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Milan Systemic Approach to Family Therapy
Transcript of Milan Systemic Approach to Family Therapy
Mara Selvina Palazzoli
"Milan Group" founded Milan Group Center for study of family in 1971
biologist/anthropologist Gregory Bateson, and the strategic therapist, Paul Watzlawick
The Milan Approach initially proposed that pathological behavior was the result of individuals being isolated or caught in the power struggles to maintain particular family relationships
therapy attempted to offer insight into the struggle for control of the family relationships , often over several generations. It also attempted to counter the family's resistance to change.
In 1980 the Milan Group split
Boscolo and Cecchin went in to training and later exploring constuctivism
Selvini Palazzili and Prata focusing on research with the invariant prescriptions and anorectic families.
The study of knowledge and knowing
Must acknowledge reciprocal cause and effect
Lack of results in systemic “crisis”
Erroneous set of beliefs or distinctions that individual or family uses to make sense of the world
Unacknowledged strategies and destructive patterns of family interaction in which members attempt to control each other’s behavior
Power is in the rules of the game which cannot be changed by the family involved in it
The aim is to change to rules of the game rather than change the players of the game
Meaning Vs. Action
Therapist helps separate between meaning and action to help correct epistemological errors
The interpretation (ex., disrespectful) is separated from the act itself (ex., does not follow rules)
The new distinction allows for creation of new belief patterns followed by new behavioral patterns
Tyranny of Linguistics
Language is linear construct that is used to describe reality, which is a circular construct
Generally assumed that distinctions made by language are correct
Therapist uses language to create new interpretations of family situations
Families should have clearly defined generational boundaries
Therapy should be neutral and not have expectations of families
Therapy is intended to help the family examine its structure and expose games
Aids in redesigning family structure for better functioning
Problematic family development is a functional issue. One member develops symptoms to control others
Conditions for Change
Resistance low and motivation high
Identify the most motivated family member
Structure of therapy
Long-term brief therapy
10 sessions at monthly intervals or longer
Uses a team approach with a male and female therapist
Community Resources and Referrals
Invitations are sent to all “possible players” of the “family game” to attend
oWhen family or other refuse to attend -therapy sessions postponed
The group’s main role is to resolve epistemological errors in the families thinking.
Linguistic conditioning and language limits emphasize unconscious linear thinking.
“The unconscious “tyranny of linguistics” can with conscious effort be mitigated into a semblance of circularity”
In this approach the therapists work as a group. One or two therapists work with the family and the rest typically watch behind a one way mirror.
“The relationship between the therapists and family, while overtly a friendly one, is covertly and adversary relationship. The therapists design their interventions to produce resistance in the family, which in turn will produce behavior that the therapists consider therapeutic.”
The team remains neutral in its approach and maintains a “curiosity in which the therapist is equally curious and interested in each person’s description of the problem rather than a form of neutrality that is distant and aloof”
“The therapist acts as a catalyst, and the goal is to activate a process in which the family creates new patterns of behavior and belief that are supportive fo the creation of more new patterns”
“The therapists formulate hypotheses that are described as metaphoric explanations about what purpose the symptom serves in the family and how the family organizes itself around the symptom. The hypotheses are used, set aside, or revised until the team has formulated the hypothesis that offers the best understanding of the family dynamics supporting the client’s symptoms. Possible hypotheses are restricted to those describing circularity. ”
The therapists will use circular questioning to highlight systemic interaction patterns in the family in an attempt to bring unconscious linear thinking patterns into circular conscious thought.
Milan Systemic Interventions
A Learning process
Therapist remains neutral (curiosity)
oParents realign together (secretive about content of parents only therapy session)
oParents go on outings (secretive to everyone about location and activities)
oSecretive even when asked by children
oJournaling children’s verbal and non-verbal reactions to the prescription.
Goals of Treatment
•New meaning & distinctions
•Elimination of dysfunctional patterns
•One person can change a system (focus on the most “motivated person”)
Systemic Family Interventions
Exploring exceptions to presenting problems
Identifying and Interrupting Negative Interactional Patterns
Identifying family strengths
Initiating absent family members to session
• Focus on changes to Family Game
o Palazzoli exposed “dirty games”
o Boscolo wanted to understand the games
o Boscolo wanted the family make their own changes
Long-Term Brief Therapy (10 sessions, once/month)
Role of Therapist
History of Milan Systemic Apprach
Theorist Who Developed this Approach
Role of the Unconscious Processes
Bevcar, Dorothy Stroh., & Bevcar, Raphael J. (2006). Family Therapy A Systemic Integration. Boston, MA: Pearson Education Inc.
Campbell, D. (1999). Family therapy and beyond: Where is the Milan systemic approach today? Child Psychology & Psychiatry Review, 4, 76-84
Gehart, Diane R., & Tuttle, Amy R. (2003) Theory-Based Treatment planning for Marriage and Family Therapists. Pacific Grove, CA: Thompson & Brooks/Cole.
Kemenof, S., Worchel, F., Prevatt, B., & Willson, V. (1995). The effects of video feedback in the context of Milan systemic therapy. Journal of Family Psychology, 9, 446-450.
Minuchin, Salvador., & Fishman, Charles H. (1981). Family Therapy Techniques. London, England: Harvard University Press.
Niolon, R. (1999, December). Strategic family theory and therapy. Retrieved fromhttp://www.psychpage.com/learning/library/counseling/strategic.html
Tomm, K. (1984). One perspective on the Milan systemic approach: Part 1. overview of development, theory and practice. Journal of Marital and Family Therapy, 10, 113-125.
The Milan group attempted to put into practice the systemic idea, by viewing family interactions as a set of rules that best intervened upon with paradox.
other contributors to the Milan approach include Lynn Hoffman, Karl Tomm, and Peggy Penn