Strategic & Systematic Family Therapy

Key Persons: MRI Group - Jay Haley - Cloe Madannes - The Milan Associates

Key Concepts:

1. The therapist is the expert – a non-collaborative approach.
2. Focus is on generating change in behavior rather than understanding.
3. Family rules and underlying premises that govern operations of the family are also important.
4. A malfunctioning family hierarchy is most likely lurking behind most problems.
5. Function of the symptom is important in understanding the problem.
6. Madannes categorized problems into four basic intentions:

• Dominance & Control  (delinquency)

• A desire to be loved (anxiety and eating disorders)

• A desire to love and protect others (suicide threats and thought disorders)

•  A desire to repent and forgive (sexual abuse and incest)

7. Focus on power related aspects of family interaction.
8. Symptoms seen as protecting the family to maintain the delicate network of family alliances.
9. Three basic explanations for why problems develop:

•  Cybernetic – Difficulties turn into chronic problems by the persistence of misguided attempts at solutions

• Structural – Problems are the result of flaws in the family hierarchy or boundaries

• Functional – Problems result when people try to protect or control one another indirectly, such that their problems come to serve a function for the system

 Therapy Strategies:

1. To bring about second-order change
2. Focus on sequences of interactions between family members
3. Transforming violence into love and acceptance
4. Change habitual patterns of thinking and behaving

 Therapy Techniques:

1. Reframing – induce compliance or change perspectives
2. Giving paradoxical prescriptions
3. Defiance-based Intervention (prescribing the symptom while hoping the client will resist)
4. Directives (Convincing each family member that each has something to gain by cooperating and following through on a direction)

 Key Words:

1. Function of the symptom
2. Second Order Change
3. Cybernetics
4. Reframing
5. Paradoxical Prescriptions
6. Structural change
7. Hierarchy of power