Monday, November 22, 2010

Contextual Family Therapy

I was mentored early on to become proficient in a number of schools of thought and approaches. Thus, to avoid the situation, 'if all you have is a hammer, everything looks like a nail', I use a range of interventions, preventions and supports that address the individual and unique needs of each client, couple or family system.  Each client or family system is unique, coming from a unique situation, and presenting with a unique set of challenges and strengths. The ultimate goal is to help each build on existing strengths and gain further understanding and insight into their lives, and develop satisfactory solutions that bring greater peace, hope and joy to the gift of life.  Couples Relationship  and Family counselling focuses on such issues as couple/family conflict,  separation,  divorce, communication issues, parenting /step-parenting issues, forgiveness issues, sandwich generation issues,  trust issues, anger management, learning to listen, learning coping skills, and more. I use a variety of approaches, including:


Contextual Therapy (Ivan Boszormenyi-Nagy)
The contextual model proposes four dimensions of relational reality:  facts (genetic input, physical health, basic historical facts, events in a person's life cycle, etc); individual psychology; systemic transactions (classical systemic family therapy, i.e.. rules, power, alignments, triangles, feedback, etc); and relational ethics. These dimensions are understood to be inter-linked. Relational focuses on the nature and roles of connectedness, caring, reciprocity, loyalty, legacy, guilt, fairness, accountability, and trustworthiness, within and between generations. Relational ethics is seen in relation to basic needs and real relationships with concrete consequences. Focuses on the interconnection between people. Contextual Therapy  aim is to evoke a dialogue of responsible mutual position-taking among family members, and consists of a sequential, empathic turning towards member after member (even absent members), in which both acknowledgment and expectation are directed at them. It is not a neutral or unilateral approach, and requires an appreciation of the 'ledger' from each person's point of view, even that of the current victimizer. The therapist has each family member explain their side of the story, in order to begin to understand the problem in terms of background facts, the relational context (i.e., intergenerational, interpersonal, and systemic), and deeper motivational factors (e.g., psychological processes, hidden loyalties and legacies, ledger imbalances, destructive entitlement resulting from real or perceived injustices, parentification of the child, etc.).  After the therapist has a preliminary understanding of the situation, issues requiring urgent attention (e.g., physical welfare, prevention of violence, etc.), are addressed,  especially in relation to the interests of the most vulnerable member(s), whether or not they are present at the therapy sessions.