Sistemik Terapi Yaklaşımı
Özet
Sistemik terapi, bireysel psikolojik sorunları ve ruhsal belirtileri kişilerin içinde yaşadığı sosyal sistemler, ilişkiler ve etkileşimler bağlamında ele alan köklü bir psikoterapi ekolüdür. Genel sistem ve sibernetik kuramlarından beslenen bu yaklaşım, patolojinin kaynağı olarak tek bir bireyi görmek yerine kişilerarası döngüsel nedenselliğe ve sosyal gerçeklik yapılarına odaklanır; böylece danışanı sorunun tek kaynağı olma yükünden kurtarır. Tıbbi modelin aksine bağlamsal modeli benimseyen bu yöntem, başlangıçta aile terapisi olarak şekillense de günümüzde birey, çift ve organizasyonları da kapsayan geniş bir uygulama yelpazesine sahiptir. Terapi sürecinde mutlak kurallar yerine esnek, katılım odaklı ve uyarlanabilir kararlar tercih edilirken; akut şiddet ve istismar gibi kriz durumlarında kontrendikedir. Süreç boyunca terapist, doğrusal yönelimden uzak, meraklı ve "bilmeyen" bir tutumla danışanın mevcut güçlü yönlerini, ihmal edilmiş öz-örgütlenme kaynaklarını ve çözümlerini açığa çıkarmaya odaklanır. Bu doğrultuda, sistem üyelerinin birbirlerinin gerçekliğinden nasıl etkilendiğini anlamak için döngüsel sorgulama tekniği etkin şekilde kullanılır. Ayrıca, yaşanan durumlara farklı açılardan bakılmasını sağlayan yeniden çerçeveleme, genogram ve metaforik eylem yöntemlerinden de sıklıkla yararlanılır. Yaklaşık 5 ila 15 seans arasında süren sistemik terapi, bireysel kalıplardan ziyade tüm sistemin ilişki ağında kalıcı bir değişim yaratmayı hedefler.
Systemic therapy is an established psychotherapy school that addresses individual psychological problems and mental symptoms within the context of social systems, relationships, and interactions in which people live. Rooted in general systems and cybernetics theories, this approach focuses on interpersonal circular causality and social structures of reality rather than viewing a single individual as the source of pathology, thereby relieving the client from the burden of being the sole cause of the problem. Adopting the contextual model instead of the medical model, this method originally shaped as family therapy but today has a wide range of applications covering individuals, couples, and organizations. While flexible, participation-oriented, and adaptive decisions are preferred over absolute rules during the therapy process, it is contraindicated in crisis situations such as acute violence and abuse. Throughout the process, the therapist focuses on revealing the client's existing strengths, neglected self-organization resources, and solutions with a curious and "non-knowing" stance, moving away from linear orientation. Accordingly, the circular questioning technique is actively used to understand how system members are affected by each other's reality. In addition, reframing, genogram, and metaphorical action methods, which allow looking at experienced situations from different angles, are frequently utilized. Lasting approximately 5 to 15 sessions, systemic therapy aims to create a permanent change in the interaction patterns of the entire system rather than individual patterns.
Referanslar
Sydow Kv, Beher S, Schweitzer J, et al. The Efficacy of Systemic Therapy With Adult Patients: A Meta-Content Analysis of 38 Randomized Controlled Trials. Fam Process. 2010;49(4):457-485. Doi:10.1111/j.1545-5300.2010.01334.x
Wagner, E. (2017). Systemische Therapie ım Kontext Psychiatrischer Störungen: In Praxisbuch Systemische Therapie : Vom Fallverständnis zum wirksamen psychotherapeutischen Handeln in klinischen Kontexten. Stuttgart: Klett-Cotta Verlag
Retzlaff R, von Sydow K. Systemische Therapie mit Kindern und Jugendlichen. Psychotherapeut. 2015;60(4):295–301.Doi: 10.1007/s00278-015-0043-6
Boston P. Systemic family therapy and the influence of post-modernism. Advances in Psychiatric Treatment. 2000;6(6):450-457. Doi:10.1192/apt.6.6.450
Lorås L, Bertrando P, Ness O. Researching Systemic Therapy History: In Search of a Definition. Journal of Family Psychotherapy. 2017;28(2):134–49.
Dallos, R., Draper, R. (2010). An introduction to family therapy systemic theory and practice (3rd Ed.). London: Mc Graw Hill Open University Press.
Şahan B, Akbaş T. Sistemik Psikoterapi Temelli Grupla Psikolojik Danışma Oturumlarının Katılımcıların Ayrışma Bireyleşmeye Yönelik Farkındalıkları Açısından İncelenmesi. Eğitimde Nitel Araştırmalar Dergisi. 2017;5(2):67-95. Doi: 10.14689/issn.2148-2624.1.5c2s4m
Sanberk İ., Akbaş T. (2020) Sistemik Terapi. Zeynep Karataş, Yasemin Yavuzer (Ed.), Psikolojik Danışma ve Psikoterapi Kuramları Örnek Uygulamalarla Temel ve Güncel Kuramlar içinde (s. 463-488). Ankara: Pegem Akademi Yayıncılık
Laszlo, A., Krippner, S. (1998). Systems theories: Their origins, foundations, and development. In: Advances in Psychology (pp. 47–74). Amsterdam: Elsevier
von Bertalanffy L. (1968) General Systems Theory: Foundation, Development, Application. New York: Brazillier
Stanton M, Welsh R. Systemic thinking in couple and family psychology research and practice. Couple Fam Psychol: Res Pract. 2012;1(1):14–30.
Sexton, T.L., Stanton, M. (2016). Systems theories. In APA handbook of clinical psychology: Theory and research (pp.213-239). Washington, DC: American Psychological Association.
Ludewig K. Systemic therapy – A practical implementation of systemic thinking. Kultura-Społeczeństwo-Edukacja. 2019:15(1):177–205.
Sydow Kv, Beher S, Retzlaff R, et al. (2007) Die Wirksamkeit der Systemischen Therapie/Familientherapie. Gottingen: Hogrefe
Schlippe, A.v., Schweitzer, J. (2016) Sistemik Müdahaleler. (Turan Akbaş, Çev. Ed.). 2. baskıdan çeviri. Ankara: Pegem Akademi Yayıncılık
Schlippe, A.v., Schweitzer, J. (2007). Lehrbuch der systemischen Therapie und Beratung 2: Das störungsspezifische Wisen. Göttingen: Vandenhoeck & Ruprecht
Kriz, J. (2014). Grundkonzepte der Psychotherapie. Psychologie Verlagsunion
Retzlaff R, Sydow Kv, Rotthaus W, et al. Systemische Therapie als evidenzbasiertes Verfahren – aktuelle Fakten, Entscheidungen und Aussichten. Psychotherapeutenjournal. 2009;1:4–16.
Schweitzer J, Beher S, Sydow Kv, et al. Systemische Therapie/Familientherapie. Psychotherapeutenjournal. 2007;1:4–19.
Delmonte MM. Systems Theory and Psychotherapy. J Contemp Psychother. 1989; 19
Sydow, K.v. (2015). Systemische Therapie. München: Ernst Reinhardt Verlag
Sydow K.v. (2007). Systemische Psychotherapie (mit Familien, Paaren und Einzelnen). In Psychotherapie: Ein Lehrbuch für Ärzte und Psychologen (3rd ed., pp. 290-315). Springer
Nicolai E, Schweitzer J, Weber G, et al. Woran erkennt man, das psychiatrische Organisationen “systemisch arbeiten”? Familiendynamik. 2001;26(2):117–34.
Maturana, H., Varela, F.J. (1980). Autopoeisis and Cognition. The Realization of the Living. Dordrecht, Holland/Boston, U.S.A./London, England: Reidel Publishing Co
Schiepek, G. (2004). Synergetisches Prozessmanagement- ein Beitrag zur Theorie und Praxis der Psychotherapie. In A. v. Schlippe, Kriz W.C. (Hg.) (Eds.), Personzentrierung und Systemtheorie Perspektiven für psychotherapeutisches Handeln (pp.252-268). Göttingen: Vandenhoeck & Ruprecht
Garven R, White H. Key Systemic Ideas as Seen Through the Eyes of First-Year Trainees. Aust NZJ Fam Ther. 2009;30(3):196–215.
Sydow, K.v. (2012). Evaluationsforschung zur Wirksamkeit systemischer Psychotherapie. In Handbuch Forschung für Systemiker (pp. 105-122). Göttingen: Vandenhoeck & Ruprecht
Lau M, Kristensen E. Outcome of systemic and analytic group psychotherapy for adult women with history of intrafamilial childhood sexual abuse: A randomized controlled study. Acta Psychiatr Scand. 2007;116(2):96–104. )
Elkjaer H, Kristensen E, Mortensen EL, et al. Analytic versus systemic group therapy for women with a history of child sexual abuse: 1-Year follow-up of a randomized controlled trial. Psychol Psychother. 2014;87(2):191–208.
Coulter S. Systemic psychotherapy as an intervention for post-traumatic stress responses: An introduction, theoretical rationale and overview of developments in an emerging field of interest. J Fam Ther. 2013;35(4):381–406.
Selvini Palazzoni M, Boscolo L, Cecchin G& PG. Hypothetisieren, Zirkularität, Neutralität: drei Richtlinien für den Leiter der Sitzung. Familiendynamik. 1981;6:123–139.
Schlippe, A. v., Schweitzer, J. (2016). Lehrbuch der systemischen Therapie und Beratung 1: Das Grundlagenwissen. Göttingen: Vandenhoeck & Ruprecht
Retzlaff R, Sydow Kv. Systemische Therapie mit Kindern und Jugendlichen. Psychotherapeut. 2015;60(4):295–301.
Seligman, L., Reichenberg, L.W. (2019) Psikolojik Danışma ve Psikoterapi Kuramları Sistemler, Stratejiler ve Beceriler. (E. Ercüment Yerlikaya, Çev.). Ankara: Pegem Akademi Yayıncılık
Becvar, D.S., Becvar, R.J. (2009). Family therapy: A systemic integration. (7th ed.). Boston: Pearson
Kindl-Beilfuss, C. (2018). Fragen können wie Küsse schmecken: Systemische Fragetechniken für Anfänger und Fortgeschrittene. Heidelberg: Carl-Auer
Fleuridas C, Nelson TS, Rosenthal DM. The evolution of circular questions: Training family therapists. J Marital Fam Ther. 1986;12:113–127.
Athanasiades C. Systemic thinking and circular questioning in therapy with individuals. Couns Psychol Rev. 2008;23(3):5–13.
Bleckwedel, J. (2015). Systemische therapie in aktion: kreative methoden in der Arbeit mit familien und Paaren. Göttingen: Vandenhoeck & Ruprecht
Retzlaff, R. (2010). Spiel-Räume. Lehrbuch der systemischen Therapie mit Kindern und Jugendlichen (4. Aufl.). Stuttgart: Klett-Cotta Verlag
Pérez-Álvarez M. Third-Generation Therapies: Achievements and challenges 1. Int J Clin Health Psychol. 2012;12(2):291–310.
Maturana, H.R., Varela, F.J. (2015). Bilgi ağacı: İnsan anlayışının biyolojik temelleri (M.Ü. Eriş, Çev.). İstanbul: Metis Yayınları
Hargens, J. (2013). Systemische Therapie und gut: Ein Lehrstück mit Hägar. Dortmund: Verlag Modernes Lerne
