Systemic Therapies: MRI Institute and Milan Therapy

Introduction

• Dr. Diane Gayhart's online lecture on systemic therapies.
• Covers the MRI Institute and Milan therapy in this part.
• Part two will cover strategic therapy.
• Lecture accompanies textbooks: "Mastering Competencies in Family Therapy" and "Theory and Treatment Planning in Family Therapy" published by Cengage.
• Systemic Family therapy originated in the 1960s by three groups:
  • Mental Research Institute (MRI) or Palo Alto Group associated with Gregory Bateson.
  • Milan Systemic Approach from Milan, Italy.
  • Strategic therapy linked with Jay Haley and Chloe Madonnas.

MRI Systemic Therapy

Overview

• One of the first groups to develop systemic therapy.
• Emphasizes viewing symptoms within the broader family and social networks.
• Focus on introducing small yet meaningful changes to family patterns.
• Not about correcting dysfunctional patterns but allowing natural family reorganization.

Systemic Reframing

• Reframe problems in terms of family dynamics, not individual pathology.
• Look for alternative explanations for symptoms.
• Example: Child acting out unifies parents, acting as a distraction from their issues.

Therapeutic Techniques

• Interventions are about interrupting patterns (e.g., changing the environment of an argument).
• Therapeutic relationship: More technical rather than empathetic.
• Maneuverability: Therapist adapts style to promote change.

Case Conceptualization

• Focus on interactional patterns, not individual psychopathology.
• Key concepts: Homeostasis, positive feedback, corrective action.
• Metacommunication: Communication about communication.
• More of the same solutions: Terrible simplifications, utopian syndrome, paradox.

Milan Systemic Therapy

Overview

• Developed by a team in Milan after studying at MRI.
• Focus on cybernetic theories of Gregory Bateson.

Key Contributions

• Circular Questions: Explore interactional dynamics gently.
• Family games: Interactional patterns as relational rules.
• Language use: Shift descriptions from nouns to verbs.

Therapeutic Relationship

• Neutrality and multipartiality: Honor all perspectives.
• Curiosity: Interest in each person’s perspective.
• Irreverence: Creative freedom in therapy.

Interventions

• Positive connotation: Positive reframing of symptoms.
• Counter-paradox and rituals: Address double binds and shift meaning.
• Invariant prescription: Sever covert coalitions.

Application Across Cultures

• Systemic approaches have no theories of health, adaptable across cultures.
• Useful in LGBTQ+ contexts and adolescent therapy.
• Evidence-based models focus on conduct disorder and substance abuse.

Conclusion

• MRI and Milan approaches are distinct but share similar concepts and techniques.
• Both focus on perturbing interactional sequences but differ in their emphasis: MRI on behavioral changes, Milan on language and meanings.