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Unformatted text preview: bservers meet briefly after each session to discuss their observations and
interventions. Cases are also discussed weekly in a longer meeting.
Treatment has six stages:
1. Obtain basic demographic data and introduce families to the treatment
arrangement. Families are not screened in advance of treatment.
2. Formulate a clear statement of the presenting problem. If a number of
problems are presented, the family is asked which is most troubling.
3. Estimate which behaviors maintain the problem by determining how family
members are attempting to solve the problem. Observation and inquiry
continue until the therapist has a concrete picture of the reinforcing
behaviors. The therapist must decide which behaviors are most salient.
4. Delineate treatment goals. Small, definable, observable goals are selected. The
therapist may ask the family to indicate the smallest change acceptable. The
goals are refined through discussion, clarification, and further inquiry. The
therapist should have a defined goal by the end of the second session.
5. Formulate behavioral interventions. Brief therapy emphasizes behavioral
intervention. The therapist uses the family’s special characteristics to
determine interventions. Homework tasks are assigned to utilize the time
between sessions and broaden the within-session gains to the real world.
Behavioral suggestions are usually indirect, implicit, suggestive, seemingly
insignificant, or contradictory. When change is recommended directly, the
family may be told to enact the changed behavior only once or twice until the
An important paradoxical intervention is to prescribe the symptom. The
family is asked to engage in the symptomatic behaviors. The goal is for the
family to rebel and in the process, lessen symptomatic behaviors or bring
seemingly automatic behaviors under voluntary control as the family
engages in the behaviors by choice. This therapeutic double bind promotes
progress no matter how the family responds.
Paradoxical instructions are also used in mor...
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- Spring '09