Feminist Therapy
Founders: This approach grew
out of the efforts of many women, a few of whom are Jean Baker Miller, Carolyn
Zerbe Enns, Olivia Espin, and Laura Brown.
Basic Philosophy
Feminists criticize many
traditional theories to the degree that they are based on gender-biased
concepts, such s being androcentric, gender centric, ethnocentric,
heterosexist, and intrapsychic. The
constructs of feminist therapy include being gender fair, flexible,
interactionist, and life-span-oriented.
Gender and power are at the heart of feminist therapy. This is a systems approach that recognizes
the cultural, social and political factors that contribute to an individual’s
problems.
Key Concepts
Core principles of feminist
therapy are that the personal is political, therapists have a commitment to
social change, women’s voices and ways of knowing are valued and women’s
experiences are honored, the counseling relationship is egalitarian, therapy focuses
on strengths and a reformulated definition of psychological distress, and all
types of oppression are recognized.
Goals of Therapy
To bring about transformation
both in the individual client and in society.
To assist clients in recognizing, claiming, and using their personal
power to free themselves from the limitations of gender-role
socialization. To confront all forms of
institutional policies that discriminates or oppress on any basis.
The Therapeutic Relationship
The therapeutic relationship is
based on empowerment and egalitarianism.
Therapists actively break down the hierarchy of power and reduce
artificial barriers by engaging in appropriate self-disclosure and teaching
clients about the therapy process.
Therapists strive to create a collaborative relationship in which
clients can become their own expert.
Techniques of Therapy
Although techniques from
traditional approaches are used, feminist practitioners tend to employ
consciousness-raising techniques aimed at helping clients recognize the impact
of gender-role socialization on their lives.
Other techniques frequently used include gender-role analysis and
intervention, power analysis and intervention, demystifying therapy,
bibliotherapy, journal writing, therapist self-disclosure, assertiveness
training, reframing and relabeling, cognitive restructuring, identifying and
challenging untested beliefs, role playing, psychodramatic methods, group work,
and social action.
Applications of the Approach
Principles and techniques can be
applied to a range of therapeutic modalities such as individual therapy,
relationship counseling, family therapy, group counseling, and community
intervention. The approach can be
applied to both women and men with the goal of bringing about empowerment.
Contributions to Multicultural Counseling
Focus is on both individual
change and social transformation. A key
contribution is that both the women’s movement and the multicultural movement
have called attention to the negative impact of discrimination and oppression
for both men and women. Emphasizes the
influence of expected cultural roles and explores client’s satisfaction with
and knowledge of these roles.
Limitations in Multicultural Counseling
This model has been criticized
for its bias toward the values of White, middle-class, heterosexual women,
which are not applicable to many other groups of women nor to men. Therapists need to assess with their clients
the price of making significant personal change, which may result in isolation
from extended family as clients assume new roles and making life changes.
Contributions of the Approach
The feminist perspective is
responsible for encouraging increasing numbers of women to question gender
stereotypes and to reject limited views of what a woman is expected to be. It is paving the way for gender-sensitive
practice and bringing attention to the gendered uses of power in
relationships. The unified feminist
voice brought attention to the extent and implications of child abuse, incest,
rape, sexual harassment, and domestic violence.
Feminist principles and interventions can be incorporated in other
therapy approaches.
Limitations of the Approach
A possible limitation is the
potential for therapists to impose a new set of values on clients – such as
striving for equality, power in relationships, defining oneself, freedom to
pursue a career outside the home, and the right to an education. Therapists need to keep in mind that clients
are their own best experts, which means it is up to them to decide which values
to live by.
Postmodern
Approaches
Founders: A number of key figures are associated with the
development of these various approaches to therapy. Steve de Shazer and Insoo Kim Berg are the
co-founders of solution-focused brief therapy.
Michael White and David Epston are the major figures associated with
narrative therapy.
Basic Philosophy
Based on the premise that there
are multiple realities and multiple truths, postmodern therapies reject the
idea that reality is external and can be grasped. People create meaning in their lives through
conversations with others. The
postmodern approaches avoid pathologizing clients, take a dim view of
diagnosis, and avoid searching for underlying causes of problems, and place a
high value on discovering clients’ strengths and resources. Rather than talking about problems, the focus
of therapy is on creating solutions in the present and the future.
Key Concepts
Therapy tends to be brief and
addresses the present and the future.
The person is not the problem; the problem is the problem. The emphasis is on externalizing the problem
and looking for exceptions to the problem.
Therapy consists of a collaborative dialogue in which the therapist and
the client co-create solutions. By identifying
instances when the problem did not exist, clients can create new meanings for them
and fashion a new life story.
Goals of Therapy
To change the way clients view
problems and what they can do about these concerns. To collaboratively establish specific, clear,
concrete, realistic, and observable goals leading to increased positive
change. To help clients create a
self-identifying grounded on competence and resourcefulness so they can resolve
present and future concerns. To assist
clients in viewing their lives in positive ways, rather than being problem
saturated.
The Therapeutic Relationship
Therapy is a collaborative
partnership. Clients are viewed as the
experts on their own life. Therapists
use questioning dialogue to help clients free themselves from their problem-saturated
stories and create new life-affirming stories.
Solution-focused therapists assume an active role in guiding the client
away from problem-talk and toward solution-talking. Clients are encouraged to explore their
strengths and to create solutions that will lead to a richer future. Narrative therapists assist clients in
externalizing problems and guide them in examining self-limiting stories and
creating new and more liberating ones.
Techniques of Therapy
In solution-focused therapy the
main technique involves change-talk, with emphasis on times in a client’s life
when the problem was not a problem.
Other techniques include creative use of questioning, the miracle
question, and scaling questions, which assist clients in developing alternative
stories. In narrative therapy, specific
techniques include listening to a client’s problems-saturated story without
getting stuck, externalizing and naming the problem, externalizing
conversations, and discovering clues to competence. Narrative therapists often write letters to
clients and assist them in finding an audience that will support their changes
and new stories.
Applications of the Approach
Solution-focused therapy is well
suited for people with adjustment disorders and for problems of anxiety and
depression. Narrative therapy is now
being used for a broad range of human difficulties including eating disorders,
family distress, depression, and relationship concerns. These approaches can be applied to working
with children, adolescents, adults, couples, families and the community in a
wide variety of settings. Both
solution-focused and narrative approaches lend themselves to group counseling
and to school counseling.
Contributions to Multicultural Counseling
Focus is on the social and
cultural context of behavior. Stories
that are being authored in the therapy office need to be anchored in the social
world in which the client lives.
Therapists do not make assumptions about people and honor each client’s
unique story and cultural background.
Therapists take an active role in challenging social and cultural
injustices that lead to oppression of certain groups. Therapy becomes a process of liberation from
oppressive cultural values and enables clients to become active agents of their
destinies.
Limitations in Multicultural Counseling
Some clients come to therapy
wanting to talk about their problems and may be put off by the insistence on
talking about exceptions to their problems.
Clients may view the therapist as an expert and be reluctant to view
themselves as experts. Certain clients
may doubt the helpfulness of a therapist who assumes a “not-knowing” position.
Contributions of the Approach
The brevity of these approaches
fit well with the limitations imposed by a managed care structure. The emphasis on client strengths and
competence appeals to clients who want to create solutions and revise their
life stories in a positive direction.
Clients are not blamed for their problems but are helped to understand
how they might relate in more satisfying ways to such problems. Strength of these approaches is the questions
format that invites clients to view themselves in new and more effective ways.
Limitations of the Approach
There is little empirical
validation of the effectiveness of therapy outcomes. Some critics contend that these approaches
endorse cheerleading and overly positive perspective. Some are critical of the stance taken by most
postmodern therapists regarding assessment and diagnosis, and also react
negatively to the “not-knowing” stance of the therapist. Because some of the solution-focused
techniques are relatively easy to learn, practitioners may use these
interventions in a mechanical way or implement these techniques without a sound
rationale.
Family Systems
Therapy
Founders: A number of significant figures have been pioneers of the
family systems approach, including Alfred Adler, Murray Bowen, Virginia Satir,
Carl Whitaker, Salvador Minuchin, Jay Haley and Chloe Madanes.
Basic Philosophy
The family is viewed from an
interactive and systematic perspective.
Clients are connected to a living system; a change in one part of the
system will result in a change in other parts.
The family provides the context for understanding how individuals function
in relationship to others and how they behave.
Treatment deals with the family unit.
An individual’s dysfunctional behavior grows out of the interactional
unit of the family and out of larger systems as well.
Key Concepts
Focus is on communication patterns
within a family, both verbal and nonverbal.
Problems in relationships are likely to be passed on from generation to
generation. Key concepts vary depending
on specific orientation but include differentiation, triangles, power
coalitions, family-of-origin dynamics, functional versus dysfunctional
interaction patterns, and dealing with here-and-now interactions. The present is more important than exploring
past experiences.
Goals of Therapy
To help family members gain
awareness of patterns of relationships that are not working well and to create
new ways of interacting.
The Therapeutic Relationship
The family therapist functions
as a teacher, coach, model and consultant.
The family learns ways to detect and solve problems that are keeping
members stuck, and it learns about patterns that have been transmitted from
generation to generation. Some
approaches focus on the role of therapist as expert; others concentrate on
intensifying what is going on in the here and now of the family session. All family therapists are concerned with the
process of family interaction and teaching patterns of communication.
Techniques of Therapy
A variety of techniques may be
used, depending on the particular theoretical orientation of the
therapist. Technique include genograms,
teaching, asking questions, joining the family, tracking sequences, issuing
directives, use of countertransference, family mapping, reframing,
restructuring, enactments, and setting boundaries. Techniques may be experiential, cognitive, or
behavioral in nature. Most are designed
to bring about change in a short time.
Applications of the Approach
Useful for dealing with marital
distress, problems of communicating among family members, power struggles,
crisis situations in the family, helping individuals attain their potential,
and enhancing the overall functioning of the family.
Contributions to Multicultural Counseling
Focus is on the family or
community system. Many ethnic and
cultural groups place value on the role of the extended family. Many family therapies deal with extended
family members and with support systems.
Networking is a part of the process, which is congruent with the values
of many clients. There is a greater
chance for individual change if other family members are supportive. This approach offers ways of working toward
the health of the family unit and the welfare of each member.
Limitations in Multicultural Counseling
Family therapy rests on value
assumptions that are not congruent with the values of clients from some
cultures. Western concepts such as
individuation, self-actualization, self-determination, independence, and
self-expression may be foreign to some clients.
In some cultures, admitting problems within the family is shameful. The value of “keeping problems within the
family” may make it difficult to explore conflicts openly.
Contributions of the Approach
From a systemic perspective,
neither the individual nor the family is blamed for a particular
dysfunction. The family is empowered
through the process of identifying and exploring interactional patterns. Working with an entire unit provides a new
perspective on understanding and working through both individual problems and
relationship concerns. By exploring
one’s family of origin, there are increased opportunities to resolve other
conflicts in systems outside of the family.
Limitations of the Approach
Limitations include problems in
being able to involve all the members of a family in the therapy. Some family members may be resistant to
changing the structure of the system.
Therapists’ self-knowledge and willingness to work on their own
family-of-origin issues is crucial, for the potential for countertransference
is high. It is essential that the
therapist be well trained, receive quality supervision, and be competent in
assessing and treating individuals in a family context.
