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Gestalt & Strategic TheoriesMeeting 7
© Cheung, M., & Leung, P. (2008). Multicultural practice and evaluation: A case approach to evidence-based practice. Denver, CO: Love.
Instructors who adopt this book may use this PowerPoint to teach your course without prior permission. Please address questions and comments to [email protected].
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Your Inner Strength
Get a piece of paper and position your pen. When the light is dimmed, concentrate on
your inner strength or some quality about you that makes you happy or feel proud.
As you are thinking, draw circles continuously on the paper without stopping until time is up.
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The NOW feeling
Interview your classmate and ask: Look at your drawing What do you see now? What feeling do you have now?
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Gestalt
As a clinical skill, this approach uses tools and techniques to catch clients’ attention, heighten their anxiety, focus on their direct experience, and encourage them to think about their issues and solutions.
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Gestalt-Oriented Family Therapy Gestalt = the organized or unified whole of an
individual
Key: direct knowledge of the SELF is the key to good mental health
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Gestalt Focus
Wholeness: Tell me how you feel about yourself in relation to your
family.
Perception Who in your family knows about this issue? How much
does he or she know?
Here and Now What are you experiencing now?
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Gestalt Goals
Help individuals within a family structure to develop better boundaries between themselves and other family members
Help individuals become more self-aware in order to complete unfinished business and change old, familiar patterns
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Gestalt Goals Balance the individual intrapsychic problems
with better interpersonal relationships that show up in family interactions
Help the family to shift its focus between individual and family issues Individual: intrapersonal and boundary issues Family: interpersonal and transactional issues
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Gestalt
5 Layers of Self: Phony Phobic Impasse Implosive Explosive
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Gestalt
5 Layers of Self: Phony (react to others in stereotypical ways) Phobic (avoid pain associated with self) Impasse (get stuck in own maturation) Implosive (experience our deadness and not
deny it) Explosive (let go of all pretenses and release
energy to enjoy life)
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Theoretical Constructs of Gestalt Theory of Cause
Theory of Change
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Theory of Cause
Human beings have a natural desire to cooperate and please others
When the emotion is unexpressed, the causes of these blocked experiences are often forgotten but are present in the here-and-now behavior of the person
Therefore, The goal is to bring these experiences back to life
NOW to see what was causing the problem and complete it in the present
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Theory of Change
4 stages of the Gestalt Experience Cycle Sensations and Perceptions Awareness Contact Ability to Let Go (Withdrawal)
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Theory of ChangeStage 1: Sensations & Perceptions Learned in childhood
Should’s + stimuli = sensitive to stimuli (Sensation)
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Theory of ChangeStage 2: Awareness Pay attention to a sensation (e.g.,
pain) + Develop appropriate way to act
out the conflict
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Theory of ChangeStage 3: Contact Learn new ways to make genuine contact
with family members + Aware that we resisted contact through
Projection Introjection Retroflection Confluence Deflection
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Aware that we resisted contact through: Projection
Making contact with disowned parts of the self rather than other people
Introjection Incorporating aspect of the other into self
Retroflection Turning against oneself
Confluence The boundaries of self and other are confused
Deflection A wall is erected to avoid conflict
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Theory of ChangeStage 4: Ability to Let Go An inability to withdraw and let go of
an experience usually results in unfinished business in relationship
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Main Therapeutic Techniques (C&L, pp. 219–228) Exaggeration & body language work
Rehearsal with empty chair I have a secret Dialogue exercise Dream work “I’ll take responsibility for it” Staying with the feeling Reversal technique Making the rounds Playing the projection
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Empty Chairs
Introduce the chair & purpose Look at the chair (use direct conversations) Create a dialogue
Alternatives (if not comfortable): Role play Role reversal
Practice with a classmate
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The Case Approach: Practice with Joe and Mary’s Family (Gestalt) Read Issue: Privacy and Boundary Setting
(pp. 215–216)
Discuss: What did you learn in this role play? What techniques would a social worker feel
comfortable to use? How do you modify this technique in your practice?
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Limitations of Gestalt
It assumes that individuals have personal control over environmental influences.
It assumes all clients are well functioning to understand the importance of wholeness
It does not help the individuals to share if they feel that the therapist is making provocative comments.
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Memory Recall
In pairs, Try to remember and identify major
components in the picture
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Memorize this (in your mind only)
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Memory Recall
In pairs, Try to remember and identify major
components in the picture Draw it out (in one minute’s time) Discuss what strategies you used in the
memorization or recall process
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Strategies You Used
Contents Order Number Words Characters Positions Gesture Uniqueness Similarities
Meanings Symbols Interactions Relationships Structure Unexpected Personalities
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How much did you get it?
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STRATEGIC APPROACH
The attempt to determine cause and effect A symptom is a strategy for controlling a
relationship (because of desire to love and control) “You started it.” (I’m only reacting to what you
did.) “No, you started it first.” (because of what you said
or did.)
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Paradoxical Interventions
Ask the family members to do things that are in apparent opposition to the goals of therapy and express their feelings after observing the opposite in action.
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Pretend Technique
To desensitize a person with repeated acts of a behavior and to train something they wouldn't ordinarily do unless it is framed as play or pretend.
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Ordeal Therapy
If one makes it more difficult for a person to have a symptom than to give it up, the person will give up the symptom.
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Positive Connotation
Reframe the symptom as a means to preserve the family's homeostasis.
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Rituals
Engage the whole family in a series of actions which run counter to, or exaggerate, rigid family rules and myths.
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Finding the Differences
Different perception of relationships "Who is closer to their father, your daughter or
your son?" Differences of degree
"On a scale of 1 to 10, how bad do you think the fighting was during this past week?"
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More Differences…
Now/then differences "Did she start losing weight before or after her
sister went off to college?" Hypothetical or future differences
“Think about three situations: If she had not been born, was born five years earlier, or was born just now), how would your marriage be different today?"
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Circular Questioning An interviewing technique aimed at
eliciting family members' opinions regarding differences
A technique to solicit answers directly from the client
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Practice with Strategic Approach Be sure to read case approach in textbook Practice the skills with a partner
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Daily Affirmation
Today I choose to do things for me that make me feel good about myself. Today is a perfect day to do something that I have been putting off.
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References
Cheung, M., & Leung, P. (2008). Multicultural practice and evaluation: A case approach to evidence-based practice. Denver, CO: Love.
Perls, F. (1973). The gestalt approach & eye witness to therapy. Palo Alto, CA: Science and Behavior Books.