CPE4103

FAMILY COUNSELLING)

LECTURER :
PROF. MADYA DR. SITI AISHAH BINTI HASSAN

PREPARED BY :
1. NURMASTIQAH BINTI MD HATTA (189564)
2. YEONG MEI WAN (188022)
3. DARRON AZZRIL (187360)
4. MOHAMMAD ASSRAFFUDDIEN BIN BASRI (187650)
5. HAMIZAH BINTI MURSHID (188555)
Table of Content
Founder of Theory
History of Theory
Premises of Theory
Key Concept
Treatment & Technique
Process & Outcome
Role of Counselor & Client
Theory Application into Multicultural Perspective

Comparison of Other Theory

Conclusion
Founder of Theory

Mara Selvini Palazzoli

Founder of theory

Was born at 1916, in Milan, Italy. as the fourth

of the five children to a merchant family.

Palazzoli attended medical school in Milan

She was influenced by interpersonal
psychoanalysis (F. Fromm-Reichmann, H. S.
Sullivan) and existential analysis (V. Frankl) and
specialised in treating patients with anorexia
nervosa (L’ anoressia mentale, 1963).
Palazzoli died at June 21,1999, at the age of
83.
Systemic (Milan) Family Therapy
• Also known as the Milan approach, stress the
interconnectedness of family members while also
emphasizing the importance of second-order change
families (Tomm, 1984)
• Described families as engaging in series games
- Families stabilize around disturbed behaviour
to try and benefit from them.
- Therapists meet with families and then parents
separately to give invariant or variantprescription
to produce firm boundary between generations.
History of Theory
• In 1967, Selvini Palazzoli went on a study trip to
Philadelphia to observe family sessions led by Ivan
Boszormenyi-Nagy, James Framo and Salvador
Minuchin.
• After her return to Milan, she established the
private institute, Centre for the Study of the Family
and of Group Techniques together with seven other
colleagues.

• Later they discovered the ideas of Bateson, Haley,

Watzlawick and others, began to modify their
approach
History of Theory

• Palazzoli left the institute in 1971 and founded

the influential “Milan Group” together with Luigi
Boscolo, Gianfranco Cecchin and Giuliana
Prata.

• The group’s focus was on the social and

communicative relationships within families
with disturbed members (referred to as the
“symptom carriers”).
Premises of Theory

Therapist will take

systemic view of problem Symptoms serve a
maintenance & strategic purpose
orientation to change

Therapeutic neutrality —
Concentrate on
keeps therapist from being
consequences of family
drawn into coalitions &
communication patterns &
disputes & gives therapist
conflict between
time to assess family
competing hierarchies
dynamics
Key Concept

Theoretical Conditions for

Epistemology
Formulations Change

Epistemologic Tyranny of Structure of

al Error Linguistics Therapy

Community
Meaning Vs.
Games Resources
Action
and Referrals
Culture-Related Diagnostic issues
Epistemology
• The study of knowledge and knowing
• Must acknowledge reciprocal cause and effect
• Lack of result in systemic “crisis”

Epistemological Error
• Systemic distress
• Faulty set of beliefs or distinction that individuals
or family uses to make sense of the world
Culture-Related Diagnostic issues
Games
• Unacknowledged strategies and destructive
patterns of family interaction in which members
attempt to control each other’s behavior.
• Power is in the rules of the game which cannot be
changed by the family involved in it
• The aim is to change to rules of the game rather
than change the players of the game

Condition for Change

• Resistance low and motivation high
• Identify the most motivated family member
Culture-Related Diagnostic issues
Meaning vs action
• Therapist helps separate between meaning and
action to help correct epistemological errors.
• The interpretation (eg: disrespectful) is separated
from the act itself (eg: does not follow the rule).
• The new distinction allows for creation of new
belief patterns followed by new behavioral
patterns.
Community Resources and Referrals
• Invitations are sent to all “possible players” of the
“family game” to attend
• When family or other refuse to attend-therapy
sessions postponed
Culture-Related Diagnostic issues
Tyranny of Linguistics
• Language is linear construct that is used to
describe reality, which is a circular construct
• Generally assumed that distinctions made by
language are corect
• Therapist uses language to create new
interpretations of family situations

Structure of therapy
• Highly structured
• Long term brief therapy
• 10 sessiont at monthly intervals or longer
• Uses a team approach with a male and female
therapist
Culture-Related Diagnostic issues
Theoretical Formulation

• Families should have clearly defined

generational boundaries
• Therapy should be neutral and not have
expectations of families
• Aids is redesigning family structure for better
functioning
• Problematic family development is a functional
issue. One member develops symptoms to
control others
Treatment & Technique

Hypothesizing

Positive
Rituals
Connotation

Invariant/
Circular
Variant
Questioning
Prescriptions
Treatment & Technique
Hypothesizing

• Hupothesis (Greek) – Foundation

• Formulation based upon the information the therapist
possesses regarding the family he is interviewing.
• Family therapy session is organized around the
hypothesis
• Establishes a starting point for investigation
• Believe that therapist must come up with ideas about
how a particular family operates
• If not the family will define the problem and treatment in
a faulty way
Treatment & Technique
Clinical Example

 Family: A Divorced mother (37) and son (13)

 Reason for consultation: Son difficult to control,
rebellious, rude and prone to delinquent behaviour
 Pre-Session Hypothesis: Behaviour of boy, a way to
get father back to the family
 During session: Hypothesis disproved
 Second Hypothesis: Charming mother, perhaps had
met another man, Boys behaviour as anger towards him
– Was proved
Treatment & Technique
Positive Connotation

• Reframing family member’s behavior is labeled as

benevolent and motivated by good intentions.
• For example, if a mother is overly involved in her son
activities, therapist might label her behavior as one of
concern.
• Reduce resistance to treatment by the family and
establish rapport.
Treatment & Technique
Circular Questioning

• Focus attention on family connection through framing

every question so that it addresses differences in
perception by family member about events.
• Involves asking each family
member questions concerning repetition interactional
patterns between family members.
• Help family raise questions
Treatment & Technique
Invariant/variant Prescription

Invariant prescription - Requires parents to unite so that

children cannot manipulate them as “winners” or “losers”
and thereby side with them.
Two powerful factors:
1. it quickly shows the dysfunctional interactions which
maintain the symptomatic behavior
2. as the guideline of therapeutic intervention is kept
constant, it is possible to evaluate and discriminate
between the responses of different types of family to
treatment.
Treatment & Technique
Invariant Prescription (task)
Treatment & Technique
Rituals

• Assignment of rituals is an attempt to break up

dysfunctional rules in the family
• Specialized directives that are meant to dramatize
positive aspects of problem situations
• Direct the members of the family to change their
behavior under certain circumstances
• Example : saying “goodnight” to everyone before go to
sleep
Therapy Process
Short period of time (10 or fewer session)

Pre-Session
• Summary of the main themes from previous session
• Information which requires clarification from previous
session
• Between session contact the therapist has had with the
family/wider system
• The current formulation/themes/hypothesis of the issues
with which the family are bringing
• Ways forward for the current session which are being
considered
• Any team – therapist issues which need to be addressed
• Any family – family/team issues which need to be addressed
Therapy Process

Post-Session
• Review of main interventions and family’s response
• Ideas for future sessions, themes/issues to follow up,
E.g. narrative prompts, unexplored areas, facts to
check
• Feedback to therapist of team observations
• Therapist’s reflections on issues evoked for them by
the session
• Review of main interventions and family’s response
Therapy Outcome
Family dynamic change

Family experienced how family members are

interlinked

Family will stop being focused on scapegoating

problem and more productively evolves and disards
the old epistemology

Make changes that are directed to their particular

circumstances

Likely more focused on affirmation of one another

and clear communication
Role of Counselor

• Therapist is an expert involving family system.

• Therapist in this takes a non blaming stance.
• Therapist does not usually try overtly to
challenges or changes families, But therapist
takes the role of paradoxical position of being a
change agent who argues against change.
• Therapist use circular question to bring about
transformation.
• Therapist stress the positive connotations of a
behaviour.
Role of Client

• Clients decided that they need counselling and

come voluntary.
• Clients are able and willing to change.
• clients feels comfortable and free to express
and explore among themselves.
• clients tries to find a solution with the help of a
counselor.
• Clients determine their own choices and actions
(with the help of a counselor).
Theory Application into Multicultural Perspective

Seeing symptom in
positive way which can Short-term treatment
be implement into (usually 10 or fewer
various family sessions)
demographic

Flexible, evolving and Able to change

creative approaches problematic behavior
Comparison with Other Theories

European bias
towards non-
intervention.

Similar to
View about
strategic family
schizophrenia.
therapy.
Conclusion
Systemic Family Therapy is among
the most popular approaches to working
with families. They are short term,
specific, positive and appealing to
families that have difficulty with
organization and development.
Overall, some of the techniques
employed in systemic therapy- for
example, hypothesizingulization of
terms, circular questioning etc are
among the most creative formula as it
able to help counselor to conduct the
session well.
Reference

Lily Mastura Harun & Ramlan Hamzah Asas Kaunseling

Keluarga, Pusat penerbitan Universiti UPENA Universiti
teknologi mara shah alam 2007 edisi 2

samuel T Glading. Family Therapy : History,

Theory, and practice, Third edition, Wake forest
University
THANK YOU