Transcript Chapter 14 Strategic Family Therapy

Chapter 14
Strategic Family Therapy
Strategic Family Therapy
A method-oriented approach which is
brief in duration.
Primary goal for treatment is change.
Milton Erickson was a noted theorist in
the approach.
Milton Erickson
Believed in utilizing the resources of his
clients and designing a “strategy for each
specific problem” (Madanes, 1991).
Did not care if people gained perspective as
long as their actions produced beneficial
results.
Conducted therapy by paying extreme
attention to details of the symptoms his
clients presented.
Erickson’s Methods
Erickson achieved his objectives in therapy by:
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Accepting and emphasizing the positive.
Using indirect and ambiguously worded
directives.
Encouraging or directing routine behaviors so
that the resistance is shown through change
and not through normal and continuous
actions (Haley, 1963).
Jay Haley
Co-founded the Family Therapy Institute of
Washington, D.C. with Cloe Madanes in 1974.
He learned from and with the three most
influential people in the evolution of family
therapy:
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Milton Erickson
Gregory Bateson
Salvador Minuchin
After being taught and trained by Erickson,
he adopted and modified Erickson’s individual
emphasis so that it would work with families.
Jay Haley
1962 - joined the Mental Research Institute
staff and became primarily involved in “family
research and the observation of therapy”
(Simon, 1982).
1967 - joined Salvador Minuchin at the
Philadelphia Child Guidance Center.
1976 – moved to Washington, D.C. area to
establish the Family Therapy Institute with
Cloe Madanes.
View of Human Nature/Personality
Strategic Family Therapists concentrate on the
following dimensions of family life:
Family Life – the overt and covert rules families
use to govern themselves.
Family Homeostasis – the tendency of the family
to remain in its same pattern of functioning
unless challenged to do otherwise.
Quid Pro Quo – the responsiveness of family
members to treating others in the way they are
treated.
View of Human Nature/Personality
Redundancy Principle – the fact that a
family interacts within a limited range of
repetitive behavioral sequences.
Punctuation – the idea that people in a
transaction believe that what they say is
caused by what others say.
View of Human Nature/Personality
Symmetrical Relationships – the fact
that relationships within a family are
both among equals (symmetrical) an
unequals (complementary).
Circular Causality – the idea that one
event does not “cause” another but that
events are interconnected and that the
factors behind a behavior are multiple.
Roles of the Counselor/Therapist
The roles of strategic therapists differ among
their subschools.
Share a belief in being active and flexible with
their family clients.
Emphasize short-term treatment, about 10
sessions.
“Brief therapists hold in common the belief
that therapy must be specifically goaldirected, problem-focused, well-defined, and,
first and foremost, aimed at relieving the
client’s presenting complaint” (Wylie, 1990).
Goals
Primary goal is to resolve, remove, or
ameliorate the problem the family
agreed to work on (Snider, 1992).
Learn how to address other problems in
a constructive manner.
Emphasis is on process rather than
content.
4 Common Procedures for
Ensuring a Successful Outcome
1. Defining a problem clearly and
concisely.
2. Investigating all solutions that have
previously been tried.
3. Defining a clear and concrete change
to be achieved.
4. Formulating and implementing a
strategy for change.
Process and Outcome
As a group strategic therapists are very
innovative.
Customization of interventions makes
strategic therapy very technique driven.
If families are going to change,
alterations in ways their members act
must precede new perceptions or
feelings.
Emphasis
Strategic family therapists emphasize:
Reframing
Directive
Paradox
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Restraining
Prescribing
Redefining
Ordeals
Pretend
Positioning Techniques
Multicultural and GenderSensitive Issues
Has been used effectively in many different
cultures and subcultures.
Sensitive to cultures and working within
them.
Premise is that emphasis is on structure of
the family and offers techniques that can be
used whatever the culture.
Also noted for its gender sensitivity.
Strengths and Contributions
Flexibility as a viable means of working with a
variety of client families.
“Real change is possible at the individual or
dyadic level – the entire system need not
always be involved in lower order change”
(Fish, 1988).
Focus on innovation and creativity.
Customization of interventions.
Can be employed with a variety of other
therapies.
Limitations and Criticisms
Most therapists concentrate on one problem,
even when most families have more than one
presenting problem.
Criticized for being too mechanical.
Controversial view about schizophrenia.
Skill necessary to implement some methods.
Time and emphasis.
Lack of collaborative input from client families.
The Case of Linda:
Strategic Family Therapy
How would you conceptualize this case using
strategic family therapy?
What would be your treatment plan for this
client using a strategic family approach?