لایب سان

Author(s): William P. Russell, Douglas C. Breunlin, Bahareh Sahebi

Series: The Family Institute Series: Clinical Applications of the Integrative Systemic Therapy (IST) Model

Publisher: Routledge, Year: 2022

ISBN: 9780367338381,9780367338398,9780429322273

Contents List of Figures xiv Acknowledgments xv Foreword xvii Preface xx List of Contributors xxiii 1 Integrative Systemic Therapy 1 Introduction 1 Empirically Informing IST 2 Theoretical Framework: Integrative and Systemic 3 The Pillars of IST 3 The Essence of IST 5 The Blueprint 6 The Hypothesizing Metaframeworks 8 The Planning Metaframeworks 9 The Contexts of Therapy 13 Guidelines for Intervention: What to do When? 14 Conversing and Reading Feedback 16 Therapist Development 17 Conclusion 19 Exercises 19 References 20 2 Convening a Client System and Defining a Problem: The First Phone Call 24 Objective 24 Introduction 25 Method 26 Assessing Risk and Level of Care 29 Deciding Who to Invite to the Initial Session 29 Describing the IST Approach 31 Specific Requests for Therapy 32 Requests for Individual Adult Therapy 32 Requests for Couple Therapy 33 Requests for Family Therapy 34 Requests for Child Therapy in Single-Parent and Two- Parent Families 34 Requests for Child or Family Therapy with Binuclear Families (Divorced, Remarried) 35 Requests for Mandated Therapy for a Child 35 Conclusion 36 Exercises 37 References 39 3 Convening a Client System and Defining a Problem: The First Session 40 Objective 40 Introduction 41 Method 41 Universal Aspects of the Initial Session 42 Assessing Risk and Level of Care Required 44 IST-Specific Aspects of the Initial Session 44 Building an Alliance 44 Cultural Humility, Cultural Competence and the Therapeutic Alliance 46 Describing IST as a Problem-solving Process 46 Defining the Problem 48 Locating a Problem in a Problem Sequence 49 Obtaining Information about the Members and the Context of the Client System 52 Individuals, Couples, and Families in the Direct Client System 53 Individuals 54 Couples 56 Families 57 Conclusion 57 Exercises 58 References 59 viii Contents 4 Strategies for Locating a Problem in a Problem Sequence 61 Objective 61 Introduction 62 Identifying Problem Sequences 62 A Classification Scheme for Sequences 63 Method 66 Holding a Systemic Frame 66 Locating a Problem in a Problem Sequence 67 Protecting Alliances 68 Managing Multiple Points of View 69 Vagueness 69 Two or More Stories Offered 70 Attitudinal Tools for Identifying a Problem Sequence 70 Curiosity 70 Creativity 71 Courage 72 The Therapeutic Conversation 74 Operational Tools 76 Hypothesizing 76 Conversing 77 Feedback 78 Case Example 79 Conclusion 83 Exercises 83 References 84 5 Identifying a Solution Sequence 85 Objective 85 Introduction 86 Method 88 Experiments 88 Strategies 91 Enactments 92 Cultural Considerations 93 Client-Therapist Differences 94 Client-Therapist Similarities 95 Therapeutic Alliance 96 Case Example 96 Conclusion 99 Contents ix Exercise 100 Identifying a solution sequence: Case illustration and questions to consider 100 References 101 6 Implementing a Solution Sequence 103 Objective 103 Introduction 104 Method 105 Readiness 105 Refinement 107 Commitment 109 Follow up 110 Hypothesizing and Planning 113 Culture 113 Therapeutic Alliance 115 Conclusion 118 Exercises 118 References 119 7 Identifying Constraints 120 Objective 120 Introduction 121 Method 121 Constraint Questions 122 Practicing Constraint Questions 122 Proposing Hypotheses about Constraints 123 The Nature of Constraints 123 Mind 125 Organization 129 Development 130 Culture 133 Gender 135 Gender Identity 135 Gender Roles 136 Gender and Relational Equity 136 Biology 137 Illness and Injury 138 Neurobiological Constraints 139 Additional Biological Issues 141 x Contents Spirituality 142 Managing Multiple Constraints 143 Conclusion 144 Exercises 144 References 145 8 Integrating Interventions to Address Constraints 150 Objective 150 Introduction 151 Method 153 Modifying Who Is in the Direct Client System 153 Addressing Constraints 154 The Planning Metaframeworks 155 Action Planning Metaframework 156 Meaning/Emotion Planning Metaframework 156 Biobehavioral Planning Metaframework 157 Family of Origin Planning Metaframework 157 Internal Representation Planning Metaframework 157 Self Planning Metaframework 158 Integrating Interventions to Address Constraints 158 Addressing Constraints of Mind 158 Addressing Organizational Constraints 162 Addressing Developmental Constraints 165 Addressing Constraints Related to Culture 167 Case Example of Addressing a Culture-Related Constraint 169 Addressing Constraints Related to Gender 171 Addressing Biological Constraints 173 Addressing Constraints Related to Spirituality 175 Conclusion 178 Exercises 179 References 179 9 Evaluating Treatment Progress and Modifying Plans 184 Objective 184 Introduction 185 The Time it Takes to See Progress 186 Method 187 Tracking Progress 187 Contents xi Evaluation Using Informal Measures of Progress 189 A Decision Tree for Progress Evaluation 193 Evaluating the Solution Sequence 193 Evaluating the Success of an Attempt to Lift a Constraint 195 Managing Two or More Constraints 195 Intractable Constraints 197 Unresolvable Relationship Issues 197 Trauma 198 Biology 199 Conducting Therapy over Time 200 Conclusion 202 Exercises 202 References 203 10 The Decision to End Therapy 205 Objective 205 Introduction 206 Method 207 Maintaining a Solution Sequence(s) and Soliciting Feedback on Overall Progress 207 The Ways That Therapy Ends 210 Reflecting on the Therapy 212 Discussion of What Would Signal a Need to Return to Therapy 214 Diversity, Inclusion, and Social Justice 214 Conclusion 215 Exercises 215 References 216 11 Pathways within Integrative Systemic Therapy 218 Objective 218 Introduction 218 Client Situations Requiring Modification of Essence Steps 219 Risk Issues 219 Mandated Therapy 221 Contexts of Therapy That Impact IST Practice 223 Workplace Requirements and Constraints 223 Case Management and Support Services 224 xii Contents Inpatient Psychiatric and Residential Programs 226 Therapist Considerations 227 Therapist style and preferences 227 Person of the Therapist 229 Conclusion 231 Exercises 232 References 233 Appendix A: Ist Tables of Strategies and Intervention Resources 236 Appendix B: Integrative Systemic Therapy Guidelines for Practice 251 Index 253 Contents xiii

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