Systemic Therapy with Individuals

Systemic therapeutic work with Individual Clients

As an MFT, your work should be based on systems theory, taking a systemic stance in conjunction with whichever model/s you find fitting to your cases (based on the presenting problem and target population). Being systemic does not merely mean seeing more than one person in therapy or even consider others, as this method of practice had existed way before MFT programs were developed. "Systemic therapy is thus not a question of how many people are seen, but refers to the theoretical framework which informs what the therapist does" (Jenkins & Asen, 1992, p. 1). So what then makes MFTs work unique compared to other mental health professionals? Wellbeing a systemic clinician (MFT) means you are conceptualizing cases considering not only the relational systems of the identified client but also conceptual systems, figurative, emotional, etc.; essentially identifying and processing anything relevant to the case that sustains the problem and may provide supportive resources to elicit wanted/needed change. Notice I did not use the words solutions or positive, as these words can seem absolute, when, in fact, the therapeutic work may provide some resolution, some alleviation, some steps, and tools, etc. and not necessarily kumbaya.

The systemic clinician makes several assumptions about the client and the identified “problem;” clients have strengths and a resilient, they are a part of several systems which they affect and it affects them conversely. As for the “identified problem,” the clinician believes it is the product of certain interactional cycles hence the need to understand the contexts including cultural beliefs. The clinician is also assumes and is interested in the unique outcomes and exceptions to the “problem,” as change is inevitable, and “the problem is the problem” and not the client. Furthermore, from this stance change has a ripple affect, that is, a small change can create other changes (within and across systems).

In working with individuals, the clinician would use circular questions (problem definition questions, sequence of interactions, comparisons/classification questions, and context inquiry) to help identify and understand the "problem," "symptoms," relationships, emotions, etc. in context. In this process, patterns and cycles will become evident, which can help identify exceptions, strengths, unique outcomes, and so forth.

On a specific note, working individually with children and teens without their caregivers can be challenging as typically working with this subsystem would provide a lot of pertinent one-sided insights not only to the problem but solutions. It's ideal to have caregivers and any relevant systems when working with young clients if not change may be short term and more likely first-order versus second, which would require systems to change. Consider what are the barriers to getting them to participate and explore how to communicate the value of their feedback and engagement for the individual and the whole. Also, culture is a factor to be considered in understanding and assessing the systemic implications, as some individuals may have misconceptions about therapy and mental wellness.

In summary, Systemic clinicians (MFTs) that work with individuals are interested in understanding the individual's patterns and cycles in context of their systems (interactional context) to create new connections and patterns.

Reference

Jenkins, H & Asen, K (1992). Family therapy without the family: A framework for systemic perspective. Journal of Family Therapy 14, p. 1-14.

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