Communication, power and hierarchies are key concepts in Haley’s approach. He considered communication to be a source of power, which he described as the ability to define the nature of one’s relationship with another person. According to Haley, power is usually determined by hierarchies within the family; and effective family functioning requires a clear generational hierarchy in which parents have more power than children.
Key Concepts:
Circular Causality: Replaces linear causality with circular causality, which is the idea that behaviors or events cause or influence each other in reciprocal ways. Therefore, once the behavior occurs, it is maintained by ongoing and mutually influential interactions between family members.
First and Second Order Change: First-order change occurs when change does not alter the family system’s fundamental rules. It may temporarily relieve symptoms, but symptomatic behavior recurs because the change has not caused a permanent alteration in the system. In contrast, second-order change involves altering fundamental rules to create new perspectives and behaviors and, consequently, results in a permanent change in the family system. Therapy is aimed primarily at promoting second-order change.
The first session is considered to be an important determinant of the course of therapy, and it is highly structured and involves four stages:
- Social Stage: the therapist observes the family’s interactions and encourages the involvement of all family members.
- Problem Stage: the therapist collects information on the reasons why the family came to therapy.
- Interaction Stage: family members discuss the identified problem, and the therapist observes their interactions to gather additional information.
- Goal Setting: therapist and family members agree on a contract that defines the goals of treatment, the next appointment is scheduled, and the therapist gives the family a direction, or task, to complete at home.
Therapists assume an active, take-charge role and use techniques tailored to the family and its problems. Techniques include issuing directives, which may be tasks to be completed outside therapy. Such directives may include:
Ordeals–a paradoxical intervention that includes unpleasant tasks that the client must perform whenever a symptom occurs.
Restraining–encouraging the family not to change
Positioning–exaggerating the severity of a symptom
Reframing–relabeling a symptom to give it a more positive meaning
Prescribing the symptom–instructing a family member to deliberately engage in the symptom
So far, we have discussed Extended Family Systems (Bowen), Solution-Focused, Narrative, and Structural Family Therapy. What other theories would you like to see here? Post in the comments below.