🔄MILAN SYSTEMIC THERAPY

Key Concepts, Interventions, Exam-Style Scenarios, Comparisons, Memorization Anchors,

Milan Systemic Therapy

A systemic model emphasizing neutrality, hypothesizing, and circular questioning to disrupt rigid family belief systems.

Founders

Mara Selvini Palazzoli, Luigi Boscolo, Gianfranco Cecchin, Giuliana Prata.

Core Assumption

Problems are maintained by rigid family belief systems and interaction patterns.

View of Symptom

Symptom serves a function in maintaining family stability and meaning.

Therapy Goal

Create change by altering family beliefs and interaction patterns.

Focus of Therapy

Family rules, meanings, and interactional patterns.

Role of Therapist

Neutral observer who avoids taking sides.

Therapy Style

Formal, structured, and strategic.

Neutrality

Therapist maintains impartiality toward all family members.

Hypothesizing

Therapist forms and tests ideas about family patterns and meanings.

Circular Causality

Problems are maintained by reciprocal interaction patterns, not linear cause-and-effect.

Circular Questioning

Questions that explore relationships, differences, and patterns among family members.

Positive Connotation

Reframing symptoms as meaningful or protective for the family.

Family Games

Repetitive interaction patterns that maintain symptoms.

Systemic Epistemology

Understanding problems through relationships, not individuals.

Paradox

Interventions designed to challenge rigid family rules indirectly.

Rituals

Prescribed behaviors to alter family patterns.

Team Approach

Original Milan model used a therapy team observing behind a one-way mirror.

Circular Questions

“Who worries most when your son doesn’t come home on time?”

Positive Connotation

Framing behavior as serving a protective or relational function.

Paradoxical Prescription

Assigning tasks that challenge family beliefs.

Rituals

Structured tasks families perform outside session to disrupt patterns.

Invariance Prescription

Parents maintain a secret alliance to destabilize child symptoms.

Hypothesis Testing

Therapist revises hypotheses based on family responses.

Avoiding Alignment

Therapist avoids siding with any family member.

Meaning Reframing

Changing how family understands the symptom.

Scenario: “Therapist asks each family member how another reacts to conflict.”

Circular questioning.

Scenario: “Therapist reframes a child’s refusal to eat as loyalty to parents.”

Positive connotation.

Scenario: “Therapist avoids agreeing with any family member.”

Neutrality.

Scenario: “Therapist assigns parents a secret task to strengthen alliance.”

Invariance prescription.

Scenario: “Therapist focuses on beliefs maintaining the symptom.”

Milan systemic focus.

Scenario: “Therapist designs a ritual to change family interaction.”

Milan intervention.

Scenario: “Therapist revises theory after observing family reaction.”

Hypothesizing.

Scenario: “Therapist avoids blame and linear explanations.”

Circular causality.

Milan vs. Strategic

Milan emphasizes neutrality and meaning; Strategic is directive and problem-focused.

Milan vs. Bowenian

Milan focuses on beliefs and patterns; Bowen focuses on differentiation and insight.

Milan vs. Structural

Milan changes meaning; Structural changes boundaries and hierarchy.

Neutrality = No Sides

Therapist stays impartial.

Circular = Relationships

Focus on interactions, not individuals.

Positive = Reframe

Symptoms are meaningful, not bad.

Hypothesis = Guess & Test

Therapist continually revises understanding.

Ritual = Action

Structured tasks disrupt patterns.