Structural Family Therapy and Strategic Family Therapies
Strategic Family Therapy
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Strategic Family Therapies
Strategic Family Therapies are method oriented and brief in duration.
Influenced by the work of Milton Erickson
Three distinct branches of strategic family therapy
The strategic family therapists of the mental research institute
The strategic family therapists of the Family Therapy Institute (Jay Haley)
The strategic family therapists of the Milan Institute
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Strategic Family Therapy: Influence of Milton Erickson
The term, strategic therapy, was coined by Jay Haley to describe the work of Milton Erickson
Milton Erickson
Especially attuned to the power of the unconscious mind as a creative, often positive, solution-generating entity
Paid particular attention to details of the symptoms his clients presented
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Milton Erickson
Achieved his objected in therapy through the following procedures:
Accepting and emphasizing the positive
Using indirect and ambiguously worded directives
Encouraging or directing routine behaviors so that resistance is shown through change and not through normal and continuous actions
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Major Strategic Theorists
Paul Watzlawick
John Weakland
Jay Haley
Cloé Madanes
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Jay Haley
Learned hypnosis from Erickson in 1953
Incorporated much of Erickson’s ideas into his own concepts about how to do therapy
First editor of the initial journal in the field of family therapy, Family Process.
Helped to organize the Institute for Family Counseling
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Cloé Madanes
Born and raised in Argentina
Gentler in her approach to strategic family therapy than Haley
Developed the pretend technique
One of her lasting contributions was in the areas of sex and violence
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Premises of the Theory
Follows many of Milton Erickson’s principles
Emphasize short-term treatment of about 10 sessions
“No one evaluates which solutions have so far been attempted for the patient’s problems” (Priebe & Pommerien, 1992, p. 433)
Concentrates on seven dimensions
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Dimensions of Strategic Family Therapy
Family rules: overt and covert rules families use to govern themselves
Family homeostasis: tendency of the family to remain in its pattern of functioning unless challenged to do otherwise
Quid pro quo: responsiveness of family members to treating others in the way they are treated
Redundancy principle: fact that a family interacts within a limited range of repetitive behavioral sequences
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Dimensions of Strategic Family Therapy
Punctuation: idea that people in a transaction believe that what they say is caused by what others say
Symmetrical relationships and complementary relationships: fact that relationships within a family are both among equals (symmetrical) and among unequals (complementary)
Circular causality: idea that one event does not cause another, but that events are interconnected and that the factors behind a behavior are multiple
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Treatment Techniques
Reframing: involves giving a different interpretation to induce a cognitive shift within family members and alter the perception of a situation
Directive: instruction from a therapist for a family to behave differently
Nonverbal messages (e.g., silence, posture)
Direct and indirect suggestions (e.g., “Go fast”)
Assigned behaviors (e.g., “When you think you won’t sleep, force yourself to stay up all night”)
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Treatment Techniques
Paradox (similar to prescribing the symptom) – gives client families permission to do something they are already doing and is intended to lower or eliminate resistance
Restraining: telling family they are incapable of doing anything other than what they are currently doing
Prescribing: instructing families to enact a troublesome dysfunctional behavior in front of the therapist
Redefining: attributing positive connotations to symptomatic or troublesome actions
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Treatment Techniques
Ordeals: involves helping the client to give up symptoms that are more troublesome to maintain than they are worth
Pretend: involves asking family members to pretend to engage in a troublesome behavior, such as having a fight, or to imagine that something is disconnected so they do not have to respond to a stimulus
Positioning: acceptance and exaggeration of what family members are saying
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Role of the Therapist
First task: Define a presenting problem so that it can be worked on and solved
Most are overtly active
Use presenting problems as a way to bring about change in families by giving the tasks that are usually carried out between sessions.
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Process and Outcome
Goal: Resolve, remove, or ameliorate the problem on which the family agreed to work
Four common procedures for ensuring a successful outcome:
Define a problem clearly and concisely
Investigate all solutions previously tried
Define a clear and concrete change to be achieved
Formulate and implement a strategy for change (Watzlawick,1978)
Focus of changing vicious cycles to virtuous ones
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Unique Aspects
Flexibility
Belief that real change is possible at the individual and dyadic level
Focus on innovation and creativity
The way it can be employed with a number of other therapies, particularly behavioral and structural family therapy
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