Systemic therapy

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Systemic therapy is a type of psychotherapy that seeks to address people in relationships, dealing with the interactions of groups and their interactional patterns and dynamics. [1]

Contents

Early forms of systemic therapy were based on cybernetics and systems theory. Systemic therapy practically addresses stagnant behavior patterns within living systems without analyzing their cause. The therapist's role is to introduce creative "nudges" to help systems change themselves. This approach is increasingly applied in various fields like business, education, politics, psychiatry, social work, and family medicine.

History

Systemic therapy has its roots in family therapy, or more precisely family systems therapy as it later came to be known. In particular, systemic therapy traces its roots to the Milan school of Mara Selvini Palazzoli, [2] [3] [4] but also derives from the work of Salvador Minuchin, Murray Bowen, Ivan Boszormenyi-Nagy, as well as Virginia Satir and Jay Haley from MRI in Palo Alto. These early schools of family therapy represented therapeutic adaptations of the larger interdisciplinary field of systems theory which originated in the fields of biology and physiology.

The development of Systemic Family Therapies began in the 1960s when families were viewed as complex systems. Depending on the number of elements and how they are organized  can alter how complex the system is. The system is required to have control and feedback mechanisms, this is where cybernetics come in place. Norbert Wiener, a mathematician, came up with the term Cybernetics which refers to the study of the automatic control system. Another contributor to this system came from Gregory Bateson, he created the idea that the family is a system governed by cybernetic principles. In one of those principles the Systemic theory is mentioned, this theory explains further into how individuals interact with each other, their connections to others, patterns, and their relationships. [5]

Early forms of systemic therapy were based on cybernetics. In the 1970s this understanding of systems theory was central to the structural (Minuchin) and strategic (Haley, Selvini Palazzoli) schools of family therapy which would later develop into systemic therapy. In the light of postmodern critique, the notion that one could control systems or say objectively "what is" came increasingly into question. Based largely on the work of anthropologists Gregory Bateson and Margaret Mead, this resulted in a shift towards what is known as "second-order cybernetics" which acknowledges the influence of the subjective observer in any study, essentially applying the principles of cybernetics to cybernetics – examining the examination.

As a result, the focus of systemic therapy (ca. 1980 and forward) has moved away from a modernist model of linear causality and understanding of reality as objective, to a postmodern understanding of reality as socially and linguistically constructed.

Practical application

Systemic therapy approaches problems practically rather than analytically. It seeks to identify stagnant patterns of behavior within a living system - a group of people, such as a family. It then addresses those patterns directly, without analysing their cause. Systemic therapy does not attempt to determine past causes, such as subconscious impulses or childhood trauma, or to diagnose. Thus, it differs from psychoanalytic and psychodynamic forms of family therapy (for example, the work of Horst-Eberhard Richter).

Systemic therapies are increasingly being used in personal and professional settings, but also have evidence in benefitting children with mental disorders as well. Behavioral disorders that affect mood and learning abilities have working evidence that supports the implementation of systemic therapy amongst younger groups of children who may struggle with these issues (Retzlaff et al., 2013). [6] The approach of reframing daily struggles for those with mood disorders helps to aid in the grounding and practicality of their situations. Those receiving help from systemic therapies are set to focus on the realities of their daily lives and offer a pragmatic perspective on problem-solving skill sets.

When approaching systemic therapy, a multitude of factors are considered in order to reach the desired results. Approach is determined on a case-by-case basis, involving the consideration of factors such as; mental disorders, the adolescent’s upbringing, situational life events, stress induced by societal factors, unconventional family dynamics, etc. (Lorås, 2017). [7] The methodology [8] of systemic therapy involves an amalgamation of various data points to be able to practice what approach might be best to implement for the individual. All contributing stress factors of the individual's reality are considered during the development of the grounded theory analysis, in order to best aid the individuals in need.

Although systemic therapy does not attempt to determine past causes, it is important to recognize that Systemic Therapy is used in family therapy also known as "Systemic Family Therapy". [9] These practices can often be seen and used in families or children that abuse drugs, have behavior problems, chronic illness, and many other uses (Cottrell & Boston, 2002) [10] These are some way Systemic Therapy has been utilized in our mental health institutions, and continues to be practiced on patients.

A key point of this postmodern perspective is not a denial of absolutes. Instead, the therapist recognises that they do not hold the capacity to change people or systems. Their role is to introduce creative "nudges" which help systems to change themselves.

An interesting study by Eugene K. Epstein [11] supports the idea that a therapist does not hold the capacity to change people or systems. Epstein argues that although we can't change systems, we can influence them. Part of Postmodernism relies on our self-agency, our cultures, practices, etc. (Epstein, 2016) Therefore these views and cultural biases affect and influence the approach of therapy, in this instance systemic Therapy. Therapists and those practicing Systemic Therapy can analyze and see patterns of emotions. Many times people can feel constrained on what they feel or be confused about what they are feeling, when you can clarify and understand what emotions you are feeling it can lead to a positive change (Bertrando & Arcelloni, 2014). This means Systemic Therapy also helps exercise emotional interpretation.

There are various forms of techniques that involve systemic therapy. One form of therapy used is structural family therapy. This consists of  Structural family therapists interfering to form the ideal family structures that are known. As for families who have complex family dynamics. A few techniques that are advised to put into practice is to confront the complex family boundaries. As well as, reestablishing the family structure by shifting the families composure and forming family relatives in pairs opposed to one another. These are a few procedures that are believed to restore position scales. [12]

An additional, overview that best helps to comprehend this approach is the outcome of this form of therapy is to gather family individuals closer to the model. Therefore the proper approach is to use guidance and recommendations. The therapists believe this is one of the most effective techniques. The therapist addresses this form of technique by implementing an oral form of communication. For instance, the therapist will begin by asking a series of questions. The questions involve demonstrating characteristics of authority.The individual who discusses new indications establishes to a situation or set of routines. Then the therapist will provide the individuals with a certain scenario that will help them better navigate an upcoming conflict that may arise. This will allow family individuals to engage in discussion and offer possible resolutions. [13]

Also, there is additional information that provides insight into the positive outcome of systemic interference in families of children with distinct difficulties. This refers to family therapy or additional family-orientated techniques. This refers to family therapy or additional family-orientated techniques. For instance, family-orientated interceptions have demonstrated positive results regarding infants' sleeping issues.

There is a brief discussion of the positive impact that family-orientated approaches are a proper remedy for establishing wakening issues. These are the most common issues presented during the infancy stage. In these forms of techniques, parents are advised on how to minimize their infant's afternoon naps. And constructing effective nighttime practices. As well as, eliminating parent-infant interaction during the nighttime sleeping cycle. There was also a sleeping agenda that helped minimize the sudden awakening of infants.

The final result indicated that the systemic approach helped reduce the awakening in infants and had a positive resultion on their sleeping issues. [14]

Another technique that involves systemic therapy is conceptualization, which allows the therapist to gather the patient's symptoms in context and looks into how the patient experiences creating a pattern with other individuals or family. [15] These forms of systemic therapy help people of any age group resolve their issues. Issues including anger management, addictions to substances, relationship problems, mood disorders, and more. Human interactions are connected to their emotions and in terms can branch out to their social, or cultural interventions. Evidence supports how systemic interventions have a positive effect on infants and certain emotional problems they may have such as behavior issues. [16]

Systemic therapy neither attempts a 'treatment of causes' nor of symptoms; rather it gives living systems nudges that help them to develop new patterns together, taking on a new organizational structure that allows growth. [17]

While family systems therapy only addresses families, systemic therapy in a similar fashion to Systemic hypothesising addresses other systems. The systemic approach is increasingly used in business, education, politics, psychiatry, social work, and family medicine. [18]

See also

Related Research Articles

Psychotherapy is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills. Numerous types of psychotherapy have been designed either for individual adults, families, or children and adolescents. Certain types of psychotherapy are considered evidence-based for treating some diagnosed mental disorders; other types have been criticized as pseudoscience.

Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind–body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.

Clinical psychology is an integration of human science, behavioral science, theory, and clinical knowledge for the purpose of understanding, preventing, and relieving psychologically-based distress or dysfunction and to promote subjective well-being and personal development. Central to its practice are psychological assessment, clinical formulation, and psychotherapy, although clinical psychologists also engage in research, teaching, consultation, forensic testimony, and program development and administration. In many countries, clinical psychology is a regulated mental health profession.

Attachment disorder is a broad term intended to describe disorders of mood, behavior, and social relationships arising from unavailability of normal socializing care and attention from primary caregiving figures in early childhood. Such a failure would result from unusual early experiences of neglect, abuse, abrupt separation from caregivers between three months and three years of age, frequent change or excessive numbers of caregivers, or lack of caregiver responsiveness to child communicative efforts resulting in a lack of basic trust. A problematic history of social relationships occurring after about age three may be distressing to a child, but does not result in attachment disorder.

Emotional reasoning is a cognitive process by which an individual concludes that their emotional reaction proves something is true, despite contrary empirical evidence. Emotional reasoning creates an 'emotional truth', which may be in direct conflict with the inverse 'perceptional truth'. It can create feelings of anxiety, fear, and apprehension in existing stressful situations, and as such, is often associated with or triggered by panic disorder or anxiety disorder. For example, even though a spouse has shown only devotion, a person using emotional reasoning might conclude, "I know my spouse is being unfaithful because I feel jealous."

<span class="mw-page-title-main">Narrative therapy</span> Form of psychotherapy

Narrative therapy is a form of psychotherapy that seeks to help patients identify their values and the skills associated with them. It provides the patient with knowledge of their ability to live these values so they can effectively confront current and future problems. The therapist seeks to help the patient co-author a new narrative about themselves by investigating the history of those values. Narrative therapy is a social justice approach to therapeutic conversations, seeking to challenge dominant discourses that shape people's lives in destructive ways. While narrative work is typically located within the field of family therapy, many authors and practitioners report using these ideas and practices in community work, schools and higher education. Narrative therapy has come to be associated with collaborative as well as person-centered therapy.

Salvador Minuchin was a family therapist born and raised in San Salvador, Entre Ríos, Argentina. He developed structural family therapy, which addresses problems within a family by charting the relationships between family members, or between subsets of family. These charts represent power dynamics as well as the boundaries between different subsystems. The therapist tries to disrupt dysfunctional relationships within the family, and cause them to settle back into a healthier pattern.

Motivational therapy is a combination of humanistic treatment and enhanced cognitive-behavioral strategies, designed to treat substance use disorders. It is similar to motivational interviewing and motivational enhancement therapy.

Attachment therapy is a pseudoscientific child mental health intervention intended to treat attachment disorders. It is found primarily in the United States, and much of it is centered in about a dozen clinics in Evergreen, Colorado, where Foster Cline, one of the founders, established his clinic in the 1970s.

Child psychotherapy, or mental health interventions for children refers to the psychological treatment of various mental disorders diagnosed in children and adolescents. The therapeutic techniques developed for younger age ranges specialize in prioritizing the relationship between the child and the therapist. The goal of maintaining positive therapist-client relationships is typically achieved using therapeutic conversations and can take place with the client alone, or through engagement with family members.

Harlene Anderson is an American psychologist and a cofounder of the Postmodern Collaborative Approach to therapy. In the 1980s, Anderson and her colleague Harold A. Goolishian pioneered a new technique that is used to relate to patients within therapy through language and collaboration, and without the use of diagnostic labels. This approach to therapy places the patient in control of the therapy session and asks the therapist to focus on the present session and ignore any preconceived notions they may have. This approach was first developed for the use of family and mental health therapists, but has since expanded into a variety of professional practices such as organizational psychology, higher education, and research.

Strategic Family Therapy is a modality of family therapy that focuses on problem-solving in relationship dynamics and utilizing behavioral solutions to facilitate change in the family. There are three prominent models of Strategic Family Therapy, through the Mental Research Institute, the teachings of Jay Haley and Cloé Madanes, and the Milan Systemic Model as posited by Mara Selvini Palazzoli, Gianfranco Cecchin, Luigi Boscolo, and Giuliana Prata.

Emotionally focused therapy and emotion-focused therapy (EFT) are a set of related approaches to psychotherapy with individuals, couples, or families. EFT approaches include elements of experiential therapy, systemic therapy, and attachment theory. EFT is usually a short-term treatment. EFT approaches are based on the premise that human emotions are connected to human needs, and therefore emotions have an innately adaptive potential that, if activated and worked through, can help people change problematic emotional states and interpersonal relationships. Emotion-focused therapy for individuals was originally known as process-experiential therapy, and it is still sometimes called by that name.

<span class="mw-page-title-main">Mara Selvini Palazzoli</span> Italian psychiatrist (1916-1999)

Mara Selvini Palazzoli (1916–1999) was an Italian psychiatrist and founder in 1971, with Gianfranco Cecchin, Luigi Boscolo and Giuliana Prata, of the systemic and constructivist approach to family therapy which became known as the Milan family systemsapproach and more generally, the school of systemic family therapy. They were variously called the Milan Team or the Milan Associates. Mara Selvini Palazzoli and the Milan Team worked with serious psychiatric disorders in families with anorexic and schizophrenic members.

<span class="mw-page-title-main">Personality systematics</span>

Personality systematics is a contribution to the psychology of personality and to psychotherapy summarized by Jeffrey J. Magnavita in 2006 and 2009. It is the study of the interrelationships among subsystems of personality as they are embedded in the entire ecological system. The model falls into the category of complex, biopsychosocial approaches to personality. The term personality systematics was originally coined by William Grant Dahlstrom in 1972.

<span class="mw-page-title-main">Bradford Keeney</span>

Bradford Keeney, Ph.D. is a creative therapist, cybernetician, anthropologist of cultural healing traditions, improvisational performer, and spiritual healer. Bradford Keeney has served as a professor, founder, and director of clinical doctoral programs in numerous universities. He is the originator of several orientations to psychotherapy including improvisational therapy, resource focused therapy, and creative therapy. He is the inventor of recursive frame analysis, a research method that discerns patterns of transformation in conversation. A Clinical Fellow of the American Association for Marriage and Family Therapy, he received the 2008 Distinguished Lifetime Achievement Award from the Louisiana Association for Marriage and Family Therapy.

Structural family therapy (SFT) is a method of psychotherapy developed by Salvador Minuchin which addresses problems in functioning within a family. Structural family therapists strive to enter, or "join", the family system in therapy in order to understand the invisible rules which govern its functioning, map the relationships between family members or between subsets of the family, and ultimately disrupt dysfunctional relationships within the family, causing it to stabilize into healthier patterns. Minuchin contends that pathology rests not in the individual, but within the family system.

Family therapy is a branch of psychotherapy focused on families and couples in intimate relationships to nurture change and development. It tends to view change in terms of the systems of interaction between family members.

<i>A Stranger in the Family</i> 1997 book by Vincenzo Di Nicola

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The dynamic-maturational model of attachment and adaptation (DMM) is a biopsychosocial model describing the effect attachment relationships can have on human development and functioning. It is especially focused on the effects of relationships between children and parents and between reproductive couples. It developed initially from attachment theory as developed by John Bowlby and Mary Ainsworth, and incorporated many other theories into a comprehensive model of adaptation to life's many dangers. The DMM was initially created by developmental psychologist Patricia McKinsey Crittenden and her colleagues including David DiLalla, Angelika Claussen, Andrea Landini, Steve Farnfield, and Susan Spieker.

References

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  3. DiNicola, Vincenzo F. Carte routiére pour le schizo-land: Mara Selvini Palazzoli et le modèle de Milan de thérapie familiale systémique. Systèmes Humains, 1986, 2(1): 61‑74.
  4. DiNicola, Vincenzo F. Mara Selvini Palazzoli et le modèle de l’école de Milan de thérapie familiale systémique: Bibliographie [Mara Selvini Palazzoli and the Milan model of systemic family therapy: Bibliography]. Systèmes Humains, 1986, 2(1): 129‑135.
  5. Gibbons, Rachel; O'Reilly, Jo (2021-06-10). Seminars in the Psychotherapies. Cambridge University Press. ISBN   978-1-108-58323-7.
  6. Retzlaff, Ruediger; von Sydow, Kirsten; Beher, Stefan; Haun, Markus W.; Schweitzer, Jochen (December 2013). "The Efficacy of Systemic Therapy for Internalizing and Other Disorders of Childhood and Adolescence: A Systematic Review of 38 Randomized Trials". Family Process. 52 (4): 619–652. doi:10.1111/famp.12041. ISSN   0014-7370.
  7. Lorås, Lennart (2018-03-01). "Systemic Family Therapy Competences in Child and Adolescent Mental Health Care". Contemporary Family Therapy. 40 (1): 1–9. doi:10.1007/s10591-017-9440-z. ISSN   1573-3335.
  8. Burck, Charlotte (August 2005). "Comparing qualitative research methodologies for systemic research: the use of grounded theory, discourse analysis and narrative analysis". Journal of Family Therapy. 27 (3): 237–262. doi:10.1111/j.1467-6427.2005.00314.x. ISSN   0163-4445.
  9. Bertrando, Paolo (July 24, 2014). "Emotions in the Practice of Systemic Therapy".
  10. Cottrell, David (May 28, 2002). "Practitioner Review: The effectiveness of systemic family therapy for children and adolescents".
  11. K. Epstein, Eugene. "The Narrative Turn: Postmodern Theory and Systemic Therapy" (PDF). The Narrative Turn: Postmodern Theory and Systemic Therapy: 10.
  12. Asen, Eia (2002). "Outcome research in family therapy". Advances in Psychiatric Treatment. 8 (3): 230–238. doi:10.1192/apt.8.3.230. ISSN   1355-5146.
  13. Cottrell, David; Boston, Paula (2002). "Practitioner Review: The effectiveness of systemic family therapy for children and adolescents". Journal of Child Psychology and Psychiatry. 43 (5): 573–586. doi:10.1111/1469-7610.00047. ISSN   0021-9630.
  14. Carr, Alan (2014). "The evidence base for family therapy and systemic interventions for child‐focused problems". Journal of Family Therapy. 36 (2): 107–157. doi:10.1111/1467-6427.12032. hdl: 10197/7270 . ISSN   0163-4445.
  15. Ph.D, Jeremy Sutton (2021-07-19). "What Is Systems Therapy? 7 Theories & Techniques Explained". PositivePsychology.com. Retrieved 2024-05-12.
  16. Carr, Alan (February 2009). "The effectiveness of family therapy and systemic interventions for child‐focused problems". Journal of Family Therapy. 31 (1): 3–45. doi:10.1111/j.1467-6427.2008.00451.x. hdl: 10197/4821 . ISSN   0163-4445.
  17. Arist von Schlippe and Jochen Schweitzer, Lehrbuch der Systemischen Therapie und Beratung (Göttingen: Vandenhoeck & Ruprecht) 1998, p 93.
  18. Arist von Schlippe and Jochen Schweitzer, Lehrbuch der Systemischen Therapie und Beratung (Göttingen: Vandenhoeck & Ruprecht) 1998, pp 245-261. For the field of family medicine see also Susan H. McDaniel, et al. Medical Family Therapy: A Biopychosocial Approach to Families with Health Problems (New York: Basic Books) 1992 pp 26-35