MULTIPLE FAMILY GROUP THERAPY
DIAGNOSTIC INTERVIEW OUTLINE
©1993 by Lewis N. Foster
A. Work toward an active interpretation of content, but focus on process, and have fun;
B. Be as unbiased as possible in your observation of the families, don't be judgmental;
C. Establish the therapists' control --- a therapist must be in control because dysfunctional families are not in control. The families will feel secure that the therapist can handle, and not be shocked by, what happens in the multiple family group therapy session.
D. Where in the family life-cycle are the families, and at what stage of development are the family members?
II. Methods (see the Evaluation and Session Guide form):
A. Take the time to make the families as comfortable as possible. Treat them as though they are in your living room.
C. Select out the important family themes. A theme(s) will emerge very early in the session. Help the families to stick with the theme(s) instead of wandering. It is more gainful for both the families and the therapist.
D. Once a theme is selected it should be discussed by each family member. Encourage interaction between the families regarding the theme, taking the theme back to the therapist for clarification if the discussion becomes punitive in nature.
E. Try to delineate areas of consensus among family members on problem issues. Point out commonalities between families.
F. Summarize and reframe as needed.
G. Contract with the families for three sessions. It will be easier to get the families to agree to three sessions than eight or ten, for example. Know that around the third or forth session each family will come to the group in crisis. This will help you keep the family in treatment for another three sessions. Begin to think about what the crisis may be about.
H. Establish as definitely as possible the conditions for treatment. Clarify the therapist's expectations (for example, who is expected to attend) and maintain an orientation to the presenting problem(s).
I. Some education on Enhancing Intimacy, Managing Conflict, Parenting, Dependency, or other issues may be needed.
III. Assessment (see Assessing The Family Dance) is an on going process from session to session and is done in the Multiple Family Therapy Group:
A. Investigate the internal organization of the families (their family dance).
1. What kind of support do they give each other and how do they communicate intimacy?
2. What kind of satisfaction of needs do they supply for each other?
3. What are the patterns of communication?
4. What are the lines of authority and who is the functioning head of the individual families?
5. How do the families share pleasures and problems?
6. What are the sex identities and sex roles in the families?
7. What are the parent-child interactions about?
8. What are the alliances between family members?
9. What is the value system of the families?
10. What are the struggles and goals?
11. Who becomes a leader in the group?
B. The external organization of patterns of interaction of the families (their connection with society).
1. What are the contacts with the outside?
a. social network
b. kin network
2. What is their position in their sub-cultural system?
C. Conflicts, Conflict Styles, and Themes.
1. What are the sources of conflict?
2. What are the resources and available coping mechanisms mobilized to deal with conflicts? Ways of coping can include the following:
a. Intensification of some dyadic relationships.
b. The mobilization of some outside or external support such as peers, neighbors, the paramour, or other "sympathetic ears."
c. Change of environment for one or more family members.
d. Re-peopling, or an increase or decrease in family participants as occurs with marriage, birth, death, divorce, extended family moving in, pets, etc.
e. Reorganization of roles.
f. Emotional divorce or distancing, (this includes the "pseudomutual" relationship which is emotional distancing with accompanying complete denial of that distancing. Pseudomutual couples operate as if they are in complete agreement. There exists a pretense of lack of
conflict in the midst of much difficulty with accompanying fear and/or incapacity to come close. Pseudomutuality may break up via the paramour).
i. Healing, or an escape to health (healing is often seen in conjunction with scapegoating).
3. What are the pathogenic features used to deal with conflicts?
D. Affect, Mood and Family Processes.
1. What are the affects (feelings and emotions conveyed by means of facial expressions) and moods of the families?
2. How do the families carry out affect and mood?
E. Family Systems and Subsystems.
1. Marital Relationships
a. The positives and negatives of the couples' sexual and emotional life.
b. The perception of each other and of each other's role (this is also known as delineation, or the perception that a person has of his mate as seen through the behavior that both exchange and how each fits into the frame of the other's future needs).
c. The stability of the marital relationships.
d. The ways in which each spouse is separate and autonomous from each other, her/his family of origin, and others in the group.
e. The role of adaptation of each partner.
2. Parenting Relationships
a. How the parents cope with their children's social maturation outside the home and in the MFT group.
b. Are there clear lines structurally between the parenting and marital relationships?
c. Is there functional parental authority?
d. At what developmental stages are the children?
3. Sibling Relationships
a. The way the siblings organize themselves to educate the parents.
b. The support they give each other in the process of each sibling's maturation or striving for independence.
4. Extended Family Relationships
a. Have the parents successfully left home?
b. Are grandparents actively involved in the
parenting of the children?
c. How involved are other extended family members?
Freud defined neurosis as separation from Self.
Jung defined neurosis as the avoidance of legitimate pain. The real Self is the love within us.
The fearful Self is an imposter.
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