CHAPTER 4: STRATEGIC AND SYSTEMIC MODELS

Study Guide for the National Marriage and Family National Licensing Exam 64 maintain the problem. For example, if a child misbehaves, i.e., deviates from the norm (the family problem) because he is jealous of a new sibling and the father responds with harsh or punishing behavior (an attempted solution), it confirms the child’s belief that he is loved less, and his behavior worsens (the deviation is amplified). MRI interventions would be aimed at changing the pattern of interaction so that the father could help the child calm his behavior and show him that he is not loved less. ASSESSMENT AND TREATMENT Assessment consists of determining the feedback loops that govern the faulty behavior patterns by observing repetitive patterns of family interactions. Treatment is usually limited to 10 sessions, which sets up a “powerful expectation for change” ( Nichols & Schwartz, 1998, p. 368 ) . The changes that occur through treatment are classified as first- order change or second-order change. First-Order Change . Family patterns of interaction or sequences are altered at the behavioral level only. Second-Order Change . Th e family rules o r underlying beliefs or premises that govern family members’ behavior or promote specific reactions are altered. In the above example, two of the father’s beliefs (that children should never show disrespect and that the child’s behavior is disrespectful) may need to be changed. Family rules may be changed by the technique o f reframing ( see below), helping the father reinterpret the child’s behavior as reflecting his unhappiness rather than as being disrespectful. Treatment follows a six-step procedure (outlined b y Nichols & Schwartz, 1998, p. 367- 368 ) : 1. Introduction to the treatment set-up. The therapist obtains basic information from the family; explains that sessions are recorded; obtains appropriate permission for recording, and discusses the length of treatment and the reasons for the involvement of multiple professionals. 2. Inquiry into and definition of the problem. The therapist asks the family about the problem that brought them to treatment. The problem must be one that the family can clearly define if treatment is to be successful. Vague complaints, such as “we just don’t get along,” do not lend themselves to interventions. 3. Estimation of the behaviors maintaining the problem. Certain behaviors or interactions among family members are assumed to be maintaining the problem. The therapist’s observations of the family interactions and inquiry into the problem should continue until he/she has a clear picture of the reinforcing behaviors. 4. a. Setting the goals for treatment. Once the problem has been articulated clearly, the therapist and family can negotiate goals for change. Goals should be measurable and observable. To help quantify the goals, the therapist might ask questions such as, “What will be the first sign that things are getting better?”