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"Strategic therapy."
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Effectiveness of Structural–Strategic Family Therapy in the Treatment of Adolescents with Mental Health Problems and Their Families
Mental health problems during adolescence constitute a major public health concern today for both families and stakeholders. Accordingly, different family-based interventions have emerged as an effective treatment for adolescents with certain disorders. Specifically, there is evidence of the effectiveness of concrete approaches of systemic family therapy on the symptoms of adolescents and family functioning in general. However, few studies have examined the effectiveness of other relevant approaches, such as structural and strategic family therapy, incorporating parent–child or parental dyadic measurement. The purpose of this study was to test the effectiveness of a structural–strategic family therapy with adolescents involved in mental health services and their families. For this purpose, 41 parents and adolescents who participated in this treatment were interviewed at pre-test and post-test, providing information on adolescent behavior problems, parental sense of competence, parental practices, parenting alliance, and family functioning. Regardless of participants’ gender, adolescents exhibited fewer internalizing and externalizing problems after the treatment. Parents reported higher family cohesion, higher satisfaction and perceived efficacy as a parent, and healthier parental practices (less authoritarian and permissive practices, as well as more authoritative ones). An interaction effect between parenting alliance and gender was found, with more favorable results for the mothers. In conclusion, this paper provides evidence of the usefulness of structural–strategic family therapy for improving family, dyadic, and individual facets in families with adolescents exhibiting mental health problems.
Journal Article
Dynamic Narrative Therapy: A Metamodern Integration of Narrative, and Strategic Family Therapy
Systemic models of couple and family therapy (CFT) are often categorized into two transtheoretical paradigms: modernism and postmodernism. Traditionally, these paradigms have been positioned in opposition to one another and are critiqued for their respective epistemologies and stances on the definitions of truth and reality. The binarizing of systemic models has created theoretical divisions in the field of CFT that restricts many clinicians from addressing the limitations and harnessing the benefits of each transtheoretical paradigm. Metamodernism, a philosophical paradigm that emphasizes theoretical pluralism, reflexivity, and dialectical processes, has arisen as a potential solution for addressing the philosophical tensions between modernism and postmodernism; however, there currently exists no approach to systemic therapy that aligns with the tenets of this paradigm. This article delineates the application of metamodernism in the field of systemic therapy through the presentation of Dynamic Narrative Therapy, an innovative approach to systemic therapy drawn from the integration of two foundational theoretical models (i.e., strategic family therapy and narrative family therapy). This integration synergizes the strategic concepts of circular causality and feedback loops as well as the narrative use of deconstruction, externalization, and narrative metaphor to illustrate a more comprehensive approach to the therapeutic change.
Journal Article
Client \SB\, Session September 23, 2013: Client's parents are extremely concerned about their son, who is experiencing psychosis, and committed himself. Client's parents also had a medical scare with him experiencing a seizure. Client's parents discuss the stress this has put on their marriage, as well as the wife's problematic drinking. Client is very upset by his parents' fighting.
Client's parents are extremely concerned about their son, who is experiencing psychosis, and committed himself. Client's parents also had a medical scare with him experiencing a seizure. Client's parents discuss the stress this has put on their marriage, as well as the wife's problematic drinking. Client is very upset by his parents' fighting.
eBook
Client \SB\, Session December 12, 2013: Client discusses his fear of his parent's divorce and how he worries that he is to blame for all of his family's issues. Client's parents are fearful of their mentally ill son, who they worry will hurt them. Client's parents discuss their money issues and the wife's drinking issues.
Client discusses his fear of his parent's leaving him and how he worries that he is to blame for all of his family's issues. Client's parents are fearful of their mentally ill son, who they worry will hurt them. Client's parents discuss their money issues and the wife's drinking issues.
eBook
Practicing Clinical Supervision in Chile: Lessons from 28 Years of Training
This article describes a model of supervision developed by Centro MIP in Santiago, Chile. This model is situated in the cultural history and legal context of psychotherapeutic practice in Chile, as well as in the unique pioneering spirit governing the institute since its founding in 1992. This psychotherapy-based model draws from constructivist and strategic orientations and includes elements of structural, solution-focused, and client-centered practice. The work has an overarching goal of serving the therapeutic growth of the supervisee and is guided by three primary principles: unwavering leadership (liderazgo irrenunciable), pursuing excellence (excelencia), and intervision (intervisión). It is argued that enhancing supervisees’ therapeutic effectiveness and their own well-being is facilitated by eschewing within-session summative evaluation in favor of encouragement and bidirectional formative feedback. Several excerpts of supervisory sessions are provided to illustrate the method.
Journal Article
The Brief Strategic Treatment of Cardiophobia: A Clinical Case Study
Many individuals presenting to medical settings with heart-related symptoms for which no medical explanation is found might suffer from cardiophobia, but this condition is still poorly identified and addressed. This article presents a case of cardiophobia treated in an outpatient cardiac rehabilitation unit and, for the first time, describes the application of brief strategic therapy for the treatment of this condition. In the case reported, the first therapeutic encounter and the key elements of the strategic approach are described in detail with the aim to explain how brief strategic therapy works and how it can be used to identify and address cardiophobia-related behaviors. A 64-year-old male presented to cardiac rehabilitation reporting intense anxiety-provoking heart palpitations, and believing he was at risk of dying from a heart attack. After 3 sessions, an overall improvement in heart-related bodily sensations followed a decrease in the patient’s continuous checking of his heartbeat and seeking reassurance—factors that were largely responsible for the persistence of the problem. Moreover, quantitative evaluation showed increased scores of mood state at the end of treatment. This improvement persisted at the 18-month follow-up. This case is an interesting example of how brief strategic therapy can contribute to the development of a new conceptual model for the diagnosis and treatment of cardiophobia. Still, more systematic research in the field is needed to prove the efficacy and effectiveness of this therapeutic approach on symptoms of heart-focused anxiety.
Journal Article
The evolution of family patterns and indirect therapy with adolescents
This text, presenting a picture of contemporary family patterns that might produce problems of social and psychopathological deviance in adolescents, is the outcome of the teamwork of thirty-two researchers and therapists, members of the Centre for Strategic Therapy in Arezzo. This work was put together over a period of five years with the aim of improving the application of specific strategic interventions in problematic parent-child relationships.
eBook
Client \BA\, Session November 21, 2013: Client talks about how a recent business trip aggravated his OCD, discusses his compulsive thought patterns and how they usually involve feeling guilty for thinking about women other than his wife.
Client talks about how a recent business trip aggravated his OCD, discusses his compulsive thought patterns and how they usually involve feeling guilty for thinking about women other than his wife.
eBook