Family of origin therapy is a kind of psychotherapy. It was originally developed by the psychiatrist Murray Bowen in the 1950s and 60s. He revolutionized how we look at human behavior with his Family Systems Theory. This theory applies not only to families but can be extended to better understand the working of organizations or even of society as a whole.

Bowen studied the way in which the family functions as a unit. He considered that the family unit is the result of an evolutionary process. For five years he observed the behavior of families with a schizophrenic member and he concluded that the behavior or problems of any one member affect the other members and the family unit as a whole. Bowen created genograms or a pictorial history of the previous generations of each family. These helped him to pick up on character traits, behaviors, or problems that were passed on from generation to generation.  

The Family Systems approach to therapy considers people to be the product of their family of origin, or the family that they grew up in. These need not necessarily be the blood family, but those who have influenced the thoughts and beliefs in the developing years. The systems approach believes that by improving the functioning of the family as a unit the problems of its members will also improve. It considers that the dynamics of a group, in this case, the family, must be understood if problems are going to be identified and solved.

What are the 3 goals of family therapy?

The three main goals of family therapy are to-

1.     Develop and maintain healthy boundaries within the family unit.

Boundaries are an integral part of all families. Families, where the boundaries are not clearly defined, are often dysfunctional, with problems and tensions within the family unit.  A family therapist will help the family members to establish boundaries between them that clarify their interactions. Some boundaries will be open to some family members and closed to others. Boundaries can help family members to understand their role in the family, the expectations that other family members have of them, and the responsibility that their role implies. Boundaries are classified as clear, rigid, or defuse. The therapist’s goal is to assist the family in the creation and maintenance of clear boundaries that are neither too rigid nor too diffuse. Boundaries should however be permeable to accommodate adequately the needs of all family members. The boundaries that need to be established include those between parents and children, between the couple, and between siblings.  

2.     Encourage communication and so increase cohesion, empathy, and understanding between family members.

Once boundaries have been established, it is easier for family members to communicate. Each person has a clearer view of their own role and that of other family members. This permits greater understanding, tolerance, and empathy. Relationships can develop positively and each member feels that they are an equally important part of the family but are more aware that each member has a different role and responsibility. Understanding this can help to diffuse tensions and conflicts and promote respectful exchanges of thoughts and ideas. The therapist will try to create a sense of unity between the family members. This is achieved by promoting trust and honesty between them. Also, by encouraging family members to forgive others and to include members who may have become isolated.

3.     Promote problem-solving and so decrease conflicts within the family.

Once the communication skills of the family have begun to improve, the therapist will then encourage them to identify problem areas within the family unit. Different techniques of family therapy will be used to allow families to explore solutions to these problems and to promote a more harmonic, positive, and cohesive unit. The family therapist frequently illustrates examples of situations with stories about other families and encourages the family in therapy to give their opinions.

Members are inspired to express their own feelings or emotions about the situation. The therapist guides them away from making accusatory claims or blaming others for the situation. Anger management may be used if one or more family members tend to become overly distraught or abusive. The therapist is trained in ways to diffuse tensions to allow the development of respectful communication that can result in finding real solutions to real problems

Family therapy helps to heal emotional, mental, and psychological problems that are tearing the family apart. Depending on the nature and the severity of the situation, different approaches may be used. The goals of family therapy can be achieved using a wide variety of different techniques that can be employed with an individual family member, a couple, or with the entire family.

What are the 4 family communication patterns?

Family Communication Patterns (FCP) reflect how parents communicate with their children. The patterns fit into two groups. They are either social-oriented or concept-oriented. Families that are social, or conformity -oriented, are controlling and commanding, and a parent is usually the authoritative figure. Children conform to their parent’s wishes to maintain the peace. Conformity orientation reflects the extent to which communication in the family reflects the hierarchy in the family.  Families with high conformity orientation typically try to avoid conflict and so have a large number of topics that are avoided in discussions. Families that are concept, or conversation-oriented, encourage the children to express their ideas and opinions and to develop their own individual ideas.

There are four types of FCP.

  1.   Consensual– high on both orientations. Here there is open conversation and communication along with a sense of conformity within the family unit, although parents usually do have the final decision. Families can discuss a wide range of subjects, and children are encouraged to voice their opinions, although ultimately the parents expect their children to follow their parental authority and to eventually develop similar opinions to them.
  1.   Pluralistic– low on social and high on concept-orientation. When there is conversation without conformity everyone has an equal input, and the family reaches decisions together as a unit.  Pluralistic families communicate openly on a wide range of subjects and parents tend to respect their children’s independence to reach their own conclusions even if they are not in total agreement with them. Children who develop in this type of family tend to be well self-differentiated or have a clear idea of who they are.
  1.     Protective– low on concept and high on socio-orientation. With conformity but without conversation, parents do not trust their children to make decisions and expect them to follow the parental rules. These children typically develop a low-level of self-differentiation. Obedience to parental authority and the interdependence between family members decrease the opportunity for frank and open conversations. Many subjects are considered difficult and best to be avoided.
  1.     Laissez-faire– low on both orientations. Without conversation or conformity family members are typically emotionally detached from each other and children are left to just do their own thing. There is little real communication or interaction, and even if an important topic needs to be discussed they are unlikely to actually enter into conversation.

These four types of FCP have a direct influence on the self-differentiation of the children. The family projection process will often define what each child will become in adulthood, the partner they will seek, and the subsequent continuation of the same types of communication patterns and behavior in their own descendants.

What is the technique in family therapy?

Family therapy uses exercises and techniques employed in behavior therapy, cognitive therapy, interpersonal therapy, and others. A family therapist will observe the inner workings of the family and guide them through appropriate exercises to promote the necessary changes. Role-playing is frequently used to act out proposed situations. The therapist will encourage family members to express their feelings in a non-conflictive way.

A family therapist has a master’s degree in psychology, psychiatry, clinical social work, marriage and family therapy, or some other related field. Additionally, they must complete two years of supervised clinical experience to receive their license. Therapists are highly trained and will choose the appropriate therapy technique for the situation of the family they are working with. Family therapy can be highly effective, but the success of therapy depends on a trusting and honest relationship between the therapist and the family.

Structural family therapy uses therapy sessions to first assess and evaluate, and later change the dynamics within the family. Early on in the therapeutic relationship, the therapist will employ techniques that build the family’s confidence in their knowledge and ability to help them. This process is known as joining. In therapy sessions, enactment or role-playing is a common tool that is used. By allowing family members to pretend that they are acting out a situation in a fantasy family often permits them to express their real feeling and thoughts that they might normally suppress in their own family setting. Later on, the therapist may guide the family to alter the hierarchies within the family unit and change the way that members relate to each other.

This technique is called restructuring. Reframing is another commonly used technique that encourages the family members to view their situation or problem from a different perspective. Often, this way of distancing themselves from the issue, and utilizing their newly acquired communication techniques can allow families to discover new and effective ways to improve the dynamics of their family and reduce tensions and solve problems. Structural family therapy is based on the premise that once the dysfunctional structure of the family unit improves, the individual health and well-being of each member will also improve, and also the relationships between them.

Another, more hands-on approach to therapy is called strategic family therapy. In this type of therapy, there are no therapy sessions, and the therapist concentrates on improving relationships between family members on the premise that this will then lead to a natural resolution of the problems in the family unit. This method tends not to look for the original cause of problems but to seek rapid and effective solutions.

Intergenerational therapy is another method of family or origin therapy where a detailed history of at least three generations of the family is analyzed. The therapist seeks traits and tendencies that have been passed down through generations. By helping people to understand the root of their problems they can seek real solutions to their present-day problems and prevent them from being passed on to their own descents.

Family therapy is an effective tool that has enabled many families to reestablish peace, harmony, and health in their family unit.

References

https://www.goodtherapy.org/learn-about-therapy/issues/family-of-origin-issues#:~:text=Therapy%20for%20Family%20of%20Origin%20Issues,-While%20one’s%20family&text=In%20therapy%2C%20a%20person%20can,choices%2C%20beliefs%2C%20and%20emotions.

https://medpsych.net/the-goals-and-benefits-of-family-therapy/

https://www.researchgate.net/publication/259574974_Family_Communication_Patterns_and_Difficult_Family_Conversations

https://okptacultivate.com/2020/01/28/cultivate-communication-by-understanding-the-family-communication-patterns-theory/

https://positivepsychology.com/family-therapy/

https://fpcej.ir/browse.php?a_id=119&sid=1&slc_lang=en

https://springer.iq-technikum.de/referenceworkentry/10.1007/978-3-319-15877-8_313-1#:~:text=The%20therapist%20facilitates%20boundary%20making,is%20encouraged%20(Colapinto%201991).

author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings

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