Family Psychotherapy

Means of achieving the goal: the study of linear and circumplex dependencies in families and the communicative value of questions; analysis of clinical cases.

After the therapist has formulated a hypothesis, he needs to draw up a therapeutic contract with the family, discussing the conditions of the course of therapy. This is done by determining the relationship between the symptom and the system and setting the dilemma of change. If a symptom is used as a “secret weapon” in a secret struggle or is fixed in a constantly repeated cycle of interaction, any attempts to alleviate it will most likely be doomed to failure. The psychotherapist will then be in a paradoxical situation, when the family will ask him to eliminate the symptom from the “identified patient”, but to resist the therapeutic change.
The central question of family psychotherapy is not how to get rid of a symptom, but what happens if it disappears; the discussion is transferred from the discussion of the problem, who is the "carrier of the symptom", what causes it and how to get rid of it, the problem, how the family will function without it, and what price it will have to pay for its disappearance. Therefore follows:
• determine which family members will be able to cooperate with the psychotherapist, and who will resist change;
• find out the impact on the family of other systems (school, work, peers, families of relatives);
• make sure of the abilities and capabilities (physical, psychological) of the psychotherapist to work with this family.

Pay attention to your own emotional response to joining the family system. Is there a feeling of closeness, security, diffusion or lack of boundaries? These reactions usually “give keys” from external system boundaries and proposed strategies for further entry into the system. Check the system for its relative tolerance for separation. For example, you can engage the patient in a dialogue about the future or marriage, using your own style, perhaps in a playful manner, and then watch the system resonate for such an intervention.
The psychotherapist needs to test his physical, psychological strength and capabilities, his motivation and desire to work with this family.
Here it is appropriate to recall the "principle of mutual acceptance of the psychotherapist and the family." The family accepts the psychotherapist and connects with them his faith / disbelief, hope and love, creativity and anxiety, and the psychotherapist accepts the family as it is.
Despite the fact that in the process of carrying out family psychotherapy it is almost impossible to separate the diagnostic and therapeutic parts, the following stages are conventionally distinguished:

• association of the psychotherapist with his family, joining it to the role structure it presents;
• formulation of a therapeutic request;
• reconstruction of family relationships.