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early years, assumed an adversarial style; the family against the therapists, and
they focused on resistance to change. The therapist did not challenge the family
directly, but rather used “creative deceptions – paradoxical prescriptions – that
would bypass…resistance” (p. 7). A family could hardly resist changing if a
therapist told them to continue the behaviors they were already engaged in.
The heart of the early Milan treatment model was positive connotation, an
outgrowth of the MRI symptom prescription technique. “A positive connotation
is a message to the family from the therapist[s] that the problem is logical and
meaningful in its context” (p. 4). They argued that simply prescribing the
symptom “negatively connoted family members’ anti-symptom views [and to
the extent that the ] symptomatic member [was] exonerated, other family
members would feel at fault (p. 7). Instead, they positively connoted not only the
symptom, but also the behavior of other family members. The intervention was
aimed not at an individual, but at the self-maintaining tendencies of the system as a
whole. The symptom was prescribed in relation to its social context, and resistance
was reduced. The method was in keeping with the emerging “nonlinear,
systemic consciousness that was to distinguish the Milan method from previous
approaches in the family field” (p. 8-9).
In their early treatment in the 1970s, the team was divided into two male-female
dyads. One would interview the family while the other observed from behind a
one-way mirror. Families were seen weekly for ten sessions. The team later
changed to having one member of the team with the family and one other
observing, and the time between sessions lengthened to monthly. The use of
observation teams (O-Teams) originated with the Milan group. It offers a way to
bring in trainees and provide on-going supervision. Rather than being fixed in
one method, the teams have shown the ability to experiment and evolve into
different forms. Although there are Milan teams around the world, th...
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This document was uploaded on 04/03/2014.
- Spring '09