Tag Archives: Family

Family Therapy Confidentiality


Although there are differing perspectives on how secrets should be handled within the context of family therapy, my personal perspective is that the family should have visibility into the individual sessions.  Essentially, anything said during an individual session is subject to being included in family therapy.  Inherent in this perspective is the assumption that this is fully disclosed and discussed in the process of informed consent, so that all members of the family understand the concept.  This perspective comes with both benefits and with drawbacks.

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There are some situations where I suspect an individual would not disclose information in an individual session where they might have otherwise.  An extra marital affair is one such example.  With my personal framework and expectations, the individual may not want to disclose such information with me in individual sessions due to the fact that I would admittedly introduce that subject up in the family session.  The end result is a perpetuation of the secret, and the therapist being “cut out of the loop” on individual secrets.

I believe the benefit is that it adds transparency into the family therapy environment.  I believe a foundation of trust and mutual respect is the foundation on which a family should be built, and as a result, there should be few if any secrets.  One party (the husband, for example) can have confidence in allowing his wife to engage in individual therapy with me because he understands that relevant findings will be brought to the attention of the entire family.  In any case, I would implement this policy because I believe the very act of keeping the secret is an act of collusion.  I agree with the text that this policy is liberating in the respect that it frees me, as a therapist, from being put in the position of keeping a secret of a client participating in conjoint therapy.  I think the situation of having to keep a secret is best avoided entirely with by establishing a framework of transparency from the outset.

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What is a healthy family?


I believe a healthy family is based on a level of mutual respect for other members and themselves.  I believe that a healthy family should provide a level of support for its members, however, each family is a unique system (much like the individuals within it) and each individual will play “roles” within the family system that they are comfortable with.  Individual role-players may exert varying degrees of influence when change occurs (like death, illness, financial issues, or divorce).  Every member of the family should enjoy a sense of security or “belonging” to the family, and all members should share good interpersonal relations with each other.  Healthy families are loyal to each other, and ideally members offer each other unconditional love.  My universal definition of family extends beyond the nuclear family to include multigenerational and extended families… it might also include groups of people with whom you have come to cohabitate (like a college fraternity).

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I am less traditional than most (I suspect) in the respect that I do not narrowly define “marriage” as a relationship that can exist between a man and a woman.  In that respect, my definition of family is predominantly relationship based.  The reader could correctly infer that I am supportive of same sex relationships.  I could potentially see issues in the counseling relationship if I were to counsel someone who was critical of that lifestyle… I might be inclined to suggest that is more “normal” than some people are comfortable with.  All that aside, I would be the first to admit that I have not always taken such a liberal position… perhaps that’s proof that you can teach an old dog new tricks?

 

Family Systems Theory


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Although I wouldn’t have considered myself a family systems theory advocate prior to taking this course, I have becoming increasingly fond of the perspective.  I do not believe you can work with a client, either individually or in the context of family therapy, without attempting to understand the systems (family, work, community, church, and other relevant social systems) that exert influence on and ultimately play a role in the decision making of an individual.  Regardless of whether I intend to work specifically as a family systems therapist, I think a foundation in family systems theory is needed in order to ethically and adequately treat individuals.  It’s even more important when working with couples or families, but I believe that is implicitly implied when you apply it to the individual.    As an aside, this is a great entry point for our earlier conversation about multiculturalism.  Culture is, by definition, is a bidirectional system that both exerts influence on, and is influenced by, our clients.  So, since we have all agreed previously that culture is a consideration we need to account for when providing mental health services, we are by default systems theory advocates (even if it is on a macro level).

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