g., Marriage Council of Philadelphia in
1932)
PR
❖ founding of the National Council on Family Relations in 1938 and the journal Marriage and Family
Living in 1939
❖ county home extension agents educated and promoted understanding family dynamics
• Family therapy: 1940 to 1949
❖ establishment of the American Association of Marriage Counselors in 1942
❖ first account of concurrent marital counseling published in 1948 by Bela Mittleman
❖ research on families with a schizophrenic member by Theodore Litz
O
❖ National Mental Health Act of 1946 funded research on prevention, diagnosis, and treatment of mental
health disorders
• Family therapy: 1950 to 1959
❖ individual leaders dominated the profession
FD
❖ Nathan Ackerman used a psychoanalytical approach to understand and treat families
❖ Gregory Bateson studied communication patterns in families with a schizophrenic member and
developed the double bind theory
▪ double bind theory - two seemingly contradictory messages may exist simultaneously and lead to
confusion
❖ Mental Research Institute was created by Don Jackson in Palo Alto, CA
O
▪ changed problem conceptualization from a pathology oriented individual perspective to a more
relationship based orientation
▪ brief therapy developed at MRI as one of the first new approaches to family therapy
❖ Carl Whitaker pushed the conventional envelope by seeing spouses and children in therapy
C
▪ set up the first family therapy conference at Sea Island, GA
❖ Murray Bowen studied families with schizophrenic members
▪ held therapy sessions with all family members present
▪ pioneered theoretical thinking on the influence of previous generations on the mental health of
families
❖ Ivan Boszormenyi-Nagy developed contextual therapy focusing on the healing of human relationships
through trust and commitment
• Family therapy: 1960 to 1969
❖ An era of rapid growth in family therapy
❖ Increase in training centers and academic programs in family therapy
❖ Jay Haley, expanding on the work of Milton Erikson, developed strategic family therapy
▪ emphasis on the therapist gaining and maintaining power during treatment
▪ strategic therapy uses directives to assist clients to go beyond gaining insight
▪ edited Family Process from 1961 to 1969, providing a means for to keep professions linked and
informed
▪ Haley joined with Salvador Minuchin at the Philadelphia Child Guidance Clinic in the late 1960's
2
