*Milan Systemic Family Therapy*

Key Figures

* Mara Palazzoli * Luigi Boscolo * Gianfranco Cecchin * Guiliana Prata

Interpret Info in order to Define Focus of Treatment

*Importance placed on referring person/referral process * Believe that some members become symptomatic while others don't; they become part of a problem-defining pattern. *Concept of homeostasis important for many rigid families; every potential change is felt as a negative threat. *Questions are asked to ascertain how behavior either maintains homeostasis or understand how problems are inevitable result of beliefs that do not fit family.

Interviewing Process: Verbal/Nonverbal assessment

-Continuous assessment Context must allow: -members to feel their POV is heard. -therapist/family must feel risk of changes -therapist has responsibility in asking the "right" questions -client/therapist feel new info. is being explored -both therapist and family should feel that interviews on problem behaviors and attempts to solve are being connected to wider beliefs in system

Source of Dysfunction

-Dysfunction occurs within context of relationships -Beliefs given meaning over course of generations/determine actions. -Actions and beliefs fit to form a good fit for the individual -Individuals construct their own "reality" and determine beliefs and what behaviors are not acceptable. When new ideas intrude, individuals may attempt to preserve the old and repeat old behaviors---labeling difference of beliefs to be symptomatic

Background of Milan Systemic

-Rooted in psychoanalysis (frustrated w/ lack of progress in treating anorexia patients, so Palazzoli created study group of 4; group focused on MRI approach, which stemmed into its own systemic model

Role of Therapist

-Therapist becomes a part of the system -Milan therapists remain very active in room/guide

Assess Stage, Age, and Life Cycle Issues

-Understand how change occurs/problems maintained -Life cycle event are important -Appreciates individual development stages -Appreciates tasks as they impact larger systemic pattern

Original Structure to Family Sessions Consist of 5 Parts:

1. Presession: gathering information 2. 3. 4. 5.

Timeline of Milan Systemic Therapy

1967-1975: birth of Milan approach 1975-1979: add hypothesizing, circularity, and neutrality 1979-1982: splitting into two teams 1979-present: dissemination/ clarification of approach 1977-present: application of approach in other settings 1983-present: new systemic approaches

Where was the model developed?

Developed in Milan, Italy w/ italians from various economic backgrounds; early work was with anorexic and psychotic families. *Influenced by contextual thinking, concepts such as gender, birth order, physical characteristics; acquiring meaning over generations.

Therapist Directive to Asking Questions: Therapist maintains a "one down position" to obtain info

Questions asked not to create a change in "here and now" but introduce differences into family belief system; may affect belief system overall. *Changes in family behavior are the result of family members choosing to act or interact in response to new information. *Therapist attempts to remain neutral/ so members focus on their own participation.

Symptomatic Behavior

Secondary phenomenon that follows initial changes in beliefs and actions that did not fit; thereby were experienced as a threat to relationships maintained by prevailing ecological balance

How does milan system adapt to working with families?

Sympomatic behaviors are maintained through interactional patterns; which are governed by rules at meta level