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Systemic therapy

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"Systemic therapy" redirects here. For the medical sense of the term, see Therapy § Systemic therapy.

Systemic therapy is a type of psychotherapy that seeks to address people in relationships, dealing with the interactions of groups and their interactional patterns and dynamics.[1]

Early forms of systemic therapy were based on cybernetics and systems theory. Systemic therapy practically addresses stagnant behavior patterns within living systems without analyzing their cause. The therapist's role is to introduce creative "nudges" to help systems change themselves. This approach is increasingly applied in various fields like business, education, politics, psychiatry, social work, and family medicine.

History

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Systemic therapy has its roots in family therapy, or more precisely family systems therapy as it later came to be known. In particular, systemic therapy traces its roots to the Milan school of Mara Selvini Palazzoli,[2][3][4] but also derives from the work of Salvador Minuchin, Murray Bowen, Ivan Boszormenyi-Nagy, as well as Virginia Satir and Jay Haley from MRI in Palo Alto. These early schools of family therapy represented therapeutic adaptations of the larger interdisciplinary field of systems theory which originated in the fields of biology and physiology.

The Systemic Family Therapy develops from Murray Bowen's theory, from the research he conducted in the late 1940s till the early 1950s at the NIMH. The research project had families live on the research ward for extended periods. Bowen and his staff conducted extensive observational research on each family's interactions.[5] Bowen's theory of Systemic Family therapy had 8 concepts: "Triangles", "Differentiation of Self", "Nuclear Family Emotional Process", "Family Projection Process", "Multigenerational Transmission Process", "Emotional Cutoff", "Sibling Position", "Societal Emotional Process" [6] In the late 1960s, he introduced the theory of family systems which was based on the structure and behavior of the family’s relationship system as opposed to traditional individual therapy. Bowen researched the family patterns of people with schizophrenia who were receiving treatment and the patterns of his own family of origin when families were viewed as complex systems. The number of elements and how they are organized can alter how complex the system is. The system is required to have control and feedback mechanisms, which is where cybernetics come in place. Norbert Wiener, a mathematician, came up with the term Cybernetics which refers to the study of the automatic control system. Another contributor to this system came from Gregory Bateson, he created the idea that the family is a system governed by cybernetic principles. In one of those principles the Systemic theory is mentioned, this theory explains further into how individuals interact with each other, their connections to others, patterns, and their relationships. [7]

Early forms of systemic therapy were based on cybernetics. In the 1970s this understanding of systems theory was central to the structural (Minuchin) and strategic (Haley, Selvini Palazzoli) schools of family therapy which would later develop into systemic therapy. In the light of postmodern critique, the notion that one could control systems or say objectively "what is" came increasingly into question. Based largely on the work of anthropologists Gregory Bateson and Margaret Mead, this resulted in a shift towards what is known as "second-order cybernetics" which acknowledges the influence of the subjective observer in any study, essentially applying the principles of cybernetics to cybernetics – examining the examination.

As a result, the focus of systemic therapy (ca. 1980 and forward) has moved away from a modernist model of linear causality and understanding of reality as objective, to a postmodern understanding of reality as socially and linguistically constructed.

Practical application

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Systemic therapy approaches problems practically rather than analytically. It seeks to identify stagnant patterns of behavior within a living system - a group of people, such as a family. It then addresses those patterns directly, without analysing their cause. Systemic therapy does not attempt to determine past causes, such as subconscious impulses or childhood trauma, or to diagnose. Thus, it differs from psychoanalytic and psychodynamic forms of family therapy (for example, the work of Horst-Eberhard Richter).

Systemic therapies are increasingly being used in personal and professional settings, but also have evidence in benefitting children with mental disorders as well. Behavioral disorders that affect mood and learning abilities have working evidence that supports the implementation of systemic therapy amongst younger groups of children who may struggle with these issues (Retzlaff et al., 2013).[8] The approach of reframing daily struggles for those with mood disorders helps to aid in the grounding and practicality of their situations. Those receiving help from systemic therapies are set to focus on the realities of their daily lives and offer a pragmatic perspective on problem-solving skill sets.

When approaching systemic therapy, a multitude of factors are considered in order to reach the desired results. Approach is determined on a case-by-case basis, involving the consideration of factors such as; mental disorders, the adolescent’s upbringing, situational life events, stress induced by societal factors, unconventional family dynamics, etc. (Lorås, 2017).[9] The methodology[10] of systemic therapy involves an amalgamation of various data points to be able to practice what approach might be best to implement for the individual. All contributing stress factors of the individual's reality are considered during the development of the grounded theory analysis, in order to best aid the individuals in need.

Although systemic therapy does not attempt to determine past causes, it is important to recognize that Systemic Therapy is used in family therapy also known as "Systemic Family Therapy".[11] These practices can often be seen and used in families or children that abuse drugs, have behavior problems, chronic illness, and many other uses (Cottrell & Boston, 2002)[12] These are some way Systemic Therapy has been utilized in our mental health institutions, and continues to be practiced on patients.

A key point of this postmodern perspective is not a denial of absolutes. Instead, the therapist recognises that they do not hold the capacity to change people or systems. Their role is to introduce creative "nudges" which help systems to change themselves.

An interesting study by Eugene K. Epstein[13] supports the idea that a therapist does not hold the capacity to change people or systems. Epstein argues that although we can't change systems, we can influence them. Part of Postmodernism relies on our self-agency, our cultures, practices, etc. (Epstein, 2016) Therefore these views and cultural biases affect and influence the approach of therapy, in this instance systemic Therapy. Therapists and those practicing Systemic Therapy can analyze and see patterns of emotions. Many times people can feel constrained on what they feel or be confused about what they are feeling, when you can clarify and understand what emotions you are feeling it can lead to a positive change (Bertrando & Arcelloni, 2014). This means Systemic Therapy also helps exercise emotional interpretation.

There are various forms of techniques that involve systemic therapy. One form of therapy used is structural family therapy. This consists of  Structural family therapists interfering to form the ideal family structures that are known. As for families who have complex family dynamics. A few techniques that are advised to put into practice is to confront the complex family boundaries. As well as, reestablishing the family structure by shifting the families composure and forming family relatives in pairs opposed to one another. These are a few procedures that are believed to restore position scales.[14]

An additional, overview that best helps to comprehend this approach is the outcome of this form of therapy is to gather family individuals closer to the model. Therefore the proper approach is to use guidance and recommendations. The therapists believe this is one of the most effective techniques. The therapist addresses this form of technique by implementing an oral form of communication. For instance, the therapist will begin by asking a series of questions. The questions involve demonstrating characteristics of authority.The individual who discusses new indications establishes to a situation or set of routines. Then the therapist will provide the individuals with a certain scenario that will help them better navigate an upcoming conflict that may arise. This will allow family individuals to engage in discussion and offer possible resolutions.[15]

Also, there is additional information that provides insight into the positive outcome of systemic interference in families of children with distinct difficulties. This refers to family therapy or additional family-orientated techniques. This refers to family therapy or additional family-orientated techniques. For instance, family-orientated interceptions have demonstrated positive results regarding infants' sleeping issues.

There is a brief discussion of the positive impact that family-orientated approaches are a proper remedy for establishing wakening issues. These are the most common issues presented during the infancy stage. In these forms of techniques, parents are advised on how to minimize their infant's afternoon naps. And constructing effective nighttime practices. As well as, eliminating parent-infant interaction during the nighttime sleeping cycle. There was also a sleeping agenda that helped minimize the sudden awakening of infants.

The final result indicated that the systemic approach helped reduce the awakening in infants and had a positive resultion on their sleeping issues.[16]

Another technique that involves systemic therapy is conceptualization, which allows the therapist to gather the patient's symptoms in context and looks into how the patient experiences creating a pattern with other individuals or family.[17] These forms of systemic therapy help people of any age group resolve their issues. Issues including anger management, addictions to substances, relationship problems, mood disorders, and more. Human interactions are connected to their emotions and in terms can branch out to their social, or cultural interventions. Evidence supports how systemic interventions have a positive effect on infants and certain emotional problems they may have such as behavior issues.[18]

Systemic therapy neither attempts a 'treatment of causes' nor of symptoms; rather it gives living systems nudges that help them to develop new patterns together, taking on a new organizational structure that allows growth.[19]

While family systems therapy only addresses families, systemic therapy in a similar fashion to Systemic hypothesising addresses other systems. The systemic approach is increasingly used in business, education, politics, psychiatry, social work, and family medicine.[20]

See also

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References

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  1. ^ "Systemic Familytherapy". European Association for Psychotherapy. Retrieved 2023-05-03.
  2. ^ DiNicola, Vincenzo F. Road map to Schizo‑land: Mara Selvini Palazzoli and the Milan model of systemic family therapy. Journal of Strategic & Systemic Therapies, 1984, 3(2): 50‑62.
  3. ^ DiNicola, Vincenzo F. Carte routiére pour le schizo-land: Mara Selvini Palazzoli et le modèle de Milan de thérapie familiale systémique. Systèmes Humains, 1986, 2(1): 61‑74.
  4. ^ DiNicola, Vincenzo F. Mara Selvini Palazzoli et le modèle de l’école de Milan de thérapie familiale systémique: Bibliographie [Mara Selvini Palazzoli and the Milan model of systemic family therapy: Bibliography]. Systèmes Humains, 1986, 2(1): 129‑135.
  5. ^ "Bowen Theory". bowen-theory. Retrieved 2024-09-02.
  6. ^ "Family Systems Approach". Newport Academy. Retrieved 2024-09-02.
  7. ^ Gibbons, Rachel; O'Reilly, Jo (2021-06-10). Seminars in the Psychotherapies. Cambridge University Press. ISBN 978-1-108-58323-7.
  8. ^ Retzlaff, Ruediger; von Sydow, Kirsten; Beher, Stefan; Haun, Markus W.; Schweitzer, Jochen (December 2013). "The Efficacy of Systemic Therapy for Internalizing and Other Disorders of Childhood and Adolescence: A Systematic Review of 38 Randomized Trials". Family Process. 52 (4): 619–652. doi:10.1111/famp.12041. ISSN 0014-7370.
  9. ^ Lorås, Lennart (2018-03-01). "Systemic Family Therapy Competences in Child and Adolescent Mental Health Care". Contemporary Family Therapy. 40 (1): 1–9. doi:10.1007/s10591-017-9440-z. ISSN 1573-3335.
  10. ^ Burck, Charlotte (August 2005). "Comparing qualitative research methodologies for systemic research: the use of grounded theory, discourse analysis and narrative analysis". Journal of Family Therapy. 27 (3): 237–262. doi:10.1111/j.1467-6427.2005.00314.x. ISSN 0163-4445.
  11. ^ Bertrando, Paolo (July 24, 2014). "Emotions in the Practice of Systemic Therapy". Australian and New Zealand Journal of Family Therapy. 35 (2): 123–135. doi:10.1002/anzf.1051.
  12. ^ Cottrell, David (May 28, 2002). "Practitioner Review: The effectiveness of systemic family therapy for children and adolescents". Journal of Child Psychology and Psychiatry. 43 (5): 573–586. doi:10.1111/1469-7610.00047.
  13. ^ K. Epstein, Eugene. "The Narrative Turn: Postmodern Theory and Systemic Therapy". The Narrative Turn: Postmodern Theory and Systemic Therapy: 10.
  14. ^ Asen, Eia (2002). "Outcome research in family therapy". Advances in Psychiatric Treatment. 8 (3): 230–238. doi:10.1192/apt.8.3.230. ISSN 1355-5146.
  15. ^ Cottrell, David; Boston, Paula (2002). "Practitioner Review: The effectiveness of systemic family therapy for children and adolescents". Journal of Child Psychology and Psychiatry. 43 (5): 573–586. doi:10.1111/1469-7610.00047. ISSN 0021-9630.
  16. ^ Carr, Alan (2014). "The evidence base for family therapy and systemic interventions for child-focused problems". Journal of Family Therapy. 36 (2): 107–157. doi:10.1111/1467-6427.12032. hdl:10197/7270. ISSN 0163-4445.
  17. ^ Ph.D, Jeremy Sutton (2021-07-19). "What Is Systems Therapy? 7 Theories & Techniques Explained". PositivePsychology.com. Retrieved 2024-05-12.
  18. ^ Carr, Alan (February 2009). "The effectiveness of family therapy and systemic interventions for child-focused problems". Journal of Family Therapy. 31 (1): 3–45. doi:10.1111/j.1467-6427.2008.00451.x. hdl:10197/4821. ISSN 0163-4445.
  19. ^ Arist von Schlippe and Jochen Schweitzer, Lehrbuch der Systemischen Therapie und Beratung (Göttingen: Vandenhoeck & Ruprecht) 1998, p 93.
  20. ^ Arist von Schlippe and Jochen Schweitzer, Lehrbuch der Systemischen Therapie und Beratung (Göttingen: Vandenhoeck & Ruprecht) 1998, pp 245-261. For the field of family medicine see also Susan H. McDaniel, et al. Medical Family Therapy: A Biopychosocial Approach to Families with Health Problems (New York: Basic Books) 1992 pp 26-35
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