Ch. 4 Strategic and Systemic Models Flashcards
Strategic Family Therapy
Came from which two primary sources?
- Grergory Bateson and the Palo Alto Group - cybernetics and family communication patterns
- Milton Erickson - who discovered revolutionary paradoxical interventions that capitalized on people’s natural reluctance to change to bring about rapid change in psychiatric symptoms.
The Palo Alto Group
Started with Bateson in 1953
- first joined by Jay and Weakland and later Fry
- joined by Jackson in ‘54 after he received a grant
- studied family communication patterns in people with schiz. to determine the origin of the symptoms
- used cybernetics
- viewed families as information processing systems and applied cybernetic concepts to the patterns of interaction
- double binds may cause schiz. - challenged the biological “disease” theory
Double Bind
6 characteristics
- the communication involves two or more people who have an important emotional relationship
- the pattern of communication is repeated.
- The communication involves a “primary negative injunction” or a command not to do something on threat of punishment.
- The communication involves a second abstract injunction also under threat of punishment that contradicts the primary injunction.
- A third negative injunction both demands a response and prevents escape, effectively binding the recipient of the demand
- The recipient becomes conditioned to respond, and, as a result, the entire sequence is no longer necessary to maintain the symptom.
Ex: dad demands that son engage in nightly discussion at dinner. When the kid tries to talk, the dad is irritated that his dinner is interrupted. The dad is then critical of son’s lack of conversation. The son is caught in a bind since both his attempt to talk and to be silent are punished. The meaning of communication is unclear and he develops a disordered style of communication (schiz)
Milton Erickson
- the idea of the time was that symptoms stemmed from deep psychological problems. “curing” required insight into the unconscious impulses governing the behavior.
- Erickson believed that first people had to ability to solve their own problems if they could be induced to try new behaviors
- second, that change could be swift rather than a long arduous process
- finally, the patient’s own natural resistance to change could, ironically, be used to bring about change
- known for using paradox
Paradox
- Erickson
- is a contradiction, and the interventions involving the use of paradox are based on the notion that families experiencing symptoms find it difficult, or are naturally resistant to, instituting change
- usually forbid clients to change or ask them to change in ways that run count to the desired goals
ex: farmer needs to get cow in barn. When pushes cow towards barn the cow pushes back. The farmer pulls the cows tail in the opposite direction and the cow resists and moves forward into the barn
What concepts do Strategic Therapy models combine?
What are the defining characteristics?
Concepts from the Palo Alto group and Erickson
- a focus on current family communication patterns that serve to maintain a problem
- treatment goals that derive from the problem/symptom presented
- a belief that change can be rapid and does not require insight into the causes of the problem
- the use of resistance to promote change by applying specific strategies
What are the primary strategic models?
- MRI brief therapy
- the Haley/Madanes model
- Grinder’s Neuro-linguistic programming (NLP)
MRI
- 1959 Palo Alto
- Bateson, Jackson, Satir, Haley, Weakland, Watzlwick, Bodin, and Beavin
- interested in family communication patterns and feedback loop mechanisms
- Brief Therapy Center 1967 at MRI…
- goal of treatment was to change the presenting complaint rather than interpret the interactions to the family or explore the past
- T first assess the cycle of problematic interactions, then breaks the cycle by using straightforward or paradoxical directives.
- T designs or selects a task or directive in order to solve the problem… thus the T takes full responsibility for the success or failure of treatment
MRI: Theory of normal development and dysfunction
What does MRI focus on?
- more focused on techniques for change than on theoretical constructs
- not concerned with changing the organization of a family (hierarchy, power structure)… they focus on the faulty cycles of interaction that are usually set into motion by misguided attempts to solve problems
- family’s problems aren’t linear, they are a point in a repetitive pattern (circular causality)
MRI: Theory of normal development and dysfunction
MRI therapists are guided by principles derived from…
Cybernetics (how info-processessing systems are self-correcting, controlled by feedback loops)
- negative feedback loops (correct a deviation in family functioning to bring it back to homeostasis)
- positive feedback loops (tries to add new info to the system. Assumes to be responsible for development of problems in a family as they are often attempted solutions which fail)
MRI: Assessment and Treatment
- figure out the feedback loops that govern the faulty behavior patterns by observing repetitive patterns of family interaction
- treatment is usually limited to 10 sessions
- the changes that occur through treatment are either first order or second order change.
- therapy done in teams with one T working with family and other clinicians observing from a one-way mirror
MRI: Assessment and Treatment
First-order change v. Second-order change
first order change: family patterns of interaction or sequences are altered at the behavioral level only
second order change: the family rules or underlying beliefs that govern family members’ behavior or promote specific reactions are altered. (instead of seeing a child’s acting out behavior as rebellion, see it as an attempt for help)
- family rules may be changed through reframing
MRI: Assessment and Treatment
6 step procedure for treatment
- introduction to the treatment set-up (T gathers basic info from family; explains sessions are recorded; discusses length of treatment and why multiple Ts are involved)
- Inquiry into and definition of the problem (has to be clearly defined and not vague)
- Estimation of the behaviors maintaining the problem
4 a. Setting up the goals for treatment (goals should be measurable and observable…“what will be the first signs that things are getting better?”)
b. Exploring previous attempts to solve the problem (3 general types:
the family might have…
1. DENIED a real problem (teenage SA), which suggests an intervention for the family to ACT.
2. tried to SOLVE a nonexistent problem (toddler masturbating), intervention to STOP ACTING
3. taken the WRONG ACTION (giving gifts instead of attention), intervention for DIFFERENT ACTION)
- Selecting and making behavioral interventions
a. Reframing
b. Paradoxical interventions…
ex: symptom prescription; restraining techniques; positioning - Termination (when behavioral changes are met; T explains therapy is a starting point on which the family might build)
MRI: Assessment and Treatment
Reframing
“the use of language to give new meaning to a situation”
- doesn’t have to actually be true
MRI: Assessment and Treatment
Symptom prescription
Type of paradoxical intervention. The family is requested to continue to perform or even expand the symptom
- intervention may be COMPLIANCE BASED if the T wants the family to do as suggested
- or DEFIANCE BASED when T wants family to defy the directive
