WACANA MINDA RAKAN PEMBIMBING JPM OKTOBER 2011

1. WACANA MINDARAKAN PEMBIMBING JPMOKTOBER 2011

2. PerananRakanPembimbing : KekeluargaandanKesihatan Mental, Apa yang perluandatahu Professor Madya Dr. Saedah A. Ghani Ketua Program Kaunseling FKP, USIM

3. Family well being / Family Health • Family Well being or family health refers to functional families that able to adapt to change, set appropriate boundaries, develop relationships through open communication, promote responsibility, express confidence in themselves and their children, and are optimist about their future ( Cutler & Redford 1999 in Glading)

4. Characteristic of Healthy Families Commitment to the family and its individuals Appreciation for each other Willingness to spend time together Effective communication patterns High degree of religious / spiritual orientation Ability to deal with crisis in a positive manner i.e adaptability Encouragement of individuals Clear roles

5. 1.Commitment - members are devoted not only to the welfare of the family but also to the growth of each of the members - members giving their time and energy to the family-related activities. - staying loyal to the family and its member through both good and adverse life events – based on emotion and intention.

6. 2. Appreciation - family members express their appreciation verbally or physically toward one another. - Family members avoid fights that take the form of personal attacks or violence.

7. 3. Willingness to spend time together - family members spend both quantitive and qualitative time together - to share thoughts, feelings, and identities e.g. family picnic to overnight campouts to vocations, etc (Gibblin, 1995) - the time they spend together needs to be good time ; no one enjoys hours of bickering, arguing, pouting, or bullying

8. 4. Effective communication patterns - includes skill of exchanging patterns of information between family members (Brock & Bernard 1999,) - members attend to messages from one another and pick up on subtle as well as obvious points. - Support, understanding and empathy - No competition for “ air time” or silence.

9. 5. Religious and spiritual orientation - a riligious / spiritual orientation helps families find meaning and moral principles by which to live (Griffith & Rotter 1999 Gld) - members of the families often deals as a group with religious / spiritual questions during certain events for example death, birth and marriages

10. 6. Ability to deal with crisis in a positive manner i.e adaptability) - Families members deal with an expected event crisis ( such as leaving one’s family of origin / get job / get married) through negotiating, seeking advice from those who are more experienced, using humours, and expressing emotion to deals with such transition - Healthy families deal with nonevents ( non expected e.g financial problem ) by expressing their emotions and supporting one another.

11. 7. Encouragement of individuals - encouragement and the development of talents and abilities within their family members. - Among the crucial times encouragement is needed are: • With school aged children • With adolescents :coping with physical changes and peer groups • With young adults as they move from their parents’ house into their own psychological and physical spaces filled with dreams and posibilities

12. 8. Clear roles - Roles in healthy families are clear, approriate, suitably allocated, mutually agreed on integrated, and enacted - determined by such factors as age culture, and tradition. - Roles as interchangeable, and flexible as possible

13. Family Life Cycle What is family life cycle ? - developmental trends within the family over time (Carter & Mc Goldericks, 1999 ) - includes all dimension of the individual life course but emphasize family as a whole

14. Stages of family Life Cycle Carter & Mc Golderick (1999) outline 6 stages of the intact middle class nuclear family: 1. Single young adults, leaving home 2. The new couple 3. Families with young children 4. Families with adolescent 5. Families launching and moving on 6. Families in later age

15. Stage 1. Single young adults, leaving home - A major task is to disconnect and reconnect with one’s family on a different level while simultaneously establishing oneself as a person - require a person to strike a balance between a career and/or marriage ambition and a desire for a personal autonomy.

16. Cont… - Issues that are likely to prompt singles to seek family therapy are those connected with : A weak personal sense of self The inability to emotionally and physically separate from one’s family of origin A lack of social skills to establish significant relationship

17. Stage 2. The new couple : Joining the family through marriage - Marriage begin with courtship – the period when individual test their compatibility with others through dating - In initial stage of marriage characterized by idealization – both men and women in marriage idealize each other and relate accordingly

18. Cont… Adjustment and adaptation stage : share space, meals, work , leisure and sleep activities – accommodate each others wishes , requests and fantacies – Adjustment with new relationship – in laws and friends most likely times for couples to divorce due to an ability of individuals to resolves differences - It is also often seen as a time of life when couples experience the greatest amount of satisfaction, especially if they later have children

19. Cont… Issues that are likely to prompt new couples to seek family therapy are those connected with : The inability to adjust to living as a couple instead of as an individual Difficulty with relatives, either family of origin or in laws The inability to work through interpersonal issues, such as developing adequate or optimal communications patterns

20. Stage 3. Families with young children - Becoming a parent is a physical, psychological and social event that alters a couple’s lifestyle dramatically - The arrival of a child has an impact on a couple’s lifestyle marital relationship (eg sexual contact) and paternal/maternal stress ( eg. new demands) – family become unbalance temporily - Couples have to adjust the time they spend working outside the house, socialising with friends and engaging in recreational activities

21. Cont… - Sharing responsibility in child rearing – ensuring that an enduring attachment bond is created - meeting the physical and psychological demands involved in having preshool children – more challenging if both parents are working - Other challenges : relationship with extended family, demands of work, use of leisure and finance

22. Cont… Issues that are likely to prompt families to seek family therapy are those connected with : “ the fallout that accompanies the necessary reorganisation of relationship and activities” of the married couple “establishment of controls” for a young child

23. Stage 4. Families with Adolescent - Couples who have adolescents must take care of themselves, their relationship, their teenagers, and often their aging parents - sandwich generation - It is filled with turbulence that varies across families – trouble setting limits, defining relationships, and taking adequate care of one another – disagreement between parents and teens – increase family conflict and tension often occur during the time adolescents are in the family.

24. Cont… - The adolescent themselves express more of a desire and assertiveness to be autonomous and independent - Peer groups and siblings become more important for them and parental influence decrease as conflicts with parents increase – parents must establish qualitatively different boundaries – parents can no longer maintain complete authority – facilitate the recognition and acceptance of difference of family members.

25. Cont… Issues that are likely to prompt families with adolescents to seek family therapy are those connected with : Conflicts between parents and their teenage offspring, such as the setting of limits and expression of opinions Detachment or anger over the couple relationship as partners age developmentally and psychologically and realize dreams and opportunities are slipping away Stress related to the care of aging parents and / or the demands of work and family life

26. Stage 5.Launching children and moving on - As children leave home for college, career, marriage, or other options, parents face the so called Empty nest – life for couples without child rearing responsibilities. - Most middle-aged women at this stage are likely to be energetically attending to their own interests and thankful for the freedom to pursue them at last.

27. Cont… - For some women who have mainly defined themselves as mothers and invested heavily in their children, the empty nest can be a time of sadness – depression, dependency, and divorce may occur. - For men the empty nest usually corresponds to midlife – focus on their physical bodies, marriages and occupational aspirations as well as the new changes in the bahaviour of their wives.

28. Cont… Issues that are likely to prompt empty nesters to seek family therapy are those connected with : A sense of loss in regard to oneself, a marriage or the moving out of a child A sense of conflict with a child who is not becoming independent enough A sense of frustration or anger in regard to one’s marriage or career ambitions

29. Cont… - Composed of a couple in their final years of employment or in early retirement (65 yrs and above). - Physical decline and dependency (Goldin & Mohr, 2000) – major concern is finance – women who live long lives – loss of spouse – chronic ill – keeping healthy is the main task. - The advantage : being a grandparent – interacting with their grandchildren.

30. Stage 6. Families in later life - The family of later life , like the newly married couple, has the most freedom to come and go as they wish. - experience the enjoyment of having lived and participated in a number of important life cycle events - a time when couples can reflect on the activities they were too busy with previously.

31. Cont… Issues that are likely to prompt families in later life to seek family therapy are those connected with : A lack of meaning or enjoyment related to the loss of actively working or caring for children or the death of a spouse A concern over adjustments in aging, such as diminish energy or facing one’s own mortality An inability to establish good relationship with children, in laws or grandchildren

32. Tools and Techniques for Family Therapy Goals of using the tools and techniques in family therapy • Help the family get in touch with its own discomfort. • Help the family have a new experience; to try say something different or in a different way. • Help the family have a new understanding or insight. • Help the family to have hope, that they can change and will get over the problem.

33. Positive Reframing • For every negative thought, feeling or behavior, there is a positive intention being expressed. • Helps confirm the good intention or character of the member. • Don’t overuse it. • Don’t say it unless you believe it. • Say it affirmatively. • Don’t try to sell it.

34. Enactments • Encouraging actual interaction between family members in the room. • Aims to getting members to talk to each other rather than the therapist and allows family members to be themselves. • Therapist will be the observer/wallflower.

35. Mapping • Help therapist get information of the case at a glance. • Draw the parent-child boundary. • Draw circles for females, squares for male. • The number of connecting lines indicates closeness; a dotted line shows distance. • The size of each figure represents relative power in the family. • Crossbars indicate the amount of conflict between family members. • Use triangles to symbolize agencies or community resources. • Note specific areas of concern, like chemical dependency with abbreviations.

36. Example F GM NA M MH Parent-Child Boundary IP DSS 5 11

37. Mapping (cont.) • Mapping gives a systemic picture of the family, which is useful for creating themes and goals in therapy. • Mapping helps us communicate our observation of family dynamic with colleagues.

38. Circle Method • Draw a circle on the paper, give each person a copy and ask them to place their family on the paper. • Draw family members with smaller circles outside or inside the big circle, close together or far apart. • Make objective comments; let the family make their own interpretations.

39. Example Alcohol Minister Kelly Friends ME

40. New Talk • A way of getting family members to say something different to each other. • Anything is okay to say as long as it has not been said before. • Interrupts repetitive patterns of talk. If negative, turn it around to be positive. • Keep spotlight on interaction until a more personal level is reached.

41. Guardrail • Helps parents see that they can set limits together and speak with one voice. • Parents hold hands to form the guardrail which symbolizes their limit-setting with child. • Parents work better as a team is more powerful when setting limits.

42. Sculpting • Each person is asked to sculpt their family by placing family members wherever they choose, in the room. • Start with a child. • Get off the stage. • Give everyone a chance. • Allows to show a picture of the family including self and how one see the family.

43. Alter Ego • Therapist sits behind a family member and speaks for them. • Start with non-threatening comments. • Ten or fifteen minutes are long enough. • Get permission first and ask client to correct you; ask them to speak for themselves. • Alter ego is a powerful tool, so always use it carefully.

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