Theory and Practice of Couples and Family Counseling

Theory and Practice of Couples and Family Counseling
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James Robert Bitter. Theory and Practice of Couples and Family Counseling

TABLE OF CONTENTS

List of Illustrations

Guide

Pages

Theory and Practice of Couples and Family Counseling

DEDICATION

FOREWORD

PREFACE

ABOUT THE AUTHOR

ACKNOWLEDGMENTS

PART 1Basic Issues in the Practice of Couples and Family Counseling

CHAPTER 1. Introduction and Overview

Why I Became a Couples and Family Counselor

An Overview of the Book

An Overview of the Theory Chapters. The Early Pioneers

Object Relations Family Counseling

Adlerian Family Counseling

Bowen and Multigenerational Family Counseling

Satir and the Human Validation Process Model

Whitaker and Symbolic-Experiential Family Counseling

Minuchin and Structural Family Counseling

Strategic Family Counseling

The Postmodern Transition

Solution-Focused and Solution-Oriented (Possibility) Counseling

Postmodern, Social Constructionist, and Narrative Approaches to Family Counseling

Feminist Family Counseling

Evidence-Based Practice

Cognitive Behavioral Family Counseling

Parenting

Current Approaches to Couples Counseling

The Science of Couples Counseling

Emotionally Focused Counseling With Couples

Imago Counseling With Couples

Suggestions for Using the Book

The Systems Perspective

Bioecological Systems Theory

The Family and Macrosystems, Normal Family Processes, Diversity, and Resiliency

Differences Between Systemic and Individual Approaches

Notes

CHAPTER 2. Genograms of Couples and Family Counseling

The History of Family Counseling I: Systemic Pioneers and Their Offspring. Sigmund Freud, Alfred Adler, and Their Followers

Murray Bowen

Carl Whitaker

The Stories of Two Women: Virginia Satir and Lynn Hoffman

The History of Family Counseling II: From Structure to Strategy to Solutions

Salvador Minuchin

Family Systems, Cybernetics, Bateson, and MRI

Jay Haley

The Milan Model

Solution-Focused/Solution-Oriented Models

The History of Family Counseling III: From Postmodern, Social Constructionism to Feminism. Postmodernism

Harlene Anderson, Harold Goolishian, and Karl Tomm

Michael White and David Epston

The Feminist Critique and Feminist Family Counseling

The History of Couples and Family Counseling IV: The Evidence-Based Practices of Cognitive Behavioral Family Therapy, Parenting, and Couples Counseling. Ivan Pavlov, John Watson, and B. F. Skinner: The Development of Behavioral Approaches

Albert Ellis, Aaron Beck, and the Development of Cognitive Approaches

Cognitive Behavioral Family Counseling

Parenting in the 21st Century

The Couples Counselors

Summary

Appendix

CHAPTER 3. The Couples and Family Practitioner as Person and Professional

The Family of the Family Practitioner

Hanging Hats and Clearing the Mind and Heart to Focus

Personal Characteristics and Orientations of Effective Family Practitioners

The Process of Change and Therapeutic Process

Beginning Your Work as a Couples or Family Practitioner

Getting Started

Have the Courage to Be Imperfect

Study Your Own Work

Cultivate Silence and Reflection

Learn to Tolerate Quiet Times

Think About Your Evolving Role as a Family Practitioner

Develop a Sense of Humor

Consider Collaborative Practice

Be Careful With Advice

Have a Life of Your Own

Toward a Foundation for Integration

Gender and Multicultural Lenses

The Scholar-Practitioner in Family Counseling and Therapy

Summary

CHAPTER 4. Virtue, Ethics, and Legality in Couples and Family Practice

A Consideration of Virtue

Systemic Perspectives

Ethics Codes and Standards of Professional Practice

Perspectives on Ethics

Principle Ethics

Virtue Ethics

Participatory Ethics

Ethical Decision-Making

Models of Ethical Decision-Making

The Critical-Evaluation Model

A Virtue Ethics Model

A Participatory Ethics Model

Common Ethical Dilemmas in Couples and Family Practice

Sidebar 4.1 • A Learning Challenge

Confidentiality

Conceptualizing the Client

Informed Consent

Handling Relational Matters in an Individual Context

Gender and Cultural Issues

Professional Regulations and Legal Requirements

Summary

Where to Go From Here

Recommended Readings

Notes

PART 2 Theories and Practice in Couples and Family Counseling

INTRODUCTION TO THE CASE OF THE QUEST FAMILY

Biography of the Quest Family

Quest Family Genogram

Note

CHAPTER 5. Object Relations Family Counseling

Key Concepts

Sigmund Freud

Melanie Klein

W. R. D. Fairbairn

D. W. Winnicott

Margaret S. Mahler

Stephen A. Mitchell

Harry Stack Sullivan

John Bowlby

Alan Schore

David E. Scharff and Jill Savege Scharff

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

First Considerations

Analysis of Resistance

Enlarging the Field of Participation

Working in the Here and Now

Interpretation and Other Interventions

Transference and Working Through

Countertransference

Working With Couples

Object Relations Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resource

CHAPTER 6. Adlerian Family Counseling

Key Concepts

Family Atmosphere

The Family Constellation

Mistaken Goals: An Interactional View

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Early Recollections

Problem Descriptions and Goal Identification

Typical Day

The Child Interview and Goal Disclosure

Reorienting and Reeducating the Family

Working With Couples

Adlerian Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resource

Note

CHAPTER 7. Multigenerational Family Counseling

Key Concepts

Differentiation of the Self and Emotional Cutoff

Triangulation and the Nuclear Family Emotional System

The Family Projection Process and Multigenerational Transmission

Sibling Position

The Societal Projection Process or Societal Regression

Counseling Goals

The Counselor’s Role and Function

Counselor Self-Awareness

Implications for Training Family Counselors

Process and Interventions

Genogram Work

Asking Process Questions

Relationship Experiments

Coaching

I-Positions

Displacement Stories

Working With Couples

Bowen Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

CHAPTER 8. Human Validation Process Model

Key Concepts

Family Life

Functional Versus Dysfunctional Communication in Families

Defensive Communication Stances in Coping With Stress

Family Roles and Family Triads

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Ingredients of an Interaction and the Personal Iceberg

Family Sculpting

Family Reconstruction

Parts Parties

Working With Couples

Satir Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

CHAPTER 9. Structural Family Counseling1

Key Concepts

Family Structure

Family Subsystems

Boundaries

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Family Mapping

Enactments

Reframing

Working With Couples

Structural Family Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

Note

CHAPTER 10. Strategic Family Counseling

The MRI Model

The Milan Model

Key Concepts

Counseling Goals. The MRI Model

The Washington School

The Milan Model

The Counselor’s Role and Function

Process and Interventions

Joining

Reframing

Directives

Paradoxical Interventions

Process and Interventions at MRI

Process and Techniques at the Washington School

Process and Techniques in Milan

Working With Couples

Strategic Family Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

CHAPTER 11. Solution-Focused and Solution-Oriented Family Counseling

Key Concepts

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

The Miracle Question

Exception Questions

Scaling Questions

Signs and Questions of Difference

Compliments and Coping Questions

Summary Messages

Introducing Doubt

Normalization

Changing the Doing of the Problem

Working With the Future

Multiple-Choice Questions

Working With Couples

Solution-Oriented Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

Notes

CHAPTER 12. Postmodernism, Social Construction, and Narratives in Couples and Family Counseling

Key Concepts

The Linguistic Approach: Harlene Anderson and Harold Goolishian

The Reflecting Team: Tom Andersen

The Narrative Approach: Michael White and David Epston

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Listening With Curiosity

Questions That Make a Difference

Naming the Problem

Deconstruction and Externalization

Metaphorical Stances

Alternative Stories and Reauthoring

Maps of Narrative Practice

Involving Outside Communities in Counseling

Letters and Documents

Working With Couples

Narrative Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

Notes

CHAPTER 13. Feminist Family Counseling

Key Concepts

Honoring the Experiences and Perceptions of Women

The Personal Is Political

Egalitarian Relationships

Social Transformation and Advocacy

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Egalitarian Relationships

Consciousness-Raising

Gender Role and Power Analyses

Self-Disclosure

Bibliotherapy

Assertiveness Training

Reframing and Relabeling

Working With Couples

Feminist Counseling With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

CHAPTER 14. Cognitive Behavioral Family Counseling

Key Concepts

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Assessments. Self-Report Questionnaires

Assessment of Cognitions: Interviews

Assessment of Interactions: Interviews

Behavioral Observation

Interventions. Communication Training

Problem-Solving Training

Challenging Irrational Beliefs

Identifying Automatic Thoughts and Cognitive Restructuring

Contracts and Behavior Change Agreements

Acting “As If”

Homework

Working With Couples

CBFT With the Quest Family

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

CHAPTER 15. The Science of Couples Counseling

Key Concepts. The Sound Relationship House

Pillars

Conflict Regulation

Four Horsemen of the Apocalypse

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Assessment and Biofeedback

Process. Conflict Management

Love Maps

The Stress-Reducing Conversation

The Gentle Start-Up

The Gottman-Rapoport Intervention

The Art of Compromise Intervention

Dreams Within Conflict

The Dan Wile Intervention

The Aftermath of a Fight or Regrettable Incident Exercise

Rituals of Connection

Working With Families

Gottman Counseling With Jane and Paul Quest

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

Notes

CHAPTER 16. Emotionally Focused Counseling With Couples

Key Concepts

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

Mirroring Present Process

Engaging in Affect Assembly and Deepening

Choreographing Engaged Encounters

Processing the Encounter

Working With Families

EFC With Jane and Paul Quest

Contributions to Multicultural Counseling and Gender Issues

Summary

Where to Go From Here

Three Essential Books on This Model

Video Resources

Note

CHAPTER 17. Imago Relationship Counseling With Couples

Key Concepts

Counseling Goals

The Counselor’s Role and Function

Process and Interventions

The Couples Dialogue

The Behavior Change Request Dialogue

The Healing Dialogue

Sidebar 17.1 • Couples Dialogue

Sidebar 17.2 • Behavior Change Request Dialogue

Sidebar 17.3 • The Healing Dialogue

Working With Families

Imago Counseling With Jane and Paul Quest

Contributions to Multicultural Counseling and Gender Issues

Where to Go From Here

Three Essential Books on This Model

Video Resources

PART 3 From Self-Discovery to Family Practice

CHAPTER 18. Integration: Forming a Relationship, Couple and Family Assessment, and Treatment

Videotaping Your Work and Taking Time for Reflection

A Process for Couples and Family Counseling Across Models

Common Factors in Couples and Family Practice

Forming a Relationship

Conducting an Assessment

Pillars of Integrative Counseling

The Seven Lenses

Formal Assessments

Hypothesizing and Sharing Meaning

Describing the System

Integrative Models

Facilitating Change

Resilience

Tailoring Treatment

Ensuring Therapeutic Efficacy: Treatment Adherence and Relapse Prevention

Integrative Counseling With the Quest Family

Core Competencies, Accreditation Standards, and Training

Some Final Thoughts

REFERENCES

INDEX

A

B

C

D

E

F

G

H

I

J

K

L

M

N

O

P

Q

R

S

T

U

V

W

Y

Z

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THIRD EDITION

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Modern systems practitioners tend to want as many members of the family as possible in the room—often including friends and other members from the family’s community. It is not, however, how many people are in the room that counts: it is how the family practitioner thinks about the people in the room. It is about focusing on transactions, sequences of interaction, interdependence, recursion, and mutual influence (concepts more fully defined in subsequent chapters): It is about process. It involves seeing the purpose and systemic logic in what often appear to be paradoxical processes. It is accepting the subjectivity of the family practitioner, studying it, knowing it, watching for its impact on the counseling session, and working to place it in the service of clients’ well-being. It is learning to see how a problem affects the couple or family and how these systems maintain the problem. It is understanding that each individual has an internal system (Schwartz, 2001), and it is learning to consider the impact of larger systems on the family, especially the politics that relate to race, gender, culture, sexual or affectional orientation, age, socioeconomic status, and creed. And most recently, it also includes listening to the stories within families, and the stories about these stories, and the ways in which each person participates in creating their own realities as well as the stories about these realities.

In short, family practitioners seek to address systems embedded in systems that are embedded still further in other systems. They seek to explore the meaning and purpose of interactions and transactions and engage in processes that support the kinds of solutions that individuals and families seek for their own lives. In Theory and Practice of Counseling and Psychotherapy (Corey, 2017), Gerald Corey and I used the case of Ann to illustrate the differences between what an individual practitioner and a systemic practitioner might do:

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