Strategic Model of Family Therapy

The leaders of the strategic school of family counseling are:

• - Jay Haley, Cloé Madanes, and the Milan group:
• - Mara Selvini-Palazzoli,
• - Peggy Papp.

The main principles of the strategic school:

• - Relationships in the family are determined by the outcome of the spouses' struggle for control.
• - The task of psychotherapy is to give people other ways of exerting influence.
• - Counselors working within strategic (brief) counseling seek to resolve existing problems and pay little attention to depth of understanding.
• - A limited number of sessions of work with the family.
• - The emphasis shifts to the present; the principle of "here and now" applies;
• - One of the productive techniques is to give an instruction to adopt particular symptoms. In the course of therapy, families
• are invited to go through ordeals, for example to make a journey or to live through shared hardships.

The theoretical views of the representatives of this approach on the processes occurring in the family generally coincide with those characteristic of the representatives of the structural model. The differences from other approaches lie in the practice of the work. After a fairly long and thorough diagnosis of the family, one or several family members are given a fairly brief and clear invariant prescription, that is, a very precise instruction, admitting no changes, about what he should do and how. If the client carries out these actions exactly, they should transform the structure of the family in such a way that the symptoms of difficulty disappear.
In the strategic approach, a family is understood to be any group that lives together under one roof. Such a broad definition makes it possible to work with homosexual couples, complex families, and families who live together only periodically.


The main aspect of strategic family counseling consists in
assigning original homework in the form of prescriptions or
directives, and using metaphorical
and paradoxical tasks. The role of the therapist is active. Carrying out the
tasks ensures equality: each family member has the right to
express his own opinion.

The goals of the homework are:

• to change the behavior of family members;
• to make the relationship between the family and the therapist more intense;
• to study the reactions of family members while carrying out the tasks;
• to provide support for family members.

The main distinguishing feature of the school of strategic family therapy is the responsibility that the therapist takes on by developing a strategy that makes it possible
to solve the client's problem. The therapist always sets a clear goal that implies solving the problem stated by the client.

The therapist plans the stages or steps of the therapeutic process, directed consistently toward the goal. Particular problems always involve at least two or three people. The therapist decides which family members are connected with the presented problem and in what way each of them is involved in it. The therapist outlines an intervention intended to change the family organization. This approach pays great attention to the intrafamily hierarchy. It is considered an axiom that parents are obliged to be responsible for their children and to care for them.

Haley proposes a particular structure for conducting the first meeting with a family. This
scheme is especially useful for a therapist who is learning family therapy.

The first meeting with the family in Haley's therapy includes the following stages:

• - introduction;
• - defining the problem;
• - the interaction stage;
• - defining the goals;
• - prescriptions.

Introduction. The therapist introduces himself and asks each family member for his or her name. It is important to get a response from everyone, thereby emphasizing that everyone is included and important. The model for this stage is the politeness we would show when receiving guests in our home. The following points are important:

• - the mood in which the family has come;
• - the relationships between parents and children, and the methods of discipline the parents use;
• - the relationships between the parents and other adults;
• - whether any family member is trying to pull the therapist over to his or her side.

Defining the problem.

Shift the focus of attention to what the family came to therapy for. What is your problem? This question defines the situation as a context in which problems are talked about.

.
The interaction stage.

The therapist invites the family members to discuss the problem with one another. This gives an opportunity to see the problem "in action".
Special attention should be paid to any violations of the hierarchy and to a coalition - the actions of two against
a third.

Defining the goal.

The therapist makes a contract with the family; the problem and the goals must be clearly defined.
Find out what would be evidence to the family that the problem
has been solved. The main goal of therapy is the elimination of the symptom.

Prescriptions are instructions that the psychotherapist gives to the family. They are not advice; they are a clear
sequence of actions, clear steps. Prescriptions are carried out in the intervals between
sessions. There are 2 general types of prescriptions:

• - direct/directive ones, given when the therapist has sufficient power.
• - indirect prescriptions, used when the therapist has less authority.

2 classes of indirect prescriptions:

• - paradoxical
• - metaphorical (parallel, isomorphic, or using analogy).

Paradoxical prescriptions. Types of paradoxical prescriptions:

• prescribing the symptom;
• intensifying the symptom;
• doubting that the client will be able to endure the normalization of the situation;
• doubting that the client will be able to change;
• rewarding the manifestation of the symptom.

Steps in using paradoxical prescriptions:

• define a relationship that will lead to change;
• clearly define the problem or symptom;
• clearly define the goals of the paradoxical prescription;
• establish that the psychotherapist is the absolute authority in this case;
• devise some reason for the paradoxical prescription;
• give the paradoxical prescription;
• observe the changes at the next meeting and encourage the patients to continue carrying out the paradoxical prescription;
• once the positive changes are stable, the therapist should not claim them as his own achievement.

Haley identifies 3 functions of prescriptions:

• the main goal of therapy is to make people behave differently and have a different subjective experience;
• prescriptions are used to make the relationship between the family and the therapist more intense;
• prescriptions serve to gather information

See also

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See also

• 12. Family counseling