Nov 8, 2017 in Informative

Integrative Models Paper


Family therapy is basically a relationship type of therapy and has been practiced in many system frameworks. It provides an effective aid to people with a wide range of difficulties. The range extends from childhood problems such as drug abuse, eating and mood disorders to adult difficulties and severe psychiatric states (Franklin, n.d.). Throughout the life span family therapy models are shown to be effective in management and treatment of chronic illness and depression and problems that accrue as the way of life of various families change. Family therapy is essentially effective in broad range of areas especially when combined with other suitable treatments and should be offered by accredited and qualified practitioners. Family therapists should register with UKCP after being trained as systematic psychotherapists so that they can be able to work within public services and offer consultations. Family therapists usually help families in mobilizing their resources so as to overcome their difficulties and further encourage them to find helpful ways to help themselves.

The most common approach that is used to evaluate the effectiveness of family therapy models is by use of meta-analysis. Meta-analysis refers to the quantitative statistical analysis which is commonly applied to separate experiments and uses pooled data. The use of the pooled data helps in testing the effectiveness of the results from the model. Meta-analysis results reveal that there is difficult in distinguishing the different family therapy models especially when comparing their overall effectiveness. All family therapy models are effective and give similar statistical results when evaluated using meta-analysis approach. Presently, meta-analysis results indicate that psycho-educational, structural, multi-systematic, functional and behavioral family therapy models give the most excellent evidence for their effectiveness. This is because each of the models has well developed treatment manuals, procedures and clinical protocols that assist many therapists in their interventions.

Behavioral models work with autism and the most common behavioral disorders of children. Studies show that parent management training is one of the effective treatment programs used in behavioral models. Functional family therapies usually integrate behavioral methods and systems theory in working with families and juvenile offenders.  Functional family therapy as a result helps in reducing arrests among younger siblings. Skills training approaches that are based on behavioral therapies are geared at ensuring that antisocial behaviors and substance abuse are reduced. These models stress on use of four key steps to instill learning skills. The therapist starts by modeling the skill followed by a session where the clients practice the skill. The clients are then assigned homework which helps them to practice the skill on daily basis. The therapist eventually obtains feedbacks from the clients based on their achievement in learning the skills. If the learning is not successful the therapist adjusts the training so as to accommodate the differences among the individuals. To work with persistent and severe mental disorders family therapists use family group interventions and psycho-education as the treatment choices (Olsen, 1993).  When carrying out psycho-education programs, a combination of social and education support happens to be the most efficacious. For the distressed couples emotion- focused and behavioral marital therapies essentially offer the most effective treatments (Johnson and Lebow, 2000). Studies further reveal that behavioral marital therapy is more effective especially when ameliorating symptoms of depressive nature than individual treatments.  

Integrative problem centered therapy is generally a psychotherapeutic structure that actually approaches therapy problem solving through integrating family biological and individual therapies. This is a model that was developed based on the believe that every psychotherapeutic approach has its distinctive domain of expertise required and that there is no any psychotherapeutic strategy that is capable of treating all the problems presented. Therefore, integrative problem centered therapy is basically a hierarchical approach towards therapy where precise psychotherapeutic techniques are used sequentially in a way that one is able to pick up from one technique fails. This model claims that therapy starts from the simplest, cheap and most direct way of treatment and extends to the more complex, extensive and indirect approaches only if the methods used previously fail (Gabbard, 2009). 

The unifying and fundamental theoretical framework of the integrative problem centered therapy consists of three components. The first component is interactive constructivism which clearly outlines the ontological and epistemological positions. Interactive constructivism emphasizes that independent and objective reality exists. It implies that diagnosis is by no means an ending process and therefore we keep learning more and more about systems. The other components are system theory and mutual causality. Integrative problem centered therapy is also composed of several concepts. The main concept is problem maintenance structure. It consists of all factors that are within the patient system that usually help to preserve the presenting problem. The people who are involved in resolving and maintaining the presenting problems of the patients are referred to the patient system. The factors that are contained in the patient system are generally known as the structure problem maintenance. It is assumed that the factors that compose the problem maintenance structure can only be allocated to a single constraint. There are several categories of the constraints which extend to include object relations, social organization, self psychological, meaning, biological and family of origin constraints. In most cases, family therapy begins by addressing the social organization constraints through behavioral interventions.

 Problem maintenance structure contains the blocks and constraints that frequently prevent and slow down the resolution of the preventing problem. It will be realized that the wider the structure the more systems will be involved. Similarly, the power and number of the determinants of historical problems will depend on the depth of the structure. All presenting problems have their unique form of the problem maintenance structure. This is because similar problems have different structures of problem maintenance while different problems may on the other hand have similar problem maintenance structures. Integrative problem centered therapy process is planned to practically and progressively disclose the natural world of problem maintenance structure. If the nature of the structure of problem maintenance is superficial and simple as actually presumed at the start of treatment then behavioral family intervention is the best effective way to resolve the presenting problem. Studies show that problem maintenance structure basically originates from therapist system construction. Therapy in most cases involves progressive testing and formulation of hypotheses on the structure of the problem maintenance.


Problem centered therapy clearly amalgamates family and individual therapies in a comprehensive and consistent approach to treatment of psychological related problems. Integrated problem centered therapy methodically progresses through a series of distinct levels and phases in exploring problems in the maintenance structure that eventually leads to problem resolution. Problem centered model is framework that is used to conduct systematic psychotherapy and fails to address critical patient systems aspects such as gender practices and beliefs.Family focused interventions help family members work together and agree on programs regarding to disease management in ways that harmonize with their operational style and beliefs. They further help the family to manage stress through preventing diseases from taking over the family life and providing new family structures with adjustments in their expectations and roles.

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