Initial Contact and First Session

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Like other forms of psychotherapy, during the first session the objective is to join with the client and assess the problem. However, unlike other forms of psychotherapy, family therapy also begins by attempting to alter the family's perspective. Almost immediately an effort is made to dilute the idea that the presenting problem associated with an individual is encased within that person; instead an attempt is made to modify beliefs so that the problem is perceived to be a byproduct of the situation that characterizes the system (i.e., environment) housing the individual. In effect, an initial objective is to have the problem viewed differently by the family. Family therapy then, especially initially, occurs through social negotiation. It involves determining what the family wants, how they see the problem, how they want it fixed relative to the assumptions and orientation of the family therapist, and how well the therapist can pull the problem away from an individual and distribute it to the system. Once this has commenced, the therapist then allows the presenting problem to be unnecessary by altering the family structure, which simultaneously alters interaction patterns, relationships, and beliefs about the family. Alternatively, the therapist modifies the beliefs about the relationship, which simultaneously alters patterns of interaction, and the family structure. Simply said, the therapist enters the family at the relationship level, not at the level of a particular individual, and alters interaction associated with the various relationships.

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