systemic hypothesis definition psychology

• qldfamilytherapy
• Jul 28, 2021

5 Tips for Systemic Hypothesizing

Updated: Aug 17, 2022

By Dr Kate Owen

Clinical Family Therapist & Clinical Psychologist

What language do you use to describe hypothesizing?

Do you say “hypothesis”, “conceptualization”, “formulation”, or simply your best guess at what is happening for the client and family?

Hypothesizing is a central part of the family therapy process. Without a hypothesis, a therapist is placed in a passive role with no direction.

Can you remember your original training in formulation? I would guess that you were taught the biopsychosocial model for understanding and explaining a client’s symptoms and presenting problems: Predisposing, Precipitating, Perpetuating, and Protective Factors contributing to the Presenting Problem. This is a great way of organizing your thoughts.

Did you know that you can give the biopsychosocial model a “systemic twist” to capture the client and family within their context, see the bigger picture, appreciate the interconnectedness of relationships, and assist clients to see the circularity of their challenges?

If this concept feels new to you and you are finding it challenging to break away from linear thinking, then read on to learn and practice some clinical tips and strategies to enhance your systemic hypothesizing skills.

View the “Identified Patient” as the barometer and thermometer for family life.

In Family Therapy there is the concept of the "Identified Patient". This is the person who is seen as "having problems" or "being a problem". This could be a teenager who is self-harming, a child who is school refusing, or an adult who is drinking heavily. They are usually the person seeking therapy, being dragged into therapy, or consistently being told that "you need help".

Family Therapists stay away from pathologizing people, instead looking at the bigger picture of family life and trying to hypothesize how this person's "symptoms" actually tells a story about what is happening in the family.

Some helpful questions to assist with your hypothesizing might include:

(1) What anxiety or tensions might be occurring in the family? And not just with the person bought to therapy.

(2) Are these symptoms an expression of anxiety and tensions in the family - now or linked to the past?

(3) Do these symptoms somehow protect the family from having to address other challenges? For example, if the family was not focused on this particular problem, then what other areas of family life would they need to address?

(4) When these symptoms started, what other events occurred around the same time? And not just related to the person brought into therapy. A common example is the "naughty child" but upon exploration is only naughty and troublesome when mum and dad are not getting along due to conflict.

So the next time that you are hypothesizing, what would happen if you thought of the client's symptoms as telling you a story? What if you considered their presentation as being a barometer and thermometer for family life?

The hypothesis must be systemic and relational.

In Systemic Family Therapy a hypothesis is only useful if it suggests interventions that will target the system rather than an individual, and which helps clients and families reach their goals.

This is often initially challenging for therapists to learn as most counselling and mental health training involves linear thinking - i.e. when “A” leads to “B” which leads to “C” for "John".

One small exercise to get you started with systemic hypothesizing is to think of the behavioural sequences around the problem.

How you do this is to be curious about "When John is upset, what happens next?", "What effect does this have on others in the family?", and "Who does what and when?"

For example, when John is upset his partner usually becomes worried which sees her increase her attention and focus on his needs.

This then allows for further exploration.

And when John's partner is worried about him and she increases her attention and focuses on him, what happens after this? And what effect does this have on the family? And who does what and when?

This curiosity continues until the client, family, and therapist start to appreciate the effect of "the problem" on the family system.

Give it a try and see what news of difference is created for you and those you are supporting. But remember....hypotheses about what is maintaining the problem is only useful if it suggests a useful intervention.

“Never marry an hypothesis – just flirt with it” (Ceccin, 1985).

Our brain has an amazing ability to "find" information that fits with our worldview and where we are focusing our attention. This is why Systemic Family Therapists hold their ideas tentatively and with curiosity.

Curiosity and holding ideas “lightly” provides the therapist with an openness to news of difference that may be more, or less, useful when working with clients.

How open are you to reviewing and revising your ideas in therapy? What mechanisms and processes can you put in place to hold this principle in mind?

Frame the hypothesis in positive terms for the client and family.

"If framed in negative terms, blame and lineal causal attribution may be introduced” (MacKinnon & James, 1987).

This is not to justify unhelpful behaviours and patterns, but rather highlights how you use language and describe your ideas.

For example, if you hypothesized that a coalition exists between a mother and teenage daughter against the husband/father, the systemic family therapist might frame this hypothesis as "It is a special bond that exists between mothers and daughters, and at the same time, when two people share such a strong connection it might not leave room for the other parent to share in the same delightful relationship with their child. I wonder if there is room for other strong connections to grow in the family? Between father and daughter? And perhaps husband and wife? This would make things feel more equal perhaps?"

Although the hypothesis relates to a family coalition, this language is too pathologizing and this jargon would not be used in contemporary systemic practice

How do you frame your hypotheses to your clients and families you work with? What style of language do you use?

To share or not to share....that is the question.

Historically, around 50 years ago, Family Therapists did not share their hypotheses with families. The prevailing framework at the time was for clinicians to hypothesize together and then instruct the family to do something different.

With the evolution of Family Therapy and the rise in social-political movements (e.g., Feminism), there has been a shift away from therapists being "experts" towards a collaborative and dialogical approach.

What does this mean?

This means that it is ethically and professionally responsible for the Family Therapist to share their hypotheses with their clients, and to seek feedback from the family about these ideas.

Engaging in this collaborative process is useful for strengthening the alliance, gauging if the therapist and family have a shared understanding, invites the family to shape the hypothesis further, and provides an opportunity for families to view “the problem" through a systemic lens.

How open are you about your ideas and hypotheses with your clients? What processes do you have in place that allows sharing of ideas?

Hypothesizing History

Are you a practitioner that enjoys linking theory to practice? Are you interested in knowing who originally influenced systemic hypothesizing ideas and practices?

A key contributor was the Milan Systemic Family Therapy team.

The original Milan team was made up of four Italian Psychiatrists who greatly influenced the field of systems thinking and practice with key ideas related to circularity, context, hypothesizing, curiosity and neutrality.

Another key Milan Systemic influence was the use of a "team" in helping clients and families. This would involve therapists sitting behind a one-way mirror and observing sessions, being one step removed from the family emotional process so that they might offer ideas or suggestions to the therapist in the room or the family.

In contemporary practice it is challenging to resource multiple therapists, however, the idea of "holding a team in mind" is still valuable and can assist the systemic therapist to stay open to different ideas that may be useful to their clients.

Reflections:

Q: Have you ever had a mid-session break to gather your thoughts - as if you were consulting with a team?

Q: Which supervisor or colleague could you hold in mind when conducting a session?

Q: Have you ever said to a client and family "If there were a team of therapists here today, I wonder what reflections they would have about what we have discussed?"

Give It A Go

Give systemic hypothesizing a try and observe the impact this has on your clinical thinking, practice and work with clients and families.

Please note that this article is educational in nature and does not constitute professional advice.

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What Is Systemic Therapy?

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What Systemic Therapy Can Help With

• Effectiveness

Things to Consider

• How to Get Started

What is systemic therapy?

Systemic therapy is a form of psychotherapy that focuses on how an individual's personal relationships, behavior patterns, and life choices are interconnected with the issues they face in their life.

The concept of systemic therapy springs from systems theory, which looks at how parts of a system affect one another to sustain the stability and equilibrium of the whole.

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Types of Systemic Therapy

Therapists apply systemic theory in individual, family, and group settings. Each type takes a slightly different approach based on the systems theory model.

• Individual psychotherapy: Incorporates the theories of Sigmund Freud with those of systems theory. It works to resolve unconscious motivations and patterns of behavior that affect an individual's life, relationships, and circumstances.
• Family therapy : Examines how the family interacts as a cohesive unit and uncovers patterns that influence or impede the potential for change within the family system.
• Group therapy : Looks at how a cohesive social unit is formed and how its members interact to fulfill individual needs so the group can function successfully as a whole.

Techniques of Systemic Therapy

Below are some examples of techniques employed in systemic therapy.

• Circular questioning: Helps the therapist explore a problem from different angles to identify its core issue
• Conceptualization: Helps a therapist put a client's symptoms into a context that spans time and space, or applies to one or more family members; looks at how individual experiences fit into a larger pattern within the person, family, community, or culture
• Reframing : Explores the client's self-perceptions and offers alternatives; often used with circular questioning, which helps clients identify patterns of behavior within social contexts

Systemic therapy can help people of any age, including children. Depending on the issue, several sessions or years might be necessary to resolve problems. It's particularly useful for those who are repressing or denying emotions for fear of appearing selfish or hurting others.

For many, systemic therapy provides insights into how patterns established early in life now limit the person's options.

For example, someone uncomfortable asserting their needs and desires may suppress their feelings. As a result, they may fail to develop interpersonal skills that would help them maintain healthy relationships.

As another example, someone who never learned how to manage their anger may lash out at loved ones in increasingly destructive ways. Systemic therapy can help people address these problems and, in some cases, discover their origins.

Issues that systemic therapy can help with include:

• Addictions and substance abuse : Helps people identify factors contributing to their substance abuse and emphasizes the connection between addiction and other aspects of their lives
• Anger management : Helps individuals learn how to express anger in more positive ways that foster their relationships and interpersonal communication
• Mood disorders : Helps people with depression or bipolar disorder work through issues so they can address symptoms when they occur
• Relationship difficulties : Helps people uncover the issues sabotaging their efforts and find more effective ways of interacting
• Conduct disorder : Helps people improve impulse control, develop appropriate social skills, and understand how family dynamics influence their actions
• Anxiety : Helps people identify the origins of their fears and provides strategies to overcome them
• Eating disorders : Helps people understand feelings of inadequacy and how they affect decision-making related to food and exercise
• PTSD : Helps people understand how memories of traumatic events affect their lives
• Schizophrenia : Can help clients work through symptoms

Benefits of Systemic Therapy

Systemic therapy helps people understand how their emotional lives affect interactions.

Systemic therapy provides a safe space to talk about personal issues that are too painful or difficult to share with others. It can provide insights that other forms of counseling or therapy can fail to uncover.

Below are some benefits of systemic therapy:

• Self-understanding : People gain understanding about themselves, thereby developing healthier relationships and reaching their potentials. People actively explore their patterns of thoughts, actions, and emotions.
• Understanding of different perspectives: This awareness helps people recognize when they're being influenced and when others are trying to exert power, as well as how these interactions affect their behavior.
• Empowerment: This type of therapy empowers the individual to take charge of their life without giving up control to someone else or a professional.
• Relationship skills: People learn how to communicate, handle conflict, and resolve problems. This can help them have more loving and fulfilling relationships.
• Core beliefs: People discover negative or destructive core beliefs and behaviors, such as perfectionism or people-pleasing.
• Identification of strengths/resources: People identify their strengths and resources, which can lead to increased self-confidence and self-worth.
• Empathy: Systemic therapy can help clients develop greater empathy, which is essential for healthy relationships with parents, partners, and children.
• Learning to work together with family: Systemic therapy encourages family members to work together for the benefit of one another.

Effectiveness of Systemic Therapy

Systemic family therapy has been shown to be an effective treatment for children and adolescents. However, more studies are needed to determine the best type of therapy and how well it works.

Systemic therapy can help identify how different relationships affect an individual. However, this type of therapy is not for everyone.

Below are things to consider before committing to systemic family counseling or therapy:

• Is the therapist trained in working with families?
• How much experience does the therapist have in dealing with the problems you want help with addressing?
• Is the therapist well-versed in systemic therapy?
• Does the therapist have your best interest at heart? Do you feel comfortable with them?
• What are their credentials, board certifications, and affiliations?

How to Get Started With Systemic Therapy

To get started with systemic therapy, find a licensed therapist who is well-versed in the modality. From there, you are encouraged to share your goals for working together. For example, you may want to work on improving relationships within your family or resolve problems at school. Be as specific as possible when detailing issues that need remedying.

A Word From Verywell

Systemic therapy can be an effective approach for family counseling. There is some evidence that this type of treatment is helpful in addressing relationship issues and helping people with communication skills. However, it may not be the best form of help for all individuals. It's important to explore this treatment option before committing to working with a therapist.

Varghese M, Kirpekar V, Loganathan S. Family Interventions: Basic Principles and Techniques .  Indian J Psychiatry . 2020;62(Suppl 2):S192-S200. doi:10.4103/psychiatry.IndianJPsychiatry_770_19

Retzlaff R, von Sydow K, Beher S, Haun MW, Schweitzer J. The efficacy of systemic therapy for internalizing and other disorders of childhood and adolescence: a systematic review of 38 randomized trials .  Fam Process . 2013;52(4):619-652. doi:10.1111/famp.12041

Georgievska, S., and S. N. Josifovska. 2023. “ A SYSTEMIC FAMILY APPROACH IN WORKING WITH CHILD VICTIMS OF VIOLENCE. ”  Annual of the Faculty of Philosophy in Skopje , 76 (1): 657–670. doi:10.37510/godzbo2376657g

By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.

What Is Systems Therapy? 7 Theories & Techniques Explained

We often become stuck in the same place, repeating our mistakes and unable to break free.

The Systems Therapy approach explores the elements of the family system, including its members’ relationships and feedback loops, that perpetuate and escalate problems. It forms new insights into the situation and aims to change the system rather than the patient (Rogers & Cooper, 2020; Watson, 2012).

This article introduces the concepts and theories behind Systems Therapy and identifies techniques to try out with your clients.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises will explore fundamental aspects of positive psychology including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

What is systems therapy & counseling 3 examples, the systemic approach to therapy explained, 4 psychology theories of the field, 3 techniques to try in your sessions.

• Training in Systems Therapy: 4 Programs

Best Books on the Topic

Positivepsychology.com’s relevant resources, a take-home message.

“Systems theory seeks to understand the dynamic behavior of complex systems, including how components of a system interact to affect the behavior of the system in often unexpected, nonlinear ways.”

Watson, 2012, p. 184

There are many methods and applications of systems theory, ranging from physics, biology, ecological, and social sciences, including therapy.

Each system has many interconnected parts, which, over time, produce their own unique patterns of behavior. They are self-organizing and despite external forces, are usually in command of their own behavior. The behavior patterns of the system are also difficult or impossible to predict from studying the individual parts, including their (Rogers & Cooper, 2020; Watson, 2012):

• Elements – such as components of a computer; leaves, branches, and roots of a tree; children in a school
• Interconnections – such as the flow of information in an organization; electrons in a computer; emotional information in a relationship
• Function or purpose – such as to teach, learn, and acquire information from a computer; to grow and reproduce as a tree; to protect and nurture the members of a family

A family is a system. As such, it is hard to anticipate how it will behave from looking individually at its members. It is also a constituent part of much larger systems, including the neighborhood, community, school, or church (Brown, 1997).

While systems are typically self-organizing and often resilient, they are not invulnerable and can be difficult to understand because of their complexity. Part of the challenge is recognizing the impact within a family of each person’s behavior on another – known as a feedback loop (Watson, 2012).

What is Systems Therapy?

Such thinking led to family systems theory . Drawing on approaches taken from psychoanalysis , clinical psychology, and social psychology, therapists began to contact and engage with the family rather than the patient alone. The suggestion was that the client or couple might not be the source of problematic behavior; instead, it may arise from feedback loops and interconnections within the family system (Watson, 2012).

Fascinatingly, the client became seen as the symptom bearer , reflecting the view that they could merely be “the person in the system who was most vulnerable to system pressures and therefore the first to develop emotional, behavioral, or relational symptoms as stress in the system increased” (Watson, 2012, p. 187).

Systems Therapy became a matter of changing the system, not directly changing the patient. According to this approach, family members will change in response to transforming the family system.

3 Examples of important family system concepts and models

There are several concepts and approaches that remain central to the core of Systems Therapy.

The biopsychosocial model is perhaps more a framework than a model. It aims to capture the interaction of all levels of life by integrating “biological, psychological, and social domains of human functioning” (Watson, 2012, p. 189). The framework is particularly helpful when using systems theory in the psychotherapeutic treatment of chronically and terminally ill patients and their families.

Circular causality recognizes the importance of recursive feedback loops within a system. The behavior of A is impacted by B, and A’s behavior subsequently affects the behavior of B. In addition, a person’s behavior can unintentionally be caused by family members trying to fix or prevent something from happening (Watson, 2012).

Emotional cutoff occurs when families refuse to engage with family members, sometimes for years or even decades. However, such an approach is typically unsuccessful in solving problems or issues and facilitates avoiding difficult activities, such as the differentiation of the self , reconciliation , and tolerating differences .

Ultimately, ‘fixing’ the situation will often take prolonged attempts by one party to reconnect, with or without an apology (Watson, 2012).

By exploring a group’s dynamic complexity (how the members of a group relate to one another), humans are considered part of a system with inputs, outputs, processes, feedback, and the need for homeostasis (Watson, 2012).

The systemic approach to therapy uses several techniques to understand the presenting problem and subsequently identify alternative ways to help the client cope, including (Evans & Whitcombe, 2015; Watson, 2012):

• Joining A comfortable and safe therapeutic relationship must be established with the family group that allows the therapist to identify relevant emotional exchanges.
• Strength orientation The ability to recognize strength orientations (rather than pathologize ) in problems, impasses, and failures is crucial. Success stories should be brought out in conversation and highlighted rather than engaging in prolonged problem talk.
• Solution-focused interventions Focusing on where we want to be can be more important than what led us to where we are now. The solution-oriented approach suggests using something similar to solve the problem now or in the future by asking what worked in the past.
• Reframing Seeing the problem in a novel way can lead to a very different outcome. Successfully reframing the issue can create emotional resonance and fit better within the dynamics and feedback loops of the system.
• Positive connotation This technique involves “describing a ‘negative’ behavior or attitude in terms of its positive, adaptive, or helpful aspects” (Watson, 2012, p. 191). For example, his anger may be due to his deep love for his daughter and concerns for her safety .
• Enactment Rather than bringing in a description of a problem, a couple or family is asked to enact how they communicate or argue and what goes wrong. This approach can be beneficial in identifying factors that are outside the awareness of the clients.
• Circular questioning This technique can be helpful to understand the interactions that lead to problems and how the other person sees the relationship. Circular questions often ask what the person would have to do to provoke the undesirable response in the other person or rank the family members according to a particular theme. For example, Who was most and least interested in coming today?
• Use of self The therapist must remain aware of their self during therapy, observing, rather than judging, their own reactions. Therapists may need to ‘dig deep’ and go beyond technique and method to engage in self-acceptance, creativity, and openness during sessions.

While far from exhaustive, the list above provides a practical insight into several key systemic approaches to therapy.

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Several different schools of family therapy developed in the second half of the 20th century. Some of the most enduring ones are discussed below.

Structural Family Therapy

Structural Family Therapy is based on the idea that the system’s behavior results from its structure and can be understood better by observing over time and recognizing misalignments in structure, boundaries, and hierarchies within the family.

Structural Family Therapy promotes “flexible interdependence and autonomy rather than an over-involved, emotionally fused enmeshment or a disconnected, under-involved disengagement” (Watson, 2012, p. 187).

Strategic Family Therapy

Strategic Family Therapy arose from the application of systems theory, cybernetics, and communications theory in the treatment of schizophrenia and family issues.

Strategic Family Therapy, along with brief therapy (which focuses on a specific problem and uses a direct intervention), utilizes a problem-centered, here-and-now focus (Watson, 2012).

Bowen Family Systems Therapy

Created by psychiatrist Murray Bowen, this form of therapy emphasizes the “individual’s ability to maintain a self-directed, principle-driven course of action while maintaining contact with emotionally significant others” (Watson, 2012, p. 188).

When anxious, the individual typically gives up their self to maintain togetherness, avoiding conflict, placating, etc. This lack of differentiation can lead to an inability to see when they are overreacting and behavior is unreasonable. Self-differentiation is, therefore, a vital aspect of resolving problems within the family system.

Narrative Family Therapy

Narrative Family Therapy “focuses on how all people assemble internal narratives of their lives, summarizing and compressing the richness of lived experience” into a series of dominant themes, receiving feedback from their families, culture, and society (Watson, 2012, p. 188).

Narrative Therapy assists people to break out of self-reinforcing loops and restores meaning while focusing on the experience itself.

In addition, Internal Family Systems Therapy is discussed in full in our dedicated article, which also provides exercises and worksheets.

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There are several tools available for Systems Therapy; we describe three of our favorites below.

Vision statement

A vision statement can help when working with a family to help them see themselves now and where they would like to be in the future (Rogers & Cooper, 2020).

For example, asking a parent or carer what they think their children would say about them now and what they would like their children to say about them in 10 years can generate potent insights. Through visualization, it provides information regarding the gap to fill or a goal to work toward, and identifies what must change.

Vision statements are a more positive and motivating approach than the therapist telling the family members the issues and difficulties they have uncovered (Rogers & Cooper, 2020).

Circular questioning

For example, asking a son why his father gets angry when he stays out late at night can lead to insights and a deeper understanding of how the parent perceives his actions and the impact they are having.

Circular questions can help define a problem, show how situations have changed, explore the impact of behavior, and invite individuals to change (Evans & Whitcombe, 2015).

Taking a one-down position

Rather than trying to get one-up on the other person or winning the (perceived) battle, it can be helpful to give ground. Stepping down or back can help either the therapist working with a client or a family member engaged with another, by (Watson, 2012):

• Disarming the other person concerned with losing dominance
• Avoiding walking into an ambush . For example, a couple may decide not to try to impress difficult family members.
• Admitting impotence and letting the client or family retain ownership when a complainer repeatedly ignores advice. Ultimately, this approach elevates the other person’s perceived importance and lets them save face (Watson, 2012).

Systemic family therapy – TheSynapse

Training in Systems Therapy: 3 Programs

There are many programs available to learn more about Systems Therapy. They often form part of a broader study of family science or therapy; four popular ones include:

• Master’s Degree in Marriage and Family Therapy – Oklahoma State University offers a master’s degree focusing on marriage and family therapy as a branch of psychotherapy. Aimed at solving problems within human relationships, it provides an effective path to licensure or PhD study.
• Master’s Degree in Couple and Family Counseling – This master’s from Northeastern Illinois University fulfills the educational requirements for licensure within the state and those considering employment in marriage and family counseling clinics. The course covers the development and theories of counseling , working with couples and families.
• Master’s in Systemic Practice and Family Therapy – Queen’s University in Northern Ireland offers a master’s that focuses on systemic practice within family therapy. Students wishing to enhance their skills of working with families and couples can learn how to help them understand and support each other.

There are many books available to explain the theory and the practice behind Systems Therapy. We have chosen several below that provide an overview and a more detailed examination of the approach.

1. Internal Family Systems Couple Therapy Skills Manual: Healing Relationships With Intimacy From the Inside Out  – Toni Herbine-Blank and Martha Sweezy

This is a valuable manual for therapists already familiar with or wishing to start using Systems Therapy.

This essential guide teaches readers how to use the authors’ model and, equally importantly, integrate it into existing approaches.

Elegant and profound, the text helps readers improve their therapeutic focus and assist healing conversations.

Find the book on Amazon .

2. Altogether You: Experiencing Personal and Spiritual Transformation With Internal Family Systems Therapy – Jenna Riemersma

Jenna Riemersma writes for those feeling stuck with unwanted feelings and behavior.

She introduces the reader to Internal Family Systems Therapy and explains why we engage in damaging behavior and how we are often at war with ourselves and our families.

This is a helpful book for anyone wishing to change their perspective and develop new insights with the goal of personal transformation.

3. Internal Family Systems Skills Training Manual: Trauma-Informed Treatment for Anxiety, Depression, PTSD & Substance Abuse  – Frank Anderson, Richard Schwartz, and Martha Sweezy

Use this highly practical book to understand Internal Family Therapy’s potential to treat anxiety, post-traumatic stress disorder (PTSD), eating disorders, and substance abuse.

Learn how to use compassion to avoid pathologizing clients and focus on healing emotional wounds.

Through a development of self and listening to ourselves and others, this book shows how it is possible to resolve trauma and attachment injury.

We have many worksheets and tools available that can help in family therapy, encouraging understanding and improving communication. Here are just a few to help get you started:

• What is Working Within the Family This activity helps family members identify and share what they feel goes well within the family or household as a means to celebrate and build on successes.
• Mind the Gap This exercise helps family members explore the gap between the values they wish to enact and their behaviors, creating an opportunity to live more in line with a value-driven moral code.
• Meeting Our Family’s Needs This exercise presents a series of questions to help family members recognize the met and unmet needs that lead to happiness or conflict within a household.
• Imago Workup Worksheet This worksheet helps clients identify the impact that the qualities and actions of their caregivers have had on their expectations of an ideal romantic partner.
• Codependent Relationships: Beliefs, Attributes, and Outcomes This checklist presents a definition of codependency and examples of beliefs, actions, and outcomes reflective of healthy versus codependent relationships.

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Breaking free of unhelpful, damaging, and habitual behavior is one of the goals of family therapy.

Systems Therapy offers an approach to explore relationships as a system, including components, parts, relationships, and purpose. As a result, an individual’s problem can be resolved by treating the family as a complex entity and effecting change at that level (Watson, 2012).

While difficult to understand, relationships can hold the key to transformation in the individual. That person be the symptom-bearer as the most susceptible person in that system.

Through empathy and recognizing the importance of feedback loops within any system, it is possible to identify the source of the problem presented and find alternative ways for the client to cope and the family to restore balance.

Why not review some techniques and theories in Systems Therapy and reflect on how they could be combined and embedded with existing approaches within your practice? Help your clients reflect on their existing situations and where they see themselves in the future.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

• Anderson, F., Schwartz, R., & Sweezy, M. (2017).  Internal family systems skills training manual: Trauma-informed treatment for anxiety, depression, PTSD & substance abuse.  PESI.
• Brown, J. (1997). Circular questioning: An introductory guide. Australian and New Zealand Journal of Family Therapy , 18 (2), 109–114.
• Evans, N., & Whitcombe, S. (2015). Using circular questions as a tool in qualitative research. Nurse Researcher ,  23 (3) 28–31.
• Herbine-Blank, T., & Sweezy, M. (2021).  Internal family systems couple therapy skills manual: Healing relationships with intimacy from the inside out.  PESI.
• Riemersma, J. (2020).  Altogether you: Experiencing personal and spiritual transformation with internal family systems therapy.  Pivotal Press.
• Rogers, M., & Cooper, J. (2020). Systems theory and an ecological approach. In M. Rogers, D. Whitaker, D. Edmondson, & D. Peach, Developing skills & knowledge for social work practice (pp. 259–268). SAGE.
• Watson, W. H. (2012). Family systems. In V. S. Ramachandran (Ed.), Encyclopedia of human behavior (pp. 184–193). Elsevier Academic Press.

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Dear Jeremy. Thanks for this. I was researching “attachment style conflict in recursive narrative loop” (for my challenging relationship) and found your article helpful. I will let my Systemics Pyschologist know that I have read it and that it resonants with my experience. But why do you reference internal family system theory as a primary source? I understood that internal family systems is an separate research area and domain from “family systemics” whereby “family systemics” should perhaps be called “external family systems”.

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8. Systemic Family Therapy: Applying Psychological Theory to Clinical Practice

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Systemic Insights on Mental Health

Explore the depth and breadth of systemic approaches to mental health..

Posted July 25, 2024 | Reviewed by Gary Drevitch

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Welcome to "Systemic Insights," the official blog of the American Association for Marriage and Family Therapy (AAMFT) here on Psychology Today. I am Chris Michaels, the CEO of AAMFT, and I’m excited to introduce you to this space where we will explore the depth and breadth of systemic approaches in mental health. Through this blog, we aim to provide valuable insights, discuss contemporary issues, and showcase the work and impact of marriage and family therapists (MFTs).

Who We Are and What We Do

AAMFT is the leading professional organization for the field of marriage and family therapy, committed to the advancement of the MFT profession. Our mission is to support our members in providing effective and ethical family therapy, enhancing individual and family resilience , and fostering healthy relationships in diverse contexts. We represent the professional interests of more than 72,000 marriage and family therapists and champion the systemic approach to therapy that views individuals within the context of their relationships and larger social systems.

Our work encompasses a wide array of issues, ranging from addressing LGBTQIA+ mental health to exploring racial disparities in therapy access, supporting military families, improving mental health support for children and more. We strive to be at the forefront of evolving therapeutic practices and advocacy, ensuring that our members are equipped to meet the diverse needs of their clients in a rapidly changing world.

Recent Highlights

Earlier this year, we published the 2024 Systemic Ethics Textbook , a pivotal resource for clinicians navigating the complexities of modern family therapy. This comprehensive guide addresses a wide range of ethical considerations, including confidentiality, cultural competence, dual relationships, and the use of technology in therapy. Developed collaboratively by experts within the AAMFT community, this textbook represents a collective effort to support ethical practice and enhance the effectiveness of family therapy. Covering diverse topics such as working with interpreters, ethical dilemmas in military families, and navigating systemic biases, it highlights our shared dedication to advancing the profession and provides a valuable tool for clinicians striving to meet the highest standards of ethical care.

We are also gearing up for our upcoming Systemic Family Therapy Conference (SFTC) in Orlando this November, a cornerstone event that fosters personal and professional growth among systemic family therapists. The conference focuses on three key areas: enhancing the systemic thinker as an individual, developing cutting -edge clinical skills and integrating into community and institutional systems that shape our global society.

Another exciting initiative we're proud to showcase is our Jobs of Tomorrow series, a six-part exploration into the evolving role of MFTs in the future of behavioral health care. This series delves into crucial topics such as how family dynamics influence mental health, the power of healing together, and the role of technology in transforming MFT practices. Other episodes focus on fostering healing conversations, finding community in crisis and navigating therapeutic decisions with an ethical compass. Each installment offers insightful perspectives on the challenges and opportunities that will shape the practice of MFTs in the years to come. We encourage you to check out these engaging episodes and learn more about the future of our profession here.

We are also actively advancing our portability efforts, aiming to ensure that licensure and practice rights for MFTs are recognized and transferable across state lines. This initiative is crucial for expanding the reach and impact of family therapists nationwide, allowing them to serve diverse communities without barriers. To learn more, click here.

What to Expect from This Page

Through "Systemic Insights," we will explore a diverse range of topics reflecting the multifaceted nature of mental health and systemic therapy. You can expect thought-provoking posts on everything from burnout and PTSD to complex family dynamics and working with special populations. We aim to cover not only clinical practices but also the broader societal issues impacting mental health and therapy.

Esteemed members and researchers from AAMFT will contribute their expertise, offering perspectives on the latest trends, emerging research, and practical applications in the field of family therapy. Our goal is to foster meaningful conversations and provide resources that enrich both personal and professional development for therapists and those interested in systemic approaches to mental health.

We invite you to join us on this journey, engaging with our posts and sharing your insights. Whether you are a seasoned therapist, a student or simply passionate about mental health, this blog is designed to be a dynamic and inclusive space for exploration and learning. Together, let’s advance the field of systemic family therapy and create a world where all individuals and families can thrive.

Warm regards,

Chris Michaels, CEO, American Association for Marriage and Family Therapy

Chris Michaels, with nearly 35 years of dedicated leadership at AAMFT, currently directs the association as its CEO, overseeing strategy, operations and member engagement for over 72,000 marriage and family therapists throughout the United States, Canada and abroad. She is instrumental in advancing AAMFT's mission through her leadership in strategic planning, stakeholder engagement, and fostering a culture of diversity, equity and inclusion.

The American Association for Marriage and Family Therapy (AAMFT) is the professional association for the field of marriage and family therapy. We represent the professional interests of more than 72,000 marriage and family therapists throughout the United States, Canada and abroad.

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Insane ; Mental disorder ; Mentally ill ; Psychopathic

“Psychosis is severe mental disorder in which a person loses the ability to recognize reality or relate to others. The person is not able to cope with the demands of everyday life. Symptoms include being paranoid, having false ideas about what is taking place or who one is, and seeing, hearing, or feeling things that are not there” (Definition of Psychosis—NCI Dictionary of Cancer Terms—NCI, 2011 ).

Psychiatric illness can be broadly classified into psychosis and neurosis. The term “psychosis” is a group of psychiatric disorders that encompasses symptoms like distortion of sense of reality, disorganized thought, and disorganized behavior. The most common disorders with features of psychosis are schizophrenia, schizoaffective disorders, mania, depression, bipolar disorder, and delusional disorders. These are considered primary psychiatric disorders (Maj et al., 2021 ).

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Agbor, C., Kaur, G., Soomro, F. M., Eche, V. C., Urhi, A., Ayisire, O. E., Kilanko, A., Babalola, F., Eze-Njoku, C., Adaralegbe, N. J., Aladum, B., Oyeleye-Adegbite, O., & Anugwom, G. O. (2022). The role of cognitive behavioral therapy in the management of psychosis. Cureus, 14 (9), e28884. https://doi.org/10.7759/cureus.28884

Article   PubMed   PubMed Central   Google Scholar  

Ali, S. A., Mathur, N., Malhotra, A. K., & Braga, R. J. (2019). Electroconvulsive therapy and schizophrenia: A systematic review. Molecular Neuropsychiatry, 5 (2), 75–83. https://doi.org/10.1159/000497376

Arciniegas, D. B. (2015). Psychosis. Continuum: Lifelong Learning in Neurology, 21 (3 Behavioral Neurology and Neuropsychiatry), 715–736. https://doi.org/10.1212/01.CON.0000466662.89908.e7

Beck, K., Hindley, G., Borgan, F., Ginestet, C., McCutcheon, R., Brugger, S., Driesen, N., Ranganathan, M., D’Souza, D. C., Taylor, M., Krystal, J. H., & Howes, O. D. (2020). Association of ketamine with psychiatric symptoms and implications for its therapeutic use and for understanding schizophrenia: A systematic review and meta-analysis. JAMA Network Open, 3 (5), e204693. https://doi.org/10.1001/jamanetworkopen.2020.4693

Bramness, J. G., Gundersen, Ø. H., Guterstam, J., Rognli, E. B., Konstenius, M., Løberg, E.-M., Medhus, S., Tanum, L., & Franck, J. (2012). Amphetamine-induced psychosis – A separate diagnostic entity or primary psychosis triggered in the vulnerable? BMC Psychiatry, 12 , 221. https://doi.org/10.1186/1471-244X-12-221

Byrne, M., Jolley, S., & Peters, E. (2018). Cognitive behaviour therapy for psychosis. In Treatment response and resistance in schizophrenia (pp. 128–143). Oxford University Press. https://doi.org/10.1093/med/9780198828761.001.0001

Chapter   Google Scholar  

Calabrese, J., & Al Khalili, Y. (2024). Psychosis. In StatPearls . StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK546579/

Chakrabarti, S., & Singh, N. (2022). Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review. World Journal of Psychiatry, 12 (9), 1204–1232. https://doi.org/10.5498/wjp.v12.i9.1204

Chaudhury, S. (2010). Hallucinations: Clinical aspects and management. Industrial Psychiatry Journal, 19 (1), 5–12. https://doi.org/10.4103/0972-6748.77625

Chokhawala, K., & Stevens, L. (2024). Antipsychotic medications. In StatPearls . StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK519503/

Chow, R. T. S., Whiting, D., Favril, L., Ostinelli, E., Cipriani, A., & Fazel, S. (2023). An umbrella review of adverse effects associated with antipsychotic medications: The need for complementary study designs. Neuroscience & Biobehavioral Reviews, 155 , 105454. https://doi.org/10.1016/j.neubiorev.2023.105454

Article   Google Scholar  

Cook, C. C. (2015). Religious psychopathology: The prevalence of religious content of delusions and hallucinations in mental disorder. The International Journal of Social Psychiatry, 61 (4), 404–425. https://doi.org/10.1177/0020764015573089

Craddock, N., O’Donovan, M. C., & Owen, M. J. (2005). The genetics of schizophrenia and bipolar disorder: Dissecting psychosis. Journal of Medical Genetics, 42 (3), 193–204. https://doi.org/10.1136/jmg.2005.030718

Definition of psychosis—NCI Dictionary of Cancer Terms—NCI (nciglobal,ncienterprise). (2011, February 2). [nciAppModulePage]. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/psychosis

Dubovsky, S. L., Ghosh, B. M., Serotte, J. C., & Cranwell, V. (2021). Psychotic depression: Diagnosis, differential diagnosis, and treatment. Psychotherapy and Psychosomatics, 90 (3), 160–177. https://doi.org/10.1159/000511348

Article   PubMed   Google Scholar  

Fiorentini, A., Cantù, F., Crisanti, C., Cereda, G., Oldani, L., & Brambilla, P. (2021). Substance-induced psychoses: An updated literature review. Frontiers in Psychiatry, 12 , 694863. https://doi.org/10.3389/fpsyt.2021.694863

Freudenreich, O., Schulz, S. C., & Goff, D. C. (2009). Initial medical work-up of first-episode psychosis: A conceptual review. Early Intervention in Psychiatry, 3 (1), 10–18. https://doi.org/10.1111/j.1751-7893.2008.00105.x

Fusar-Poli, P., Borgwardt, S., Bechdolf, A., Addington, J., Riecher-Rössler, A., Schultze-Lutter, F., Keshavan, M., Wood, S., Ruhrmann, S., Seidman, L. J., Valmaggia, L., Cannon, T., Velthorst, E., De Haan, L., Cornblatt, B., Bonoldi, I., Birchwood, M., McGlashan, T., Carpenter, W., … Yung, A. (2013). The psychosis high-risk state: A comprehensive state-of-the-art review. JAMA Psychiatry, 70 (1), 107–120. https://doi.org/10.1001/jamapsychiatry.2013.269

Gaebel, W., & Zielasek, J. (2015). Focus on psychosis. Dialogues in Clinical Neuroscience, 17 (1), 9–18. https://doi.org/10.31887/DCNS.2015.17.1/wgaebel

Gilden, J., Kamperman, A. M., Munk-Olsen, T., Hoogendijk, W. J. G., Kushner, S. A., & Bergink, V. (2020). Long-term outcomes of postpartum psychosis: A systematic review and meta-analysis. The Journal of Clinical Psychiatry, 81 (2), 19r12906. https://doi.org/10.4088/JCP.19r12906

Griswold, K. S., Regno, P. A. D., & Berger, R. C. (2015). Recognition and differential diagnosis of psychosis in primary care. American Family Physician, 91 (12), 856–863.

PubMed   Google Scholar  

Grover, S., Davuluri, T., & Chakrabarti, S. (2014). Religion, spirituality, and schizophrenia: A review. Indian Journal of Psychological Medicine, 36 (2), 119–124. https://doi.org/10.4103/0253-7176.130962

Haddad, P. M., & Correll, C. U. (2018). The acute efficacy of antipsychotics in schizophrenia: A review of recent meta-analyses. Therapeutic Advances in Psychopharmacology, 8 (11), 303–318. https://doi.org/10.1177/2045125318781475

Ibrahim, A., & Whitley, R. (2021). Religion and mental health: A narrative review with a focus on Muslims in English-speaking countries. BJPsych Bulletin, 45 (3), 170–174. https://doi.org/10.1192/bjb.2020.34

Kahn, R. S., Sommer, I. E., Murray, R. M., Meyer-Lindenberg, A., Weinberger, D. R., Cannon, T. D., O’Donovan, M., Correll, C. U., Kane, J. M., van Os, J., & Insel, T. R. (2015). Schizophrenia. Nature Reviews Disease Primers, 1 (1), 1–23. https://doi.org/10.1038/nrdp.2015.67

Kamperman, A. M., Veldman-Hoek, M. J., Wesseloo, R., Robertson Blackmore, E., & Bergink, V. (2017). Phenotypical characteristics of postpartum psychosis: A clinical cohort study. Bipolar Disorders, 19 (6), 450–457. https://doi.org/10.1111/bdi.12523

Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis and schizophrenia: The widening gap between basic and clinical neuroscience. Translational Psychiatry, 8 (1), 1–12. https://doi.org/10.1038/s41398-017-0071-9

Keshavan, M. S., & Kaneko, Y. (2013). Secondary psychoses: An update. World Psychiatry, 12 (1), 4–15. https://doi.org/10.1002/wps.20001

Lee, H. S., & Kim, J. S. (2022). Implication of electrophysiological biomarkers in psychosis: Focusing on diagnosis and treatment response. Journal of Personalized Medicine, 12 (1), 31. https://doi.org/10.3390/jpm12010031

Lin, H.-T., Liu, S.-K., Hsieh, M. H., Chien, Y.-L., Chen, I.-M., Liao, S.-C., Tsai, H.-J., & Wu, C.-S. (2018). Impacts of electroconvulsive therapy on 1-year outcomes in patients with schizophrenia: A controlled, population-based mirror-image study. Schizophrenia Bulletin, 44 (4), 798–806. https://doi.org/10.1093/schbul/sbx136

Luvsannyam, E., Jain, M. S., Pormento, M. K. L., Siddiqui, H., Balagtas, A. R. A., Emuze, B. O., & Poprawski, T. (2022). Neurobiology of schizophrenia: A comprehensive review. Cureus, 14 (4), e23959. https://doi.org/10.7759/cureus.23959

Maj, M., van Os, J., De Hert, M., Gaebel, W., Galderisi, S., Green, M. F., Guloksuz, S., Harvey, P. D., Jones, P. B., Malaspina, D., McGorry, P., Miettunen, J., Murray, R. M., Nuechterlein, K. H., Peralta, V., Thornicroft, G., van Winkel, R., & Ventura, J. (2021). The clinical characterization of the patient with primary psychosis aimed at personalization of management. World Psychiatry, 20 (1), 4–33. https://doi.org/10.1002/wps.20809

Menezes, A., & Moreira-Almeida, A. (2010). Religion, spirituality, and psychosis. Current Psychiatry Reports, 12 (3), 174–179. https://doi.org/10.1007/s11920-010-0117-7

Mitra, S., Mahintamani, T., Kavoor, A. R., & Nizamie, S. H. (2016). Negative symptoms in schizophrenia. Industrial Psychiatry Journal, 25 (2), 135–144. https://doi.org/10.4103/ipj.ipj_30_15

Morrison, A. P., & Wood, L. J. (2023). Cognitive Behavior Therapy for Psychosis (CBTp). In Oxford research encyclopedia of psychology . https://doi.org/10.1093/acrefore/9780190236557.013.329

Nelson, J. C., Bickford, D., Delucchi, K., Fiedorowicz, J. G., & Coryell, W. H. (2018). Risk of psychosis in recurrent episodes of psychotic and nonpsychotic major depressive disorder: A systematic review and meta-analysis. American Journal of Psychiatry, 175 (9), 897–904. https://doi.org/10.1176/appi.ajp.2018.17101138

Oeztuerk, O. F., Pigoni, A., Antonucci, L. A., & Koutsouleris, N. (2022). Association between formal thought disorders, neurocognition and functioning in the early stages of psychosis: A systematic review of the last half-century studies. European Archives of Psychiatry and Clinical Neuroscience, 272 (3), 381–393. https://doi.org/10.1007/s00406-021-01295-3

Paljärvi, T., Tiihonen, J., Lähteenvuo, M., Tanskanen, A., Fazel, S., & Taipale, H. (2023). Psychotic depression and deaths due to suicide. Journal of Affective Disorders, 321 , 28–32. https://doi.org/10.1016/j.jad.2022.10.035

Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2014). Schizophrenia: Overview and treatment options. Pharmacy and Therapeutics, 39 (9), 638–645.

PubMed   PubMed Central   Google Scholar  

Pollak, T. A., Lennox, B. R., Müller, S., Benros, M. E., Prüss, H., Elst, L. T. van, Klein, H., Steiner, J., Frodl, T., Bogerts, B., Tian, L., Groc, L., Hasan, A., Baune, B. T., Endres, D., Haroon, E., Yolken, R., Benedetti, F., Halaris, A., … Bechter, K. (2020). Autoimmune psychosis: An international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin. The Lancet Psychiatry, 7 (1), 93–108. https://doi.org/10.1016/S2215-0366(19)30290-1

Porter, A., Fei, S., Damme, K. S. F., Nusslock, R., Gratton, C., & Mittal, V. A. (2023). A meta-analysis and systematic review of single vs. Multimodal neuroimaging techniques in the classification of psychosis. Molecular Psychiatry, 28 (8), 3278–3292. https://doi.org/10.1038/s41380-023-02195-9

Rasmussen, S. A., Mazurek, M. F., & Rosebush, P. I. (2016). Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology. World Journal of Psychiatry, 6 (4), 391–398. https://doi.org/10.5498/wjp.v6.i4.391

Robinson, N., & Bergen, S. E. (2021). Environmental risk factors for schizophrenia and bipolar disorder and their relationship to genetic risk: Current knowledge and future directions. Frontiers in Genetics, 12 , 686666. https://doi.org/10.3389/fgene.2021.686666

Roche, E., Creed, L., MacMahon, D., Brennan, D., & Clarke, M. (2015). The epidemiology and associated phenomenology of formal thought disorder: A systematic review. Schizophrenia Bulletin, 41 (4), 951–962. https://doi.org/10.1093/schbul/sbu129

Sabe, M., Zhao, N., & Kaiser, S. (2021). A systematic review and meta-analysis of the prevalence of cocaine-induced psychosis in cocaine users. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 109 , 110263. https://doi.org/10.1016/j.pnpbp.2021.110263

Sami, M. B., & Liddle, P. (2022). Neurobiology of psychosis and schizophrenia 2021: Nottingham meeting. Schizophrenia Bulletin, 48 (2), 289–291. https://doi.org/10.1093/schbul/sbab152

Schifano, F., Orsolini, L., Duccio Papanti, G., & Corkery, J. M. (2015). Novel psychoactive substances of interest for psychiatry. World Psychiatry, 14 (1), 15–26. https://doi.org/10.1002/wps.20174

Sharma, D. B., Gupta, V., Saxena, K., Shah, U. M., & Singh, U. S. (2020). Role of Faith healers: A barrier or a support system to medical care- a cross sectional study. Journal of Family Medicine and Primary Care, 9 (8), 4298–4304. https://doi.org/10.4103/jfmpc.jfmpc_868_20

Shrivastava, A., Johnston, M., Terpstra, K., & Bureau, Y. (2014). Cannabis and psychosis: Neurobiology. Indian Journal of Psychiatry, 56 (1), 8–16. https://doi.org/10.4103/0019-5545.124708

Sinclair, D. J., Zhao, S., Qi, F., Nyakyoma, K., Kwong, J. S., & Adams, C. E. (2019). Electroconvulsive therapy for treatment-resistant schizophrenia. Cochrane Database of Systematic Reviews, 3 , CD011847. https://doi.org/10.1002/14651858.CD011847.pub2

Staines, L., Healy, C., Coughlan, H., Clarke, M., Kelleher, I., Cotter, D., & Cannon, M. (2022). Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychological Medicine, 52 (15), 1–12. https://doi.org/10.1017/S0033291722002550

Staines, L., Healy, C., Murphy, F., Byrne, J., Murphy, J., Kelleher, I., Cotter, D., & Cannon, M. (2023). Incidence and persistence of psychotic experiences in the general population: Systematic review and meta-analysis. Schizophrenia Bulletin, 49 (4), 1007–1021. https://doi.org/10.1093/schbul/sbad056

Sur, S., & Sinha, V. K. (2009). Event-related potential: An overview. Industrial Psychiatry Journal, 18 (1), 70–73. https://doi.org/10.4103/0972-6748.57865

Thom, R. P., Levy-Carrick, N. C., Bui, M., & Silbersweig, D. (2019). Delirium. American Journal of Psychiatry, 176 (10), 785–793. https://doi.org/10.1176/appi.ajp.2018.18070893

Wagner, G. S., McClintock, S. M., Rosenquist, P. B., & McCall, W. V. (2011). Major depressive disorder with psychotic features may lead to misdiagnosis of dementia: A case report and review of the literature. Journal of Psychiatric Practice, 17 (6), 432–438. https://doi.org/10.1097/01.pra.0000407968.57475.ab

Weber, S. R., & Pargament, K. I. (2014). The role of religion and spirituality in mental health. Current Opinion in Psychiatry, 27 (5), 358–363. https://doi.org/10.1097/YCO.0000000000000080

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P. E, S.K. (2024). Psychosis. In: Shackelford, T. (eds) Encyclopedia of Religious Psychology and Behavior. Springer, Cham. https://doi.org/10.1007/978-3-031-38971-9_455-1

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