that the therapist possesses great authority and influence over the family members’ lives. Therefore, it is incumbent upon the therapist to self-reflect on her or his own views of working with lesbian, gay, and bisexual youth. Such self-reflection is useful to combat countertransference – those feelings that are brought up within the therapeutic encounter which trigger subconscious feelings in the therapist. Therapists, like all members of society, live in a world where heterosexism and homophobia are common, and they need to be both aware of and work to change such deeply instilled attitudes and beliefs. To be most helpful in conducting family therapy, and to make sure they are not doing harm, therapists should initiate this process and perhaps attend diversity training or their own counseling to ensure that they have extinguished their own heterosexism and homophobia to the extent possible. A final consideration relates to current understandings of trauma because some of the youth with whom practitioners work – and some of these youth’s family members as well – Structural family therapy is currently the most influential model of family therapy in the United States and abroad (Nichols, 2014). Originated by Salvador Minuchin and developed by Minuchin and his colleagues in their work with families in Wisconsin and later in Philadelphia, structural family therapy “[recognizes] the overall organization that regulates [family] … interactions” (Nichols, 2014, p. 110). (For additional readings on this model of therapy, see the Resources section of this course.) The goal of structural family therapy is for the family and the therapist to reorganize the family’s structure in order to improve the experiences of all family members (Minuchin, 1974). Table 4 shows the central concepts and intervention skills associated with structural family therapy. Table 4: Concepts and Intervention Skills of Structural Family Therapy Concepts ● Family structure. Structural family therapy Theory
might have diagnoses that include PTSD, acute stress disorder, or even dissociative identity disorder (DID). In this “Age of the Brain,” groundbreaking research is uncovering the extent to which psychological trauma – from abuse, neglect, and similar experiences – impacts individuals’ brain development and functioning (Van der Kolk, 2014). Neurological research currently focuses on trauma’s impact on brain components such as the amygdala (which regulates emotion) and the hippocampus (which stores memories), as well as a host of neurotransmitters (including the “stress hormone” cortisol and the “bonding” hormone oxytocin). There is also promise that positive interactions and activities such as therapy can mitigate the negative effects of trauma on the brain (Van der Kolk, 2014). Therefore. practitioners are encouraged to seek additional continuing education in the dynamic field of trauma-informed care because it enhances their work with all clients, including work with LGB youth and their families. is the clear boundary, which promotes a healthy combination of nurture and independence. The following brief family description demonstrates these concepts. The family consists of a mother, father, and two children – a 15-year-old daughter and a 14-year-old son. The parents have decided to seek family therapy because the son has been suspended from school for fighting and “they need help.” In family therapy it is revealed that the son was actually fighting in self-defense because he was bullied for being gay. This family’s structure includes three subsystems: the “couple” subsystem (the wife and husband); the “parents/children” subsystem (which includes the various subsystems of “father/ son,” “father/daughter,” “mother/son,” and “mother/ daughter”); and the “sibling” subsystem (the sister and brother). The couple’s boundary is rigid, meaning the couple are emotionally distant with one another and therefore tend to be disengaged. In the parent/child subsystem, the boundary between the mother and her children is also rigid (she is more emotionally distant with her children), while the father’s boundary with his children is more enmeshed (he is overly emotionally involved with his children). The siblings have a clearer boundary with one another; they care for one another appropriately as well as honor each other’s need to be independent. General information on the hypothetical Davis/Leonard Family is presented in the vignette below. As structural family therapy, solution-focused family therapy, and narrative family therapy are discussed, the various skills and interventions appropriate to each of these models will be applied to this family that is in the midst of the coming out process. The Davises are a middle-class African American family who reside in Denver, Colorado. Danielle Leonard is a 15- year- old girl who has recently come out to her family as a lesbian. Danielle is the daughter of Mrs. Davis and her first husband, Mr. Leonard, who has sporadic contact with his daughter. Danielle is a sophomore in high school and an A student. Mrs. Davis, Danielle’s mother, is 46 years old. She works as an accountant for a law firm in the city. Mrs. Davis is married to Mr. Davis, 42, a construction foreman who works in the neighboring county. Mrs. Davis has no other children; Mr. Davis has two children from a previous relationship who live three hours away. The Davises have been married for 10 years. The family has been fairly close-knit. One of the major activities they do as a family is to attend church weekly. For Mrs. Davis, church attendance is very important because her father is a retired Baptist minister. Mrs. Davis’s father lives next door and stays with Danielle when the Davises are away for any extended period of time.
● Subsystems. ● Boundaries:
○ Rigid (Disengagement). ○ Clear (Normal). ○ Diffuse (Enmeshment).
Intervention Skills ● Joining and accommodating. ● Enactment. ● Structural mapping. ● Highlighting and modifying interactions. ● Boundary making. ● Unbalancing. ● Challenging unproductive assumptions.
Note . From Nichols, M.P. (2014). The essentials of family therapy (6th ed.). Boston: Pearson; and Minuchin, S. (1974). Families and family therapy. Cambridge, MA: Harvard University Press. This model focuses on three central concepts: 1) family structure, 2) subsystems, and 3) boundaries (Minuchin, 1974; Nichols, 2014). Family structure relates to the overall expected patterns of family interaction as well as the relationship patterns in its subsystems. Subsystems contain smaller units of family members such as the parental system, the parent/child system, the female system (mother and daughters), and the sibling system. Boundaries refer to the type of relationships that exist between and within subsystems; boundaries can range from “rigid” to “clear” to “diffuse” (Minuchin, 1974). Neither boundary extreme is that helpful in family functioning because rigid boundaries reflect “disengagement,” in which nurture is limited, while diffuse boundaries reflect “enmeshment,” in which independence is limited. In the middle of these extremes
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Book Code: PYCA1423
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