1. Strategic Family Therapy
Chapter 6

2. Theoretical Formulations
• Watzlawick, Beavin and Jackson focused on mapping the
framework of human communication using the concept of
The Pragmatics of Human Communication
• The Pragmatics of Human Communication is composed of a
series of different axioms
• The first axiom states that people are always communicating
• It is important to remember that the framework of all behavior
is communicative
• Communication still takes place in situations where there is
an absence of mutual understanding; or if it was done
unconsciously or unintentionally
• The second axiom states that all messages contain two
functions: report and command

3. Theoretical Formulations
• The presence and utilization of Command
messages within a family, results in the
individuals accepting these messages as rules.
• This phenomenon can be witnessed from the
observation of the redundancy of interactions
between family members
• Don Jackson used the term family rules to
describe regularity, and not regulation.
• There isn’t a specific individual who sets the
rules; as a matter of fact, family members
often fail to recognize their presence.

4. Theoretical Formulations
• The rules which govern family interaction
function as a method of ensuring the maintenance
and preservation of family homeostasis.
• Homeostasis is responsible for bringing the family
back to its original state (equilibrium) when
experiencing any type of disturbance; making the
family very resistant to change
• Jackson’s definition of homeostasis closely
resembles the conservative idea of a family
system; as well as, bearing a very close
resemblance to the concept of negative feedback.

5. Theoretical Formulations
• Communication researchers hold that families are
inherently goal-oriented
• Researchers decided avoided searching for basic
motives
• Instead they chose to assume circular causality, in
order to investigate specific modes of communication
bonded by additive chains of stimulus and response
as feedback loops
• For example if a member of the family elicits a
response in reaction to a challenging behavior or
situation exhibited by another member of the family,
this response chain is defined as a positive feedback
loop

6. Theoretical Formulations
• The benefit of this procedure lies in its focus
on specific relationships which cause various
difficult situations.
• These interaction can then be modified and
altered, instead of making various assumptions
about the causes; which are very resistant to
change

7. Theoretical Formulations
• Strategic Therapists employed the concept of the positive
feedback loop as the primary component of their models
• The MRI therapists stated that all families will inevitably
come into contact with a number of problems in their lives
• The reactions exhibited by the family in response to the
aversive or unfavorable events, determine whether or not
the difficult transforms into a problem
• Families make various attempts, which at the time seem
reasonable; but in actuality, turn out to be faulty attempts
made in trying to uncover a resolution for their problems
• When they discover that their issues still exists, individuals
end up using the same ineffective and maladaptive
response methods
• This results in the production of a vicious cycle of these
behaviors.

8. Theoretical Formulations
• The majority of family behaviors are controlled and
regulated by unspoken rules
• Rules promote and encourage inappropriate solutions to
problems; it turns out that it isn’t only the behavior needing
to be altered, but the rules need to be changed as well
• First-Order Change occurs when only a particular
behavior within the system changes
• Nichols defines First –order changes as temporary or
superficial changes within a system that do not alter the
basic organization of the system itself
• Nichols defines Second-order changes as basic
changes in the structure and functioning of a system
• Second-Order Change takes place when there is a
modification or alteration to the rules within the system

9. Theoretical Formulations
• The question remains of “ How Do We Change The Rules?”
• One method which can be utilized to change the rules is through
Reframing
• Reframing involves the complete transformation of the families
definition of behavior; in order to facilitate, its compliance and
willingness to achieve therapeutic change
• The method used by the MRI group to deal with problems
is :
1. Identify the positive feedback loops responsible for
maintaining the problem
2. Determine the Rules or Frames supporting those
interactions
3. Find a way to change the rules to interrupt the
maintenance of the problem

10. Theoretical Formulations
• Jay Haley stressed the importance of the
rules surrounding the hierarchical
structure of family
• Haley believed that the cause of most
behavioral problems lies in ineffective
parenting hierarchies
• Haley utilized Erikson’s method for
ordeals ; in order to set a higher price for
the individual, for maintaining a symptom
than for giving it up

11. Normal Family Development
• The General Systems Theory model states
that normal families, like all living systems,
depend on two vital processes:
• They maintain integrity in the face of
environmental challenges through negative
feedback
• All living systems require a coherent structure
in order to survive; however having an overly
rigid system hinders the families ability to
adapt to changing conditions and situations
• This is the reason why appropriately
functioning families also possess a positive
feedback system

12. Normal Family Development
• Negative Feedback defends the system from
any disruptions in order to provide a state of
stability and balance
• Positive Feedback works to intensify or increase
change in order to adjust to various alterations
and variations of events and behaviors
• In essence, the main point is that healthy
families have the capability and willingness to
change.
• This is achieved as a result of the establishment
and preservation of open and clear lines of
communication; as well as, the families
adaptability

13. Normal Family Development
• The individuals in the MRI group firmly oppose
the idea of standards of normality, stating that
• “As therapists, we do not regard any particular
way of functioning, relating, or living, as a
problem if the client is not expressing discontent
with it.”
• The MRI group strongly opposed taking a
position regarding what they believe constitutes
proper or appropriate behavior in families.
• The Milan Associates made every effort to
maintain a position of neutrality; refraining from
using any preconceived goals or normative
models when treating families.

14. Normal Family Development
• They chose to discuss various questions and
uncertainties; which in turn, facilitated the families
ability to examine themselves.
• The central focus of Haley’s approach concentrated
on the notion of sound family functioning
• The purpose of his therapeutic method aimed to assist
families in the process of reorganizing themselves,
into more functional structures; which encompass
explicitly stated boundaries, as well as a generational
hierarchy

15. Development of Behavior Disorders
• Communication theory stresses that the fundamental
purpose of symptoms is responsible for sustaining
homeostasis within the family
• Poorly functioning families were regarded as being
trapped in homeostatic, dysfunctional patterns of
communication
• These particular families displayed a strong adherence
towards inflexibility; responding to various alterations
and modifications as negative feedback
• These particular families regard change as something that
is threatening; instead of an opportunity for growth

16. Development of Behavior Disorders
• Strategic Models provide three different explanations, which
describe the method by which problems develop
• The first is Cybernetic: Difficulties are turned into chronic
problems by misguided solutions, forming positive-feedback
escalations
• The second is Structural: Problems are the results of incongruous
hierarchies
• The third is Functional: Problems result when people try to
protect or control one another covertly, so that their symptoms
serve a function for the system
• The individuals in the MRI group associated themselves with
only the first explanation
• Haley and The Milan Associates acquainted themselves with all
three explanations

17. Development of Behavior Disorders
• The central theme of the strategic model states
that self-defeating behaviors are responsible for
the maintenance of problems in an individuals
life
• Haley drew attention to the notion that self-
defeating patterns of behavior may possibly be a
contributing factor to dysfunctional family
organizations
• Families must be able to alter their configuration
or construction in order to facilitate changes
within the family

18. Goals Of Therapy
• The therapeutic methods of Strategic Family Therapy
proclaims that as soon as the individuals presenting
problem is treated, the therapy is terminated
• The policy of terminating therapy as soon as the
presenting problem is resolved, even extends to
situations where other issues exist.
• If the family members fail to personally request
therapeutic intervention for these behaviors, the therapist
refrains from targeting them
• MRI therapist provide an explanation in regards to this
issue by stating that, they view those individuals who
have problems as being stuck rather than sick
• Their role and responsibility as a therapist lies in proving
a little assistance or a small push to help the individual
get moving again

19. Goals of Therapy
• One of the obligations that MRI therapists are held
responsible for is assisting the family members to
identify and define clear, attainable goals; this way all the
family members are made aware to recognize when the
treatment is deemed a success
• Strategic therapists go on to state that the majority of the
time in the treatment session is spent driving and
motivating the clients to establish a set of clear
behavioral goals
• The reason for this is that through the establishment of
clear behavioral goals, clients are pressured to clarify
ambiguous dissatisfactions
• Pushing clients to provide concrete definitions of their
goals, leads to the disappearance of their utopian
desires and wishes; which almost always result in
disappointment

20. Goals of Therapy
• The foundations of the MRI model are behavioral in its goals,
as well in its observations of pattern interactions
• In order to achieve the largest objective of problem resolution,
the primary priority lies in altering the behavioral reactions
exhibited by the individual in response to their problems
• The therapist may employ a number of different methods to
accomplish their target goal of behavioral change
• Such as reframing the problem, while simultaneously,
presenting a cognitive element to the client.
• Strategic theorists should never engage in practices of placing
the blame on the clients lack of motivation, as a result of the
treatment failing; conversely, they should discover methods to
provide their clients with motivation

21. Conditions For Behavior
Change
• The MRI method of resolving problems is to alter
the behaviors that are associated with them
• The theory holds that through the client’s
visualization of the results that occur in response
to the alteration of rigid behavioral responses,
this will yield a higher degree of flexibility of
problem-solving skills in clients
• The presence of this event, causes clients to
achieve a second-order change (Changes in the
rules governing their responses to problems)

22. Therapy
Assessment
• The objectives of MRI assessment are
• 1. Define a resolvable complaint
• 2. Identify attempted solutions that maintain the
complaint
• 3. Understand the clients unique language for
describing the problem
• The first two goals direct the therapist to the
point where they should intervene, while the
third goal relates to the “how”

23. Assessment
• The first step of assessment requires the therapist to
become very specific regarding, the behavioral
complaint, the individual who sees this behavior as
maladaptive or problematic, and what features currently
make it a problem
• As soon as there is a clear definition of the problem, the
therapist goes on to determine the individuals who have
made attempts to try and solve the issue, and what
methods or interventions they used
• Posing this question, results in the appearance of a
specific procedure or method of the problem-solution
loop, as well as the target behaviors which will become
the focus of intervention
• The strategic method represents a 180-degree rotation
from what the client has previously been doing
• The main focus of assessment is to prohibit the
performance of the behavior responsible for maintaining
the problem

24. Assessment
• It is crucial to acquiring a solid understanding of
the clients’ unique language; along with the
specific modes they employ to see their
problem.
• It is vital component necessary to acquire in
order to facilitate the process of framing
suggestions; which relate with specific tactics
and strategies the client will recognize and agree
to

25. Therapeutic Techniques
MRI Approach
• The MRI model adheres to a six-step treatment
procedure:
• 1. Introduction to the treatment setup
• 2. Inquiry and definition of the problem
• 3.Estimation of the behavior maintaining the
problem
• 4.Setting goals for treatment
• 5.Selecting and Making Behavioral Interventions
• 6.Termination

26. MRI Approach
• Once the introductory steps have been completed, the
therapist then proceeds to ask for a clear definition of the
target problem
• If the client states the problem vaguely, the therapist
steps in to assist the process of translating the problem
to feature clear and concrete goals
• After a clear definition has been established for the
client’s problems and goals, the MRI therapist proceeds
to make inquiries about the previously attempted
solutions, which might serve as the feature responsible
for the maintenance of the problem

27. MRI Approach
• Typically, the solutions which have an inclination to be
held responsible for the production of the problems fall
into one of three categories:
• 1. The solution is to deny that a problem exists; action
in necessary but not taken.
• 2. The solution is an effort to solve something that isn’t
really a problem; action is taken where it shouldn’t be
• 3.The solution is an effort to solve a problem within a
framework that makes a solution impossible; action is
taken but at the wrong level

28. MRI Approach
• Once the therapist generates a strategy which will be
utilize for changing the problem- behaviors maintaining
the sequence, clients must then be persuaded and
influenced to ensure that they will adhere to this method
• To accomplish the goal of persuading the client, MRI
therapists reframe the problem in efforts of increasing
the probability that the individual will comply
• To produce a disruption of the problem-maintaining
sequences, strategic therapists may bring the family
members into play, by attempting to get the family
members to perform a behavior that contradicts common
sense.
• These types of counterintuitive techniques are called
paradoxical interventions
•

29. MRI Approach
• The methods that are frequently referred to as paradoxical
represent symptom prescriptions which communicated
information to the family instructing them to maintain or
elaborate the specific behavior they find to be problematic
• In some situations these types of prescriptions may be
accomplished with the anticipation that the family will attempt
to act in accordance with it, and in turn require the reversal of
their attempted solutions.
• In other situations the therapist may assign the symptoms,
while secretly desiring that the clients will react against their
assigned command with rebellion
• In other instances the therapists purpose of the prescribing
symptoms is to increase the likelihood that this will expose the
network of relationships maintaining the problem

30. MRI Approach
• MRI therapist attempt to steer clear of
undertaking a position of power or authority
• Their one-down stance stand for the
representation of equality, and summons
clients to decrease their levels of anxiety and
resistance

31. The Haley and Madanes Approach
• The definitive technique is the use of directives
(Homework Assignments designed to help families
interrupt homeostatic patterns of problem-
maintaining behavior)
• Haley starts out by interviewing the entire family
• His approach to his preliminary interview adheres
to a four stage model:
• 1. Social Stage
• 2. Problem Stage
• 3. Interaction Stage
• 4. Goal- Setting Stage

32. The Haley and Madanes Approach
Social Stage
• Initially family members display
defensiveness when they first come to
therapy; as a result, of not knowing what
to expect, or a fear that the therapist will
place all the blame on them for their
problems
• So Haley utilizes the first couple minutes
of the session to help everyone calm down

33. The Haley and Madanes Approach
Problem Stage
• Haley asks each individual to describe their personal
perspectives
• He asserted that since mothers are generally assume a more
focal role than fathers, Haley preferred to speak with the
fathers first in efforts of increasing their participation
• Haley makes a special effort to actively listen and understand
the manner used by each individual in describing the problem;
making it a point to prevent any interruptions before each
person has had their turn
• Haley uses this stage to locate and uncover various clues about
triangles and hierarchy
• Haley resists providing his comments and opinions about these
observations, to avoid running the risk of a particular family
member interpreting his comments in a defensive manner

34. The Haley and Madanes Approach
Interaction Stage
• When everyone has spoken, Haley instructs the family members to
talk to each other and discuss the statements and arguments each of
them made
• This stage provides the therapist with the opportunity to observe,
rather than just listen to the discussions and conversations which
surround the problem
• As the individuals converse, specifically looks to locate any
coalitions between the family members against one another
• Haley states that the definition of a truly effective therapist is not
someone who tells people what to do, but one who gets them to do it

35. The Haley and Madanes Approach
Haley
• An truly unique aspect about Haley’s technique is his
concentration on interpersonal payoff of psychiatric
symptoms
• The notion that individuals receive something from
their symptoms was rejected by the majority of schools
of family therapy because it was seen as a method of
placing blame on the victim
• The point that Haley was trying to emphasize, was that
the development of problems such as anxiety;
contained the possibility of influencing, promoting and
maintaining interpersonal struggles within the family

36. The Haley and Madanes Approach
Haley
• The primary goal of Haley’s treatment technique
is to understand the heart of the family drama
that symptoms revolve around
• Haley declares that people’s hardships carry a
deeper meaning with it, and in turn suggest the
ability of discovering reasonable solutions
• The solution lies in providing assistance to
families with finding new methods and
approaches they can utilize to resolve their
issues

37. The Haley and Madanes Approach
Madanes
• Cloe Madens illustrated the method by which one relationship
can metaphorically imitate another
• Madens also focused on attending to the issue of power
balance in couples, and the effects brought upon the role it
plays on numerous symptoms
• Her concentration focused upon the lives of couples, where
there is a regulation of power; including issues of money,
education, control of children, coalition with in-laws, religion
and sex
• What Maden discovered was that the partner who held the
least amount of power developed the most emotional problems
• Symptoms included: depression, headache, substance abuse,
eating disorders, and phobias
• Madanes made the observation that individuals will exhibit
behaviors they wouldn’t normally perform, if the behaviors are
framed as play to develop an entire range of pretend
techniques

38. The Haley and Madanes Approach
• The current name for Haley/Madanes
therapeutic approach is strategic humanism
• Its still entails giving directives, however the
directives are geared more towards
encouraging and strengthening the family
members capabilities to provide love and
comfort to each other,

39. The Milan Model
• The previous Milan Model operated through
treating families with a male-female co
therapist, while being observed by other
members of the team
• The customary layout contained 5 parts :
• 1. Presession
• 2. Session
• 3. Intersession
• 4. Intervention
• 5.Postsession Discussion

40. The Milan Model
• The Positive Connotation was by far the
most distinguished advance to emerge from the
Milan Model
• Positive Connotation is Selvini Palazzoli’s
technique of ascribing positive motives to family
behavior in order to promote family cohesion
and avoid resistance to therapy
• Rituals were employed in efforts of attempting
to engage families in a sequence of actions
which contradicted or exaggerated rigid family
rules
• Rituals were also made use of to dramatize
positive connotations

41. The Milan Model
• The Milan team originally represented therapy in
terms of a struggle to achieve power between
the therapist and the family
• Their main advice to the therapist was to remain
neutral and avoid taking sides
• The exhibition of neutrality in the therapist was
demonstrated as distance, so the therapist
presented their melodramatic statements all
while behaving in a remote and detached
• What ended up happening was families often
became infuriated and never returned to therapy

42. The Milan Model
• In the early 1980’s the original Milan group split.
• In the 1990’s Selvini Palazzoli reinvented her
therapeutic technique ; discarding the use of
short-term, strategic therapy for long-term
therapy with patients and their families
• The new technique focuses on understanding
the denial of family secrets and suffering over
generations

43. The Milan Model
• Circular Questioning hallmark feature
of the Milan Model
• Circular Questioning designed with the
intention of decentering clients by
orienting them towards seeing themselves
in a relational context and seeing that
context from the perspective of other
family members

44. Other Contributions
• 1. Strategic family therapists lead the way to the
establishment of the team approach
• The interaction between teams and the therapist paved
the way for later approaches where the team entered
into a room and openly discussed the family while they
watched
• 2. Functional Family Therapy focuses on the function
that family behavior is designed to achieve
• Functional family therapists believe that the majority of
behaviors exhibited by families are attempt to become
either more or less intimate and through relabeling,
facilitate the ability of family members being able to see
each others behaviors in a benign light
• Also assists families in setting up contingency
management programs to help them obtain the type of
intimacy they desire