Milan

Question 1

Primary Contributors

Answer 1

Palazzoli and Prata (Early Milan)

Boscolo and Cecchin (Later Milan)

Question 2

positive connotation

Answer 2

thp will reframe negative statements to find the positive in the bxs

Question 3

rituals

Answer 3

assignments used to shift meaning

Question 4

paradoxical perscription

Answer 4

bxs identified, but family instructed not to change. describe in detail what act is to be done, by whom, when, and in what sequence. challenges a rigid or covert family rule

Question 5

neutrality & irreverence

Answer 5

non partiality toward family members/problems, doesn’t acknowledge a person as a flaw which allows them to be creative, they view the systems as self-correcting; multipartiality: willingness to honor all perspectives, even if they conflict

Question 6

counterparadox

Answer 6

like the therapeuitc double bind, tell the family not to change, used to warn against premature change, to help families feel less blamed

Question 7

A learning proces

Question 8

Hypothesizing

Answer 8

team will hypothesize about the problem and what intervention will work, it will be assigned as a directive to use over the month

Question 9

Team Approach

Answer 9

each session conducted by 2 thps, and then seen by a treatment team to discuss the session

Question 10

The Invariant Prescription

Answer 10

severes coalition between parent and child, you create a secret between the parents and the child doesn’t get to know

Question 11

Hypothesizing

Answer 11

teams will present an intervention from a hypothesis to the family Reframing: restating the problem in a positive way

Question 12

1. The Dirty Game:

Answer 12

(Later Milan)

Question 13

Circular Questioning

Answer 13

asking each member questions that help address a difference or define a relationship between two other members of family

Question 14

epistemology

Answer 14

what we know what we know

Question 15

epistemological error

Answer 15

people make the error of thinking they know what’s going on but do not address the relational component between each other, limited by their descriptions

Question 16

games

Question 17

analogical message

Question 18

digital message

Question 19

metacommunication

Question 20

punctuation (different than structural)

Answer 20

new meanings!, how people tend to define and describe events or problems

Question 21

Time

Question 22

the dirty game

Answer 22

how family members struggle with and against one another in order to control each other’s bxs, when members of family engage in foul bxs such as: seductions, manipulations, treachery, ambiguous promises, and betrayels

Question 23

circular questioning (Later Milan)

Answer 23

(Later Milan) asking each member questions that help address a difference or define a relationship between two other members of family

Question 24

5 parts of every session

Answer 24

1. pre session: team would meet w/out family to build hypothesis;
2. session: team meets with family to check hypothesis; 3. intersession: team meets privately to discuss intervention;
3. intervention: thp returns to deliver intervention to family in either positive connotation or ritual (presented paradoxically);
4. Post-session discussion: team debriefs and makes plans and hypothesis for next session

Question 25

Length of Time

Answer 25

1 session per month (10 total) over the course of a year

Called LONG TERM BRIEF THERAPY

Question 26

Unit of Treatment in Milan

Answer 26

as many familiy members directly related to the problem, EARLY MILAN was not as concerned with family history and more focused on problem..

Question 27

assumptions

Answer 27

1. believed that famillies benefit from introduction to new ideas, mattered little whether they followed through with directives;
2. systems are self-correcting
3. non-pathologizing/doesn’t view person as a problem; 4. therapist effects the systems, should be monitored,
4. not the expert
5. if something not helpful, change it
6. flexible, curious, openminded

Question 28

Early Milan

Answer 28

-spacing of therapeutic session, five sessions apart extended to a year
- they see the family together with one therapist and other therapist watching in a one way mirror
- they do not let the let patient move up sessions
- the idea is to help families recognize choices and assist members in exercising prerogative choosing and
moving away from identified patient
-structured sessions into 1.5 segments: pre session * first (telephone call, tone, problem, how intense), session (all met beforehand), intersession (modifying prescription, post session (reaction to the intervention).
- never joined the family game

Question 29

Later Milan - evolving model

Answer 29

Hypothesizing, neutrality and circular questioning
A. Model was changed because IDP symptoms persisted
B. Family Although seemingly stuck did not become differentiated
1) Utilized circular questioning** less focus on paradox
a) Perceptions about family who is closer to father- son or daughter- scale of 1 - 10
b) Questioning family belief system
c) Month long session become more flexible

Question 30

Later/post Milan - Systemic

Answer 30

Systemic not strategic
A. Three guidelines for conducting a session
1) Hypothesizing - speculating and making assumptions about the family
a) No true or false starting point
b) Allows therapist to search for new information and identify patterns that sustain family behavior
c) How does each family member contribute to systemic functioning
d) How does the family organized around the symptom change not truth
3) Circular questioning

Question 31

Later Milan -evolving model neutrality

Answer 31

• being connected and being avoid being caught in the coalitions and entanglements
• remain connected, but avoid being caught in coalitions and entanglements

Question 32

Later Milan structure

Answer 32

• they worked on the Milan system for ten years and then they split up
• viewed family system as the “meaning system” (rather than family system)
• moved into a systemic direction and moved away from directives and strategic techniques
• hypothesizing, neutrality, circular questioning takes every family member into account (unlike previous model focused on identified patient)
• began reducing the use of paradoxes
• goal of therapy is change not truth, proof (later model)

Question 33

Boscolo and Cecchin Split

Answer 33

treating unit as a meaning system *

• therapist as an active contributor
• the system does not create the problem, the problem creates the system
• they cannot change the family through therapeutic intervention, but can perturbed the family, if family allows it (deconstruct old family assumption)
• therapist do not always have to have the answers
• circular questioning
• neutrality
• join family
• permission to not be experts
• do not issue directives, use neutrality from observing system to the family