MRI, Milan, and Strategic

Milan: Therapy Structure

1. The pre-session- Team meets and makes initial hypothesis. 2. Session- Team meets with family to check hypothesis. 3. Intersession- Team meets to discuss and form an intervention. 4. Intervention- Therapist returns and delivers intervention to family; either a positive connotation or prescription of a ritual. 5. Post-session Discussion- Team debriefs and makes plans and hypotheses for next session.

Milan: Analogical Message

A metaphorical message (process).

Milan: Epistemological Error

A set of beliefs that are incongruous with reality and become problematic.

Milan Team Approach

A team of therapists that strategically hypothesize and plan interventions regarding the family. Often, the team watches therapy through a one-way mirror as it happens.

Strategic: Unbalancing

An intervention where the therapist intentionally sides with one family member over the other. Meant to disrupt homeostasis.

Milan: Positive Connotation

Assigned a positive motive or value to each family member's behavior, whether it's a desirable behavior or not.

MRI: Complementary Relationship

Based on differences that fit together.

MRI: Symmetrical Relationship

Based on equality, behavior of one mirrors that of the other.

MRI: Metacommunication

Communicating about communicating. Can also refer to non-verbals going on in the room that have an impact on what is being said verbally.

Milan: Paradoxical Prescription

Either prescribing the symptom or asking the family not to change.

Milan Systemic Therapy

Endorsed the concept that family interactions are governed by a set of rules that may be adapted through the use of paradoxical intervention. Each family was seen by a therapist dyad while being observed - live- by other members of the therapy team. Each session had five delineated parts.

MRI: Report and Command Functions

Every communication has 2 components: Report- Content of the message. Command- A message about the relationship.

MRI: Who is Involved

Fewer family members. Utilizes a team approach, meaning several therapists gathering to consult on one case, hypothesize, and at times interchangeably work with the family.

MRI: Primary Contributors

Gregory Bateson Don Jackson (Founder of the Mental Research Institute) Virginia Satir Jay Haley John Weaklend Paul Watzlawick Richard Fisch

MRI: Out-of-Session Directive

Instructing the clients to engage in behavioral change outside of the session as opposed to in session.

Milan: Rituals

Intervention presented by therapy team that is described in great detail, instructing individuals in the family to carry our specific behaviors at specific times of the day for a distinct period of time. Serves to provide consistency and clarity as to the hypothesized problem within the family.

Milan: Counterparadox

Intervention used to unravel a family's double-bind message by referring to their dysfunction as legitimate and necessary, and as so, instructing the family not to change.

Milan: A learning Process

Interventions are viewed as this by the therapist. The therapist can test the hypotheses and interventions through trial and error as they learn about the family.

Strategic: Paradoxical Interventions

Interventions used to address the concept that families are naturally resistant to change.

Strategic: Primary Contributors

Jay Haley Cloe Madanes

Milan: Primary Contributors

Mara Selvini-Palazzoli Guliana Prata Luigi Boscolo Cecchin

Strategic Family Therapy

Merges Bateson's systemic concepts with Minuchin's emphasis on the family structure. Primarily brief, pragmatic, solution-focused interventions.

Strategic: Incongruous Hierarchies

Occurs when children create symptoms in attempt to change their parents.

Strategic: Pretend to Have Symptom

Paradoxical Intervention where therapist instructs child to have a symptom and instructs parents to help child through it.

Strategic: Ordeal Therapy

Paradoxical directive that places a client in a situation where it creates more work for them to maintain problem symptoms than it would be to change it.

MRI: Positioning

Paradoxical intervention of pushing a family member further into the absurdity of their initial position, thereby making them realize their own absurdity.

MRI: Restraining the Progress of Change

Paradoxical intervention where clients come into session and report that they are experiencing change so therapist encourages them to slow down and be cautious about changing too fast.

MRI: Prescribing the Symptom

Paradoxical intervention where one instructs the client to intentionally engage in the behavior they wish to change. Client may rebel and experience desired change or comply and realize they have control.

Strategic: Metaphoric Task

Prescribing a directive to a family that engages them in conversation or activity that is easier than talking about the problem directly. By discussing it through ___________, it will indirectly contribute to resolving the actual problem.

Strategic: Reframing

Presenting an alternative perspective on a family member's view of another's problematic behavior.

MRI: More of the Same

Problem when families fail to appropriately respond to normal life circumstances, families will do more of the failed solution as opposed to trying a different solution.

MRI: Goals of Therapy

Resolve current problem and provide symptom relief and create second-order change.

Strategic: Directives

Specific, directed behavioral tasks for the family to engage in during session and then carry out at home between sessions.

MRI: First-Order Change

Surface change. Changes in family patterns that occur at the behavioral level.

Strategic Presenting Problem as Metaphor

Symptom is redefined as a metaphor of a larger problem.

MRI: Second-Order Change

Systemic change. Changes in family patterns of interaction that occurs at the level of beliefs or rules.

Strategic: Aligning with Parental Generation

Technique directed at strengthening the parental hierarchy and reinforcing that parents are in charge of the children. Therapist breaks neutrality and intentionally aligns with parental subsystem.

Milan: Digital Message

The content of the message (objective).

Milan: Punctuation

The manner in which individuals attribute their behaviors as a result of another's behavior. (I only nag you because you never offer to help).

Milan: Epistemology

The manner in which one makes sense of the world, including their relationships to and with others.

MRI: Problem as Attempted Solution

The problem is not the problem, the attempted solutions to fix the problem reinforces the interactional behavioral sequence.

Milan: Circular Questioning

The therapist asks one family member to comment on the interactions of the two other family members to create circularity within the system and help the therapist build a more elaborate hypothesis.

Milan: The Invariant Prescription

The therapist will instruct the mother and father to tell their family that they have a "secret," and to then take a trip together, away from the family, for a few days. They are cautioned not to tell the family anything more than the fact that they have a secret prior to leaving.

Milan: Neutrality and Irreverence

The therapist's stance of being open to multiple hypotheses regarding the family's behavior.

MRI Systemic Therapy

This approach finds that families get stuck in problematic, interac.tional cycles of repetitive behaviors which prevent the family from appropriately adjusting to environmental changes

Milan: Games (Family Games)

Unacknowledged strategies that result in destructive interactions within families, often unspoken and used as attempts to control another's behavior.

MRI: Paradoxical Intervention

Used to address that families are naturally resistant to change. Involves instructing family not to change or to change in ways that contradict their desired change.

Milan: The Dirty Game

When parents struggle fro control, they triangulate a symptomatic child who then works to defeat the parents