PROBLEM SOLVING THERAPY

Information gathered by Sonam & Aparna

II Year M.Sc.

Department of Psychology,

Jain University, Bangalore

Problem Solving Therapy is a brief intervention used in family therapy where the client and the therapist work together to identify and define the problems, solve these identified problems by coming up with practical solutions and improve the client’s general approach to problems.

It is also called as talk therapy.

Sessions in Problem Solving Therapy usually last for four to eight sessions.

It is associated with creative thinking. Steps in creative thinking include:

·         Orientation

·         Preparation

·         Incubation

·         Illumination

·         Verification

The problem is explained to every member of the family and the focus is on the client’s general approach to the problem.

Problem Solving Therapy involves seven steps. They are:

1)  Problem orientation:

In this step, the client’s attitude to solve the problem is evaluated. It must be noted that this is different from the actual problem solving skills they possess. There is an assessment of the client’s thoughts and feelings regarding the problem and also their ability and awareness about their strengths to solve problems. These two elements will determine how a client will respond in a stressful situation. All the dimensions about the problem are identified. To check whether the thoughts about problems are emotional or intellectual also becomes essential in this step. It is believed that many problems are created because people think about it emotionally rather than intellectually.

The kind of orientation about the problem that the individual has is also assessed. There are two kinds of orientation. They are:

Positive orientation - A person with a positive problem orientation is rational and effective in their problem solving style. They think about the positive aspects of the problem. They are also capable of bringing about a positive and effective problem solving style.

Negative orientation - Persons with negative problem orientation are impulsive, careless or avoidant in their problem solving style. They make immediate decisions without being ready to think about possible solutions. They also may ignore or deny the problem.

2) Recognizing and identifying the problem

Problem solving therapy aims to develop positive problem orientation in the client which can be achieved by helping the client recognize and challenge the negative orientation, and by motivating the client to believe in their ability to solve problems through positive experiences. In this step, the client is taught to recognize a problem so that the client’s can begin to solve the identified problem. This can be done by:

·         Making the client report the current problem and making a problem list

·         Learning how to track problem indicators and helping them understand the interconnection between thoughts, emotions, behavior and physical symptoms.

·         Educating the clients about some procedures to solve problems.

·         Using a checklist

This process of recognizing and identifying will help in the production of a list of problem areas which will serve as the foundation of the client and therapist working together.

3)  Selecting and defining a clear problem:

The focus of this step is to assist the client to select one clear problem that has to be solved first from the list of problems that have been identified in the problem list. Once the problem is selected, the client has to clearly define it so that possible solutions can be found and worked on. A problem has to be chosen in such a way that it also solves other related problems. The client is then asked to define the problem from his/her own perspective. While defining the problem, the client understands all the aspects related to the problem, for example, what is the problem? When does it occur? Where does it occur? How does it occur? Why is that problem a problem? Who is involved? What have you done to solve the problem in the past? Do you have control over the problem?

4) Generate solutions:

In this step, a process of brainstorming happens to create as many solutions as possible for the problem. The client is asked to generate solutions that are practically relevant and has a chance of solving the problem.  Every solution that the client comes up with is written down and the potentiality of each solution is identified.

5) Decision making:

In the decision making step, as a consequence of the brainstorming process, the client checks the pros and cons of the relevant solutions which was generated and hence, a decision is made as to which solution out of the listed can be implemented effectively and accurately.

This stage can become difficult for the clients, therefore, the therapist has to assist the client a systematic way to sort the solutions by using decision making guidelines. First, checking if there are solutions that can be discarded immediately (initial selection). Then, similar solutions are grouped together to determine the options available (grouping solutions) and finally, choosing very few (2 or 3) solutions which will have to be evaluated in depth (weighing the advantages and disadvantages).

6) Creating or implementing a SMART action plan:

The achievable steps are identified. In this step, the client creates and then implements the action plan. The action plan should be Specific, Measurable, Achievable, Relevant and Time-bound. Each family member including the children can be approached to establish the procedures that they want to follow. The client can also include a time-line. Targets reached have to be reviewed.

7) Reviewing the progress of the process:

This step basically reviews the client’s progress with the action plan. The therapist has to check if the clients are underway with their plans, if the plan has the desired impact on solving the problem, to check if any more needs to be done to make the plan more workable and to check if any areas or skills of the client’s needs to be  repaired/fixed or improved.

Advantages of Problem Solving Therapy:

·         It improves problem solving skills, communication, coping skills and reductions in family conflict.

·         Problem solving therapy is systematic and pragmatic.

·         Allows the client to come up with different solutions by himself/herself. Focus is on the client.

Disadvantages of PST:

·         It is too scientific and less humanistic.

References:

University of Auckland, (2015) from http://www.problemsolvingtherapy.ac.nz/index.php?p=steps

COMPARISON BETWEEN INDIVIDUAL THERAPY AND MARITAL AND FAMILY THERAPY

Information gathered and presented by:

Tumchobeni and Beni

Students of M.Sc.Psychology,

Jain University,

Bangalore

In individual therapy, the person who seeks treatment will be an individual. However in family therapy, there will be two or more individuals who seek therapy. The goal of individual therapy is for the therapist to provide some emotional healing for the client. The goal of couple therapy is for the therapist to help the two partners provide emotional healing for each other.

In individual therapy, the therapist may focus on understanding one person’s view and experiences. This is to help them to know what they want and to communicate that assertively and clearly. In family therapy, the therapists will likely focus on what both people want, how they can communicate that and do something about it. In a family therapy, it may involve some negotiating and compromises. It also mostly focuses on communication skills. As with individual clients, you try to help them come to an understanding of what’s going on for them, how this came to be a problem, and why it has continued. For couples, you do the same, but you help them both see what’s been happening in their relationship, how it came to be and how each of them has been a factor in it, and why it has continued.

In individual therapy the therapists traditionally meet their clients once a week for 50 minutes or so. This helps the therapist in providing some stability for the client, and creates a place where the client regularly pauses in life to reflect, evaluate their progress toward their goals, and make decisions. It may be seen as a weekly review to assess the personal life goals as well as the progress toward them. Family therapy is often much more flexible, the therapist may see the client for more than an hour and may meet clients once a month or after few months. This helps as a way to reduce relapse into problems.

When it comes to the effectiveness of the therapy, there are many studies that show the effectiveness of the many therapies available in individual therapy. Sometimes studies may show one kind of therapy is better than another for a specific problem. More often they show most therapies can help with most all problems. As for family therapy, according to a study done by Liddle et al. (2002) report that the transition from “distressed” to “non-distressed” after treatment occurs for 35% (Jacobson et al., 1984) to 41% (Shaddish et al., 1993) of couples. In other words, they get better, but generally only a third or so are in the “normal and happy with their relationship” range. The issue for studies of the effectiveness of therapy is that when married couples in treatment are compared to married couples on a wait-list, the couples on the wait-list decline into the “very distressed” range while they wait for therapy. Thus, the treatment really has only to halt the decline in order to yield significant results, and a statistically significant result may not mean much (Gollan and Jacobson’s chapter in Liddle et al. 2002). However, Johnson & Greenberg (1994), however, using the Emotion Focused Therapy they developed, found much better results. Cloutier et al. (2002) found 62% of couples were improved (less distressed) when they finished six to ten sessions of Emotion Focused Therapy. However, 77% were improved two years later, meaning they were in the “normal and happy with their relationship” range) at the end of six to ten sessions of Emotion Focused Therapy, while 64% were recovered with two years of follow up. Thus, with specific couples therapy treatments shown to work, about three-fourths get better, and two-thirds are “healed” after only six to ten sessions of work.

ADVANTAGES OF FAMILY AND MARITAL THERAPY

The main advantage of Family and Marital therapy is that it involves the entire family during the therapy sessions.  It tries to make each other understand and help one another handle his or her problems. It gives each member an opportunity to share information and be part of the solution. This helps in leading to a greater sense of commitment among the members of the family. In the therapy couple/ partners participation allows the therapist to get more information which can greatly improve the effectiveness of treatment, also help the therapist observe and plan approach to look into the various problems. Family and Marital therapy is also beneficial in terms of dealing with parent child conflicts. It is difficult for parenthood sometimes especially when there is no common ground between the child and the parent, in such situation the therapist becomes a neutral person and offers common ground and help foster peace.

Family and Marital therapy helps individuals and their household handle many issues other than of psychologically based alone. It can be used to understand how each household functions, to identify strengths and weaknesses that exist in each household system and help set goals and develop approaches to tackle challenges. It is beneficial in the improvement of communication skills and strengthening the entire community. Family therapy plays a big role in helping those with struggling with substance abuse, eating disorders and depression, severe mental illness, couple problems and parenting concerns. All in all the advantages is that it teaches family members about how families function in general and, in particular, their own functions. It helps the family focus less on the member who has been identified as ill but focus more on the family as a whole and helps in identifying conflicts and anxieties and develop strategies to resolve them. This therapy works in strengthening all family members so they can work on their problems together and teach ways to handle conflicts.

INCORPARATING INDIVIDAUL THERAPY TO FAMILY AND MARITAL THERAPY

Just like in Individual therapy which focuses on one person, at times in Marital and Family therapy it may require incorporating this individual technique in dealing one members of the family to facilitate change, confront barriers that interfere among the members of the family and increase positive attitude to look into the problem and solve it.  Individuals are equally important in a family so it is necessary to look into their area of concern and conflict and involve them for effective result in the therapy.

Individual therapy allows people to speak without worry of being judged by a partner. This technique can be used in the Family and Marital therapy as well so as  to allow the individual express freely and also in this way help the therapist get information and allow him/her arrange the approach to tackle the challenge/ problems. In Individual therapy, therapist assigns the individuals certain works or exercise to complete by the therapist in the process of counselling as part of therapeutic process. Likewise, in Family and Marital therapy, each member can be assigned tasks, for example, maintaining separate dairies or notes for couples, use of reinforcement for enhancing positive behaviour for children etc.  Similar to Individual therapy, in Family and Marital therapy psychological assessment can be used as well; for example screening test, Self Report Questionnaires and Family Heath Questionnaires.

 References:

Niolon R (November 21, 2010) what’s the difference between couples and individual therapy. Retrieved from http://www.psychpage.com/family/library/couple_therapy_genera.html

Family Therapy (2014). Retrieved on 8.02.14 from http://www.webmd.com/balance/family-therapy-6301

Defining Family Counselling from a systems framework

-Neha and Ramaa

Family is an interconnection of people who rely on each other for emotional, mental, monetary, physical wellbeing and various such purposes. Some families are very strong and seem perfect in terms of mutual understanding or support whereas there are other families who are a little bit weak at their base and need some guidance from somewhere. But as it is mostly seen that people are not very open and do not find it important to take help form outside as it is very commonly thought to keep it within the boundaries of the family. But that scenario is changing and there a major emphasis on family counselling rises.

In a general context, family counselling can be defined as a type of therapy used to resolve the problems within the family and help them get along well with the other members. It does not restrict to only issues concerning fights between the members, but also how to deal with issues such as taking care of someone with any kind of mental health issue also. The purpose of such services is to maintain or improve the functioning of the family. Counselors may work with the entire family or can even work with just one parent or child depending upon the situation. Sometimes it can also include the extended family.

Murray Bowen in one of the pioneers of Family Therapy. 

Bowen’s System Theory

The family systems theory is a theory introduced by Dr. Murray Bowen that suggests that individuals cannot be understood in isolation from one another, but rather as a part of their family, as the family is an emotional unit and all are interconnected and interdependent.

According to Bowen, a family is a system in which each member had a role to play and rules to respect. System is an assembly of objects related to each other, i.e. it is a group interacting, interrelated, or interdependent elements forming a complex whole. The system looks at both i.e the individual as a separate being and a family as a whole to uderstadn the case.

Each member of the system is expected to respond to each other in a certain way according to their role, which is determined by relationship agreements. They all exhibit a coherent behavior which will bring out a trait of the system. This inter connection between the elements will create the structure of the family.

There is a boundary of the system which helps to develop a pattern of interaction between the members of the family. Patterns develop as certain family member's behavior is caused by and causes other family member's behaviors in predictable ways. Maintaining the same pattern of behaviors within a system may lead to balance in the family system, but also to dysfunction. For example, if one member of the family is experiencing stress then the others in the family needs to take responsibility and make things work. Changes in the role can help but over doing them may cause dysfunction again.

There are eight interlocking concepts in Dr. Bowen's theory:

1) Triangles: The smallest stable relationship system. Triangles usually have one side in conflict and two sides in harmony, contributing to the development of clinical problems.

2) Differentiation of self: The variance in individuals in their susceptibility to depend on others for acceptance and approval.

3) Nuclear family emotional system: The four relationship patterns that define where problems may develop in a family:

• Marital Conflict
• Dysfunction in one spouse
• Impairment of one or more children
• Emotional Distance

4) Family projection process: The transmission of emotional problems from a parent to a child.

5) Multigenerational transmission process: The transmission of small differences in the levels of differentiation between parents and their children. 

6) Emotional cutoff: The act of reducing or cutting off emotional contact with family as a way managing unresolved emotional issues.

7) Sibling position: The impact of sibling position on development and behavior.

8) Societal emotional process: The emotional system governs behavior on a societal level, promoting both progressive and regressive periods in a society.

According to Bowen, family is a system of interconnections where one person influences another and thus leads to dependence among the family members. His model is very straight forward which states that families are bounded by interconnections. But then I would also like to add a few essential points and make my own model which would support his idea that people in the families are influenced by one another but then they are also bound by mutual respect, love, trust, understanding and friendship which will help families share a very healthy relationship with one another. The inclusion of smaller elements helps us define the system better.

Family counselling, according to us based on systems framework is the understanding of the family in terms of its structure and behavior. It is a type of therapy wherein a therapist is understanding the functioning of a family by not only understanding the situation but also by taking into consideration the smaller aspects which affects and individual and thus in return affects the family as a whole. For example, if a child in a family is not happy with the behavior of the parents then the child can start to become emotional numb towards them just to protect himself/herself. We have tried explaining the model in a diagrammatic from where an emphasis is given both to the structure and the dynamics of the family system. If one member of the family is showing any kind of dysfunction then the others should take responsibility otherwise the entire mechanism comes to a standstill. Apart from the structure and the functioning another important aspect of family counselling is the way the members of the family interact. If there is any malfunction in the interaction than higher are the chances for the system to break down.