Strategic- Milan

Rituals

A Milan systemic intervention consisting of a series of actions that involve the whole family in a sequence of steps forming a "play" to be repeatedly enacted under prescribed circumstances. By engaging family members in a sequence in new ways, it is hoped that they will gain new perceptions which will result in changes in beliefs and behaviors.

Sacrifice Intervention

A closing statement in a Milan system (early Milan) session that includes a statement of paradox. The person with the symptom is characterized as being in the service of the homeostasis. This intervention tends to overcome resistance by causing a rebellion against the symptom.

Logical Connotation

A development in the Milan systemic model that grew as the use of a paradox declined. The therapist communicates that the development of a symptom is understandable, given the context. There is no implication that a problem is useful, beneficent, or functional (as with Positive Connotation), only that people have gotten used to it and that habits are hard to change.

Circular Questioning

A technique for interviewing and hypothesis validation designed by the Milan systemic group, based on Bateson's idea that people learn by perceiving differences. In this technique, each family member comments on the behavior and interactions of the two other members. It is hoped that beliefs will become less rigid when members are exposed to different perspectives.

Hypothesizing

A technique used by Milan systemic therapists. A trial and error process by which the therapist makes initial suppositions about the presenting problem, and then tests the supposition by asking questions or making an intervention based on that hypothesis. The original supposition is then revised according to the new information. This cybernetic process makes use of information resulting from completed feedback loops.

Milan Systemic Family Therapy

A theory and therapeutic model influenced by Bateson and the MRI Group, originally developed in Italy by Selvini Palazzoli, Boscolo, Cecchin, and Prata. Known for the concepts of circularity, hypothesizing, and neutrality, the primary techniques associated with the early Milan Group were rituals and positive connotations. The Milan Group split in the early 1980s with Selvini Palazzoli and Prata forming one group, adhering to the strategic model and developing a ritualistic technique, invariant prescription, to counteract the Dirty Game, or power struggle between the parents and their child. Boscolo and Cecchin moved away from the strategic approach, developing a collaborative style of therapy. In this model, problems are maintained when the family holds to an old epistemology that does not fit its current circumstance.

Reflecting Team

A therapy technique or process involving a team of therapists using a one-way mirror to observe the family and the therapist. The team then discusses the family while being observed by the family and the therapist. The therapist and family then discuss the team's observations.

Invariant Prescription

Created by the Milan systemic group, this unchanging prescription, given to all families with symptomatic children, requests that parents spend time together away from the children and is intended to break the pattern of destructive "games" and create clearer generational boundaries.

Dirty Games

From Milan systemic family therapy, the unacknowledged power struggle between parents and the symptomatic child.

Odd Day/Even Day Ritual

From Milan systemic, a technique to encourage the irreverence or a more flexible view of the family. The family is given a directive that on odd days one set of opinions would be true, but on even days, false. On the seventh day, the family should act spontaneously.

Neutrality

From later Milan systemic, a technique and stance with the family in which the therapist withholds judgement, either positive or negative, in an effort to avoid becoming part of the family's struggles. The therapist is indifferent to treatment outcome, recognizing that his/her role is simply to perturb (or have an impact on) the system.

Positive Connotation

From the Milan systemic group, a complex paradoxical reframing technique which includes all family members in the system itself. Each member's contribution to the problem is reframed as an effort to solve the problem and help meet the family's needs (See Logical Connotation).

Circularity (Circular Causality)

The notion held by the Milan systemic group that causality in families cannot be thought of as a simple, single cause and effect relationship (linear causality). Instead, events, behaviors, and interactions are seen in a more complex way, as mutually influencing one another (feedback loops). Each is the effect of a prior cause and in turn influences future behaviors. Family system events create an endless (and beginning-less) circular chain. In this model it is meaningless to identify an individual as having caused or started a problem. Instead, all elements of the problem coexist and are reciprocally reinforcing. The problem could not be maintained if any one element were to be removed.