Theory and Practice of Couples and Family Counseling. James Robert Bitter
Clinical family practitioners are also trained in schools of social work. And both psychiatry and psychology now have divisions devoted to family practice.
In general, those who are associated with the American Association for Marriage and Family Therapy and family practice in psychiatry and psychology tend to focus on psychopathology—both how it is maintained and what effects it has on family systems. Those associated with the International Association of Marriage and Family Counselors and counseling programs in general tend to focus more on family growth and development, resource identification, and what is now considered resiliency practice (J. B. Simon et al., 2005). Here the emphasis is on normalizing family process, activating ignored or denied individual and family skills and abilities, and focusing on what works and avenues to desired solutions. To be sure, these are not dichotomous positions, and many family approaches are embraced by both orientations (see Carlson et al., 2005; Sperry et al., 2019).
The theory chapters in this book have a relatively consistent format to aid you in comparing and contrasting the various approaches. Each chapter begins with a short introduction that introduces the founders and major contributors to the theory as well as its main emphasis. This introduction is followed by dialogue from an actual counseling session conducted by one of the main contributors to the model. Within the presentation of this counseling session, I ask you to consider certain questions that relate to understanding the model, its application, and how it relates to your own values and beliefs about helping others and family practice. A section that highlights key concepts of the model follows the counseling session; here the heart of the theory is presented for your consideration. Somewhat shorter sections on counseling goals and the practitioner’s role and function follow so that an emphasis is placed on the purpose and the person of the counselor. The section on process and interventions is designed to provide you with the process, skills, and interventions most associated with the theory. In this section, I address how to use the model with couples and/or families. This section is followed by an application of the model to the fictitious Quests as a couple or a family. A full description of the Quest family is presented at the beginning of Part 2. Again, the purpose of presenting the Quest family is to allow you to compare and contrast the different theories in actual practice. Each theory chapter ends with a summary of the approach; gender and cultural contributions associated with practitioners of the model; and a list of suggested readings, DVDs, and references. Although the word “counselor” is used throughout this text, it is intended to include all family practitioners from the fields of counseling, marriage and family therapy, psychiatry, psychiatric nursing, psychology, and social work.
An Overview of the Theory Chapters
The Early Pioneers
The first modern psychologist to adopt a systemic orientation and actually conduct family therapy sessions was Alfred Adler. The American pioneers included Murray Bowen; Virginia Satir; Carl Whitaker; Salvador Minuchin; and the strategic therapists, especially Jay Haley. Later, David and Jill Scharff would apply object relations to couples and family work. Each of these models adopted a modernist perspective in which there was a search for the essence of what made up a functional family. Some found that essence in communication, some found it in structure and hierarchy, and some focused on the development of the person within the system. Each of these founding models is unique in its perspectives and interventions, but all of them are systemic in nature.
Object Relations Family Counseling
Key figures: David and Jill Scharff, Nathan Ackerman, Ivan Boszormenyi-Nagy, Mary-Joan Gerson, Peggy Papp, Samuel SlippThe theory chapters start with the systemic approach of object relations therapists. Beginning with Sigmund Freud’s original drive/structure psychology, multiple scientist-practitioners began in the late 1920s and 1930s to investigate actual children and the nature of their relationships with significant caregivers. Many of these investigations were initiated in England, and the theorists came to be known as object relations practitioners. David and Jill Scharff developed object relations family therapy more fully using emotional tracking and an analysis of transference and countertransference to uncover unconscious processes within the family.
Adlerian Family Counseling
Key figures: Alfred Adler, Rudolf Dreikurs, Oscar Christensen, Len Sperry, Jon Carlson, Paul Peluso, Bill Nicoll, Jim BitterAdler was the first practitioner-theorist to speak of social embeddedness, family atmosphere, family interactions, the family constellation, and birth order, and he was the first psychologist to engage in family practice and interventions. His initial work with families and communities was systematized and expanded by Rudolf Dreikurs, who was, during his lifetime, the most prominent of Adlerian practitioners in the United States. Adler’s focus represented a huge paradigm shift in the development of psychodynamic theories, just as the general field of family counseling and practice would be another paradigm shift away from a focus on private, individual work.
Bowen and Multigenerational Family Counseling
Key figures: Murray Bowen, Betty Carter, Thomas Fogarty, Phillip Guerin, Michael Kerr, Monica McGoldrickSixty years ago, the models that would become the foundation for the field of marriage and family therapy began to emerge. These models included the multigenerational approach taken by Murray Bowen with his emphasis on differentiation of self, the problems of triangulation, and the passing of problems from one generation to the next. Murray Bowen also emphasized that the personal development and the professional development of the therapist were linked and were essential to the practice of family therapy.
Satir and the Human Validation Process Model
Key figures: Virginia Satir, John Banmen, Jean McLendon, Maria Gomori, Jane Gerber, Sharon LoeschenPerhaps no family practitioner emphasized the use of self in therapy more than Virginia Satir. A pioneer in the field of family therapy, Satir brought her background as a clinical social worker to her understanding of family process. She emphasized self-esteem and communication as avenues for understanding and intervening in family dynamics, and she provided us with a process for change that included human contact, touch, caring, and nurturance.
Whitaker and Symbolic-Experiential Family Counseling
Key figures: Carl Whitaker, David Keith, Thomas Malone, Gus NapierAlthough Satir was highly experiential in her approach, it was really Carl Whitaker who introduced the symbolic (with all of its existential meaning) to experiential counseling with families. Whitaker gave a whole new meaning to the process of coaching in family counseling. He stretched the boundaries of creativity and innovation when he danced with families. Whitaker often provoked anxiety in an effort to promote change. He also demonstrated the value of working with cotherapists in family sessions. A chapter on this method is available at www.jamesrobertbitter.com.
Minuchin and Structural Family Counseling
Key figures: Salvador Minuchin, Harry Aponte, Jorge Colapinto, Charles Fishman, Patricia MinuchinOne of the family practitioners who both influenced and was influenced by Carl Whitaker was the great master of structural family therapy Salvador Minuchin. Minuchin helped the field of family counseling understand the organization of families through the sequences of interactions and the boundaries (or lack of them) that existed between subsystems. Using joining, reframing, and enactment, Minuchin and his followers provided the early foundation for systemic work with families, especially poor families.
Strategic Family Counseling
Key