Milan Systemic Family Therapy Model

Key Buzzwords

• Games: Family games, dirty games; related to control, power, influence.
• Circular: Circular causality and circular questioning.
• Therapeutic Team: Unique to Milan model.

Background

• Developed by four psychiatrists in Milan, Italy, in response to psychoanalysis limitations.
• Focus on incorporating family interventions for issues like anorexia nervosa and schizophrenia.
• Based on the idea that family involvement reduces relapse rates in mental illness treatment.

Key Concepts

• Family as a self-regulating system: Homeostasis achieved through trial and error.
• Family Games: Patterns and rules within families that influence power dynamics.
• Alliances: Subsystems formed within families due to repeated patterns.

Maladaptive Behavior

• Dirty Games: Tactics used to avoid change, often subconsciously.
• Example: Child acting out to avoid family change or manipulation through psychosis.

Therapy Goals

• Recognize influence and power within the family.
• Acknowledge and practice new patterns; create a new family game.

Unique Aspects of Milan Therapy

• Therapeutic Team: Multiple therapists involved, one or two interact directly with family.
• Structured Sessions:
  1. Pre-session team discussion.
  2. Family interview.
  3. Team discussion post-interview.
  4. Conclusion and task assignment.
  5. Plan next session.
• Observational component: Use of a one-way mirror.

Techniques

• Hypothesizing: Focus on identifying family alliances.
• Neutrality: Therapist remains an ally to all family members, accepting differing perceptions.
• Circularity:
  • Circular causality: Influence of actions and behaviors.
  • Circular questioning: Encourages perspective-taking among family members.

Circular Questioning

• Encourages family members to consider others' perspectives.
• Examples include scaling questions and hypothetical implications.

Conclusion

• Milan model is characterized by its structured, scientific approach.
• The aim is to empower families by recognizing and altering patterns of influence and alliances.

Engagement

• Open invitation for feedback and requests for covering other models.
• Encourages sharing and discussing the model with others.

Personal Note

• Stephanie finds techniques like circular questioning valuable even outside the full Milan approach.

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This summary covers the key points from Stephanie's lecture on the Milan Systemic Family Therapy Model, outlining its concepts, techniques, and unique aspects that differentiate it from other models.