Milan Flashcards
Primary Contributors
Palazzoli and Prata (Early Milan)
Boscolo and Cecchin (Later Milan)
positive connotation
thp will reframe negative statements to find the positive in the bxs
rituals
assignments used to shift meaning
paradoxical perscription
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
neutrality & irreverence
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
counterparadox
like the therapeuitc double bind, tell the family not to change, used to warn against premature change, to help families feel less blamed
A learning proces
Hypothesizing
team will hypothesize about the problem and what intervention will work, it will be assigned as a directive to use over the month
Team Approach
each session conducted by 2 thps, and then seen by a treatment team to discuss the session
The Invariant Prescription
severes coalition between parent and child, you create a secret between the parents and the child doesn’t get to know
Hypothesizing
teams will present an intervention from a hypothesis to the family Reframing: restating the problem in a positive way
- The Dirty Game:
(Later Milan)
Circular Questioning
asking each member questions that help address a difference or define a relationship between two other members of family
epistemology
what we know what we know
epistemological error
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
games
analogical message
digital message
metacommunication
punctuation (different than structural)
new meanings!, how people tend to define and describe events or problems
Time
the dirty game
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
circular questioning (Later Milan)
(Later Milan) asking each member questions that help address a difference or define a relationship between two other members of family
5 parts of every session
- pre session: team would meet w/out family to build hypothesis;
- session: team meets with family to check hypothesis; 3. intersession: team meets privately to discuss intervention;
- intervention: thp returns to deliver intervention to family in either positive connotation or ritual (presented paradoxically);
- Post-session discussion: team debriefs and makes plans and hypothesis for next session
Length of Time
1 session per month (10 total) over the course of a year
Called LONG TERM BRIEF THERAPY
Unit of Treatment in Milan
as many familiy members directly related to the problem, EARLY MILAN was not as concerned with family history and more focused on problem..
assumptions
- believed that famillies benefit from introduction to new ideas, mattered little whether they followed through with directives;
- systems are self-correcting
- non-pathologizing/doesn’t view person as a problem; 4. therapist effects the systems, should be monitored,
- not the expert
- if something not helpful, change it
- flexible, curious, openminded
Early Milan
-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
Later Milan - evolving model
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
Later/post Milan - Systemic
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
Later Milan -evolving model neutrality
- being connected and being avoid being caught in the coalitions and entanglements
- remain connected, but avoid being caught in coalitions and entanglements
Later Milan structure
- 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)
Boscolo and Cecchin Split
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
