strategic therapy (problem solving and MRI) Flashcards
founders of strategic
Milton Erikson and Gregory Bateson
explain Gregory Bateson
-Born in 1904 in Grantchester, England
Original member of the Macy Conference-met from 1946-53
Circular Causality, Feedback Mechanisms in Biological and Social Systems.
Steps to an Ecology of Mind (1972)
Cybernetics: the interdisciplinary study of the structure of regulatory systems.
Created the concept of the Double-Bind in 1957
-Was not wrong, but it was wrong in what it was causing (did not cause schizophrenia
-When non verbals and verbals do not align
explain Milton Erikson
Psychiatrist who shifted to become a hypnotist
-Believed therapy was a hypnotic process, follows the idea that there are ideas we are implanting in people
Haley refers to him as the “first therapist” since instead of devoting himself to understand the human mind, Erickson concentrated on how to change people.
He was fascinated about how to influence people. He would do so with hypnotism, directives or persuasion.
central concepts of strategic therapy
Encourage resistance (what need does the symptom satisfy)
Encourage a relapse (“Is there a part of your problem you wish to recover?”)
-By encouraging relapse in a certain time it is pinpointing the idea that this is something you can control
Encourage a response by frustrating it (“We could work on your ability to enter a restaurant, or continue discussing your upbringing”)
Re-label behavior to highlight the positive
Seed Ideas (When you no longer feel depressed…)
what models are covered under the label of strategic
-Problem Solving—Jay Haley and Cloe Madanes
Brief Interactional (MRI)—Fisch, Weakland, Jackson
Milan (Systemic)-Selvini-Palazzoli, Cecchin, Boscolo, Prata
Solution Focused-deShazer, Berg
Narrative-White and Epston
Others who have been highly influenced- MSFT & DBT & Motivational Interviewing and ACT
-Haley MRI and Milan were more influenced by Erikson
-Solution focused and narrative more influenced by Bateson
explain problem solving in strategic
In PST, the “problem” is defined as a “type of behavior that is part of a sequence of acts among several people.”
-Ex. Mourning is not a problem, has to be a way that it is a part of a repeating sequence, my mourning is preventing me from going to work
The repeating sequence of behavior is the focus of therapy.
For Haley, “depression” is a contract between people and is adaptive to a relationship.
Haley stated that, “if a symptom was a way of adapting to the current social situation it follows that therapy should focus on changing that social situation.”
Diagnosis is part of the problem. He felt that we (as mental health professionals) participate in the creation of the problem in such a way that change is made more difficult.
-By giving people certain diagnoses, this label does very little to actually help them
who to include in strategic and what is the therapist’s role
-PST advocated bringing in everyone involved.
-Client should not decide how therapy will be done. The therapist is in control of the process and responsible to create change.
four stages in first interview
social stage, problem stage, interaction stage, and task setting stage
what is the problem stage
-Question: What change do you want to see?”
-Better to be a bit vague—in essence, what do you want from therapy?
-PST recommends that the adults are acknowledged first. You want the family to return.
-Everyone should speak.
-Connections between behavior and marriage concerns are not to be made out loud.
Understanding the problem
-PST speculates that family members usually think of the problem in reference to one person, the therapist must use language to expand the problem description to include more people.
What does each person want from therapy?
The task (to be introduced later) comes directly from the problem.
The problem must be put into a form that is solvable.
Is the problem: predictable? goes away? more intense sometimes?
Allow the focus to be on the “problem person” for leverage.
-what is the interaction stage
-The family is encouraged to discuss their view of the problem among each other, the therapist can be uninvolved, if such a discussion is productive.
-Enactments are encouraged. Actions are considered more useful than are words. The therapist observes the complex organization. Are people siding with particular people? Is the child functioning as a parent?
what is the task setting stage
The problem is formulated in such a manner that something can be done about it.
Goal of a task
-Getting people to behave differently is the primary goal.
-Tasks are used to intensify the relationship with the therapist.
-Tasks are used to gather more information.
Types of Directives or Tasks
-Straightforward
-Indirect
Review the task and go over direct instructions
Involve everyone in the task, everyone should have a role
task report?
-Always check.
-If done, congratulations and move on
-Partially done, make it clear that the family must have seen the task as unimportant.
Not done
-Nice way—apologize
-Not nice—you have failed yourselves
main principles of strategic
-Symptom Oriented
-Problems are situational
-Problems grow out of everyday difficulties
-Two main ways problems develop (treat normal difficulty as problem-utopian); (take a problem and not recognize it as such-screaming is normal)
-Attempted solution increases the problem
-Problems are not chronic, just badly handled
-New behavior must interrupt repetitive loop
-If situation is sad, “I am surprised you are not more sad”
-What and how Q’s rather than why
initial steps of MRI
What is the problem bring the client into therapy?
-Try to find a workable problem to teach that any problem can be worked on or worked through
Why is this a problem for this person or family?
-Perfect Fold
Are you, the therapist, able to understand fully why this is a problem for the client?
The therapist must become less dramatically helpful.
-We fight the inclination to jump in and make it better
The client must struggle to fully grasp the problem they want to see change.
who is the customer
If the person in front of you is not the person that wants change (family, spouse, boss wants change more), then it is unlikely that therapy will help.
-Will not accept a problem that relates to someone else that is not in the room
