Theory and Practice of Couples and Family Counseling

James Robert Bitter

• Publisher: American Counseling Association
• Year: 2020
• ISBN:
  9781119685159
• Edition: 3
• Topic: Didattica
• Subtopic: Formazione professionale

This introduction to couples and family counseling lays the foundation for student skill-building by encouraging the development of personal, professional, and ethical standards of practice. This third edition has been expanded to include couples counseling and updated to reflect recent research and current practice. Primary text features include a genogram delineating the history of the field; a comprehensive discussion of 13 widely used theories with real-life examples of quality work for each approach; a single, bicultural couple/family system case for comparison across models; and strategies for the integration and application of the models into clinical practice with diverse clients. To help readers apply the concepts they have learned, Dr. Bitter provides numerous Illustrative examples, case studies, sample client dialogues, and exercises for personal and professional growth.

*Requests for digital versions from ACA can be found on www.wiley.com

*To request print copies, please visit the ACA https://imis.counseling.org/store/detail

*Reproduction requests for material from books published by ACA should be directed to [email protected]

PART 1
Basic Issues in the Practice of Couples and Family Counseling

CHAPTER 1 Introduction and Overview

CHAPTER 2 Genograms of Couples and Family Counseling

CHAPTER 3 The Couples and Family Practitioner as Person and Professional

CHAPTER 4 Virtue, Ethics, and Legality in Couples and Family Practice

• • •

CHAPTER 1
Introduction and Overview

Fifty years ago, family practice promised greater effectiveness than had been achieved with either individual or group counseling. Because these relational approaches sought to change the very systems in which individuals actually lived, many professionals hoped that the changes enacted would endure and that both individual and system relapse would disappear. Although these hopes have not been fully realized, family practice has had enormous success, and it is now a fully integrated part of most treatment programs.

Couples and family practice is fundamentally different from individual counseling. Although both couples and family systems share some similarities with groups, their intimacy and intensity make them a treatment unit unlike any other. Perhaps the hardest task for those trained to work with individuals is learning assessment and interventions with couples and families from multiple systemic perspectives. I will say more about this later. In the meantime, this book provides you with an invitation to experience the thinking of the pioneers and leaders who have shaped systemic approaches in the field of couples and family practice.

This book surveys 13 approaches to family counseling and practice, highlighting key concepts, therapy goals, techniques, process, and application. Two additional chapters that were part of an earlier edition of this book have been updated and are available on my website (www.jamesrobertbitter.com). These chapters are on symbolic-experiential family therapy (Carl Whitaker’s model) and effective approaches to parenting. I hope you will read this book with the goal of learning the breadth and depth of each counseling orientation. The models presented here sometimes have a great deal of similarity and sometimes are quite different and even contradict one another. Consider not only the ideas and interventions of each model but also the worldview espoused by both the founders of the theory and the practitioners who currently contribute to its development.

Each of these models will, most likely, have some relevance to your own family of origin. The family of origin is often a good place to start the personal exploration that is so essential to couples and family practice. It is almost axiomatic these days that family practitioners-in-training must consider the impact that their families of origin have had on their personal development (see McGoldrick, 2011a). If we do not make this journey into our own histories, we are in danger of trying to work out our personal family issues with every new family we encounter.

Over time, various ideas and models will start to appeal to you: They will fit with your values and beliefs and, in some cases, they will even enhance or broaden your worldview. You will start to create a foundation for your work, and you will find that parts of different models will integrate into that foundation. This is not a process that happens quickly. It will certainly not happen at the end of a course or two on the theories and practices of marriage and family counseling. This is a lifelong journey.

You might start by asking yourself the following questions:

• What beliefs do these theorists and practitioners have about families in general?
• Do I hold these same beliefs, ideas, or values, or do other values and positions seem more important to me?
• If I were bringing my family of origin and/or my current family members to counseling with me, would I want to go to a family practitioner, counselor, or therapist using this approach? Why or why not? What would my expectations be? What goals would I have for the work I was contemplating in counseling?
• What kind of relationship would I want to have with the family practitioner? What would contribute to my trust, comfort, willingness to work, determination to change, and feeling of accomplishment at the end?

There are useful parts to every theory and model we will consider in this book. None of the approaches considered here holds a claim to absolute truth, however, or even to the right way to do family practice. Each theory is built on a perspective and provides a different kind of lens through which families may be viewed and understood. And each of these perspectives inevitably has continually developing implications for family practice.

Finding a model or models that work for you is an important first step as a professional. Such a discovery provides a framework for working with the multitude of diverse families you will encounter—families that are often facing very complicated and even severe problems. Family practice is supposed to be a challenge. It is supposed to engage your mind and your heart. It will endlessly change you as a person, and it will require you to reflect on your use of self in counseling as much as your use of skills and techniques. Family counseling and practice will test your strengths, poke at your weaknesses, and enlarge your view of life. Ultimately, it can be one of the most rewarding careers in the helping professions.

Why I Became a Couples and Family Counselor

Like most people who are attracted to the helping professions, I came from a family that had its happy times and its struggles. You can probably say the same thing about your family. In my particular case, my father was a man who kept a lot inside himself and was somewhat aloof and distant, not really knowing what to do with children and leaving us to be raised by my mother. My mother was a warm, gregarious woman who loved her life as a homemaker and community volunteer. My mother and father were both devout Catholics; they also believed that they were soulmates, and they were committed to a marriage that was to last forever. They adopted me when I was 6 months old. Two years later, they would adopt my 6-week-old sister, Jo Ellen. We were a working-class nuclear family of the 1950s, seeking the promise of a better life through hard work and dedication. We lived in a small town in central Washington known for its production of apples and its traditional values, with little or no diversity acknowledged or appreciated in the community. In short, we were what the world called a “normal” family. Manners were important, faith was important, hard work was important, and extended family and community were important and intertwined. Contributing to others and making a difference in the world were expected and valued.

My grandfather died when I was 9, and my grandmother came to live with us. She and my mother were very close, and they loved being together. My grandmother was respectful of the relationship between my father and mother, and she helped everyone when she could, but she also had her own life and interests. I remember having long talks with my grandmother and being amazed by her stories of being a schoolteacher in Wisconsin before she met and married my grandfather. Having Grandma with us in the family seemed as natural to me as having parents. In a short period of time, it was as if she had always been in our home.

Then, when I was 14, my mother died from cancer. Both of my parents were heavy smokers, and both were addicted to it long before the Surgeon General started putting warnings on the sides of cigarette packages. My mother’s death turned everything upside down. Both my father and my grandmother met my basic needs and those of my sister, but both were grieving, crying with a sadness that seemed as though it would never end. Within a year, I would distance myself from the pain in the family by heading off to a Catholic boarding school. My sister would not be able to find such a convenient way out: She led a troubled life throughout high school and, as soon as possible, she started a lifelong search for her “real” parents.

This is a relatively short synopsis of my early life. When you read it, what issues do you think have been part of my own development as a person and as a counselor? What is emphasized in my life? What do you think I left out? Do you have any guesses about how I have approached women and men? Do you think the limited experience and traditional values that were part of my upbringing had an effect on how I view race, diverse cultures, gender issues, and roles and functions in the family? Do you think that coming of age in the 1960s had any effect on how I see people and life? What effect do you think adoption has had on me—and on my sister? Do you think the two of us are more alike or different? What would lead you to your conclusions? If you had to write your own autobiography, what facts, interpretations, values, and beliefs would you emphasize? What parts would you choose to forget or simply not mention?

Here is a little more information about how my educational and professional experiences began. My father dedicated the proceeds from my mother’s life insurance to sending his children to college. I was blessed with a great education (academically as well as in life) at Gonzaga University in Spokane, Washington. I majored in English literature with a minor in philosophy. It turned out, however, that my father was right: There really were not any jobs waiting for a person with a degree in English literature and philosophy. For a year after I graduated, I worked in a gas station and tried to figure out what I wanted to do with my life.

I had many of the common developmental difficulties that occur in late adolescence and early adulthood. If it was possible to engage in life the hard way, I usually did. It was the counselors at Gonzaga who really helped me begin the process of growing up. They were the people who, it seemed to me, had a handle on kindness, caring, and stability as well as a moral and ethical life. It was their modeling of effective engagement that led me to want to become a counselor.

In 1970, I headed off to Idaho State University in Pocatello to get a master’s degree in counseling. At that time in the history of the counseling profession, the skills and interventions associated with Rogerian or person-centered therapy made up the majority of our training. We spent hours learning to do reflections and active listening, continually paraphrasing content and feelings, hoping that it would all become second nature to us. For many of my peers, it did become second nature, but I struggled. I always had more questions I wanted to ask: How did everything fit together? Who said what to whom? How did people react when my clients did one thing or another? What were the different parts that made up the personalities of the individuals I was seeing, and how did those parts work for people or against them? I was also far more directive in my interventions than would make any of my supervisors comfortable, because I genuinely wanted to help people find solutions to their problems. In the early days of my training, I seldom felt that I was effective and, in truth, I am sure that I was not.

In early 1971, one of my professors went to a conference in which a man named Ray Lowe demonstrated Adlerian family counseling. My professor brought back tapes and books, and later he even brought Ray Lowe himself to our campus. I absorbed everything I could about the Adlerian model. The more I read about Adlerian psychology, the more at home I felt. Alfred Adler was systemic before we even had such a word in our profession. He saw people as socially embedded; he took into account the effects of birth order, the family constellation, and family atmosphere; and he considered interaction and doing central to understanding human motivation and behavior. Discovering the works of Adler and Rudolf Dreikurs helped me to make sense out of my own life as well as the lives of the clients entrusted to my care.

I was part of a team that opened up the first public (open-forum) family education center at Idaho State University. I even conducted the first family counseling interview ever done there. I had lots of support and was given lots of room to make mistakes—and to learn. But I had found my approach. As graduate students, we ran parent study groups, held weekly family counseling sessions, and carried what we were learning into local area schools and community agencies. I stayed at Idaho State University to get my doctorate in counselor education. In 1974, we held a conference on Adlerian psychology that featured, once again, Ray Lowe and such masters as Heinz Ansbacher, Don Dinkmeyer, and the man who was to become my best friend and colleague...