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Strategic Family Therapy - ACU Family Therapy

STUDY
PLAY
Key Figures
Chloe Madanes
Gregory Bateson
Jay Haley (influenced by Minuchin)
Milton Erikson
Paul Weakland
Don Jackson
John Watzlawick
Basic Concepts
Therapy focuses on the present
It is action-oriented
It is oriented toward resolution of the presenting problem
Therapist thinks hierarchically, recognizing that power and status occur and are not granted equally to all members of a family
Symptoms indicate problems in hierarchy
Basic Concepts
Digital communication
One referent
Analog communication
More than one referent
Report and command
Double Bind
Assumptions
"A problem is defined as a type of behavior that is part of a sequence of acts between several people" (Haley, 1976).
The approach emphasizes the analogical in the way it conceptualizes a problem (Madanes).
Therapists will have a specific strategy for each family and problem that is designed to solve the presenting problem.
What brings the family therapy?
Attempting the same solutions with no results
Getting stuck in vicious cycles
Family life cycle transitions
The symptom is an indication of a family disturbance.
Assessment and Diagnosis
Social context is the focus of treatment
Haley (1976)
Structure of the family
Therapeutic change - focus on breaking patterns of the self-regulating system
Pathology - a rigid, repetitive sequence of a narrow range
Observing duration of sequences
Ahistoric, focused on presenting problems
Avoid diagnostic labels - seen as crystallizing family members' thinking
Functions of symptoms
Communicative acts with specific functions
Indications of confused hierarchical arrangement
Indications the family is having trouble getting past a life cycle stage
As a contract between people and seen as adaptive to relationships
Goals of therapy
Prevent repetition of sequences, introduce complexity and alternatives
Helping people past family life cycle transitions
Definition of problem
Clear, solvable
Therapy is brief
Present focused, solve problem as quickly as possible
Theory of Change
Problems are explained:
cybernetically
structurally
functionally
Problem sequences are interrupted and the problem does not continue.
General stages of therapy
Determine who is involved in presenting problem and in what way
Design an intervention to shift focus of presenting problem
This is the strategy for change
Evaluate success of intervention
Haleys 5 stages of Therapy
Social stage - all family is involved
Problem stage - issues are defined
Interaction stage - assessing for structure
Goal-setting stage - changes are specified
Task-setting stage - directives are given
Stages of Therapy - Madanes
Therapy is managed by:
Who is involved in the problem and how?
What intervention will change the organization that the problem is no longer needed?
Interventions
Usually take the form of directives the family is to do in and out of session.
Not concerned with insight or understanding
Directives
Straightforward
Giving advice, coaching, setting up ordeals
Indirect
Paradoxical, restraining change, absurd tasks, remaining the same
Paradox
Reframing
Double bind
Unbalancing system via joining with members
Going with, versus fighting resistance
Paradoxes
A seemingly illogical intervention
Appears in apparent contradiction to goal of therapy
Prescribing the symptom
Restraining change
Ordeals
Asking a client to engage in tasks that are appropriate for the problem but cause distress that is equal to or greater than the problem
Straightforward
Roles/functions of the therapist
Plan a strategy to solve problem
Develop hypotheses
Take an active, direct role
Remain outside the family system
Avoids triangulation
Develop strong therapeutic alliance
Responsible for therapy goals and successes
Assess and address resistance and accept responsibility for it