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severity of the symptom and attention is paid to what was happening at the
time. The focus is on what happens when things are going right rather than
on when things go wrong. The assumption is that people already know
what they need to do to solve their complaints; the therapist has only to
help them discover their own creative solutions for coming ‘unstuck’. The
solution may not be closely matched to the problem and may comprise
quite different elements. De Shazer uses the metaphor of coming upon a
locked door blocking progress to a more satisfactory life. Rather than spend
a long time agonising about why the door is there and who locked it, all
that is necessary is for the family to find a set of ‘skeleton keys’ that will
open this door and others blocking their progress.
Techniques
Precise descriptionof the problem is requested: ‘How would I know if
her depression was getting better? What would I see?’ Limited but
achievable goals are aimed for, and by focusing on precise descriptions,
the families are led to recognise improvements, however small. These
then become reinforcing and provide the motivation for the family to
keep doing things differently, and so lead on to further change.
Miracle question: What would it look like if you woke up tomorrow and
the problem was gone? What precisely would be different?
Miracle intervention: X is to act tomorrow as if he had no problem, Y is
to implicitly acknowledge this by her responses, X is to implicitly note
these, but there is to be no discussion about it.
Focus on successes: become aware of those occasions when the problem is
absent. What is going on at the time? Notice these successes: how on
earth did you manage not to do it (the symptom behaviour)? How are
you managing not to do it now? So you managed the urge, let’s develop
your ‘urge surfing’. If a strategy works, stick with it; if it doesn’t, do
something different.
Milan systemic family therapy
Developed by Selvini-Palazzoli, Prata, Boscolo and Cecchin in Milan, Italy,
for chronic, resistant cases, this approach concerns itself with bringing out
covert beliefs and meanings that constrain a family’s behaviour. The model
is to recognise and challenge the beliefs, so they can be re-examined and
modified to fit what is going on more precisely, and the expectation is
that behaviour will then be changed to fit in with the new set of beliefs
or priorities. This is the opposite of structural family therapy, where the
objective is to change behaviour through direct action rather than as a
consequence of adjusting beliefs. According to Milan systemic therapy,
there may be several conflicting sets of beliefs regarding a single action.
Regarding a daughter who is staying out late, for example, a parent may
feel she should come home earlier as she is at risk of being taken advantage
of, but may also feel that if too much discipline is applied, she will run