Chloe Madanes Gregory Bateson Jay Haley (influenced by Minuchin) Milton Erikson Paul Weakland Don Jackson John Watzlawick
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
Digital communication One referent Analog communication More than one referent Report and command Double Bind
"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
Straightforward Giving advice, coaching, setting up ordeals Indirect Paradoxical, restraining change, absurd tasks, remaining the same
Reframing Double bind Unbalancing system via joining with members Going with, versus fighting resistance
A seemingly illogical intervention Appears in apparent contradiction to goal of therapy Prescribing the symptom Restraining change
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