PPBC, Milan Systemic Flashcards
Milan Systemic
Palazzoli, Prata, Boscolo, Cecchin
Seen by male-female dyad and observed by other therapy team members.
Sessions always a month apart.
WHO? Whoever is related to the problem. Usually fewer.
HOW LONG? Long-term, brief therapy. 10 sessions over months.
GOALS: Integrate new beliefs, info. Helps with functioning.
EARLY Milan
Influenced heavily by MRI Group, Strategic.
Used paradoxical interventions.
Therapist dyad - one male, one female - observed live.
5 delineated parts in sessions
sessions 1 month apart, 1 year
POSITIVE CONNOTATION
RITUAL
Benefits merely from considering the issue vs doing it.
Epistemology
Milan Systemic
PPBC
How families make sense of the world, incl. relationships
Epistemological Error
Milan Systemic
PPBC
Beliefs that don’t fit/are incongruent with reality.
I’m not responsible for my behavior.
Games
Milan Systemic
PPBC
Unspoken behaviors that are destructive in families. Used to control others.
Analogical Message
Milan Systemic
PPBC
Metaphor/symbolic message - the process
Digital Message
Milan Systemic
PPBC
Objective content of message.
Metacommunication
MRi & Milan
COMMAND communication - what isn’t being said, what is being communicated about the communication.
Punctuation
MILAN - diff than structural
The way I attribute my behavior to someone else’s behavior. I nag because you don’t help
STRUCTURAL - diff than milan
therapist intentionally emphasizes someone’s body language/statement so they become conscious/can reflect
Time
Milan Systemic
PPBC
The way I view a problem - it influences how I felt about it then and how I feel about it now. If right now I feel my mom is cold, I only recall cold memories.
Milan Systemic: Assessment & Diagnosis
Assessment is ongoing.
Hypotheses based on treatment team.
Initial: phone call - expectations, presenting problem.
Team then makes hypotheses during pre-session meeting. These are adjusted as treatment continues.
Positive Connotation
Milan
PPBC
EARLY MILAN INTERVENTION - Hallmark
circularity: positiver attribute assigned to each behavior, whether desirable or undesirable.
Rituals
Milan
PPBC
EARLY MILAN INTERVENTION
Prescribed behaviors to happen at specific times of day for specific periods of time to build consistency/clarity.
Paradoxical Prescription
Milan
PPBC
EARLY MILAN INTERVENTION
Prescribing the symptom or ask family to not change.
Neutrality & Irreverence
Milan
PPBC
EARLY MILAN
Therapist’s stance - open to multiple hypotheses about behavior.
Counterparadox
Milan
PPBC
EARLY MILAN
To unravel a family’s double-bind message - your dysfunction is needed, so don’t change.
A Learning Process
Milan
PPBC
EARLY MILAN
All interventions are just for learning. Testing hypotheses, trial and error.
Hypothesizing
Milan
PPBC
EARLY MILAN
Ongoing conceptualization of what’s happening in a family. - guides questions, interventions
Team Approach
Milan
PPBC
EARLY MILAN
Team consults and discusses progress. Meets pre-session to come up with plan and hypotheses. Use of one-way mirror.
Milan Systemic Therapy Structure
Every session: 5 parts
1) Pre-Session: w/o family, make hypotheses
2) Session: meet w/family, check hypotheses
3) Intersession: Meet w/team, form intervention
4) Intervention: Deliver intervention - positive connotation, ritual. Always given as against change - use of paradox!
5) Post-Session Discussion: team debriefs, prelim plans, hypoth for next session.
LATER MILAN
Palazzoli, Prata and Boscolo, Cecchin
PP: interrupting destructive family games - used invariant prescription
BC: No use of paradoxical intervention. Intro new info. Work toward new epistemology, new ways of B. Used hypothesizing, circularity, neutrality.
The Dirty Game
LATE MILAN
Palazzoli, Prata
Parents struggle for control, then triangulate symptomatic child - then child works to defeat parents.``
The Invariant Prescription
LATE MILAN INTERVENTION
PP
3rd session
Mom/Dad tell fam you have secret. Take trip away form family. Don’t tell family more than they have a secret.
Circular Questioning
LATE MILAN INTERVENTION
Boscolo, Cecchin
Therapist - ask one fam member to comment on interactions of 2 others. Creates circularity. Helps build hypotheses.
