ETHICAL ISSUES IN COUPLE AND FAMILY THERAPY

Ethical issues in couple and family therapy



Ethical issues in couple and family therapy

Introduction

The essence of all family or systemic therapies is an understanding of people in terms of their relationships with others: an individual is always considered as a member of a social group, usually, but not necessarily, the family. The family, in turn, is considered as a system in interaction with other systems, such as the neighbourhood, school, work and health and welfare agencies. In practice, however, the focus of the therapist's interventions has typically been on the family group, although, it must be said, family therapists seem to be well aware of variations in the definition and understanding of what constitutes 'the family'. A number of ethical issues are raised when seeing people through this lens.

Discussion

A family's patterns of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn't just the person - even if only a single person is interviewed - it is the set of relationships in which the person is imbedded. Marriage and family therapy is:

brief

solution-focused

specific, with attainable therapeutic goals

designed with the "end in mind."

Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems. Some critics (Haley 1991)have argued that family therapy has over-focused on the family and that historical and sociological influences have too easily been ignored. Thus families can inappropriately or disproportionately 'take the blame' for behaviours which are caused or strongly influenced by wider social and structural factors: inner-city delinquency is one example. The French writer, Jacques Donzelot in his book The policing of families (1980) characterizes professionals who intervene in families in order to educate them or to repair faults as, 'technicians in human relations.' He argues that interventions into families construct the entities they are supposed to treat. In other words, family therapy does not just treat families, it also constructs families and family problems, so that therapists see dysfunctional families with problems in their structure and hierarchy, families with communication problems, psychosomatic families, and so on. What family therapists fail to see is the impact of social disadvantage and exploitation: poverty, class, gender, age, race and disability. An ethical objection to family therapy itself is, therefore, that it colludes with such oppression rather than confronts it. At its worst, family therapy can be seen as an instrument of state control, both holding families responsible for creating problems and for caring for its weaker members (Golden 2003)

A systemic perspective, in itself, brings an awareness of the consequences of change which might be overlooked or ignored by an individual therapist. Thus, Gladding (2007)sees change within a system as being not a solution to a single problem (removing the symptom or freeing the oppressed) but rather as a dilemma to be solved. 'Change extracts a price and raises the question as ...