EXPANDING THE CONTEXTUAL ANALYSIS OF CLINICAL PROBLEMS

One source of failure in behavior therapy is neglect and/or insufficient assessment of the social context that influences a problem. In this paper, we draw upon concepts and tools from family therapy to broaden the functional analysis of problems. We discuss how the analysis of family interaction sequences surrounding symptomatic behavior and the exploration of intergenerational material can illuminate the problem-solving role symptoms may serve in managing a family dilemma. By reframing symptoms in light of their beneficial social functions, the therapist may reconceptualize the client's problem and target relevant interaction patterns in designing interventions. Further, an expanded contextual analysis allows the therapist to more fully appreciate and utilize reasons why clients may have difficulty changing during the therapeutic process. This helps the therapist to time and structure compliance-based interventions more sensitively, and avoid negative attributions for noncompliance.