SISTER NIVEDITA GOVT.

NURSING COLLEGE
I.G.M.C. SHIMLA

SUBJECT- MENTAL HEALTH NURSING

TOPIC- FAMILY THERAPY

Submitted To: Submitted By:

Madam Roop Sharma Roll No.- 13
C.I. Cum Sister Tutor Priyanka Sharma
SNGNC, IGMC, Shimla Msc Nursing 1st Year
SNGNC, IGMC, Shimla

Submitted On:
 INDEX

SR.NO. CONTENT PAGE NO.

1 Introduction of family therapy 1

2 History 1

3 Concept of family therapy 1

4 Definition of family therapy 1-2

5 Purpose of family therapy 2

6 Adequate qualities of healthy family 2

7 Healthy family functioning 2

8 Goals 3

9 Types of family therapy 3-4

10 Stages of family therapy 4

11 Functions of family therapy 4-5

12 Family therapy assessment 5

13 Indications of family therapy 5

14 Contraindications of family therapy 5-6

15 Functions of family therapist 6

16 Role of nurse in family therapy 6

17 Conclusion 6

18 Bibliography 6

FAMILY THERAPY
INTRODUCTION
Family therapy is the branch of psychiatry which sees an individual’s psychiatric symptoms
as inseparably related to the family in which he lives. Thus the focus of treatment is not on
the individual, but the family. Family therapy is a relatively new development that came
about in the mid-twentieth century as an adjunct to individual treatment and refers to the
treatment of the family as whole. Family therapists use a wide variety of theoretical
philosophies and techniques to bring about change in dysfunctional patterns of behaviour and
interaction, some therapists may focus on the here and now.Several or sometimes all
members of a family members take part in this treatment. Usually both parents are involved,
often together with a child, grandparents, or others members of the extended family.

HISTORY
Akerman(1958) and Murray Bowen(1978) were leaders in family therapy.The family has
been recognized as a fundamental unit of social organization. Regarless of the specific
pattern of family life,the fundamental narrative,myths,legends and folklore of all cultures
emphasizes the power of famly relations to mould the character of the individual and serve as
an exemplar of molar and political order of society. A type of therapeutic modality in which
the focus of treatment is on the family as a unit. It represents a form of intervention in which
members of a family are assisted to identify and change problematic, maladaptive, self-
defeating, repetitive relationship patterns.

CONCEPT
The term family is coined by the American psychiatrist Nathan Ackerman in the
1950s.Family therapy is a method drawn from one or more of a range of, schools,which seeks
to help the individual patient who is the locus of the psychopathopathology . According to
this view psychopathology reflects recurring problematic international patterns among the
family members and between the families,midway between these two positions is one that
views the family as acting potentially either as a resource.

DEFINITION
FAMILY-

1. Family are groups of individual that interact, support, and influence each other in
performing basic functions.
2. They are an integral part of the society, bound together by intense and longlasting ties
of past experience, social roles, mutual support, and expectations.

SYSTEM-

System is a set of interacting or interdependent components forming an integrated whole.

FAMILY AS A SYSTEM
 1. In the early 1950’s , the psychotherapist began to look not only at the individual with
problems, but also at the pattern of relationships that correspond with the family
problems.
2. Family system is a concept of looking at the family as a cohesive emotional unit.The
family functions as a system where in each member plays a specific role must follow
certain rules. Based on the roles within the system, people are expected to interact
with and respond to one another in a certain way.

FAMILY THERAPY

1. Family therapy is a method of treatment in which family members gain insight into
problems, improve communication, improve functioning of individual members as
well as the family as a whole.
2. Family therapy is a type of psychological counseling ( psychotherapy) that can help
family members improve communication and resolve conflicts.

PURPOSES

1. Family therapist deals with the family plan-

When one person in a family has pain which shows up in symptoms,all the family
members are feeling this pain in same way.Many therapist have found it,useful to call
the member who carries the symptoms.
2. Family therapist assist for family homeostasis-
According to the concept of the family homeostasis the family acts as to maintain the
balanced relationships.Members help to maintain this balance overtly and covertly.
3. Therapist gives marital counseling-
The marital relationships influences the character of family homeostasis.The marital
relationship is the axis around which all the family relationship are formed.The mates
are the architects of the family.A pained marital relationship tends to produce
dysfunctional parenting.

ADAPTIVE QUALITY OF HEALTHY FAMILY

1. Strong parental leadership qualities

2. Effective communication patterns
3. Clear boundaries and roles
4. Flexibility

HEALTHY FAMILY FUNCTIONING

1. No single member dominates or control another

2. Family members participates in activites together
3. Children are allowed to express opinions
4. Family members adapt to the changes

GOALS
 1. Defining and clarifying the relationship between the family members.
2. Helping family members develop one-to-one relationships with each other and
minimizing triangles within the system.
3. Teaching family members about the functioning of emotional systems
4. Promoting differentiation by encouraging “I position” stands during the course of
therapy.

TYPES OF FAMILY THERAPY

INDIVIDUAL FAMILY THERAPY

In individual family therapy, each family member has a single therapist. The whole family
may meet occasionally with one or two of the therapists to see how the member’s ae relating
to one another and work out specific issues that have been defined by the individual
members.

CONJOINT FAMILY THERAPY

The most common type of family therapy is the single-family group, or conjoint family
therapy. The nuclear family is seen, and the issues and problems raised by the family are the
ones addressed by the therapist. The way in which the family interacts is observed and
becomes the focus of therapy. The therapist helps the family deal more effectively with
problems as they arise and are defined.

COUPLES THERAPY

Couples are often seen by the therapist together. The couple may be experiencing difficulties
in their marriage, and in therapy, they are helped to work together to seek a resolution for
their problems. Family patterns, interaction and the communication styles, and each partner’s
goals, hopes and expectations are examined in therapy. This examination enables the couple
to find a common ground for resolving conflicts by recognizing and respecting each other’s
similarities and differences.

MULTIPLE FAMILY GROUP THERAPY

In multiple family group therapy, four or five families meet weekly to confront and deal with
the problems or issues they have in common. Ability or inability to function well in the home
and community fearing of talking to or relating to others, abuse, anger, neglect, the
development of social skills, and responsibility for oneself are some of the issues on which
these group focus. The multiple family group become the support for all the families. The
network also encourages each person to reach out form new relationships outside the group.

MULTIPLE IMPACT THERAPY

In multiple impact therapy, several therapists come together with families in a community
setting. They live together and deal with pertinent issues for each family member within the
context of the group. Multiple impact therapy is similar to multiple family group therapy
except that it is more intense and time limited. Like multiple family group therapy, it focuses
on developing skills or working together as a family and with other families.

NETWORK THERAPY

Network therapy is conducted in people’s homes. All individuals interested or invested in a

problem or crisis that particular person or persons in a family are experiencing take part. This
gathering includes family, friends, neighbours, professional groups or persons, and anyone in
the community who has an investment in the outcome of the current crisis. People who form
the network generally know each other and interact on a regular basis in each other’s lives.
Thus a network may include as many as 40 to 60 people.

STAGES OF FAMILY THERAPY

1. The Initial Interview

2. The intervention or working phase
3. Termination phase

THE INITIAL INTERVIEW

1. Engagement stage – In this the family engage with the therapist to solve the problem.
They identity there is something wrong with the family, that’s needs to be solved.
2. Assessment stage –In this the therapist assess the family functioning and find the
problem.
3. Exploration stage- In this the therapist and explore the problem and tends to find out
the solution of the problem.
4. Good setting stage- In this good settings are given to the family and they chooses
which one is appropriate.
5. Termination stage- In this the problem is solved and the bond between therapist and
family break.

THE INTERVENTION OR WORKING PHASE

1. The goal of the intervention phase is to help the family accept and adjust to change.
2. Occurs once a week.
3. The therapist role is to clarify and interpret communication as well as to offer
suggestion and guidance.

THE TERMINATION PHASE

If the family has achieved the goals and identified specific problems have been
resolved then its time to initiate the termination phase.

FUNCTIONS OF THE FAMILY THERAPY

1. Boundary function: boundaries will maintain a distinction between individuals with

the family. Rigid boundaries prevent family members from trying out new ideas.
 2. Communication function: communication within the family encourages its members
to express their feelings or emotions appropriately. 3. Supportive function: supportive
function within the family give freedom to grow and explore new roles within the
family members.
3. Socialization function: socialization helps to interact, negotiate and plan adopts
coping skills within the members of the family.
4. Biological function: family is a medium where the sex relations are regulated.
5. Psychological function: love, belongingness, affection, sympathy, security, attention,
emotional satisfaction, sexual relationship, intimacy etc. will be attained through
family.
6. Educational function: mother is the first teacher and primary care giver who will take
care of the children. Child’s personality and character formation will be attained
through family.
7. Protective function: family protects the interest of the child, provides security to
cultivate healthy behavior.
8. Recreational function: family creates an atmosphere where the child’s interest can be
fulfilled. The love among family members will create positive interest in the child.
9. Religious function: family develops religious thoughts, kind heartedness and fellow
belonging. The child learns more moral values, ethics, codes, honesty, truthfulness,
traditions and religious patterns.
10. Cultural function: family molds its members according to its culture. It transmits
ideas, folkways, mores, customs, traditions, beliefs and values from one generation to
another generation
11. Social function:
-maintain social status and controls member’s activities.
-Promotes safety and security and lays emphasis on kinship patterns provides
physical shelter, food, clothing which are necessary to the existence of life.

INDICATIONS OF FAMILY THERAPY

1. Problems in the relationship within the family(e.g existence of communication or

generation gap)
2. Interdependence of symptoms(e.g. the wife’s depression being contingent on the
husband’s alcohol consumption and vice versa)
3. Failure of individual therapy(may be because family tensions have not been handled)
4. Development of stress in other family members when one family member improves
(e.g. development of depression in wife following husband’s giving up drinking,
leading to his improves participation in family matters)

CONTRAINDICATIONS OF FAMILY THERAPY

1. Family in the process of breaking up

2. Families in which tense, dysfunctional equilibrium is present.
3. Families staying apart
4. No availability of the key family member
 5. Unwillingness to accept the therapy.

FUNCTIONS OF FAMILY THERAPIST

1. Establishes a rapport,empathy and communication among family members.

2. Evolves the major conflicts and ways of coping clarifies by dissolving barriers.
3. Helps to bring to more mutual and accurate understanding.

ROLE OF NURSE IN FAMILY THERAPY

1. Extends emotional support,plays a role of a true parent figure-a controller of danger.

2. Serves as a personal instrument of reality testing for the family.
3. Serves as an educater and a personifier of useful models of family health.
4. To coordinate treatment everyone is working towards same goals in a collaborative
supportive way.
5. To pay attenion to the social and clinical needs of patient and family.
6. To provide optimum medication management.
7. To explore family expectation.
8. To listen to families and treat them as equal partners.
9. To assess family’s strengths,problems and goals.

CONCLUSION

Family therapy is a relatively new development that came about in the mid-twentieth century
as an adjunct to individual treatment and refers to the treatment of the family as whole.
Family therapists use a wide variety of theoretical philosophies and techniques to bring about
change in dysfunctional patterns of behaviour and interaction, some therapists may focus on
the here and now.

BIBLIOGRAPHY

1. Mary townsmen., Textbook of mental health nursing.8th ed. Jaypee Brothers Medical
Publishers (P) Ltd. _Pp 38-40
2. Sreevani R, Textbook of mental health nursing, 7th ed. Jaypee Brother Medical
Publisher (P) Ltd._Pp 67-70
3. www.wikipedia.com
4. www.slideshare.com