MILAN SYSTEMIC THERAPY

Milan Systemic Therapy

Systemic family therapy model emphasizing meaning

Systemic Epistemology

Understanding families as interconnected systems shaped by shared beliefs

Constructivism

Reality is co-constructed and subjective

Non-normative Stance

Therapist avoids defining normal family functioning

Hypothesizing

Ongoing process of forming and revising ideas about family dynamics

Circularity

Behavior is part of recursive interaction patterns

Neutrality

Therapist avoids alliances and remains balanced

Curiosity

Therapist maintains openness to multiple perspectives

Circular Questioning

Questions highlighting differences in relationships and perceptions

Triadic Questioning

Asking one person about two others’ relationship

Reflexive Questions

Questions designed to promote insight and change

Interventive Interviewing

All therapist communication is considered intervention

Family Games

Repetitive dysfunctional interaction patterns

Paradox

Contradictory message maintaining dysfunction

Counterparadox

Therapist uses paradox to disrupt patterns

Epistemological Error

Family operates on outdated beliefs about reality

Positive Connotation

Reframing behavior as serving a positive function

Therapeutic Ritual

Structured task to disrupt family patterns

Family Rituals

Symbolic actions marking transitions or change

Invariant Prescription

Universal intervention disrupting family games

No-Change Prescription

Therapist prescribes continuation of symptom

Odd/Even Days Prescription

Alternating roles to highlight differences

Long Brief Therapy

Few sessions spaced over time

Five-Part Session Structure

Presession, session, intersession, intervention, postsession

Irreverence

Therapist challenges rigid beliefs

Strategizing

Therapist continuously evaluates interventions

Meaning System

Therapy focuses on changing meanings