Chapter 14 Strategic Family Therapy

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.

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.

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).

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.

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.

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.

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.

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.

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).

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.

4 Common 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.

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.

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

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.

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.

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.

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?