Chapter 14

1. Chapter 14 Strategic Family Therapy

2. Strategic Family Therapy • A method-oriented approach which is brief in duration. • Primary goal for treatment is change. • Milton Erickson was a noted theorist in the approach.

3. Milton Erickson • Believed in utilizing the resources of his clients and designing a “strategy for each specific problem” (Madanes, 1991). • Did not care if people gained perspective as long as their actions produced beneficial results. • Conducted therapy by paying extreme attention to details of the symptoms his clients presented.

4. Erickson’s Methods Erickson achieved his objectives in therapy by: • Accepting and emphasizing the positive. • Using indirect and ambiguously worded directives. • Encouraging or directing routine behaviors so that the resistance is shown through change and not through normal and continuous actions (Haley, 1963).

5. Jay Haley • Co-founded the Family Therapy Institute of Washington, D.C. with Cloe Madanes in 1974. • He learned from and with the three most influential people in the evolution of family therapy: • Milton Erickson • Gregory Bateson • Salvador Minuchin • After being taught and trained by Erickson, he adopted and modified Erickson’s individual emphasis so that it would work with families.

6. Jay Haley • 1962 - joined the Mental Research Institute staff and became primarily involved in “family research and the observation of therapy” (Simon, 1982). • 1967 - joined Salvador Minuchin at the Philadelphia Child Guidance Center. • 1976 – moved to Washington, D.C. area to establish the Family Therapy Institute with Cloe Madanes.

7. View of Human Nature/Personality Strategic Family Therapists concentrate on the following dimensions of family life: • Family Life – the overt and covert rules families use to govern themselves. • Family Homeostasis – the tendency of the family to remain in its same pattern of functioning unless challenged to do otherwise. • Quid Pro Quo – the responsiveness of family members to treating others in the way they are treated.

8. View of Human Nature/Personality • Redundancy Principle – the fact that a family interacts within a limited range of repetitive behavioral sequences. • Punctuation – the idea that people in a transaction believe that what they say is caused by what others say.

9. View of Human Nature/Personality • Symmetrical Relationships – the fact that relationships within a family are both among equals (symmetrical) an unequals (complementary). • Circular Causality – the idea that one event does not “cause” another but that events are interconnected and that the factors behind a behavior are multiple.

10. Roles of the Counselor/Therapist The roles of strategic therapists differ among their subschools. • Share a belief in being active and flexible with their family clients. • Emphasize short-term treatment, about 10 sessions. • “Brief therapists hold in common the belief that therapy must be specifically goal-directed, problem-focused, well-defined, and, first and foremost, aimed at relieving the client’s presenting complaint” (Wylie, 1990).

11. Goals • Primary goal is to resolve, remove, or ameliorate the problem the family agreed to work on (Snider, 1992). • Learn how to address other problems in a constructive manner. • Emphasis is on process rather than content.

12. 4Common Procedures for Ensuring a Successful Outcome • Defining a problem clearly and concisely. • Investigating all solutions that have previously been tried. • Defining a clear and concrete change to be achieved. • Formulating and implementing a strategy for change.

13. Process and Outcome • As a group strategic therapists are very innovative. • Customization of interventions makes strategic therapy very technique driven. • If families are going to change, alterations in ways their members act must precede new perceptions or feelings.

14. Emphasis Strategic family therapists emphasize: • Reframing • Directive • Paradox • Restraining • Prescribing • Redefining • Ordeals • Pretend • Positioning Techniques

15. Multicultural and Gender-Sensitive Issues • Has been used effectively in many different cultures and subcultures. • Sensitive to cultures and working within them. • Premise is that emphasis is on structure of the family and offers techniques that can be used whatever the culture. • Also noted for its gender sensitivity.

16. Strengths and Contributions • Flexibility as a viable means of working with a variety of client families. • “Real change is possible at the individual or dyadic level – the entire system need not always be involved in lower order change” (Fish, 1988). • Focus on innovation and creativity. • Customization of interventions. • Can be employed with a variety of other therapies.

17. Limitations and Criticisms • Most therapists concentrate on one problem, even when most families have more than one presenting problem. • Criticized for being too mechanical. • Controversial view about schizophrenia. • Skill necessary to implement some methods. • Time and emphasis. • Lack of collaborative input from client families.

18. The Case of Linda: Strategic Family Therapy • How would you conceptualize this case using strategic family therapy? • What would be your treatment plan for this client using a strategic family approach?