UNIT 1 FAMILY COUNSELING                                                               Family Counselling
              Structure
              1.0  Introduction
              1.1  Objectives
              1.2  Evolution of the Concept of Family Counseling
                   1.2.1  Developments in Psychoanalysis
                   1.2.2  Growth of Child Guidance Movement
                   1.2.3  Emergence of Marriage Counseling Movement
                   1.2.4  Initiation of Group Counseling
                   1.2.5  Influence of General Systems Theory
                   1.2.6  Researches on Schizophrenia and Family Communication
              1.3  Concepts of ‘Family Life Cycle’ and ‘Communication Pattern within
                   Families’
              1.4  Approaches to Family Counseling
              1.5  Types of Family Counseling
              1.6  Family Counseling in Relation to Individual Counseling
              1.7  Family Counseling Process
              1.8  Indications and Contraindications for Family Counseling
              1.9  Let Us Sum Up
              1.10 Unit End Questions
              1.11 Suggested Readings
              1.0    INTRODUCTION
              This unit deals with family counseling. The unit starts with evolution of family
              counseling in terms of how developments in psychoanalysis, child guidance
              movement, marriage and group counseling etc. This is followed by concepts of
              family life cycle, in which there is a discussion about communication within
              families. Then we take up different approaches tom family counseling and types
              of family counseling. This is followed by family counseling in relation to
              individual counseling. Then we deal with family counseling processes. Then we
              deal with do’s and don’ts in family counseling.
              1.1    OBJECTIVES
              After reading this unit, you should be able to:
              •   Define family counseling;
              •   Describe the historical evolution of family counseling;
              •   Understand the concept of family life cycle;
              •   Understand the concept of adaptive and dysfunctional communication
                  patterns;
              •   Familiarise with the different approaches to family counseling;
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            Psychological Counselling       •    Understand the different types of family counseling;
            other than Psychoanalysis       •    Describe the process of family counseling in terms of laying down its aims
                                                 and objectives, process of assessment and the intervention process in family
                                                 counseling;
                                            •    Describe the indications and contraindications for applying family
                                                 counseling; and
                                            •    Critically analyse or evaluate the entire family counseling process.
                                            1.2      EVOLUTION OF THE CONCEPT OF FAMILY
                                                     COUNSELING
                                            Family counseling is a program of providing information and professional
                                            guidance to members of a family concerning specific health matters, such as the
                                            care of a severely retarded child or the risk of transmitting a known genetic
                                            defect. Family is a group of people related by heredity, such as parents, children,
                                            and siblings. The term is sometimes broadened to include related by marriage or
                                            those living in the same household, who are emotionally attached, interact
                                            regularly, and share concerns for the growth and development of the group and
                                            its individual members.
                                            Family counseling, is a program that consists of providing information and
                                            professional guidance to members of a family concerning specific health matters
                                            Legal Definition of family counselling
                                            Family counselling is a process in which a family counsellor helps:
                                            Family counseling is a process in which
                                            a)   one or more persons to deal with personal and interpersonal issues in relation
                                                 to marriage; or
                                            b)  one or more persons (including children) who are affected, or likely to be
                                                 affected, by separation or divorce to deal with either or both of the following:
                                                 i)    Personal and interpersonal issues;
                                                 ii)   Issues relating to the care of children.
                                            Family therapy provides a safe environment and temporary structure for people
                                            during these difficult times. People can re-build and create new ways of being
                                            that are more effective for their current life.
                                            I think relationship counseling should be tailored to each person’s or family’s
                                            goals by using a combination of techniques and styles that best suit their
                                            personality and needs. All facets of an individual or a family are important to
                                            consider: mind, body, relationships, spirituality, and culture. I always look at a
                                            client’s struggle in the context of their relationships. I help clients alter negative
                                            thinking and behaviour patterns, and use relaxation techniques to relieve stress
                                            and anxiety.
                                            Most people already know what they need to do, but need the motivation, support,
                                            and feedback of a compassionate counselor to do it.
                                            Family therapy is generally conducted by a therapist or team of therapists who
                                            are trained and experienced in family and group therapy techniques. Therapists
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               may be psychologists, psychiatrists, social workers, or counselors. Family therapy            Family Counselling
               involves multiple therapy sessions, usually lasting at least one hour each,
               conducted at regular intervals (for example, once weekly) for several months.
               Typically, family therapy is initiated to address a specific problem, such as an
               adolescent with a psychological disorder or adjustment to a death in the family.
               However, frequently, therapy sessions reveal additional problems in the family,
               such as communication issues. In a therapy session, therapists seek to analyse
               the process of family interaction and communication as a whole and do not take
               sides with specific family members. Therapists who work as a team can model
               new behaviours for the family through their interactions with each other during
               a session.
               Family therapy is based on family systems theory, in which the family is viewed
               as a living organism rather than just the sum of its individual members. Family
               therapy uses systems theory to evaluate family members in terms of their position
               or role within the system as a whole. Problems are treated by changing the way
               the system works rather than trying to fix a specific member. Family systems
               theory is based on several major concepts.
               Concepts in Family Therapy
               1)  The identified client
               The identified client is the family member with the symptom that has brought
               the family into treatment. Children and adolescents are frequently the indentified
               client in family counseling.
               The concept of the identified clinet is used by family counselors to keep the
               family from scapegoating the client or using him or her as a way of avoiding
               problems in the rest of the system.
               2)  Homeostasis (Balance)
               Homeostasis means that the family system seeks to maintain its customary
               organisation and functioning over time, and it tends to resist change. The family
               counsellor can use the concept of homeostasis to explain why a certain family
               symptom has surfaced at a given time, why a specific member has become the
               client, and what is likely to happen when the family begins to change.
               3)  The extended family field
               The extended family field includes the immediate family and the network of
               grandparents and other relatives of the family. This concept is used to explain
               the intergenerational transmission of attitudes, problems, behaviours, and other
               issues. Children and adolescents often benefit from family counseling that
               includes the extended family.
               4)  Differentiation
               Differentiation refers to the ability of each family member to maintain his or her
               own sense of self, while remaining emotionally connected to the family. One
               mark of a healthy family is its capacity to allow members to differentiate, while
               family members still feel that they are members in good standing of the family.
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            Psychological Counselling       5)   Triangular relationships
            other than Psychoanalysis       Family systems theory maintains that emotional relationships in families are
                                            usually triangular. Whenever two members in the family system have problems
                                            with each other, they will “triangle in” a third member as a way of stabilising
                                            their own relationship. The triangles in a family system usually interlock in a
                                            way that maintains family homeostasis. Common family triangles include a child
                                            and his or her parents; two children and one parent; a parent, a child, and a
                                            grandparent; three siblings; or, husband, wife, and an in-law.
                                            In the early 2000s, a new systems theory, multisystemic therapy (MST), has
                                            been applied to family counseling and is practiced most often in a home based
                                            setting for families of children and adolescents with serious emotional
                                            disturbances. MST is frequently referred to as a “family-ecological systems
                                            approach” because it views the family’s ecology, consisting of the various systems
                                            with which the family and child interact (for example, home, school, and
                                            community).
                                            Several clinical studies have shown that MST has improved family relations,
                                            decreased adolescent psychiatric symptoms and substance use, increased school
                                            attendance, and decreased re arrest rates for adolescents in trouble with the law.
                                            In addition, MST can reduce out of home placement of disturbed adolescents.
                                            6)   Preparation
                                            In some instances the family may have been referred to a specialist in family
                                            therapy by their pediatrician or other primary care provider. It is estimated that
                                            as many as 50 percent of office visits to pediatricians have to do with
                                            developmental problems in children that are affecting their families. Some family
                                            doctors use symptom checklists or psychological screeners to assess a family’s
                                            need for counselling. For children and adolescents with a diagnosed psychological
                                            disorder, family therapy may be added to individual therapy if family issues are
                                            identified as contributing factors during individual therapy.
                                            Family therapists may be either psychiatrists, clinical psychologists, or other
                                            professionals certified by a specialty board in marriage and family therapy. They
                                            usually evaluate a family for treatment by scheduling a series of interviews with
                                            the members of the immediate family, including young children, and significant
                                            or symptomatic members of the extended family. This process allows the
                                            therapist(s) to find out how each member of the family sees the problem, as well
                                            as to form first impressions of the family’s functioning. Family therapists typically
                                            look for the level and types of emotions expressed, patterns of dominance and
                                            submission, the roles played by family members, communication styles, and the
                                            locations of emotional triangles. They also note whether these patterns are rigid
                                            or relatively flexible.
                                            Preparation also usually includes drawing a genogram, which is a diagram that
                                            depicts significant persons and events in the family’s history. Genograms include
                                            annotations about the medical history and major personality traits of each member.
                                            Genograms help uncover intergenerational patterns of behaviour, marriage
                                            choices, family alliances and conflicts, the existence of family secrets, and other
                                            information that sheds light on the family’s present situation.
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