Different Models of Family Therapy
Family problems are the cause of psychological disorders such as anxiety, depression, and trauma, among others. The disorders are detrimental to an individual’s health and may affect the family and the community at large. Family therapy is one of the most effective ways of treating broken relationships among family members. Narrative and internal family systems (IFS) are two common approaches to family therapy. While narrative therapy allows the patients to be their experts, IFS therapy identifies and addresses multiple sub-personalities and families within an individual’s mental systems. While narrative and IFS therapies have similarities and differences, narrative family therapy is the most effective approach when treating broken relationships within a family.
Narrative Therapy
Although expert opinions and advice is crucial, an individual perspective on a particular problem can be more significant. Narrative family therapy, propounded by Michael White and David Epston helps people become experts when solving their problems (Béres, 2022). The therapy opines that people have stories that they develop and carry with them through their lives. For instance, women who have been sexually harassed may experience trauma throughout their lives (Downey & Crummy, 2022). As individuals experience awful events and interactions in their lives, they give them meaning. Therefore, narrative family therapy aims to have an empowering effect and provides non-blaming and non-pathological counseling.
Conceptualization
Various techniques are adopted by therapists when defining the “problem” within the narrative therapy model. Putting together a narrative, externalization, deconstruction, and unique outcomes are the techniques that a narrative family therapist can adopt (Blaylock-Johnson, 2021). Telling one’s story involves the therapists helping their clients to find their voice and explore events in their lives (Shelton et al., 2022). As the patients tell their stories, they identify the dominant and problematic story. Externalization allows the patients to narrate their experiences while creating a distance between themselves and their problems (Blaylock-Johnson, 2021). While externalization involves an already identified issue, putting together a personal narrative helps in identifying the dominant problem.
While narrative therapy is focused on an individual’s perspective, a therapist can help the patients better identify a problem. Problematic stories may feel like to have been for a long period, confusing the clients. Consequently, the patients may over-generalize their life experiences, making it difficult to identify a dominant problem. Therapists help the patients divide their stories into smaller parts to clarify a problem and make it approachable through deconstruction (Blaylock-Johnson, 2021). Meanwhile, ‘unique outcomes’ is applied when the stories feel concrete and as if they could never change. Therefore, the patients become stuck in their stories, influencing their behaviors and relationships. A narrative family therapist helps patients to challenge their problems and widen their views by considering alternatives.
Treatment Plan
Narrative therapy involves three main processes for a treatment plan: externalization, re-authoring conversations, and remembering conversations. Externalization of the problem involves a patient’s action of creating a distance between themselves and their problems. The process mirrors the mapping exercise steps of developing and experiencing near-problem definition, identifying and evaluating the effects of the problem, and justifying the evaluation (Blaylock-Johnson, 2021). After externalization, the therapists reauthor the conversations by helping the patients include neglected aspects and shifting the problem-centered narrative (Blaylock-Johnson, 2021). Finally, the conversations that actively engaged the clients are remembered in the process of renewing the relationships and removing those that no longer serve them.
Case Application: Narrative Therapy
In the case study, Jacie’s family seeks therapy because of the potentially broken family. Jacie and her husband, Edward, seemingly have a poor relationship that motivated the husband to seek divorce. The news may not be lightly accepted by the family members since they have had a consistent relationship of twenty-three years. The therapists would allow Jacie to narrate her story to identify the root cause of the conflict between her and her husband. Some of the issues that the therapists may discuss include any events that they have had marital problems.
Meanwhile, their sons will be involved in narrating how their parent’s conflicts have affected them. However, the therapy sessions with Jacie should be more than that with the sons since the overarching problem is the intimate relationship between her and her husband. The sessions should be between four to ten since it is a small group. Upon hearing their stories, the therapist would help Jacie focus on the dominant story that caused marital problems. After that, Jacie will be helped to renew her family relationship and remove the one that no longer serves her: her husband. Consequently, she might be helped to focus on her relationship with the sons and given mechanisms to strengthen it.
IFS
Psychological disorders are caused by an individual’s wounded parts and painful emotions. Broken relationships, such as marriages, affect the individual emotionally and may put an entire family at risk. IFS helps patients to identify and address their sub-personalities, such as anger and shame (Popejoy, 2022). Therapists believe that individuals’ sub-personalities are often in conflict with each other and one’s core self. IFS utilizes the family systems theory that individuals cannot be fully understood in isolation from the family unit. Consequently, the therapists develop techniques and mechanisms that address issues within an individual internal family. The approach combines individuals’ sub-personalities, and how they help in achieving better healing (Popejoy, 2022). IFS is an integrative model that assumes the human mind is subdivided into unknown parts and individuality should be central in coordinating the inner family.
Conceptualization
IFS adopts three main techniques to identify a dominant problem within the family relationship: firefighter, exile, and manager. The firefighter is an individual’s parts that are protectors and are activated when a trigger is present (McVicker & Pourier, 2021). For instance, a therapist may remind the patient of a painful moment in their lives and use a behavior like substance use to put out the ‘fire’ of pain. Meanwhile, the managers protect the patients by ‘managing’ situations through active planning and avoiding pain by whichever means possible. The manager and the firefighter work to keep the ‘exile’ from emerging, flooding the patient with memories of pain and trauma (McVicker & Pourier, 2021). Therefore, IFS adopts the ‘managers’, ‘exile’, and ‘firefighters’ to trigger the dominant problem within an individual self.
Treatment Plan
IFS’s treatment plan is a six-dimensional model that involves finding, focusing, fleshing out, feeling toward, befriending, and fearing. The therapists utilize the six steps consecutively to help the patients identify and address their problems. Find involves the therapists asking their patients to turn their attention inward, starting with meditation. The patients pay attention to the sensations in their bodies that come up to identify the part to work with (McVicker & Pourier, 2021). After that, the patients will be asked to focus on those parts. Once the patients have found and focused on the sensitive parts, they flesh them out. Consequently, they can see what else they can learn about the identified parts. Additionally, the patients can associate their different emotions with the parts.
Thereafter, the patients tell how they feel about those parts to help the therapists identify the role of the parts in their clients’ lives. Befriend involves the patient’s capacity to accept the existence of the parts that trigger negative emotions (McVicker & Pourier, 2021). The patients accept the parts during the befriending step, but that does not mean they will stay there. Fear is the final step of the treatment plan, and it involves individuals identifying what their fears are of that part of themselves.
Case Application: IFS
While narrative family therapy can be used to identify Jacie’s problems, the father and the kids could be subjected to the IFS. The father and the kids would be taken through the six steps of IFS to help the entire family understand the cause and the consequences of the looming divorce. First, the father and kids will be asked to meditate and turn their attention inwards. For instance, if the father was upset by the mother because she accused him of not taking part in their children’s school Parents’ Day. Meanwhile, if the kids were nervous upon hearing about their parents’ potential divorce, second, they will be asked to turn their focus on the identified parts.
Third, the father and the kids will be asked to flesh out the part identified. Additionally, they will have to learn more about the parts and identify any emotions associated with them. For instance, the emotional impact of the mother’s accusations against the father and the psychological effect of divorce on children. Fourth, the father and the kids will be required to feel towards the identified parts, helping the therapist know the impact of the problem on their lives. Fifth, they will be rehired to befriend the problems identified and see how they take shape in their lives. Last, the father and the kids will discover what fears are part of the identified problems. For instance, the fear among the kids upon their parents’ divorce. IFS will help the father and the kids address any phycological issues associated with the broken marriage.
Narrative Therapy vs IFS: Similarities and Differences
Narrative and IFS therapies help treat a wide range of psychological disorders involving intimate relationships. Both approaches utilize family members as the core agents in helping an individual identify and address their problems. Therefore, theoretically narrative and IFS utilize the family systems approach in treating relationship problems. Practically the two therapies involve expert intervention for a smooth problem-finding process. However, the approaches exhibit differences. While the narrative involves the patients as their experts, the IFS puts the experts at the center of the entire process. Unlike narrative therapy which utilizes narration to identify a problem, IFS involves observing an individual’s sub-personalities. While the narrative and IFS therapy approaches are different, they help solve relationship problems.
The Most Effective Model
While narrative therapy will be effective for the mother, the IFS will be appropriate for the father and the children. The narrative therapy is non-blaming, and the mother will focus on the existing problem without pointing a finger at anyone. Moreover, the therapy will put Jacie at the center of problem-finding, giving an accurate perspective of the situation. Meanwhile, IFS will be more effective for the father and children. IFS is significant in preparing the father and the children for emotional difficulties in the future. Additionally, IFS will help the children view depression symptoms as normal reactions to stressors. Therefore, while the mother will be subjected to narrative therapy, IFS should be used for the father and children.
References
Béres, L. (2022). The self/identity in narrative therapy. In The Language of the Soul in Narrative Therapy, 13–31.
Blaylock-Johnson, D. A. (2021). Holy sex: using narrative therapy and mindfulness to address church hurt and embrace the erotic. In An Intersectional Approach to Sex Therapy. 176-186. Routledge.
Downey, C., & Crummy, A. (2022). The impact of childhood trauma on children’s wellbeing and adult behavior. European Journal of Trauma & Dissociation, 6(1), 100237.
McVicker, S. A., & Pourier, W. (2021). Two counselors envision IFS (Internal Family Systems) therapy for addictions treatment in Indian country. Alcoholism Treatment Quarterly, 39(2), 175-197.
Popejoy, E. K. (2022). Parental incarceration and family reunification. In Counseling Strategies for Children and Families Impacted by Incarceration. 240-257. IGI Global.
Shelton, K., King, M. M., & Mahlet Endale. (2022). A handbook on counseling African American women: psychological symptoms, treatments, and case studies. Praeger.