Milan Systemic model

Gianfranco cecchin

Leaders : 

Boscolo, Palazzoli, Prata, Cecchin

This therapy gets its name because of the origin Milan,Italy. This therapy is based on team approach. this approach would look at both structural (power struggles and games) and functional models to the problem.

Assumptions :

1. Family systems involve language, relationships, and differences which comprise complex circular interactions that are beyond linear understanding. Observers are subject to errors because of the limitations of our brains.
2. There are different levels of meaning in behavior. The may is not the territory…and the behavior we observe provides information about the organization of a system. Family systems have homeostatic functions. Family member interactions are described as a showing of behaviors as opposed to a way of being.
3. No distinction exists between the "symptom" of an identified client and the "symptomatic behaviors" shared by all members of the client's family.
4. All systems have some way of organizing themselves.
5. Each family system presents a therapist with conflicting sets of information. Change me/don’t change me.
6. Much of family interaction takes place at a non-verbal and unconscious level. Families cannot verbalize interactions or provide insight. Interventions should be made to jog the system within its own structure.
7. Intent of therapy is to disrupt the homeostasis of the system by confronting them with rituals, behaviors, prescriptions, or insights that capture different levels of meanings within the family structure.
8. A covert family game is a useful metaphor for describing family dynamics and processes that maintain the symptomatic behavior of family members. The behaviors and attitudes of family members are viewed as moves with the purpose of perpetuating the family game. All family interactions are geared toward the continuation of the game and increased involvement amongst its players. "Anything goes" as long it serves to perpetuate the game.
9. Families will induct therapists into the family game and therapists have to avoid this tendency. Therapy is supposed to be neutral and distant.
10. Milan therapists do not believe in normality for families. Families should have clear generational boundaries.

Assumptions according to Palazzoli, Cecchin, Boscolo, and Prata (1978):

1. The family regulates and organizes itself by adhering to rules or guidelines that are formed through the process of trial and error ("a series of transaction and corrective feedbacks").
2. In pathological systems, people have the habitual inclination to repeat established solutions so that they can maintain balance within the family.
3. It is an error in thinking to say that one person's actions are the direct cause of another person's behaviors.
4. Power does not belong to anyone involved in an interaction, but rather in the rules of the game (which cannot be altered by people in the situation). Nobody wins and nobody loses, though each player may believe in secret that they are winning.
5. Every family transaction is a series of behavioral responses which influence other behavioral responses and so forth.
6. A relationship must be clearly defined before its redefinition can be made possible.

Key concepts to keep in mind 

• family games (patterns that maintain the problem)
• invariant prescriptions
• rituals
• positive connotation
• hypothesizing (the therapy always starts with hypothesizing the problem, which might change in course of future therapy sessions)
• therapy team
• circularity, neutrality
• incubation period for change
• equifinality

Assessment

1. family games
2. dysfunctional patterns

Interventions

• Ritualized prescriptions 
• rituals
• circular questions
• counter paradox
• odd/even day
• positive connotation (developed from MRI model's reframing technique) use of this techniques , the symptom is reframed as protective function
• reflecting team
• letters
• prescribe the system
• paradoxical injuction - do more of the same - a strategy to produce opposite effect (eg : asking a teenager who is depressed to remain depressed)

Reference :

http://postmoderntherapies.wikispaces.com/Milan+Family+Therapy

To practice :

http://quizlet.com/21238910/milan-systemic-family-therapy-flash-cards/