Strategic Family Therapy the main offspring of cybernetic theory marriage and family counseling with dr. sparrow

Systems Concepts A family is a rule-driven system When families encounter developmental or environmental stressors, they tend to enforce the rules instead of accommodating new challenges (i.e. family homeostasis)

Systems Concepts families tend to interpret emergent problems (e.g. teenager’s staying out late on the weekends) as reason to assert the old rules (“He’s being rebellious and should be punished”), instead of a reason to change the rules. (“He’s growing up and needs to be given more freedom and responsibility.”)

Original Premises Families are resistant to change (homeostasis) -- outdated; now family therapists accept the concept of morphogenesis, as well, which is the desire to change and outgrow the status quo Families have to be tricked into change, and don’t need to be informed about what the therapist is doing (outdated)

Original Premises Families are caught in perpetuating non-solutions through reciprocal dynamics (Wife: “The harder I try to get his attention, the more he withdraws and calls me a nag.”) Remember the approach/distancer, overfunctioning/underfunctioning dynamic. Directives that are tailored to a family’s needs can bring about dramatic change (Therapist: “I want you to keep one secret from your husband and see if he can guess what it is,” or “Sometimes, people who are as depressed as you are want to push their spouses off a tall building. So tell us what’s bothering you so you won’t have to be depressed or find a tall building.”

Why Problems Develop MRI Brief Therapy Group: escalation of misguided “solutions” Haley: incongruous hierarchies Haley: covert control through symptoms Mandanes: symptoms serve a function in the family -- they mean something

Assessment & Intervention Identify efforts to maintain status quo that are not working determine the rules find a way to change rules; reframing Haley -- identify inadequate parental hierarchies Haley -- identify the interpersonal payoff Mandanes -- determine how are symptoms are functional

Interventions Reframing -- changes perception of symptom, may make symptoms fit with family rules, or may initiate changes in rules Assign Ordeal -- removes the interpersonal payoff of symptoms (The next time you decide you don’t want to go to bed with your wife by midnight, then why don’t you do something useful and clean the house?) Assist children in helping parents openly to eliminate need to engage in sacrificial behavior (e.g. taking care of Junior so parents can go out on a date instead of getting in trouble so they can work together to deal with a crisis.)

Erickson -- introduced rapid change tactics drawn from hypnotherapy. He introduced paradoxical interventions, such as: predicting continuation of symptoms (e.g. you will probably keep having at least one or two arguments a week) using indirect suggestion, and metaphor to activate dormant capabilities, such as the suggestion to have dinner by candlelight Interventions

one-downsmanship to defuse resistances. “I don’t know exactly what you need to do, but if you talk to your husband, but I suspect that in a few minutes something will occur to one of you... prescribing symptoms, encouraging resistance, etc. under slightly different conditions (I think it would be a good idea to keep having at least one argument a week,at least until you really start listening to each other.) Interventions

restraining or slowing down change (I think you’re getting over your differences a little too quickly, and could have major setback, you need to slow down and make sure that you don’t overlook something important.) Providing an experience from which the client will discover resources that he or she was not aware of. Climbing Squaw Peak Taking the social phobic man out to eat Interventions

Paradoxical directives make it difficult for the client to resist you fail This is called a “therapeutic double bind” Example: Tell your spouse that you think it would be a good idea for him/her not always to listen to everything you say. Interventions

Whatever I say, do not close your eyes... Example: Tell your teenager to complain more loudly and persuasively so he won’t be keeping everything locked up and make himself sick. Example of my client whose husband wouldn’t show her any attention. Interventions

Goals of therapy Behavioral change first order change: When therapy results in behavior changes second order change: When therapy results in a change in family rules Address presenting problem through structural reorganization support parental hierarchies enforce generational boundaries

Therapeutic Process Four stages: social stage (i.e. joining) problem stage (i.e. problem description and spontaneous sequences of behavior) interaction stage (i.e. enacting new dynamics) Are there triangles/coalitions? Dsfunctional hierarchies? goal-setting stage