STRATEGIC THERAPY Flashcards
Three Major Schools of Strategic Therapy
- Haley
- Mental Research Institute (MRI-Palo Alto School)
- Milan Group
Founders
●Based on Gregory Bateson’s model of Brief Therapy ●Milton Erikson and Jay Haley are the founders.
Underpinnings
●Focuses on the process versus the content
●It is prescriptive, sometimes manipulative, and focused on the function of the whole system around it’s current homeostasis
●Basedon the premise that families are always communicating through Reports(what happens) and Commands(do something)
○Command messages are patterned as family rules.
●Family rules around the hierarchical structure are often the cause of family problems
●Strategic therapists modify and alter these rules to elicit change.
○Rules are changed by re-framing the interpretation of a behavior. For example, an overbearing meddling mother will be re-framed as concerned or looking out for the best interest of her children.
●Healthy families have the capability and willingness to adapt to changing conditions and situations.
Theory of Change
●Change results from alterations in the family system, which is seen as maintaining the presenting problem; the system is changed as the therapist provides directives that alter patterns of communication between family members.
●The presenting problem is a symptom of a larger system issue.
●Change is achieved through open and clear lines of communication, boundary flexibility and view change as an opportunity for growth.
Role of the Therapist
●The therapist becomes part of the family system through joining and delivers directives that facilitate change, particularly around patterns of communication.
●The therapist takes responsibility for the outcome of therapy.
Main Concepts
●Family Homeostasis:The rules that govern family interaction function as a method of ensuring the maintenance and preservation of the family’s current functioning level.
●Circular Causality:A system view that one family member’s behavior is caused by and causes the other family members’ behaviors. They are each impacting the other, in a circular manner.
●Feedback Loops: Information pathways that help the system balance and correct itself. Can be negative (maintains the current bias and level of functioning) or positive (changes the bias/level of functioning). For example, a problem behavior from a child may elicit a response from a parent that continues the problem or worsens it.
●Negative Feedback Loops: Ways that families correct a deviation of their family functioning and return it to the previous state of homeostasis.
●Positive Feedback Loops: This concept is central to the Strategic model. In their effort to maintain homeostasis, family members participate in new behaviors, which then create and reinforce negative communication patterns and exacerbate the problem.
●First Order Change: A particular behavior in the system is changed.
●Second Order Change: Changes in the system rules that affect a behavior change.
●Reframing: Relabeling through language to give new meaning to a situation. The alteration of meaning invites the possibility of change.
●Therapeutic Paradox:Maneuvers that are in apparent contradiction to the goals of therapy yet are actually designed to achieve them.
●Prescribing the Symptom: A strategy in which the therapist encourages or instructsthe client to engage in or practice the symptom.
●Restraining:The therapist will discourage change or changing too quickly in an effort to elicit the desire to change from the client.
Development of Behavior Disorders
●When families encounter problems that threaten to change the current family system (sometimes a healthy change), the family will try to stop the problematic behavior by engaging in other behaviors in an effort to address the perceived problem and maintain the current state of homeostasis.
●Families are stuck in dysfunctional patterns of communication and have rigid and inflexible boundaries; they view change as a threatening.
Explanation of How Problem Behaviors Develop
●Cybernetic(communication): Difficulties are turned into chronic problems by misguided solutions that maintain the problem
●Structural:Problems are the result of incongruous hierarchies, when a child uses symptoms to change the behavior of the parents.
●Functional:Problems result when people try to control one another covertly, so their symptoms serve as a function for the system.
Treatment Goals
●Identify issues that need to be addressed collaboratively with both the therapist and family.
●Goals as a result are created by both the therapist and family.
Interventions
●Homework assignments or directives are frequently used for the family to do outside of therapist.
●The therapist exaggerates the symptom in order to help the family understand how damaging the symptom is to the family.
●The connotation of one symptom is changed from negative to positive in order to give new meaning to the symptom.
