Theory and Practice of Couples and Family Counseling. James Robert Bitter
figures: Jay Haley, Cloe Madanes, Mara Selvini Palazzoli, Paul Watzlawick, John WeaklandBy the 1980s, Minuchin’s work was often integrated with the problem-solution focus of the strategic therapists. Strategic therapists focused on the possibilities for change in systems that they understood to be hierarchies of power and function. Many of these practitioners were influenced by the theories and systemic thinking of Gregory Bateson as well as the indirect messages and trance work of Milton H. Erickson. This was especially true of Jay Haley and the practitioners at the Mental Research Institute in Palo Alto, California, where a focus on brief family therapy was first introduced. In turn, strategic therapists in the United States would also influence the strategic model in Milan, Italy, where Mara Selvini Palazzoli and her associates would focus on paradox, counterparadox, and circular (or relational) questioning.
The Postmodern Transition
By the 1990s, the field of family counseling itself had begun to experience a paradigm shift. Most of the approaches mentioned earlier fell into what we would now call a modernist perspective, in that they all searched for the essence of what makes up family process and sought to change the family in more functional and useful ways. The postmodern perspective challenged the idea of essences and a true knowing of the family system, suggesting that knowing a family depends as much on the perspective of the knower as the family. Thus, if we were to replace any family practitioner with any other family practitioner, a whole new understanding of the family would emerge. If there are multiple therapists working with a family, there are multiple perspectives on both understanding and helping the family. In this sense, most postmodern practitioners adopt a collaborative, social constructionist approach to family counseling. They believe that families are literally coconstructed in the language, stories, and processes that make up their lives and even in the process of counseling itself. Today the heart of social constructionist approaches to family counseling comes in the form of challenging dominant cultural and social positions and taking a stand against the ways in which such dominance constricts and restricts individuals, couples, and families.
Solution-Focused and Solution-Oriented (Possibility) Counseling
Key figures: Insoo Kim Berg, Steve de Shazer, Eve Lipchick, Bill O’Hanlon, Jane Peller, John Walter, Michele Weiner-DavisThe bridge between modern and postmodern family therapies is really in the solution-focused and solution-oriented therapies of Steve de Shazer/Insoo Kim Berg and Bill O’Hanlon/Michele Weiner-Davis, respectively. Growing out of and away from the strategic family therapy models, the solution approaches joined the postmodern movement and developed questions of difference (including exception questions, the miracle question, and scaling questions) to orient clients toward preferred solutions.
Postmodern, Social Constructionist, and Narrative Approaches to Family Counseling
Key figures: Tom Andersen, Harlene Anderson, David Epston, Kenneth Gergen, Harold Goolishian, Stephen Madigan, Michael WhiteThese models that ushered in the postmodern era in family counseling— narrative approaches to family counseling—were first introduced Down Under when Michael White and David Epston began to think of families as living out narratives often imposed on the system. Using externalization, unique events, and reauthoring interventions, narrative therapists seek to separate clients from problem-saturated stories and to cocreate stories of competence and capabilities. Counselors who use postmodern, social constructionist approaches often adopt what Harlene Anderson and Harold Goolishian called a decentered or not-knowing position characterized by interest, curiosity, and inquiries about the next most interesting development. Reflecting teams are used in each of these models to add diverse, multiple voices and perspectives to the process of counseling. Tom Andersen from Norway was the first to design reflecting teams. The purpose of the reflecting team is to provide an audience for counseling that will respond from multiple perspectives and give families many different lenses from which to view their struggles and successes.
Feminist Family Counseling
Key figures: Carol M. Anderson, Judith Myers Avis, Laura Brown, Betty Carter, Phyllis Chesler, Barbara Ehrenreich, Carolyn Enns, Carol Gilligan, Rachel T. Hare-Mustin, bell hooks, Deborah Anna Luepnitz, Dell Martin, Monica McGoldrick, Jean Baker Miller, Peggy Papp, Pam Remer, Patricia Robertson, Olga Silverstein, Lenore Walker, Froma Walsh, and Judith Worell, to name a very fewGrowing out of the feminist revolution of the 1960s and 1970s, feminist family therapists challenged patriarchy and the acceptance of White, male, heterosexual privilege inherent in the field of family therapy. They then went on to place gender role and power assessments, egalitarian relationships based on informed consent, consciousness-raising, assertiveness training, gender issues, and cultural diversity at the center of family counseling. Feminist family therapists understand patriarchy to be the dominant culture in all societies, and they have critiqued family systems theory for its lack of focus on gender and multicultural issues.
Evidence-Based Practice
Since the dawn of the 21st century, increased emphasis has been placed on interventions that show results. Cognitive behavioral counseling has led the way as an evidence-based practice, but solution-focused counseling from the postmodern tradition has also adopted this orientation, as have all three couples counseling models I present in this book.
Cognitive Behavioral Family Counseling
Key figures: Frank Dattilio, Albert Bandura, Aaron Beck, Albert Ellis, John Gottman, Neil Jacobson, Donald Meichenbaum, Gerald Patterson, Ivan Pavlov, B. F. Skinner, John Watson, Joseph WolpeAn application of behavioral learning theory and evidence-based practice to family counseling, cognitive behavioral family counseling blends the work of cognitive therapists, confronting irrational beliefs, with meth ods for shaping and reinforcing desired behaviors and interactions in families that research has shown to be effective. This model is preferred by most managed care facilities because it pragmatically addresses client actions and problems: It designs specific, often time-limited, interventions enacted in the service of ending identified dysfunctions or pathologies.
Parenting
Key figures: Alfred Adler, Diana Baumrind, Don Dinkmeyer, Rudolf Dreikurs, Haim Ginott, Thomas Gordon, John Gottman, James Lehman, Gary McKay, Cheryl McNeil, Jane Nelson, Michael PopkinA review of the major parent education programs and models currently used in the United States, this chapter presents models focused on democratic or authoritative-responsive parenting that use encouragement, active listening, reflective practice, natural and logical consequences, choices, and coaching in the service of building self-esteem in children and understanding and redirecting their mistaken goals. Emotion coaching and emotional intelligence are at the heart of raising competent, self-reliant kids and preparing them to cope with the challenges they will face throughout their development. This chapter is available at www. jamesrobertbitter.com.
Current Approaches to Couples Counseling
Three models of couples counseling currently dominate the field. They are the scientific approach of John and Julie Gottman, the emotionally focused therapy with couples developed by Susan M. Johnson, and imago therapy with couples as designed by Harville Hendrix and Helen Hunt. Each of these models is addressed in its own chapter. As you will have seen for the chapters above, there are also practitioners of couples counseling in the other models covered in the book. In addition, many prominent couples therapists, such as Pat Love (2001), Esther Perel (2009, 2017), and Froma Walsh (2016a, 2016b), work from their own unique perspectives.
The