Gladding Ch. 14 - Strategic Family Therapies Flashcards
Strategic System: Premise
● Allows individual members to work on their own unique needs through interaction, dialogue, and engagement of all family members ● Emphasis on identifying problems in the family structure ● Very brief with little focus on insight
Strategic System: Key Figures
s ● Jay Haley ○ Collaborated with Bateson ○ Mental Research Institute (MRI) ○ Instructure for Family Counseling (IFC) ● Cloé Madanes ○ Mental Research Institute (MRI) ○ Therapy Institute of Washington
Strategic System: Treatment & Techniques
Reframing: involves the use of language to
induce a cognitive shift within family
members and alter the perception of a
situation. In reframing, a different
interpretation is given to a family’s
situation or behavior.
Directive: is an instruction from a family
therapist for a family to behave differently.
“The direc-tive is to strategic therapy what
the interpretation is to psychoanalysis.
Paradox: Although fine distinctions can be
made between them, this process is very
similar to prescribing the symptom. It gives
client-families and their members permission to do something they are
already doing and is intended to lower or
eliminate resis-tance.
Strategic System: Treatment & Techniques, ctd
1. Restraining: the therapist tells the client-family that they are incapable of doing any-thing other than what they are doing. 2. Prescribing: Family members are instructed to enact a troublesome dysfunctional behavior in front of the therapist. 3. Redfining: is attributing positive connotations to symptomatic or troublesome actions. The idea is that symptoms have meaning for those who display them, whether such mean-ing is logical or not.
Strategic System: Treatment & Techniques, ctd 2
Ordeals: involves helping the client to give
up symptoms that are more trouble-some to
maintain than they are worth. In this
method, the therapist assigns a fam-ily or
family members the task of performing an
ordeal in order to eliminate a symptom.
Pretend: is a gentler and a less confrontive
technique than most of the other procedures
used in strategic family therapy
Positioning: The act of positioning by the
therapist involves acceptance and
exaggeration of what family members are
saying. If conducted properly, it helps the
family to see the absurdity of what they are
doing. They are thereby freed to do
something else.
Strategic System: Role of Therapist
- Attempting to define the problem so the
family has voluntary control over and
involves a power struggle and helping the
family make changes altering the dynamics
and competitive stance to a position. - Being overtly active in sessions
- Use presenting problems as ways to bring
about change in
families by giving them tasks that are
usually carried out between sessions,
Strategic System: Process & Outcome
- Is to resolve, remove, or ameliorate the
problem the family agreed to work on. - Breaking up the vicious cycles and
replacing it with virtuous cycles
Strategic System: Unique Aspects
- Flexibility as a viable means of working
with a variety of clients-families. - Most therapists who use it believe real
change is possible at the individual and
dyadic level. Meaning the entire system
doesn’t need to always be involved in lower
order change. - Focuses on innovation and creativity
- The way it can be employed with a
number of other therapies (particularly
behavioral and structural family therapy
Strategic System: Comparison w/ other theories
- It concentrates on one problem at a time.
- Can be considered “cookbookish” and
“mechanical” due to the methods used by
certain subgroups of this system. - The view on schizophrenia in which
Haley doesn’t recognize its existence. - The skills required to implement some of
its methods. - Concerns on time and emphasis in most
practitioners of this school believe in
restricting the number of sessions. - Lack of collaborative input of the
client-families. Certain models rely on the
power technique and expertness of the
therapist
Milan Systemic Family System: Premise
Stresses the interconnectedness of family
members while also emphasizing the
importance of second-order change in families.
● Therapists will take a systemic view of the
problems and a strategic orientation to change
● Therapeutic neutrality is one of the main pillars
in this system’s approach.
Milan Systemic Family System: Key Figures
Mara Selvini Palazzoli:
○ Specialized working with eating disorders.
○ Lead a group of eight psychiatrists who were
working to integrate psychoanalytic ideas to
family therapy.
○ Broke from the strategic model and founded
the systemic approach.
○ Contributed to the formation of the Center for
the Study of the Family in Milan in 1971
○ Highlighted the importance of breaking the
cycle of games within the family system
○ Additional contributors: Luigi Boscolo,
Gianfranco Cecchin, Guiliana Pata, Karl
Tomm, Joseph Eron, Peggy Papp, Olga
Silverstein, Peggy Penn, Richard Rabkin, Joel
Bergman, Carlos Sluzki, James Coyne, and
Thomas Lund
Milan Systemic Family System: Techniques & Treatment
Hypothesizing: central part of the system
approach. It is the formulation by a therapist based
upon info the therapist possesses on the family and
involves a meeting of a treatment team prior to the
arrival to formulate and discuss aspects of the
family’s situation that could be generating a
symptom.
Positive Connotation: is a type of reframing in
which each family member’s behavior is labeled as
benevolent and motivated by good intentions.
Questions: an effective way to introduce news of
differences among family members into the family
system
Milan Systemic Family System: Techniques & Treatment, ctd
Circular questinoing: focuses attention on connections through framing
every question so that it addresses differences in
perception by family members about events or
relationships
Invariant Prescriptions: involves a specific kind
of ritual, and it is given to parents with children
who are psychotic or anorexic in an attempt to
break up the family’s dirty game, that is, a power
struggle between generations sustained by
symptomatic behaviors
The invariant prescription requires parents to unite
so that children cannot manipulate them or
stereotype them as “winners” or “losers” and
thereby side with them
Variant prescription: is given for the same
purpose as an invariant one. The difference is that a
variant prescription is tailored to a particular family
and considers unique aspects of that family.
Rituals: assigning rituals is an attempt to break up
dysfunctional rules in the family. Additionally,
rituals are specialized directives that are meant to
dramatize positive aspects of problem situations.
Effective rituals are specific in describing what is to
be done, who is to do it, and how it is to be done.
Milan Systemic Family System: Role of the Therapist
- The therapist is both an expert and “a co-creator
of the constantly evolving family system” - The therapist in these roles takes a non blaming
stance, gives directives, and is neutral to the point
of even avoiding the use of the verb “to be” - The therapist does not usually try overtly to
challenge or change families. Instead, the therapist
takes a paradoxical position of being a change
agent who argues against change
Milan Systemic Family System: Process & Outcome
- Family symptoms are removed, and family
members experience how they are interlinked. - Family members give up outdated ideas.
- Change focuses on breaking up vicious cycles of
interaction and replacing them with virtuous cycles.
