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What is the center piece of strategic therapy?
positive feedback loops
What are the axioms/truths of human communication?
- People are always communicating
- All messages have a report and a command function
- Whether a difficulty becomes a problem depends on how the family members respond to it
- A problem is not a problem if the client is not expressing discontent with it (neutrality)
- A symptom is a metaphor for underlying problem
What is the MRI approach to problem solving?
- identify the positive feedback loop that maintains the problem
- determine the rules that support those interactions
- find a way to change to rules to interrupt the problem-maintaining behavior
What did Haley believe was crucial and inadequate, and the root of most problems?
rules around the hierarchical structure
What are the three ways in which problems develop in strategic models?
- Cybernetic – misguided solutions to difficulties that are maintained through feedback loops
- Structural – problematic family hierarchies
- Functional – family members use symptoms to try to control or protect each other
how are family rules communicated and enforced?
through command messages
- Function to preserve homeostasis (negative feedback), maintenance of the problem
- Can be deduced from interactional patterns
according to general systems theory, what are the two vital processes that normal families depend on?
- maintain integrity in the face of environmental challenges through negative feedback loops
- amplify innovations to accommodate to changing circumstances through positive feedback loops
according to communications theory, what is the essential function of symptoms?
to maintain the homeostatic equilibrium of family systems
How might an MRI therapist attempt to address the issue of a defiant child?
- Focus on the parent's attempted solution
- the assumption that this attempt likely to maintain the child's defiance
- the parent's explanation, or frame, for the child's behavior, believe this might be driving their false solution
How might a Haley style therapist attempt to address the issue of a defiant child?
- interested in the parent's attempted solution
- the parent's marriage
- the ways in which the child was involved in the struggles between the parents and/or family members
- the possible protective nature of the child's problem
- the child's problem might be a part of a dysfunctional triangle with the parents
How might a Milan systemic therapist attempt to address the issue of a defiant child?
- not worry so much about attempted solutions
- ask about past and present relationships with the family, trying to uncover the network of power alliances
- symptoms might be a way of protecting the family members
MRI goals of therapy
- define clear and reachable goals so everyone knows when treatment has been successful
- setting concrete goals
- let go of utopian aspirations
- change the behavioral responses to problems
- interpret vicious feedback loops
Goals of therapy for Haley's approach
- downplay the importance of insight
- structural reorganization of the family as they relate to the presenting problem
What are the goals for assessment?
- Define a specific, behavioral problem
- Identify failed attempts at solutions that actually maintain the problem
- Understand clients’ language for relating to the problem -- Important to offering effective reframes
- Identify dysfunctional structural arrangement -- Triangles, cross-generational coalitions, etc.
what are the four stages of Haley's initial interview and who did it involve?
- the whole family
- Social stage -- helping his clients feel comfortable
- Problem stage -- asking each person for their perspective
- Interaction stage -- encouraging family members to discuss their points of view among themselves
- Goal-setting stage -- helping families find new ways to solve their problems
shift client’s causal attribution from linear (individual) to circular (systemic)
pointing out problematic interactions, their impacts
interrupting harmful interactions
encouraging clients to approach change slowly
interventions: Reframe/positive connotation
change the clients’ interpretation of a problem behavior so they can orient to it differently
engage in a different interaction
prescribe a price for maintaining a symptom so the cost of maintaining outweighs the effort to change it
interventions: Paradoxical interventions
do something counterintuitive to interrupt problem
Define Paradoxical Interventions and their possible effects
Prescribing an activity that is counter to common sense -- E.g. “prescribing the symptom”
- Family could comply, reverse previous attempts at solutions
- Family could rebel, reducing symptoms
- Could expose network of relationships that maintain the issue
What is the most distinctive innovation to emerge from the Milan model?
Positive connotation: a technique of ascribing positive motives to family behavior in order to promote family cohesion and avoid resistance to therapy
Define rituals in the Milan Model
used to engage families in a series of actions that ran counter to or exaggerated rigid family rules or myths
What is the purpose of circular questioning?
designed to shift clients from thinking about individuals and linear causality and towards reciprocity and interdependence
What is the definitive technique used by Haley and Madanes approach?
directives: thoughtful suggestions targeted to the specific requirements of each case