Systemic Hypothesising
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Systemic hypothesising (also referred to as systemic consultation) is a branch of
psychology Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
and
Systemic therapy Systemic therapy is a type of psychotherapy that seeks to address people in relationships, dealing with the interactions of groups and their interactional patterns and dynamics. Early forms of systemic therapy were based on cybernetics and syste ...
that works with behaviour practitioners and other allied health professionals to reflect upon the interpersonal and relational dynamics that may be inhibiting positive behaviour change efforts in people with an
intellectual disability Intellectual disability (ID), also known as general learning disability (in the United Kingdom), and formerly mental retardation (in the United States), Rosa's Law, Pub. L. 111-256124 Stat. 2643(2010).Archive is a generalized neurodevelopmental ...
or other neurodivergent conditions. Systemic hypothesising provides an opportunity for behaviour practitioners, psychologists, School counsellors and others such as case managers working with individuals with severe and complex challenging behaviours to reflect on interpersonal and relational dynamics as factors inhibiting positive change. This approach, draws from
family systems therapy Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychotherapy focused on families and couples in intimate relationships to nurture change and de ...
a model that is gaining some acceptance within the field of intellectual disability, has the potential to augment behaviour support, nurture change and development, enabling practitioners to understand and negotiate problematic interpersonal dynamics when responding to behavioural difficulties. Systemic consultation, in a similar fashion to family therapy tends to view change in terms of the
system A system is a group of interacting or interrelated elements that act according to a set of rules to form a unified whole. A system, surrounded and influenced by its open system (systems theory), environment, is described by its boundaries, str ...
of interaction between all members of the support environment. The aim of Systemic Hypothesising is to assist the practitioner working with
challenging behaviour Challenging behaviour, also known as behaviours which challenge, is defined as "culturally abnormal behaviour(s) of such intensity, frequency or duration that the physical safety of the person or others is placed in serious jeopardy, or behaviou ...
to develop hypothesise regarding interactional and systemic restraints to effective behavioural intervention. This may be carried out as a part of the assessment phase therapy


History and theoretical frameworks

In recent years there has been an increasing recognition of the critical role of relationships, including family relationships as well as those between clients and carers in the maintenance and amelioration of challenging behaviour, as well as in attempts to integrate the fields of family therapy and applied behaviour analysis. The treatment of challenging behaviour in intellectual disabilities has at the same time evolved dramatically since the 1950s, from a reliance on psychopharmacological restraint and
operant conditioning Operant conditioning, also called instrumental conditioning, is a learning process in which voluntary behaviors are modified by association with the addition (or removal) of reward or aversive stimuli. The frequency or duration of the behavior ma ...
to a multifaceted support plan that recognises the communicative intent of the client alongside their need for meaningful community participation. Relationship of familiar
positive behavior support Positive behavior support (PBS) uses tools from applied behaviour analysis and values of normalisation and social role valorisation theory to improve quality of life, usually in schools. PBS uses functional analysis to understand what maintains ...
approaches to systemic consultation is the integration of the functional-ecological approach challenging behaviour, drawn upon
applied behavior analysis Applied behavior analysis (ABA), also referred to as behavioral engineering, is a behavior modification system based on the principles of respondent and operant conditioning. ABA is the applied form of behavior analysis; the other two are: ...
and grounded in ideas of learning, person-centered values, inclusion, and multi-element frameworks therapy with the constructs of family therapy. Whilst systemic consultation is in its infancy (less than two decades) the theoretical precepts and skills of systemic family therapy provide the potential to significantly enhance the effectiveness of behavioural practice. A key limitation of applied behaviour analysis is its failure to adequately consider the complexities of familial (and other important individuals in the client’s word including carers, case workers, teachers, etc) relationships as they do not sufficiently differentiate between employed professionals and family members.


Techniques

The consultation commences with a practitioner providing a rationale for the presenting behaviours or problems also known as sequences. These sequences are manifestations of recurrent patterns of interaction that are sometimes guided by the beliefs of family members. The practitioner is invited to present the case by illustrating first stakeholder group in
Sociogram A sociogram is a graphic representation of social links that a person has. It is a graph drawing that plots the structure of interpersonal relations in a group situation. Overview Sociograms were developed by Jacob L. Moreno to analyze choice ...
,
genogram A genogram, also known as a family diagram, is a pictorial display of a person's position and ongoing relationships in their family's hereditary hierarchy. It goes beyond a traditional family tree by allowing the user to visualize social patterns ...
(and less often augmented with Systograms .) The reflecting team inquire about demographic information as the consultation progresses. The team speculate about the nature of relationships mindful that they can have a more qualitative nature and can involve different degrees of closeness, intimacy, compatibility, hostility, dependence, enmeshment, and so on. Another potentially useful line to speculate about events that might provide a context for the onset of the challenging behaviour, or the onset of its intensification as well as the exploration of other settings follows the same format as above. A
genogram A genogram, also known as a family diagram, is a pictorial display of a person's position and ongoing relationships in their family's hereditary hierarchy. It goes beyond a traditional family tree by allowing the user to visualize social patterns ...
is replaced by simple organizational charts outlining the key players. Managers, school principals and medical practitioners might be represented at the top of the various hierarchies. The final step involves asking the practitioner to sit outside the reflective team and listens/observes a conversation between them. One of the members of the reflecting team prompts the group to share their thoughts with the aim of easing any anxiety and emphasizing the noncritical and affirming intentions of the group.


Footnotes

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Further reading

* T. Andersen, ''The reflecting team in action: Collaborative practice in family therapy.'' New York: Guilford Press. 1995. * Coles, D., The challenge of disability: Being solution focused with families. Palo Alto, The Australian and New Zealand Journal of Family Therapy, 200. * Harris, S.., Intervention planning for the family of the autistic child: A multilevel assessment of the family system, . Journal of Marital and Family Therapy, 1984. * Coles, D., The challenge of disability: Being solution focused with families. Palo Alto, The Australian and New Zealand Journal of Family Therapy, 200. *Rhodes, P., Behavioural and family systemic intervention in developmental disabilities: Towards a contemporary and integrative approach, Journal of Intellectual and Developmental Disabilities, 2003 Family therapy Systems psychology