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what turned therapists against strategic therapy?

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the manipulative aspect of coercing or tricking clients into changing

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what are two important insights into family therapy provided by strategic theory?

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1) families perpetuate problems with their own actions, 2) directives tailored to a particular family can bring sudden change

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strategic therapy grew out of

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communications theory - developed in Bateson's schizophrenia project

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the birthplace of all three models of strategic was

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MRI founded by Don Jackson

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paradoxical techniques (commonly used in strategic) are a result of

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Erickson's work with hypnosis

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the Milan systemic model is based on the

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MRI model

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the axioms of human communication are

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1) people are always communicating, 2) all messages have report (content) and command (statement of the relationship) functions

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Jackson's family rules are

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a description of regularity not regulation

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family rules work to preserve

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family homeostasis which serve to resist change

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communications theorists assume

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1) families are goal-oriented and rule-governed, 2) circular causality analyzed as feedback loops

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for strategics, problems are the result of

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how one responds to difficulties, not the difficulties themselves

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a first order change is

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when a specific behavior changes

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a second order change is

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when the rules of the system change

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what is reframing?

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strategic approach to changing rules, changing interpretation of behavior

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the three steps of MRI problem-solving are:

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1) identify positive feedback loops, 2) determine the family rules, 3) find a way to change the rules

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Haley added a functionalistic approach to MRI with

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his interest in interpersonal payoff of behavior and his addition of structural concepts

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Haley finds inadequate hierarchies behind

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most family problems

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Haley prescribes ordeals (Erickson technique) to

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counter a problem's payoff so that the price of continuing behavior was not worth the benefit

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Madanes incorporated

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attention to rescuing operations involved with children and parents - a functional approach

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normal families depend on two vital processes:

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1) maintaining integrity through negative feedback, and 2) amplifying innovations to adapt through positive feedback

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healthy families are able to change because they

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communicate clearly and adapt

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the MRI group does not have a theory of

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normalcy; if the family is not unhappy there is no problem - exception is Haley

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for strategic, what is the essential functions of symptoms?

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to maintain the equilibrium of the family

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the three main explanations of how problems develop for strategic are:

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1) cybernetics - caused by positive feedback loops, 2) structural - caused by incongruous hierarchies, 3) functional - caused by people trying to protect or control each other covertly

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the MRI group limits themselves to which explanation of problems?

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1) cybernetics

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what kind of strategic therapist is most likely to look for hidden power alliances?

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the Milan group

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what are paradoxical injunctions? (strategic)

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paradoxes in family communications; demanding a behavior that should be spontaneous

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what is metacommunication? (strategic)

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the way to escape paradoxical injunctions; talking about communicating

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what are double binds?

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a malignant form of paradoxical injunctions; two contradictory messages with an implicit injunction on commenting on the discrepancy. ex. asking another to express feelings and then attacking them when they do

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what is Haley's prescribing the symptom?

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demanding something involuntary be done voluntarily; it is a paradoxical injunction that forces one of the outcomes

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For the MRI school, whe way to resolve problems is to

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change the behavior that's been maintaining them

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the MRI school believes that second order changes can be the result of

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first order changes and their results

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Haley believed that changes in behavior

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alter perceptions and that telling people what they're doing wrong creates resistance

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The Milan group differs from Haley in their perception of client knowledge of issues in what way?

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The Milan group used a reframing technique of positive connotation to get families to see things differently; less behavioral, more cognitive

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The goals of an MRI assessment are:

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1) define a reasonable complaing, 2) identify attempted solutions that maintain complaing, 3) understand the client's unique language for understanding the problem

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Haley and Madanes' theory's assessment differs from the MRI assessment in what ways?

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1) he explores structural arrangements that may be contributing to the problem, especially pathological triangles and cross-generational coalitions, 2 )they also consider interpersonal payoff of actions

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Haley tends to assume that all symptomatic behavior is

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voluntary

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How is the Milan model's assessment unique

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1) it assumes an identified patient whose problems are serving a protective function for the family, 2) assessment begins with a preliminary hypothesis which is dis/confirmed in the initial session, 3) it explores the family as an interconnected web of relationships

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The MRI technique approach consists of six steps:

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1) introduce the treatment setup, 2) inquire about and define the problem, 3) estimate the behavior that is maintaining the problem, 4) set goals for treatment, 5) select and make behavioral interventions, 6) terminate therapy

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for the MRI group, solutions that perpetuate problems fall into what three categories?

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1) denial of problem; action is necessary but not taken 2) punishing something that isn't a problem; action is not necessary but is taken, and 3) trying to solve a problem within a framework that makes the solution impossible; action is taken but at the wrong level

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MRI therapists refram problems in order to

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increase the likelihood of client compliance

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paradoxical interventions are used by strategics to

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interrupt problem-maintaining sequences

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what are some reasons a strategic therapist might prescribe paradoxical interventions?

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1) hoping the clients will comply and thereby reverse attempted solutions, 2) hoping clients will rebel and resolve the behavior, 3) to expose the underlying network of relationships that maintain the problem

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Weakland's restraining technique is

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a one-down position to imply equality and helps clients to reduce anxiety and resistance.

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while the MRI approach is systematic, Haley and Madanes' approach can be thought of as

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artful

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For H&M, the definitive technique is

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the use of directives

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Haley's approach to the initial interview with the entire system consists of what four stages?

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1) social 2) problem, 3) interaction - therapist observes, and 4) goal-setting

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during what phase does Haley look for clues about triangles and hierarchies?

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the problem stage

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during what phase does Haley look for clues about coalitions?

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the interaction stage

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Haley explored the covert function of symptoms and their payoffs because

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these problems may come to play a role in interpersonal struggles in the family

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unique to the H&M technique is

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the attention to power issues, communication and how it relates to power, and how to use that info to help families comm. more equitably

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Haley uses metaphor

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to consider the symptom as a metaphor for the underlying problem

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what example is given for Haley's artful common sense?

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the high-conflict divorce

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a couple of H&M techniques are:

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1) negotiation, 2) pretend techniques (Madanes)

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what is the current form of H&M called?

answer

strategic humanism; more geared towards using the directives to teach how to soothe and love rather than to gain control

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the five parts of the standard treatment plan for the Milan group are what?

answer

1) presession, 2) session, 3) intersession, 4) intervention, 5) postsession discussion

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the early Milan model used what techniques?

answer

1) positive connotation - reframing, 2) family rituals - series of prescribed actions counter to family rules, 3) neutrality

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the second version of the Milan model emphasized what?

answer

the invariant prescription - parents would go out together mysteriously

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the final version of the Milan model emphasized what?

answer

becoming long-term and insight based, focusing on the understanding of secrets and suffering over generations

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Boscolo and Cecchin (Milan model) devised what technique

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circular questioning

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strategic therapists pioneered

answer

the team approach to therapy

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Jim Alexander, a behaviorist, devised what?

answer

functional family therapy by including some strategic ideas, though practice is still based on research

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evidence for strategic is

answer

more anecdotal than research-based

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