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Strategic- Source of Strategic- Source of motivationmotivation
Normal families are:Normal families are: Flexible enough to modify Flexible enough to modify
solutions that do not work.solutions that do not work. Flexible enough to adjust to Flexible enough to adjust to
development. development.
Strategic- View of human Strategic- View of human naturenature
Positive feedback loops- . Positive feedback loops- . Hierarchy and structure in families.Hierarchy and structure in families. People can be temporarily off People can be temporarily off track track Symptoms are the result of Symptoms are the result of misguided attempts at changing an misguided attempts at changing an existing difficulty.existing difficulty.Attempted solutions to the Attempted solutions to the problem are what maintains the problem are what maintains the problem.problem.
Strategic- View of Strategic- View of human naturehuman nature Symptoms and attempted Symptoms and attempted
solutions are imbedded in a solutions are imbedded in a recursive feedback situation.recursive feedback situation.
Symptoms are a homeostatic Symptoms are a homeostatic mechanism regulating marital or mechanism regulating marital or family transactions.family transactions.
The focus is not so much on The focus is not so much on family therapy theory, as it is no family therapy theory, as it is no the theory of what contributes to the theory of what contributes to change.change.
Strategic- View of Strategic- View of human naturehuman nature Feedback loop is a positive loop that Feedback loop is a positive loop that
equals: problem – attempted equals: problem – attempted solutions – more problems – more solutions – more problems – more (greater) attempted solutions, etc. (greater) attempted solutions, etc. Positive feedback loop says keep Positive feedback loop says keep going in the direction. The answer going in the direction. The answer is a negative feedback loop is a negative feedback loop (restraint of any of the points in the (restraint of any of the points in the system) or 180system) or 1800 0
change.change.
View of problemsView of problems
Relativistic view of family life as Relativistic view of family life as well as human behavior.well as human behavior.
Neutrality with respect to life.Neutrality with respect to life. Problems are only defined as such Problems are only defined as such
by those who are involved and by those who are involved and who believe them to be problems.who believe them to be problems.
Strategic- Development Strategic- Development of pathologyof pathology
Problems maintained through Problems maintained through misguided solutions. (attempted misguided solutions. (attempted solutions). solutions).
Problems in hierarchy or structureProblems in hierarchy or structure Functional problems- Members try Functional problems- Members try
to protect or control others. to protect or control others. (no longer seen as a function of (no longer seen as a function of the symptom but as a misguided the symptom but as a misguided attept to correct the problem.attept to correct the problem.
Strategic- BriefStrategic- Brief Nature of problems Nature of problems
Problems are typically situational Problems are typically situational Adapting to life changes Adapting to life changes Treat ordinary problems- Treat ordinary problems- overemphasis overemphasis Treat difficult problems- Treat difficult problems- underemphasis underemphasis Problems maintained through Problems maintained through positive feedback loops positive feedback loops
Strategic conceptsStrategic concepts First order change – is a difference that First order change – is a difference that
occurs within a system according to the occurs within a system according to the rules of that system. (compliance) we rules of that system. (compliance) we think it is a logical change to a problem.think it is a logical change to a problem.
Second order change – a change in the Second order change – a change in the rules of the system, thus the change is rules of the system, thus the change is within the system. (operating principles within the system. (operating principles are changed) It is outside the box are changed) It is outside the box change that effects the whole system – change that effects the whole system – Tx, Pt., Etc.Tx, Pt., Etc.
Manipulation is unavoidable (all Manipulation is unavoidable (all relationships have hidden agendas).relationships have hidden agendas).
Connect the dots using Connect the dots using only four straight lines.only four straight lines.
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Strategic conceptsStrategic concepts Utilization – using persons Utilization – using persons
strengths to effect change.strengths to effect change. One down vs. one up – utilizing One down vs. one up – utilizing
hierarchy and complementarity hierarchy and complementarity as a means of changing patterns.as a means of changing patterns.
Rituals – forcing changes in Rituals – forcing changes in patterns through ordeals. patterns through ordeals. (breaking up is hard to do)(breaking up is hard to do)
Tasks will compress to the time Tasks will compress to the time allotted.allotted.
Strategic conceptsStrategic concepts Implications (Illusion of alternatives)Implications (Illusion of alternatives) Metaphors – unconscious bypassMetaphors – unconscious bypass Directives - homework – (poor Directives - homework – (poor
grades, but high ability)grades, but high ability) ReframingReframing Restraining – go slow, there are Restraining – go slow, there are
costs and reasons not to change so costs and reasons not to change so quickly.quickly.
Positive Connotations – No one can Positive Connotations – No one can change when the system has a change when the system has a negative connotation of them. negative connotation of them.
Strategic Therapy foundersStrategic Therapy founders
MRI – Brief therapy; communications MRI – Brief therapy; communications theory, theory of change (not theory, theory of change (not therapy). (second order change)therapy). (second order change)
Jay Haley – (Milton Erickson’s Jay Haley – (Milton Erickson’s hypnosis) and later adding Minuchin’s hypnosis) and later adding Minuchin’s structural work. Think structural, work structural work. Think structural, work strategic.strategic.
(The purpose of therapy is behavior (The purpose of therapy is behavior change, not insight).change, not insight).
Milan Team – Paradox and Counter Milan Team – Paradox and Counter paradox, prescribing the symptom, paradox, prescribing the symptom, Batesonian view of systems.Batesonian view of systems.
Milton H. Erickson, M.D.Milton H. Erickson, M.D.
Each person is a unique Each person is a unique individual. Hence, psychotherapy individual. Hence, psychotherapy should be formulated to meet the should be formulated to meet the uniqueness of the individual’s uniqueness of the individual’s needs, rather than tailoring the needs, rather than tailoring the person to fit the Procrustean bed person to fit the Procrustean bed of a hypothetical theory of human of a hypothetical theory of human behavior.behavior.
When presented with Christ, have When presented with Christ, have Him make bookshelves.Him make bookshelves.
Jay Haley & Cloe Jay Haley & Cloe MadanesMadanes Jay Haley Jay Haley is widely acclaimed as a is widely acclaimed as a
pioneering therapistpioneering therapist and and master master teacherteacher. Haley has served as Professor at . Haley has served as Professor at the University of Maryland, Howard the University of Maryland, Howard University, the University of Pennsylvania University, the University of Pennsylvania and US International University. He was and US International University. He was Director of Family Therapy Research at the Director of Family Therapy Research at the Philadelphia Child Guidance Clinic and Co-Philadelphia Child Guidance Clinic and Co-Founder of the Family Therapy Institute of Founder of the Family Therapy Institute of Washington, D.C.Washington, D.C.
Hallmarks are redefining the symptom as Hallmarks are redefining the symptom as behavioral and solvable, using directives, and behavioral and solvable, using directives, and paradoxical interventions. Use of pretend to paradoxical interventions. Use of pretend to work around resistance. work around resistance.
MRI MRI From the roots of communications From the roots of communications
theory, the MRI provides a simple yet theory, the MRI provides a simple yet effective method of change.effective method of change.
Determine customershipDetermine customership Assess the presenting problemAssess the presenting problem Determine the attempted solutionsDetermine the attempted solutions Get commitment to try a 180Get commitment to try a 180
00
Assess outcome and either retry or Assess outcome and either retry or terminate.terminate.
Treatment failures are seen as the Treatment failures are seen as the result of the therapist either result of the therapist either misunderstanding the problem, or not misunderstanding the problem, or not communicating well.communicating well.
Milan TeamMilan Team
Batesonian view of systemsBatesonian view of systems Respect for system’s own wisdomRespect for system’s own wisdom Paradoxical intentionsParadoxical intentions Reframes families reluctance as Reframes families reluctance as
their wisdom at not wanting to their wisdom at not wanting to change or rock the boat.change or rock the boat.
Use of team and long breaks in Use of team and long breaks in beteen sessions.beteen sessions.
Strategic- Nature of changeStrategic- Nature of change Primary goal is resolution of presenting Primary goal is resolution of presenting
problem. problem.
The guidepost of change is to assess The guidepost of change is to assess level of commitment to change.level of commitment to change.– Customer (involved in all dimensions, Customer (involved in all dimensions,
agreement with goals, treatment process, agreement with goals, treatment process, assessment of outcome)assessment of outcome)
– Complainant (someone else is the problem Complainant (someone else is the problem – goal is to get them to either bring in the – goal is to get them to either bring in the person that they complain about, or find person that they complain about, or find ways of changing their own behavior that ways of changing their own behavior that will create other changes – Weiner-Davis)will create other changes – Weiner-Davis)
– Visitor (checking Tx out – goal is to make Visitor (checking Tx out – goal is to make them comfortable so that they might them comfortable so that they might engage at a later time)engage at a later time)
Strategic- Brief Strategic- Brief theraptherapy y
Weakland, Watzlawick, & Bodin Weakland, Watzlawick, & Bodin MRI Brief therapy:MRI Brief therapy: 10 one hour weekly sessions10 one hour weekly sessions Attempted solutions are the problemAttempted solutions are the problem Bigger Hammer theory – doing more of Bigger Hammer theory – doing more of
the same, rather than finding new the same, rather than finding new alternatives. Work to change sequence alternatives. Work to change sequence – do something different.– do something different.
Strategic- Brief therapyStrategic- Brief therapy Philosophical Philosophical assumptions assumptions
Problems maintained in families Problems maintained in families by behavior. by behavior.
If problem-maintaining behavior If problem-maintaining behavior changes, problem changes.changes, problem changes.
Minor changes or re labeling leads Minor changes or re labeling leads to behavior change to behavior change
Strategic TechniquesStrategic Techniques
Therapeutic change comes about through Therapeutic change comes about through and interactional process that occurs and interactional process that occurs when a therapist intervenes actively and when a therapist intervenes actively and directively in a system.directively in a system.
The therapist works to substitute new The therapist works to substitute new behaviors or sequences for the vicious, behaviors or sequences for the vicious, positive feedback circles already existing.positive feedback circles already existing.
The goal is to change the dysfunctional The goal is to change the dysfunctional sequences of behavior.sequences of behavior.
Strategic TechniquesStrategic Techniques
The utilization of tasks and directives The utilization of tasks and directives is the cornerstone of this approach.is the cornerstone of this approach.
The problem must be put in some The problem must be put in some solvable form. It must be something solvable form. It must be something that is objectively agreed upon, so all that is objectively agreed upon, so all can assess the outcome (poor self-can assess the outcome (poor self-esteem is not a good goal, unless esteem is not a good goal, unless accompanied by behavioral tags).accompanied by behavioral tags).
Strategic TechniquesStrategic Techniques
Considerable emphasis is placed Considerable emphasis is placed on extra-session (outside of on extra-session (outside of sessions) change – altering the sessions) change – altering the process occurring outside the process occurring outside the sessions. The use of directives, sessions. The use of directives, homework, experiments, etc. are homework, experiments, etc. are used to create opportunities.used to create opportunities.
Strategic TechniquesStrategic Techniques
Power struggles with the family Power struggles with the family (client) are generally avoided, the (client) are generally avoided, the tendency being to take the path of tendency being to take the path of least resistance and use indirect least resistance and use indirect ways of turning the family’s ways of turning the family’s involvement into positive use.involvement into positive use.
Positive interpretation to the client Positive interpretation to the client of its symptoms or motives and of its symptoms or motives and homeostatic tendencies are homeostatic tendencies are employed.employed.
Strategic TechniquesStrategic Techniques
Paradoxical interventions, Paradoxical interventions, restraining change, “go slow” restraining change, “go slow” messages, and prescribing the messages, and prescribing the symptom are typical techniques symptom are typical techniques used in strategic therapy, and used in strategic therapy, and may be directed toward the may be directed toward the whole family or to certain whole family or to certain members.members.
Strategic- BriefStrategic- Brief Goals for change Goals for change
Small, concrete, behavioral goals Small, concrete, behavioral goals Interrupt feedback loops Interrupt feedback loops
Strategic- Brief- Stages Strategic- Brief- Stages of treatmentof treatment
Introduction to treatment Introduction to treatment Definition of problem Definition of problem Estimation of behavior maintaining Estimation of behavior maintaining problem problem Setting treatment goals Setting treatment goals Selecting and making interventions Selecting and making interventions
Termination, evaluation and resultsTermination, evaluation and results
Strategic- MadanesStrategic- Madanes Conceptualizing Conceptualizing problems problems
Involuntary vs. voluntary behavior Involuntary vs. voluntary behavior Helplessness vs. power Helplessness vs. power Metaphysical vs. literal sequences Metaphysical vs. literal sequences Hierarchy vs. equality Hierarchy vs. equality Hostility vs. love Hostility vs. love Personal gain vs. altruism Personal gain vs. altruism
Strategic- MadanesStrategic- Madanes Goals of therapy: Goals of therapy:
To dominate and control- Fear To dominate and control- Fear Correct hierarchy Correct hierarchy Negotiations and contracts Negotiations and contracts Changing benefits Changing benefits Rituals and ordeals Rituals and ordeals
Strategic- MadanesStrategic- Madanes Goals of therapy: Goals of therapy:
To be loved- Desire To be loved- Desire Change parental involvement Change parental involvement Prescribe the symptom Prescribe the symptom Prescribe a symbolic act Prescribe a symbolic act Prescribe pretending of symptom Prescribe pretending of symptom
Strategic- MadanesStrategic- Madanes Goals of therapy: Goals of therapy:
To love and protect- Despair To love and protect- Despair Reunite family members Reunite family members Change who is helpful to whom Change who is helpful to whom Empower children to be helpful Empower children to be helpful Orient to future Orient to future
Strategic- MadanesStrategic- Madanes
Goals of therapy: Goals of therapy: To repent and forgive- Shame To repent and forgive- Shame 16 step process 16 step process
Strategic- MadanesStrategic- Madanes
Eliminate secrets Eliminate secrets Discuss offense Discuss offense Spiritual pain Spiritual pain Spiritual pain of victimizer Spiritual pain of victimizer Pains of victimizer Pains of victimizer Spiritual pain of family Spiritual pain of family Victimizer repents Victimizer repents Family repents Family repents
Strategic- MadanesStrategic- Madanes Discuss consequences Discuss consequences Meet victim alone Meet victim alone
Find protector Find protector Reparation Reparation Orient to normal life Orient to normal life Restoration of love Restoration of love Restore victimizer Restore victimizer Offender self-forgiveness Offender self-forgiveness
Connect the dots using Connect the dots using only four straight lines.only four straight lines.
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