Introduction to systemic family therapy (original) (raw)

S ome practitioners are drawn to auditory verbal (AV) practice, in part, due to their desire to help children with hearing loss. Yet, to effectively help children, it is imperative that practitioners learn to work effectively with children's families. Presented in this chapter is a brief historical review of the profound importance of family involvement with special needs children in general, and children with hearing loss in particular. Challenges facing families with children who have special needs are considered. A case is then made for why practitioners should think systemically, considering the child, parents, siblings, and any other persons living in the home, including grandparents, as a whole context. This leads to a select and very brief discussion on the history of systemic family therapy and some of its models. Next reviewed are some central insights of family therapy, including suggested techniques from various family therapy models that practitioners can implement. Finally, there is a discussion of situations in which referral to qualified family therapists is the best course of action. Case Example. The mother sat in the family therapy office, tired and with tearstains on her face. She had hoped to bring in her son with hearing loss for therapy, to get help with the problem of his repeated truancy from school. However, he refused to come and, at seventeen, he was too big for her to drag into the therapy room. "Is it him, or is it me?" she 113 Auditory-Verbal Practice 114 asked. "If it's me, what am I doing wrong? And if it's him, how can you help him if he won't even show up?" What this mother did not yet fully understand is that her family therapist (the first author) practiced in the tradition of systemic family therapy. Therefore, there would be no need to assign blame to either her or her child, nor would everyone in the family need to be present in order for the family therapist to view the problem as a function of the complex interaction between all involved family members. Systemic family therapy, recognizing the interdependencies of relationships, is based on the twin assumptions that all behavior makes sense in context, and that the most useful therapeutic focus is a focus on pattern and context, rather than on individual pathology (Cottrell & Boston, 2002). Working from this understanding, the family therapist was able to resolve this mother's and her son's difficulties. This scenario will be referred to repeatedly in the rest of this chapter, but from the perspectives of family therapists embracing different systemic models. WHY THE FAMILY SYSTEM IS IMPORTANT In this section, the compelling reasons why family involvement is crucial to the treatment of children with special needs will be reviewed. In addition, a case will be made for the shift in thinking required to conceptualize the family system as a unit, as more than just a collection of individuals. Thinking systemically will open the door to numerous effective ways to intervene with children in their home context. Family Advocacy For Children With Special Needs The vast majority of achievements-increased rights, widespread inclusion, and more individualized special services-on behalf of children with special needs were the result of advocacy by family members, rather than by practitioners or legislators alone (Asberg, Vogel, & Bowers, 2008; Turnbull & Turnbull, 1997). While practitioners supported family members in their efforts, and legislators responded to advocates' pressure, it was parents, grandparents, older siblings, and other concerned family members working together to push for change who were the primary catalysts (Asberg et al., 2008; Turnbull & Turnbull, 1997). Worldwide, the history of special education followed a predictable pattern (Winzer, 2009). Initially, in areas either rural or without great economic resources, children with special needs were seen as the primary responsibili