Strategic- Source of motivation

1. Strategic- Source of motivation Normal families are: • Flexible enough to modify solutions that do not work. • Flexible enough to adjust to development.

2. Strategic- View of human nature Positive feedback loops- . Hierarchy and structure in families. People can be temporarily off track Symptoms are the result of misguided attempts at changing an existing difficulty. Attempted solutions to the problem are what maintains the problem.

3. Strategic- View of human nature • Symptoms and attempted solutions are imbedded in a recursive feedback situation. • Symptoms are a homeostatic mechanism regulating marital or family transactions. • The focus is not so much on family therapy theory, as it is no the theory of what contributes to change.

4. Strategic- View of human nature • Feedback loop is a positive loop that equals: problem – attempted solutions – more problems – more (greater) attempted solutions, etc. Positive feedback loop says keep going in the direction. The answer is a negative feedback loop (restraint of any of the points in the system) or 1800 change.

5. View of problems • Relativistic view of family life as well as human behavior. • Neutrality with respect to life. • Problems are only defined as such by those who are involved and who believe them to be problems.

6. Strategic- Development of pathology • Problems maintained through misguided solutions. (attempted solutions). • Problems in hierarchy or structure • Functional problems- Members try to protect or control others. (no longer seen as a function of the symptom but as a misguided attept to correct the problem.

7. Strategic- BriefNature of problems • Problems are typically situational Adapting to life changes Treat ordinary problems- overemphasis Treat difficult problems- underemphasis Problems maintained through positive feedback loops

8. Strategic concepts • First order change – is a difference that occurs within a system according to the rules of that system. (compliance) we think it is a logical change to a problem. • Second order change – a change in the rules of the system, thus the change is within the system. (operating principles are changed) It is outside the box change that effects the whole system – Tx, Pt., Etc. • Manipulation is unavoidable (all relationships have hidden agendas).

9. Connect the dots using only four straight lines. * * * * * * * * *

10. Strategic concepts • Utilization – using persons strengths to effect change. • One down vs. one up – utilizing hierarchy and complementarity as a means of changing patterns. • Rituals – forcing changes in patterns through ordeals. (breaking up is hard to do) • Tasks will compress to the time allotted.

11. Strategic concepts • Implications (Illusion of alternatives) • Metaphors – unconscious bypass • Directives - homework – (poor grades, but high ability) • Reframing • Restraining – go slow, there are costs and reasons not to change so quickly. • Positive Connotations – No one can change when the system has a negative connotation of them.

12. Strategic Therapy founders • MRI – Brief therapy; communications theory, theory of change (not therapy). (second order change) • Jay Haley – (Milton Erickson’s hypnosis) and later adding Minuchin’s structural work. Think structural, work strategic. (The purpose of therapy is behavior change, not insight). • Milan Team – Paradox and Counter paradox, prescribing the symptom, Batesonian view of systems.

13. Milton H. Erickson, M.D. • Each person is a unique individual. Hence, psychotherapy should be formulated to meet the uniqueness of the individual’s needs, rather than tailoring the person to fit the Procrustean bed of a hypothetical theory of human behavior. • When presented with Christ, have Him make bookshelves.

14. Jay Haley & Cloe Madanes • Jay Haley is widely acclaimed as a pioneering therapist and master teacher. Haley has served as Professor at the University of Maryland, Howard University, the University of Pennsylvania and US International University. He was Director of Family Therapy Research at the Philadelphia Child Guidance Clinic and Co-Founder of the Family Therapy Institute of Washington, D.C. • Hallmarks are redefining the symptom as behavioral and solvable, using directives, and paradoxical interventions. Use of pretend to work around resistance.

15. MRI • From the roots of communications theory, the MRI provides a simple yet effective method of change. • Determine customership • Assess the presenting problem • Determine the attempted solutions • Get commitment to try a 1800 • Assess outcome and either retry or terminate. • Treatment failures are seen as the result of the therapist either misunderstanding the problem, or not communicating well.

16. Milan Team • Batesonian view of systems • Respect for system’s own wisdom • Paradoxical intentions • Reframes families reluctance as their wisdom at not wanting to change or rock the boat. • Use of team and long breaks in beteen sessions.

17. Strategic- Nature of change • Primary goal is resolution of presenting problem. • The guidepost of change is to assess level of commitment to change. • Customer (involved in all dimensions, agreement with goals, treatment process, assessment of outcome) • Complainant (someone else is the problem – goal is to get them to either bring in the person that they complain about, or find ways of changing their own behavior that will create other changes – Weiner-Davis) • Visitor (checking Tx out – goal is to make them comfortable so that they might engage at a later time)

18. Strategic- Brief therapy • Weakland, Watzlawick, & Bodin • MRI Brief therapy: • 10 one hour weekly sessions • Attempted solutions are the problem • Bigger Hammer theory – doing more of the same, rather than finding new alternatives. Work to change sequence – do something different.

19. Strategic- Brief therapyPhilosophical assumptions • Problems maintained in families by behavior. • If problem-maintaining behavior changes, problem changes. • Minor changes or re labeling leads to behavior change

20. Strategic Techniques • Therapeutic change comes about through and interactional process that occurs when a therapist intervenes actively and directively in a system. • The therapist works to substitute new behaviors or sequences for the vicious, positive feedback circles already existing. • The goal is to change the dysfunctional sequences of behavior.

21. Strategic Techniques • The utilization of tasks and directives is the cornerstone of this approach. • The problem must be put in some solvable form. It must be something that is objectively agreed upon, so all can assess the outcome (poor self-esteem is not a good goal, unless accompanied by behavioral tags).

22. Strategic Techniques • Considerable emphasis is placed on extra-session (outside of sessions) change – altering the process occurring outside the sessions. The use of directives, homework, experiments, etc. are used to create opportunities.

23. Strategic Techniques • Power struggles with the family (client) are generally avoided, the tendency being to take the path of least resistance and use indirect ways of turning the family’s involvement into positive use. • Positive interpretation to the client of its symptoms or motives and homeostatic tendencies are employed.

24. Strategic Techniques • Paradoxical interventions, restraining change, “go slow” messages, and prescribing the symptom are typical techniques used in strategic therapy, and may be directed toward the whole family or to certain members.

25. Strategic- BriefGoals for change • Small, concrete, behavioral goals Interrupt feedback loops

26. Strategic- Brief- Stages of treatment • Introduction to treatment Definition of problem Estimation of behavior maintaining problem Setting treatment goals Selecting and making interventions Termination, evaluation and results

27. Strategic- MadanesConceptualizing problems • Involuntary vs. voluntary behavior Helplessness vs. power Metaphysical vs. literal sequences Hierarchy vs. equality Hostility vs. love Personal gain vs. altruism

28. Strategic- MadanesGoals of therapy: • To dominate and control- Fear Correct hierarchy Negotiations and contracts Changing benefits Rituals and ordeals

29. Strategic- MadanesGoals of therapy: • To be loved- Desire Change parental involvement Prescribe the symptom Prescribe a symbolic act Prescribe pretending of symptom

30. Strategic- MadanesGoals of therapy: • To love and protect- Despair Reunite family members Change who is helpful to whom Empower children to be helpful Orient to future

31. Strategic- Madanes • Goals of therapy: To repent and forgive- Shame 16 step process

32. Strategic- Madanes • Eliminate secrets Discuss offense Spiritual pain Spiritual pain of victimizer Pains of victimizer Spiritual pain of family Victimizer repents Family repents

33. Strategic- Madanes Discuss consequences • Meet victim alone Find protector Reparation Orient to normal life Restoration of love Restore victimizer Offender self-forgiveness

34. Connect the dots using only four straight lines. * * * * * * * * *