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Communications Theory

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Theory developed in Bateson's schizophrenia project in Palo Alto, later led to strategic therapy.

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Three Models of Strategic Therapy

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1) MRI's Brief Therapy 2) Haley and Madanes's Strategic Therapy 3) Milan Systemic Model

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Milton Erickson

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A hypnotist who inspired the team in Palo Alto/MRI to keep therapy brief, pragmatic, and focused on problem-solving.

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Paradoxical Interventions

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A technique in hypnotherapy that turns resistance into advantage (i.e. a hypnotist does not point out that a person is fighting going under, but instead tells the person to keep their eyes open until they become heavy)

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Mental Research Institute (MRI)

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Jackson founded this organization in 1959, bringing together a staff that included Jules Riskin, Virginia Satir, Jay Haley, John Weakland, Paul Watzlawick, Arthur Bodin, and Janet Beavin.

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Brief Therapy Project

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Promoted a brief approach to therapy based on interrupting vicious cycles that occur when attempts to solve problems only make them worse (Jackson, Fisch, Bodin, Haley, Watzlawick, and Weakland)

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Jay Haley

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-Worked with the Bateson Project and MRI before leaving to join Minuchin at the Child Guidance Clinic in Philadelphia. Later, he founded the Family Therapy Institute in Washington D.C alongside Cloe Madanes. -Unlike the Milan Group and the MRI Group (relativists), he made assessments based on assumptions about sound family functioning, and he was convinced that changes in behavior alter perceptions, as opposed to the other way around.

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Milan Group

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Inspired by the ideas of Bateson, Haley and Watzlawick, and developed the Milan Systemic Model in the late 1960s. Focused on power games in the family and often explored extended family alliances. Interested in changing cognitions. (Palazzoli, Boscolo, Cecchin, Prata) *Maintained an attitude of neutrality

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The Ackerman Institute

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Promulgated the strategic and Milan models (Papp, Bergman, Penn, Silverstein)

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Karl Tomm

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Canadian psychiatrist who interpreted the Milan model, and has developed his own ideas about the impact of the therapist on families.

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Axioms of Human Communication

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1) "People are always communicating" (even if it is unconscious) 2) "All messages have report and command functions" (the report conveys information, the command is a statement about the definition of the relationship)

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Family Rules

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The patterns of command messages; redundancies in interaction that the family is generally unaware of

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Principle of Problem Formation

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Families encounter many difficulties over the course of their lives, but whether a difficulty becomes a problem depends on how family members respond to it. Families often make misguided attempts to solve difficulties, which creates a positive feedback loop that escalates problems.

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First-Order Change

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When only a specific behavior within a system changes.

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Second-Order Change

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When the rules of a system change.

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Reframing

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A technique used to change the rules of a system by changing the interpretation of the problem.

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MRI Model

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1) Identify the positive feedback loops that maintain problems 2) Determine the rules that support those interactions 3) Find a way to change the rules in order to interrupt the problem-maintaining behavior *Resolutely opposed standards of normality

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Hierarchical Structure

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The structure upon which a family's subsystems are organized, reinforced by family rules

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Cybernetic Problem

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Difficulties are turned into chronic problems by misguided solutions, forming positive-feedback escalations (MRI Group, Haley, Milan)

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Structural Problem

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The result of incongruous hierarchies (Haley, Milan)

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Functional Problem

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Results when people try to protect or control one another covertly, so that their symptoms serve a function for the system (Haley, Milan)

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MRI Assessment

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1) Define a resolvable complaint 2) Identify attempted solutions that maintain the complaint 3) Understand the client's unique language for describing the problem

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Haley Assessment

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Begins with a careful definition of the problem, with an exploration of the possibility of structural problems and/or an interpersonal payoff of the problem behavior (general assumption that all symptomatic behavior is voluntary)

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Milan Model Assessment

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Begins with a preliminary hypothesis, which often assumes that the identified patient's problems serve a protective function for the family.

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MRI Therapeutic Approach

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1) Introduction to the treatment setup 2) Inquiry and definition of the problem 3) Estimation of the behavior maintaining problem 4) Setting goals for treatment 5) Selecting and making behavioral interventions 6) Termination

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Three Categories of Solutions

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1) The solution is to deny that a problem exists; action is necessary but not taken (i.e. son using drugs) 2) The solution is an effort to solve something that isn't really a problem; action is taken when it shouldn't be (i.e. son masturbating) 3) The solution is an effort to solve a problem within a framework that makes a solution impossible; action is taken but at the wrong level (i.e. husband buys expensive gifts for neglected wife) *MRI

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One-Down Stance

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A restraining technique in which a therapist avoids taking a directive posture. It implies equality and helps anxiety and resistance (i.e. warning families not to change too fast)

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Four Stages of Haley's Initial Session

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1) Social Stage (greeting each family member) 2) Problem Stage (ask each family member for their perspective, often asking father first to increase involvement) 3) Interaction Stage (family discusses point of view among themselves) 4) Goal-Setting Stage (directives)

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Metaphor

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When a symptomatic behavior mimics an underlying problem (i.e. an underachieving child might be a reflection of an underfunctioning parent)

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Negotiation

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When one party makes a request and the other names a price - a strategic way of reframing a problem (Keim and Lappin)

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Pretend Technique

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Technique used to encourage an individual to do something they wouldn't ordinarily do (Madanes)

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Ordeal

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Prescribed to make symptoms more trouble than they're worth, i.e. get up in the middle of the night and exercise strenuously whenever the symptoms emerges during the day (Haley)

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Strategic Humanism

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Directives more oriented toward increasing family members' abilities to soothe and love than to gain control over one another (current form of Haley/Madanes therapy)

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Five Parts of the Milan Model

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1) Presession 2) Session 3) Intersession 4) Intervention 5) Postsession discussion

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Positive Connotation

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A patient's behavior is framed as a means to preserve the family's overall harmony (Milan)

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Rituals

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Engage families in a series of actions that run counter to or exaggerate rigid family rules and myths, and/or dramatize positive connotations (Milan)

Family Therapy I: Strategic – Flashcards

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