Integrated Therapy Treatments

I combine multiple practice theories when working with clients. For six years, I was employed as an in-home family based therapist. I continue to 
provide individual, family, and couples therapy within a private practice setting. Over the course of my career in the mental health field and working 
with families, many children within these families were placed there through the foster care system. As a mental health therapist, it is vital that one 
truly understand how to effectively implement therapeutic modalities that are both effective and sensitive to the foster care population. These areas 
include trauma, culture, and transitional family dynamics to name a few. As a family therapist, I have been clinically trained to implement eco-systemic 
structural family therapy (ESFT). I apply structural family therapy with the families I serve. Structural family therapy is an evidenced based practice 
that I received three years of intense clinical training including both didactic and active clinical presentations of current cases. Through the 
completion of the training I became certified as a mental health professional in ESFT. Structural family therapy has a premise that every family has 
an underlying internal structure. The structure of the family may be highly organized and some have no structure with few interactions among the 
family members. Within the family are subsystems composed of individual members. Coalitions of family members often occur within these structures. 
Boundaries and structuring are vital principles of structural family therapy. Boundaries may be clear, rigid, or diffuse allowing for various types of 
functional or dysfunctional family interactions. Foster care families exhibit a much higher structural challenge due the new family structure. The family 
must adapt to form a level of trust,  While ESFT is the model I operate within, I use an integrative approach of experiential family therapy, cognitive 
behavioral therapy (CBT), and narrative therapy combined with an ever present strength based approach.
    
Experiential family therapy focuses on the present moment, not the past. The theory indicates that family members suppress their emotions due to 
the domination of family avoidance. The theory is less structured than ESFT, but cohesiveness and togetherness are believed to create family 
growth.  The goal is to help a family eliminate defensiveness and begin to experience one another on deeper levels. The approach views the family 
through the lens of experiencing each other in a new more functional ways. The theory believes certain members of the family may be suppressed by 
the family which hinders that person’s growth. Family secrets are also emphasized within the approach. These secrets are thought to lead to 
dysfunction. Authenticity of the family has been lost through these secrets. As foster families become more united and cohesive, relationships are 
built upon trust. If the foster child is brought into an environment that reinforces defensiveness and secrets; the child will not be given the opportunity
to experience personal growth while continuing to suppress their deeper trauma which only serves to cause further emotional damage and hurt.  
These two approaches are utilized the most from a family therapy perspective, but in conjunction I also use CBT and narrative therapy with 
individuals.
    
CBT centers upon how we create cognitive schemas that help us interpret and organize our world. These schemas are developed during childhood 
and are based on past experiences. When CBT is employed, it is based on a client’s automatic thought reaction that can be distorted or inaccurate. 
The cognitive distortions thus lead to maladaptive behaviors. I often use CBT techniques primarily when working with a single family member.
    
Narrative therapy concentrates on the client’s life story as the basic experience within treatment. A person’s story interprets meaning to themselves 
and others regarding their own experiences of life. Narrative therapy understands we live more than one story at a time. The approach focuses on 
dominant, alternative, and preferred stories, while analyzing the setting and characterization. Finally, the narrative therapists do not focus on 
psychopathology. They see psychopathology as a social construct from another’s perspective. Each family, father, mother, son, daughter, 
grandfather, and grandmother all have their own story and reality. The therapist must allow these stories to be shared within the foster family to best 
understand one another and promote an environment where empathy may reside.