Milan Systemic Family Therapy

Milan therapists view on change

- Change occurs when the family can see problems in a healthier way - By the use of relationship centered questions, the Milan therapist helps reveal new ways of thinking and even embracing the problem - Therapist needs to assess family members to see who is most willing to accept new perspectives of viewing his or her problems

Family epistemology (what is targeted in therapy?)

- How family punctuates events. - How events are described in terms of cause and effect -The circular reasoning used i.e. "because he nags, I withdraw"

The tyranny of linguistics

- How language is used changing the "hes depressed" to "the persons doing depression" (It is less of a label and more of an action)

Counter paradox

- Requests that the family not change. - This amplifies the problem that the family spontaneously gives up. - Appropriate with uncooperative families. - Interesting because the symptom will never be the same again

Invariant prescription

- Severs covert coalitions between parent and child - i.e. parents are prescribed a date and asked to not tell the children were or why. - Creates secret between parents. - Ends inappropriate coalitions. - Creates clear boundaries b/w unified parent and child. - Works with any family

Systemic hypothesizing

- The Milan's way of confirming or dis-confirming necessary information regarding how the family functions and how the therapists conceptualizes their functioning - Begins with initial telephone call from family. The team exhausts all possible hypothesis about family's symptom and functioning before first session. - During the session the therapist is often summoned by the reflecting team who are observing behind mirror to discuss a new hypothesis

Therapeutic letter

- was sometimes written as both a summary and an intervention - allows family to continue in the therapeutic process away from the sessions

Rituals

-Behavioral assignment addressing double binds -Helps to shift meanings -Odd day/ even day ritual - Creates measurable ritual by putting conflicting directives in sequence i.e. be wife on even days and mom on odd days

Circular questions - (bread and butter of therapy)

-Interviewing method used to gain descriptive assessments and deliver assessments through questioning of the family members -Feedback generates new questions -Aim is to expand the family's beliefs beyond the meanings that they currently hold. It involves asking what everyone's perspective is -Often effective in reviewing structure of the system to the family

Positive connotation

-To re-frame symptom positively with benevolent connotation -I.e. re-framing symptom child as glue to keep family together -Difference between positive re-frame and positive connotation is that there is a systemic component to it

Milan Therapists view

1. We are not the experts 2. The Family is a system 3. The symptom serves a purpose 4.. The therapy is language based

3 types of hypotheses

1. What alliances are there? 2. Hypotheses re myths and premise? 3. Hypothesis that analyze communication?

First order change

A change that occurs with a specific behavior in the system

Second order change

Change occurs as a result of new rules and premises, which leads to a permanent change in the system

Interaction patterns are ...

Family games - That are played through unacknowledged alliances and coalitions

MILAN therapist objective

Therapist comes up with a positive hypothesis that can be accepted or rejected - If it is rejected it is the therapists that is wrong not the family