Contextual therapy is an approach mainly to family therapy but also to individual therapy, that was developed by Boszormenyi-Nagy. Contextual therapy can be used for many different types of mental disorders though such as a dissociative disorder. Contextual therapy integrates individual psychological, interpersonal, existential, systemic, and intergenerational parts of individual and family development.
Contextual therapy is most well-known for its four dimensions of related reality.
The four dimensions of contextual therapy include:
- Facts. Facts meaning, genetic input, physical health, ethnic-cultural background, socioeconomic status, basic historical facts, events in a person’s life.
- Individual psychology. This includes what most individual psychotherapies cover.
- Systemic transactions. This includes what systemic family therapy covers. Such as rules, power, alignments, triangles, feedback and more.
- Relational ethics. Relational ethics focus on the nature of roles and connectedness of family members, caring, reciprocity, loyalty, legacy, guilt, accountability, and trustworthiness.
Contextual therapy has an aim to induce a dialogue between family members to take responsibility of their actions. Contextual therapy consists of empathic turns towards member after member of the family, in which both acknowledgement and expectation are directed at them. It requires an appreciation of each person’s point of view, even that of the current person being victimized.
The focus and nature of contextual therapy is influenced by the ethical dimension of relationships. One such ethical concept is called multidirectional partiality. This concept focuses on the best interests of each individual, even those not in the room, and relational fairness. For example, contextual therapy cannot take a focus that would be genuinely harmful to any one family member even if it’s helpful to another.
A good example of contextual therapy would be of a family that comes into therapy to help fix their son or daughter’s outburst and defiant behavior. The contextual therapist would first gain basic information such as medical information or clinical information and maybe even a genogram. The contextual therapist would then begin to have each family member explain their side of the story in order to understand the problems in the terms of background, relational context, and motivating factors. The contextual therapist would also get a good idea of the psychological processes such as hidden loyalties, destructive entitlement, scapegoating, real or perceived injustices, and ledger imbalances.
Contextual therapy would then adapt while keeping its basic principles according to what is going on in the family. Contextual therapy allows for many different aspects and approaches to be included in the therapy. Contextual therapy focuses on the emotional healing that can occur within families. Contextual focuses on the individual but still all the family members benefit on an individual basis. Contextual therapy asks families to work on increasing fairness in their relationships. Fairness is based on an understanding of the other person’s side, being responsible and accountable for behaviors and taking action. Contextual therapy gives insight regarding the relationships with family members in order to help and lead to an exploration of actions that can be taken to balance or heal the relationships.