Cognitive–Behavioral Family Therapy

Cognitive–Behavioral Family Therapy

Cognitive–behavioral family therapy applies principles of learn-ing theory to help family members solve problems by modifying cognitive distortions and repetitive problem-inducing interactions, and by learning new knowledge and skills. Cognitive–behavioral family therapy relies heavily upon family psychoeducation and a teaching/coaching stance of the therapist.

Cognitive interventions engage family members as coin-vestigators who study the ecology of family problems and symp-toms and discern how thoughts, feelings and behaviors interplay. A therapist assists family members in identifying when such cog-nitive distortions as catastrophic thinking, overgeneralization, or misattributions lead to conflicts in relationships (Epstein et al., 1988; Freeman et al., 1989).

What to Look For

Families presenting problems for therapy often have:

·              difficulties in recognizing deviant behavior

·              lack of clearly-defined family rules

·              problems in emotional communication among family mem-bers, usually a paucity of expression of positive feelings cou-pled with an excess of negative expressions

·              relational conflict associated with either a paucity of relational skills or interpretive errors based on faulty assumptions or cognitive distortions

What to Think About

A cognitive–behavioral family therapist considers each member of the family to be doing his or her best to cope with the behavio-ral contingencies perceived at that point in time, given the practi-cal and emotional restraints experienced. Family members need to acquire knowledge about cognitive and behavioral principles, to gain skills needed to reinforce desired behaviors, to eliminate reinforcement of undesired behaviors, to modify faulty assump-tions and interpretations of others’ actions, and to learn skills for communicating clearly and effectively.

What to Do

·              Psychoeducation Educational modules about the present-ing problem are taught when family members appear to lack a significant understanding of issues, ranging from such general topics as developmental milestones of children and principles of learning theory, to specific information about a particular psychiatric disorder (Falloon, 1991).

·              Communication training Empathic listening, express-ing positive feelings, and speaking negative communications more respectfully are taught as skills (Falloon, 1991).

·              Problem-solving training Family members practice con-sistent, structured approaches for resolving conflicts (Falloon, 1991).

·              Operant-conditioning strategies Behavior shaping and time-out procedures are taught to increase desirable behaviors among children (Falloon, 1991).

·              Contingency contracting Coercive, blaming patterns of family behavior are replaced by contracts that specify what behaviors involved family members each to agree to perform (Falloon, 1991).

·              Thought diaries Out-of-session, assignments are made to track habitual patterns of thoughts, feelings and behaviors in generating symptoms (Freeman et al., 1989