Systemic Family Therapy ala Milan

Question 1

Which theory most in common with? (1)

Answer 1

1. Bateson’s circular epistemology
   - focuses on information (“difference that makes a difference”), cybernetics
   - search for differences in behaviors, relationships and in one’s perception

Question 2

Model Premises of Milan Center & Milan Associates (5)

Answer 2

1. Mental phenomena reflects social phenomena (looks outside family)
2. Built on circular epistemology (recursive patterns; family decides what’s problematic)
3. Linear thinking incomplete; circular perspective incorporates larger system
4. Focus on language (breaking out of linear ways of thinking; i.e. storytelling)
   - father is depressed (linear)
   - father is showing depression (circular)
5. Change in family through meaning & action

Question 3

How Symptoms Develop? (Both Models) (3)

Answer 3

1. Symptoms = efforts made to maintain family system’s homeostatic balance
2. Symptoms seen as functional (serves system positively at the moment)
3. Reactions to symptoms - useful info about how family is organized

Question 4

Goals of Therapy (Both Models) (1)

Answer 4

• Change rules in order to change behavior (2nd order change)

Question 5

Therapy set-up - Milan Center (2)

Answer 5

Who is seen: Entire family (may involve others to increase consultation; very strategic)
Role of Therapist: Becomes part of patterns they are observing

Question 6

Therapy Process - Milan Center (3)

Answer 6

1. Team Approach - 5 part session @ 2-3 hrs; Presession (discuss fam members w/team, circular hypothesizing); Interview (done by one therapist as team watched); Intersession (break; looks at fam based on feedback); Intervention (therapist outlines steps, happens quickly); Post-session (fam interactions analysed w/team members)
2. Strong strategic influence - “rules of the game”
3. Hypothesis, Circularity, Neutrality
   H: fam would come up w/own hypothesis
   C: basis of feedback from fam; shifts thinking from individuality/linear to relational/circular questioning
   N: therapist’s effort to remain neutral, keeps curiosity

Question 7

Interventions - Milan Center (2)

Answer 7

1. Positive connotation - reframing family behavior
2. Ritual - used as experimenting; interrupt fam patterns to welcome new light; each member had new role, methodically plotted

Question 8

Further Development - Milan Associates (4)

Answer 8

1. Neutrality emphasized as more effective
2. Therapist & family both influencing forces
3. Therapist not responsible for outcome; family finds own answers
4. Family does not create the problem; the problem creates the system

Question 9

Therapy Process - Milan Associates (1)

Answer 9

• Continued use of Team Approach (5 part session)

Question 10

Interventions - Milan Associates (1)

Answer 10

1. Circular Questions with goal of eliciting difference
   - difference in perception of relationships
   - difference in degree
   - now & then differences
   - hypothetical or future differences