Theory and Practice of Couples and Family Counseling. James Robert Bitter
its goals. In this sense, it “is preferable, and less stigmatizing, to identify particular family processes or relational patterns that are dysfunctional and not to label the family” (Walsh, 2016a, pp. 8–9).
Family life in Western societies has always been diverse, and in the 21st century it is increasingly so. Here are just a few of the statistics:
Since 1960, the percentage of married adults has dropped from 70% to just over 50%.
The average age at which people marry is now 28 for men and 26 for women, 6 years later than couples in 1960.
Many couples today exercise the option not to have children; most of these couples, however, choose to raise a pet.
More than 50% of all adults will cohabit sometime in their lives, and most of these people will think of it as a step before marriage.
A growing number of couples are in stable, intimate relationships but living apart.
A total of 25% of all households are headed by single parents, 85% of whom are women; 40% of all children are born outside of marriage, and half of these children have a female single parent who is still living with the child’s father.
Dual-career/dual-earner families make up two thirds of all two-parent households.
Since 1980, the divorce rate has peaked and then declined to around 45%; most divorced people remarry.
Remarriage often results in the creation of stepfamilies, and 60% of these marriages fail.
Both single parents and couples have been adopting more; most adoptions are now open, and keeping siblings together in an adoption is a primary goal.
Two decades of research has demonstrated that children raised by gay men or lesbians do just as well as children raised by heterosexual parents.
Lesbian couples are more likely to truly share household and child-rearing responsibilities, engage in cooperative decision-making, and have high levels of parental involvement with the children.
The flow of families coming to the United States from Asia and Latin America is 3 times what it was before the turn of the century, and Hispanics are becoming the largest minority group.
Immigrant families are often more resilient in the face of challenges than native-born families.
Poverty is affecting more families today than a decade ago, with African Americans, Hispanics, and female-headed households getting hit the hardest.
Because people are living longer, it is increasingly likely that individuals will have several committed coupled relationships over a lifetime.
More than 50% of all first marriages last a lifetime. (Adapted from Walsh, 2016a)
Early family counseling models focused primarily on family dysfunction, especially models in which the therapist assumed the position of being skilled at resolving family difficulties. In the past two decades, the emphasis in family counseling has shifted to a focus on family strengths and to the family’s capacity for resilience, or the ability to recover, heal, and grow after facing adversity or personal and often family challenges. Any personal or relational crisis is initially experienced as a shock. Some of these shocks are basically short-term problems with which the individual, couple, or family must cope. When a complex shock hits the couple or family system, it signals a need for change and often sends the system into chaos. In many families, it is not one stressor that does the system in but rather the cumulative effect of many stressors over a long period of time. This latter condition almost always forces the couple or family to redefine who they are. Still, in the face of significant stressors, it is amazing how many couples and families rise from what seem like ashes. They seldom do this alone: They often have help and support from extended family, from friends, from religious and spiritual communities, and from social agencies. Counselors who bring a strengths-based framework to family counseling often start by noting the strengths the family has already demonstrated under stress; they assume that no single approach to healthy functioning fits all families; they interview the couple or family as experts in finding their own solutions; and they focus on optimism, courage, possibilities, flexibility, connectedness, and internal as well as external resources. Resiliency-focused counselors support clear communication, the expression of personal truths and shared pain, the use of empathic responding, and an appreciation of diversity. Those who place an emphasis on problem-solving seek to engage the family in brainstorming, resource hunting, shared decision-making, negotiations, fairness, collaborative planning and implementation, and above all else a positive stance.
Differences Between Systemic and Individual Approaches
There are some significant differences between systemic approaches and those associated with individual counseling. To be sure, there are some similarities too, but it is the differences that set the orientation of the helper toward those who are served.
Individual counseling tends to focus on the development of the individual’s self, coping responses, and problem-solving. People are seen in isolation from the systems in which they live, and the counselor is betting that the 1 hour of influence they have each week will be greater than the influences in the rest of the client’s life. In individual counseling, clients are assessed against fixed norms, and their symptoms are considered in relation to standard descriptions of psychopathology. In many therapeutic models, the counselor is still expected to be objective, to discover the cause of painful emotions or disruptive behavior, and, having found the cause, to do something to fix it. It is not uncommon in these same approaches for close attention to be paid to the content of what people say, and constant judgments must be made about the functionality or improvement of the client.
Modern systems practitioners tend to want as many members of the family as possible in the room—often including friends and other members from the family’s community. It is not, however, how many people are in the room that counts: it is how the family practitioner thinks about the people in the room. It is about focusing on transactions, sequences of interaction, interdependence, recursion, and mutual influence (concepts more fully defined in subsequent chapters): It is about process. It involves seeing the purpose and systemic logic in what often appear to be paradoxical processes. It is accepting the subjectivity of the family practitioner, studying it, knowing it, watching for its impact on the counseling session, and working to place it in the service of clients’ well-being. It is learning to see how a problem affects the couple or family and how these systems maintain the problem. It is understanding that each individual has an internal system (Schwartz, 2001), and it is learning to consider the impact of larger systems on the family, especially the politics that relate to race, gender, culture, sexual or affectional orientation, age, socioeconomic status, and creed. And most recently, it also includes listening to the stories within families, and the stories about these stories, and the ways in which each person participates in creating their own realities as well as the stories about these realities.
In short, family practitioners seek to address systems embedded in systems that are embedded still further in other systems. They seek to explore the meaning and purpose of interactions and transactions and engage in processes that support the kinds of solutions that individuals and families seek for their own lives. In Theory and Practice of Counseling and Psychotherapy (Corey, 2017), Gerald Corey and I used the case of Ann to illustrate the differences between what an individual practitioner and a systemic practitioner might do:
Ann, age 22, sees a counselor because she is suffering from a depression that has lasted for more than 2 years and has impaired her ability to maintain friendships and work productively. She wants to feel better, but she is pessimistic about her chances.
… Both the individual [counselors] and the systemic [counselors] are interested in Ann’s current living situation and life experiences. Both discover that she is still living at home with her parents, who are in their 60s. They note that she has a very successful older sister, who is a prominent lawyer in the small town in which