Strategic Family Therapy (Haley & Madanes) – Flashcards

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Interventions
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Straight Forward Directives Offer Prescription Prescribe the Symptom/Pretending Ordeal Predicting Relapse Declaring Hopelessness Offer Description Reframing Relabeling Restraining
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Straight Forward Directives
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Telling the ct in session what to do outside of the session. ex: specific directions on how a couple is to negotiate
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Prescribe the Symptom/Pretending
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IP told to practice or pretend to have the symptom while another family member helps or vice versa. ex: son has panic attacks. Therapist asks son to pretend to have a panic attack each day and asks the mother to also pretend to have panic attacks. ex: son sets fires. asking father to make this many fires with the son every day and at least one fire must be made in the middle of the night.
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Ordeal
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Making the symptom not worth it anymore to keep, harder to have than to give up. ex: if you have insomnia, you must wax the floors every night before going back to bed.
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Declaring Hopelessness
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Tell the family they cannot change and therapy is hopeless. ex: You're right, there is not hope for you...
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Predicting Relapse
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Telling the family they cannot sustain the success. ex: you've done really well, but you'll probably fail soon and have a huge blow up.
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Offer Description
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Describe the situation. ex: the two of you should be commended for avoiding confrontation. Too risky to change now.
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Strengths
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Short term. Once the symptom is gone, therapy is over. Focus on behavioral change, not insight. Based on specific goals. Pure systemic therapy, so it works for the families because they believe in the system.
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Balance of Power
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Purpose of symptom: Power struggle exists in relationships Symptomatic behavior is an attempt to gain control in relationship. Symptom: husband is withholding sex from wife. Purpose: Withholding sex is an attempt to gain control of power in the marriage. Metaphor: Rejection of wife is a metaphor for her rejection of his son. Intervention: Straight forward directives, offer prescription.
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Desire FOR Love
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Purpose of symptom: ct desires to be loved by others Symptomatic behavior is an attempt to gain attention in the relationship. Symptom: Son is setting fires Purpose: Setting fires to get attention from father. Metaphor: Setting fires to gain attention is a metaphor for wanting positive attention/to be loved by father. Intervention: Prescribe the symptom, restraining.
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Desire to Love/Protect
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Purpose of symptom: addresses the needs of someone else. Symptomatic behavior is an attempt to love someone else. Symptom: Son is depressed and refusing to go to school. Purpose: Son stays home to keep mom company. Metaphor: Son's depression was a metaphor of the mother's depression. Intervention: Straight forward directive, ordeal, reframing.
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All symptomatic behavior serves asa purpose. 3 dimensions:
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Balance of Power Desire For Love Desire to Love/Protect
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Treatment Population
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Families and couples
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Framework
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to identify the symptom and then understand the purpose and metaphor of the symptom.
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