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Strategic Models of Family Therapy

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Eli Johnerson

on 25 March 2011

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Transcript of Strategic Models of Family Therapy

Strategic Models Strategic and Structural family therapy has been heavily influenced by Bateson's cybernetics model. They are mostly intent upon changing behavior rather than insight, and as such are famous for creative interventions. There are 3 main models in this theory. MRI’s brief therapy model: (mental research institute) o First order change: when the specific behavior changes within the system.
§ Example: a temperamental child changes and is no longer temperamental
o Second order change: the rules of the system change
§ Example: by reframing, the father seeing the child’s behavior
as temperamental when he truly fears they love the sister more than him Inspired by Gregory Bateson and Milton Erikson
Don Jackson founded the MRI in 1959
Brief MRI: was an active approach, focused on the presenting symptom and limited to ten sessions
Problems form based on the family’s response to the problem. Families often try to make solutions to solve their difficulties but worsen the problem by more of the same attempted solutions.
Problems arise through forming positive feedback explanations. Two types of changes that can fix the problem: Give scenario!!




o 1. Introduction to the treatment setup, 2. Inquiry and definition of the problem, 3. Estimation of the behavior maintaining the problem, 4. Setting goals for treatment, 5. Selecting and making behavioral interventions, 6. Termination
o One-down stance: Implies equality and invites clients to reduce anxiety and resistance. Puts them on the same level, unlike Haley’s approach.
o Paradoxical interventions: Counterintuitive techniques. Telling the client to continue or embellish the behavior that is complained about. Theoretical Formulations: o First: identify the positive feedback loops that maintain problems
o Second: determine rules or frames
that support those interactions
o Third: find a way to change the rules Goals of Therapy:
o Proudly minimalistic, once problem is resolved therapy is concluded
o “ As therapists, we do not regard any particular way of functioning, relating, or living as a problem …” (p 150)
§ MRI therapists only address the problems that are given and the therapist prevents taking a position on how the family should behave.
o MRI model is behavioral and its goals focus on observable patterns of interactions and avoid intrapsychic intentions
o Assessment: 1) Define a resolvable complaint, 2) Identify attempted solutions that maintain the complaint, 3) Understand the clients’ unique language for describing the problem
The MRI Approach: Current form of Haley/Madanes therapy is called strategic humanism. Still gives directives, but they are more oriented toward increasing family members’ abilities to
soothe and love than to gain control over one another. Increase harmony! Haley and Madanes Approach: Jay Haley had no clinical credentials when he entered the field. He was sarcastic in his writings and redefined psychoanalysis as a game of “one-upmanship.”

* An effective therapist isn’t one who just tells people what to do, but one who gets them to do it. 4 Stages of Therapy:
1. Social Stage:
- Greet everyone in the family.
- Help them feel relaxed and comfortable.

2. Problem Stage:
- Speak to the father first to increase his involvement.
- Ask each person for his/her perspective on situation

3. Interaction Stage:
- Encourage the family to discuss their points of view among themselves.
- Therapist observes interactions and looks for coalitions and hierarchy.
- Can end first session with a task for the family to complete.

4. Goal Setting Stage:
- help families find new ways to solve their problems. - Metaphor = when a child seems to have a problem, but they are really creating this problem in order to distract from a deeper problem within another family member.

- People’s struggles have meaning, and he wanted to suggest reasonable solutions in order to help the deeper meaning of the problem. - One way family members can hold power is through symptoms. (such as
depression, substance abuse, phobias, etc.) does not always happen on a conscious level.

- Paradoxical intervention = pretend techniques and ordeals. - Shift in the Milan model resulted in one of the most useful and frequently used
techniques— Circular questions: designed to decenter clients by orienting them toward seeing themselves in a relational context from the perspective of other family members

- This technique is what is will be demonstrated in the skit…. Milan model Highly scripted therapy

Both a male and female therapist, as well as a small team of observers who dialoguewith the therapists

Saw issues as being rooted in the family, not the individual—therefore, any behavior/communication changes in the intervention involved the family as a whole.

Unlike the other Strategic approaches, took into account how the history of the family has effected where they are now—maladaptive circular processes develop over time - Positive connotation: reframing symptoms in the family, to be seen as a protective factor.

Ex: a depressed child who’s trying to distract his parents from their marital problems

- Rituals: used to engage families in a series of actions that are counter to or exaggerate rigid family rules and myths The Mental Research Institute (MRI) - Started by Jackson who worked with Bateson, as well as with Haley on the Bateson project. The Haley and Madanes Strategic approach- They were heavily influenced by Erikson, Bateson, and Minuchin. Erikson believed the unconscious was full of wisdom - thus, he didn't need to give people insight, just help them get access to it on their own. The Milan Model - Palazzoli was a prominent Italian psychoanalyst. She and her team of 8 other analysts read the works of Bateson, Haley… and did lots of research. In 1980, they split, with ½one continuing research and the other doing training. - Pre-session
- Session
- Inter-session
- Intervention
- Post-session Therapy consists of… Therapy techniques… Therapy techniques cont’d… Madanes: Strategic therapeutic strategies All were commited to altering destructive patterns of communitcation
Focus their techniques on a problem-centered approach
Pragmatic focus on changing behavior
Have a predetermined approach to their therapy session (Strategic) Differences between 3 models MRI- Strictly interactional/Avoids the intentions of behavior

Haley/Madanes- Interested in motives/Required structural change/improvements to family heirarchy

Milan- focus on multi-generational games that surrounded symptoms/powerful interventions to expose meaning of problem QUESTIONS ABOUT.... ?
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