Defining principles of Strategic family therapy

Strategic therapy focuses on present observable behavioral interaction and uses deliberate intervention to change the ongoing system. Family therapy doesn’t consist in having everyone present in the therapist’s office but in working from an interactional point of view. Effective intervention usually requires reframing. Strategic family therapy is brief; its duration is about 3 months and ten sessions.

I.Defining principles

1.Reality is constructed: there is no truth Reality is a social concept, fluid, not fix. We are all in a different chair, so we have our own perspectives of reality. We perceive things differently (filters). We have inner belief that we believe the same thing but there is nothing such as a reality. The therapist has a view of what the problem is and his view determines how he organizes the therapy, who is involved and what intervention he will be doing.

2.The problem is not individual: it is interactional, in the system All behavior is viewed as being structured and maintained by interactions between people, especially in the family system but also in other systems such as school or organisations. Problems are outcome of everyday difficulties in adaptation to a life change or transition, mishandled by the parties involved. The question is: what behavior in the system is maintaining the problem? Sometimes, the problem seen through a subsystem is unsolvable. Situating in a larger system gives the necessary information to understand it and the leverage to solve it The unit (the client) is all people involved in the problem.

3.The attempted solution is often the problem The attempted solution maintains the problem and makes the problem worse. It’s a vicious cycle. Change must be of the second order to break the pattern. We draw from our past something that worked before. People with difficult problems have a hard time in finding a new coping. What’s important is to give up the old coping: 180° turn is not the opposite but a significant shift in another direction.

4.The therapist enters the client’s world Through attentive observation of verbal and non verbal behavior, the therapist tries to understand the client’s language, perception, beliefs, values in order to find motivation for change.

5.The therapist changes the meaning by reframing He reframes the problem situation so that the values and motives of the client will allow him to accept the change. He uses the belief system and the social context of the client to disrupt his pattern. He changes the perception by reframing. For instance: “ Anxiety is an important function. It is your body’s signal that something is wrong. It’s a protective signal”. What do you need to do to answer the signal? Learn how to use it and to lower it. In understanding the situation, the therapist assumes that any behavior is protecting a person in the system. He rewrites the story.

6.The therapist builds a contract with the client The therapist asks the client to define clearly a minimum goal for the therapy in terms of observable behavior. What new behavior would be satisfactory to him? The therapist has to agree to the contract as feasible and ethically acceptable.

7.The therapist elaborates a strategy What has been tried : work or did not work ? He proposes a solution that generally fixes the hierarchy or interrupts the sequence of interaction that maintains the problem. He uses hypnosis tools: Confuses the process by dissociation Amplifies the confusion Makes Indirect suggestions Offers alternatives Proposes metaphores, anecdotes

8.The therapist uses paradox The therapist prescribes the symptom. Do more the same: low level primitive type of paradox. When you tell people to do what they are doing, they cannot do it any more. Still, paradox is not used systematically, but with oppositional clients when other things didn’t work. Example: Schedule your anxiety. When can you be anxious and still be safe? If you can bring it on, you can get rid of it. To limit the risk, build safeguards: how do you sense that anxiety is too much? How do you stop it when it’s too much? Activate a sense of control.

9.The therapist gives homework Often the homework is initiated and enacted during the session. It extends the therapy to the week and makes the client collaborate with the therapist. It helps him experiment a small change and allows him to build his strength step by step. The change disrupts the homeostasis of the system and allows to experiment new behaviors. The therapist always starts the new session inquiring about the realization of assigned homework. If the homework is done, the therapist compliments the client and listens to his report about how it was and its benefits. If the homework isn’t done, the therapist acknowledges the fact and shifts to an indirect approach.

10.The therapist seems concerned about the progress The therapist: it is too much. You need to slow down and have real small change. Restraining progress allows client to feel in control, no pressure. Then, he is more likely to do it himself.

11.The client decides when the therapy is over and his goal is reached The client is master of the duration of the therapy.

Strategic family therapy differs as well in its spirit and procedure of more traditional therapies that are individual, strive to seek the origin of the troubles in the past and expect the change from the insight of the causes of the behavior. The therapist abandons his passive and neutral attitude, limited to interpreting the Speech of his client, to become an actor and partner responsible for the change. Doing so, the therapist gets close to the Gestalt approach and hypnosis and away from psychoanalysis.

The strategic approach to family therapy is based on two basic concepts: there is no pathology, there are problems. These problems are generated by the operating system and maintained by the players. There is therefore no individual patient to be treated. This approach has the advantage of impacting all stakeholders and produce a new long-term equilibrium.

Moreover, as it is part of the brief therapies, a number of sessions and a deadline is set by mutual agreement with the client. This avoids the endless drift of therapy and the development of dependence family / therapist. Allowing it to fit properly in the context of payment by a third party.