Psychiatry and psychology from the emphasis upon

“People are born princes and princesses and then, their parents kiss them and turn them into frogs.” They spend the rest of their lives at work and home living in “froggyness” until shown the way to transcend this maladaptive behavior (Berne, E. 1971). Many adults spend their lives playing psychological “games” that involve players, rules, moves and predictable outcomes that conceal true motives. These games are not enjoyable, but are cycles of compulsive, repetitious scenarios played to reinforce negative feelings and keep individuals from intimacy. These are patterned scripts for desired outcomes that are played in both work and home life.

Family Systems, Transactional Analysis (TA), and Choice Theory are the three over-arching theories that address the family as the creator of maladaptive behavior and the individual as responsible for the choice to continue in this behavior. The basic tenets of the three theories are: One, individuals in families develop patterns of relating to each other and choose behaviors in an attempt to fulfill basic needs. Two, individuals as adults can choose to change their behavior if they are aware of the impact current and historical family behavior has on the definition of his or her choices. And three, any attempts to change the individual will result in family system changes.

In recent years there has been a shift in psychiatry and psychology from the emphasis upon the processes within the individual to the emphasis upon his relationships with other people (Haley, J.1963). As such, the goal of the therapy is to get individuals to become self-aware of past relationships to create an environment for change and to focus on the present relationships for current behavior changes (Madanes, C. 1981).

Therapists act as the catalyst for clients to change by first developing a relationship of unconditional positive regard and then helping to develop an action plan. It is important for the therapist to move at the clients pace. To get ahead or behind the client may result in no change or slow change. Getting too far ahead of the client may create resistance and the client may discontinue therapy. Each of the theories and modalities can be used effectively in a wide variety of multicultural issues including grief, suicidal ideation, organizational development, motivation and addiction. The therapist may uses a multiplicity of modalities such as TA’s drama triangulation, Reality Therapy’s contracts and Solution-Focused Brief Therapy’s future oriented goal approach.

Reality Therapy has two defined steps. The first, setting the counseling environment. Counselors need to establish an unconditional positive regard with their client. The second step is to develop procedures that lead to change with the client determining what they want and what they are willing to do to get it. The application of Reality Therapy is a series of questions designed to get the client thinking of a simple, well-defined action plan. What do you want?

This question is to seek out the unfulfilled need the client may be experiencing. What are you doing to reach this goal? This question is to teach the client to accept control for their behavior and who is choosing the behavior they are now presenting. What is your plan? This is to determine the client’s willingness to choose to do the work toward their unmet need. What will happen if you continue to do what you are doing? This helps clients to self-evaluate their behaviors they are choosing or will choose.

Recognizing the verbal and non-verbal communication that goes on between family members’ help the therapist and client change the scripted patterns. Karpman’s Drama Triangle is an example of communications often used in families. The “Drama Triangle” roles are use to position the initiator into power and control over others in the team. The roles include the rescuer, the victim and the persecutor.

The victim is the easiest role to adopt. The victim uses language such as “poor me” and acts the part, I am life’s fall guy. The victim is seeking the Rescuer for validation. The Rescuer then undertakes saving the victim with a quiet martyrdom attitude. The Rescuer always believes they are working hard even to the point of physical illness. The persecutor will use the triangle with critical intention. They use rigidity, intimidation and will persecute when they want to punish others for not playing their roles correctly. The design of this triangle is to manipulate others into doing for the initiator and leaving the others feeling angry or guilty.

In the family setting, individuals will respond to this triangle by focusing not on the tasks, but by attempting to maintain equilibrium. They will confirm each other’s role and validate each other’s script. We come into conflict with others when we become dependant on them to meet our needs. We use reactive language that transfers the responsibility by creating self-fulfilling prophecies. This is accomplished by reinforcing the individual feelings of helplessness. It keeps them in the “Drama Triangle”. Individuals will feel angry and frustrated. They will respond from a position of blame and guilt rather than on the honest acceptance of authenticity and responsibility for the circumstance. “It is to be very stuck and without choices” according to Michael Foust, the author of Recovery From A Dysfunctional Family and Codependency.

Much like TA and Reality therapy, Solution focused Brief Therapy (SFBT) is a present and future focused goal oriented therapeutic approach that helps clients change by looking for solutions rather than dwelling on the problem. The most important principal in SFBT is being with the client, “Rogerian with a twist” (Miller, Hubble, Duncan, 1996). The client must feel heard, understood, and supported before considering change. The second principal is how the techniques are applied. It is important to validate the client’s experience while pursuing possibilities. Listen closely to the client, the answer lies within him or her. When the answer is found highlight it for their use (p.244).

Acknowledgment or validating the client’s experience of the problem is the most important part of working with clients. The second most important, is to believe that clients have the resources to change and have the goals to accomplish it. The function of the counselor is to provide the environment for change. The therapist acknowledges difficulties while pursuing possibilities through what is known as a “both/and” perspective instead of an either/or view (Lipchik, 1993). The possibility approach includes future-oriented questions, exceptions and coping questions, scaling questions and tasks to be completed.

Future-oriented questions of SFBT are powerful tools that can help clients think about possibilities, because it takes the client to the future where “things” could be better. Imagining different future can free clients from hopelessness. Theses questions are content free and allow the client to construct their own solutions which is key to being brief. Exceptions and coping are another very useful technique to focus attention on exceptions. Exceptions are times when the problem is either absent or not as intense. The questions asked are how do you cope? Or how do you keep it from getting worse. These questions focus the client on what they are doing to improve their situations.

Scaling questions are simple straightforward questions to measure progress. They explore exceptions and future steps or to assess motivation to take action. Scaling questions are useful in orienting the client toward taking action. Tasks are another useful tool for clients. Tasks are intended to help the client take therapy out into the world between sessions. The tasks are generally formed around the acknowledgement and possibilities message and may any suitable activity that supports the goal.

Unhealthy family communications creates dysfunctional individuals. Family Systems, Transactional Analysis and Choice theories maintain that individuals as adults have a choice whether to keep their dysfunctional behavior or change by becoming aware of their past relationships and by changing their current behavior. The therapist’s role is to provide a nurturing environment and assist in the development of an action plan to assist clients in their change. The modalities of these theories are multicultural and effective in many clinical settings they include Karpman’s Drama Triangle, Reality Therapy, and SFBT.


Berne, E. (1972). What Do You Say After You Say Hello: The Psychology of Human Destiny. New York: Grove Press.

Glasser, W. (1984). Take effective control of your life. New York: Harper& Row.

Glasser, W. (2001). Counseling with Choice Theory. New York: HarperCollins

Glasser, W. & Wubbolding, R.E. (1995). Reality Therapy. In Current Psychotherapy

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