Strategic - General Flashcards
(36 cards)
What makes Strategic therapy modalities brief?
They are designed to be brief, directive, and task-oriented.
What is the general approach of the Strategic Family Therapy modalities?
Strategic Therapy is any type of therapy where the therapist initiates what happens during therapy and designs a particular approach for each problem. The THERAPIST TAKES RESPONSIBILITY for directly influencing people.
THE SYSTEM IS CENTRAL. Strategic family therapy is based on the premise that the family plays the most important role in the life and development of children. This type of therapy seeks to identify and change the structural interaction patterns that make up the family environment. By addressing family behaviors and interactions that contribute to problem behavior, this approach helps families function better.
SEEING THE PATTERNS HELPS BOTH THERAPIST AND CLIENT. Within the safety of therapeutic settings, strategic family therapists replicate family interactions and conversations, prompting and engaging participants with provocative questions and discussions. During these sessions, problems present themselves, and the therapist engineers the situation so that participants come to realize and understand the socially impaired interactions taking place.
THE SYSTEM CAN HEAL ITSELF. The therapist trusts that the system can reorganize itself without the therapist forcing change. The therapist provides effective directives that unbalance the system and nudge it towards second-order change.
IT’S STRENGTHS-BASED. The therapist also knows how to uncover the family’s strengths and abilities at solving its own problems, drawing on internal resources that they hadn’t before acknowledged or even realized that each family member possessed.
What are internalizing vs externalizing symptoms?
Externalizing symptoms in kids may include rebelliousness, truancy, delinquency, substance use, and association with problematic peers. In adult, they include violence, anger, blaming, criticism, problems keeping a job or friends, substance use, and social problems.
Internalizing symptoms include depression and anxiety.
How are Strategic therapy and Solutions-Focused therapy similar?
In both modalities:
- PRESENT FOCUSED - The therapist isn’t concerned with where or how the problem started, only how to address it and solve it NOW.
- The pattern of BEHAVIOR IS THE FOCUS, more than the reasons behind it. Therapy is not a person laying on a couch describing what kind of inner turmoil or thoughts he or she is having or experiencing, what past childhood experiences contributed to a sense of self, or how a particular psychological issue could have arisen from past experiences.
- The THERAPIST IS INVOLVED actively, and directive, and responsible in helping clients turn their lives around, through helping them strategically plan, execute, and measure “game winning” outcomes. Therapists are active problem-solvers and solution-finders.
What is the role of the therapist in Strategic family therapy?
In strategic family therapy, the therapist develops techniques for solving problems that are specific to the family’s interactions and structure.
What are techniques of Restructuring in Strategic Therapy?
- Enacting transactional patterns
- Recreating communication channels - having family members talk to each other, not about each other
- Manipulating space
- Escalating stress, to see how they manage it and help them practice coping strategies
- Assigning tasks/homework
- Reframing
- Unbalancing (joining a subgroup and using authority to change dynamics)
What are key concepts across all forms of Strategic therapy?
- Not interested in how problems got started!
- Families seek homeostasis and resist change
- There are unspoken family rules
- Whether a challenge becomes a problem depends on the family’s response to it. There isn’t a problem if the client doesn’t see it as a problem!
- People are always communicating – one cannot communicate!
- Some communication is not intentional, conscious, or successful
- All messages have report and command functions
- Symptoms are messages
- Reframing is important
- Content vs. process
- First vs. second order change
- Paradoxical interventions
- Irreverence towards the problem
- Trust in the family’s abilities to change and their strengths
How do therapists use Reframing in Strategic Family Therapy?
With reframing (“News that makes a difference”), the therapist helps the clients think about their situation differently, to create a fundamental shift in their mindset and open up new opportunities.
Reframing creates a different sense of reality; it gives family members the opportunity to perceive their interactions or situation from a different perspective. Reframing is a re- structuring technique that typically does not cause the therapist to lose his or her rapport with the family.
This is a “constructivist” position - creating an alternative, yet equally plausible, explanation for the same set of facts. First, need to know the client’s current view.
What are Report & Command functions in communication, in Systemic therapy theory?
The Report conveys information (= content).
The Command is a statement about the relationship (somewhat aligned with process).
Command messages are implications, patterned as unspoken instructions for how the hearer should take the message, i.e. family rules. People/families are generally unaware of them.
What is the typical process of Strategic Family Therapy?
- Phase 1 - Joining & Obtain basic info
- Phase 2 - Assess & define the problem - often using enactments
- Phase 3 - Interactional diagnosis: Determine behaviors maintaining & reinforcing the problem (feedback loops, rules)
- Phase 4 - Set goals for treatment - measurable & observable - in collab w/family. Explore previous attempts to fix the problem.
- Phase 5 - Restructuring change - Select & make behavioral interventions with an eye to second order change
- Phase 6 - Termination
How does Joining work in Strategic Family Therapy?
- Establish a therapeutic relationship with clear rules
- Therapist sets up a new system
- Each person in family is respected & recognized
- Therapist attends to each client’s experience
- Therapist recognizes interactional patters
- Therapist validates family members
- Therapist notes how the family is organized
- DON’T challenge structure too early!
What role do Enactments play in Strategic Family Therapy?
- Allow therapist to directly observe interactions
- Show patterns of interaction
- Crucial for diagnosis
- Not interested in how problems got started!
- Concerned with present observable interactions
Is a Strategic therapist concerned with the past, present, or future?
The therapist works in the PRESENT.
- Diagnosis via interactions in the present that demonstrate the problem
- Working to get behaviors in therapy to mirror behaviors at home
- Creating the here and now in therapy
What is the goal of restructuring in Strategic Family Therapy?
To create more adaptive alliances, shift boundaries to create flexibility and improved connections, and open up lines of communication
Who founded the Mental Research Institute (MRI)?
Who else was on staff?
Richard Fisch and Don Jackson founded MRI.
Paul Watzlawick - co-founded Brief Therapy Center at MRI
John Weakland - co-founded Brief Therapy Center at MRI
Richard Fisch - joined the Bateson group, then proposed creation of MRI. Co-founded the Brief Therapy Center at MRI.
Wendell Ray - former MRI director
Eileen Bobrow - founded & directs the Strategic Family Therapy & Training Center at MRI
Jim Keim - research fellow at MRI
What therapies were influenced by MRI?
- Jay Haley and Cloe Madanes’ Strategic Therapy (conceptualized prior to MRI) (the two were married)
- Virginia Satir’s Human Growth Model
- Solution-Focused Brief Therapy
- Milan Systemic Therapy
Who was in the Bateson Group?
Gregory Bateson
William Fry
John Weakland
Jay Haley
What was the Bateson Group known for?
Studying communication in families with members diagnosed with schizophrenia
Who originated the concept of Reframing, in Systemic-Strategic therapy?
The MRI team, which approached reframing from a constructivist position.
Who originated the concept of circular questions?
Jay Haley.
Circular questions = questions that ask about reactions or interactions.
The Milan group suggested circular questions gently help clients reframe issues for themselves.
What are different types of circular questions?
- Behavioral sequence questions
- Behavioral difference questions - how one person does something, vs. another person
- Comparison & ranking questions - who/what is most vs. least helpful?
- Before and after questions
- Hypothetical circular questions - what if’s
What are Directives?
Directives are basic Strategic techniques: directions for the family to complete a specific tasks, either within the session or between sessions. Directives are meant to perturb the system’s interaction patterns to create new interactions. The changes may seem inconsequential or even playful: a different place, timing, or style.
Haley & Madanes originated this idea.
Directives get people out of their rut with the smallest change possible.
Who was Karl Tomm?
- Founder of Calgary Family Therapy Center at U Calgary in 1973
- Creator of Tomm’s IPScope
- Also developed internalized other interviewing, in which a therapist interviews a client’s internalized image of their partner.
Who was Cloe Madanes?
- Co-founder of Family Therapy Institute in Washington, DC
- Co-creator with Jay Haley of Strategic Therapy
- Also at MRI
