Story of Psychology - Morton Hunt [395]
Groups range in size, although most therapists consider eight an ideal number. They usually meet once a week, cost only a fraction of what individual therapy costs, and last anywhere from eight weeks to years, depending on their goals and the therapists’ orientations. Group psychotherapy used to be an American specialty but now is practiced in many countries; there are still, however, more group therapists in this country than any other. The American Group Psychotherapy Association has close to three thousand members; probably ten times that many therapists not in the association conduct groups at least part of the time.107
Couples therapy: Couples therapy was originally known as marriage counseling but today often proceeds at a deeper level than old-time counseling and is offered not only to married couples but to premarital, extramarital, and homosexual couples, all of whom have somewhat similar relationship problems.
The therapist’s role in couples therapy is a tightrope act: If he or she is perceived by either member of the couple as siding with the other member, the therapy may be abruptly broken off. The therapist therefore seeks to avoid transferences that would generate strong feelings by either client; acts as interpreter, adviser, and teacher; and stresses that the troubled relationship, not either individual, is the client.
The therapist solicits information and makes interpretations; teaches communications skills and problem solving; plays back to the couple how they sound and look in their interaction (“Are you aware that you sat as far apart as possible?”); brings up sensitive issues that they avoid discussing with each other but can safely fight about in the relative safety of the therapist’s office; and assigns homework to teach them new and more satisfying patterns of behavior. Couples therapy is usually conducted on a weekly basis, and most problems can be resolved in a year or less. In some cases, the partners in couples therapy recognize that what one or both really want is the end of the relationship. In that case, the therapist sometimes is able to help them separate cooperatively rather than combatively and minimize the damage to themselves and to the children, if there are any.108
Family therapy: Family therapy was developed almost simultaneously in several different places in the United States in the 1950s, most notably in Palo Alto and New York. Its basic assumption is that psychological symptoms and difficulties of all sorts stem from faulty relationships within the family rather than from individual intrapsychic mechanisms (although these are not ruled out).
Even though the family may come in with an “identified patient”—a scapegoat or supposedly sick member on whom the family blames its troubles—the therapist regards the family as the patient, or, to be more precise, the family’s interactions, rules, roles, relationships, and organization. All these make up the “family system”; family therapy draws heavily on systems theory, which was borrowed and adapted from biology. In systems theory terms, the family members may be either overly or insufficiently involved with one another; cut off from outside influences by rigid family boundaries; conversely, lacking in a sense of familial belonging because of vague family boundaries; and so on.109
The therapist diagnoses the family’s problems in systems theory terms by means of genograms (diagrams of family patterns over three generations), by determining what the alliances are within the family, and by using other methods special to family therapy. There are several schools of family therapy, each of which has developed its own intervention techniques. Family therapy is offered not only privately but in clinics and community mental health centers.
The American Association for Marriage and Family Therapy now has more than 23,000 members, who come from various disciplines and have met the association’s requirement of training and supervised postgraduate