Strategic Family Therapy Roffman, A. (2007). Function

Strategic Family Therapy

Roffman, A. (2007). Function at the Junction: Revisiting the Idea of Functionality in Family Therapy. Journal of Marital and Family Therapy. 31 (2): 259-68.

Strategic Therapy -- "The ideas of strategic therapy are deceptively simply. Carrying out these ideas in action is not so simple" (Haley, 2003). Traditional views of therapy hold that the focus should be upon abuse, trauma, and even guilty pleasures or pastimes if they are detrimental to mental health. It directs tasks that follow and uses the past and the future as templates for recovery. Instead, strategic therapy asks: what is happening in one's life now -- in one's environment, and takes the approach that it is the social grouping of the environment that either allows for a predilection to continue the unwanted behavior, or to reinforce the triggers that make that behavior habitual in the first place.

Strategic family therapy then is a way to look at more than just the pathology of an individual or event -- it is a unique plan based on a particular set of environmental factors that, in combination, either reinforce or act as a detriment, to the needed change. This can be most appropriately illustrated when one looks at the hierarchy of human relationships and communication structures. For instance, as Aristotle noted, two people are a group -- more than two form politics. There are always sessions of group dynamics and a struggle for power. A strategic family approach attempts to resolve that strive for hierarchical power by investigating the inner relationships and signals within the family that cause behaviors and to deal with the present as a situation -- and intervene appropriately (Roffman).

Because each family dynamic is unique, the therapeutic plan for each family must be fluid and likewise unique. Too, as postmodern models and critiques emerge, the basis of forming functionality as the sole means of dealing with family issues has fallen by the wayside. Instead, using theroists like Haley and others, functional hypotheses that can utilized as an outlining structure for strategic family therapy form the new basis for a more pragmatic and robust approach:

1. Establish a relationship defined as one to bring about change. This tends to be implicit in the framework of the plan when someone asks for, or contracts for, therapy. This should be emphasized by specifically addressing how the individual wants to change the behavior(s).

2. Define the problem. The more precisely defined that problem, the more likely it will be solved, or at least addressed appropriately.

3. A clear set of goals. The clearer the therapist's goals, the less probably any distraction or wavering will occur. It is possible, that the therapist agrees on a goal with the client while also having a divergent goal in mind.

4. Offer a proposed plan. In setting up a plan, the therapist must provide a reasonable explanation and/or rationale to make that plan reasonable and workable for the client. While it is unnecessary that the therapist elaborate on every aspect of planning, the client must understand, and agree, to the direction the plan takes.

5. Put down current authority on the problem in a graceful way. It is important that this not be an antagonistic critique, but more benevolent and loving -- defined for the purpose of being helpful.

6. Reemphasize the framework as one designed to bring about change. Remind the client that they sought out change, and change is a positive step towards healing.

7. Give a paradoxical directive. This directive is essentially to remain unchanged -- it can be to encourage behavior, structure or sequence. It may be implicit or explicit, but must be relatively apparent.

8. Observe response and continue with encouragement of usual behavior. Rationale for continued behavior will likely be necessary, but the therapist should not relent when there is rebellious improvement or upset.

9. As change continues, the therapist should avoid taking credit. It might be more pleasant to share change, but the therapist must remain aloof -- almost puzzled about the changes that occur.

10. Begin to disengage, perhaps by recessing, and as change stabilizes, the therapy will terminate (Roffman, 2007; see also Haley, pp. 10-11).

Analysis of Methodology -- As the field of therapy evolved since the 1950s, therapists began to realize that the nuclear family, the structured "Ward and June Cleaver" family unit promulgated on television, was not necessarily a workable model that would account for therapeutic change for most individuals. The field of family therapy became, by necessity, more divergent and differentiated. With that, the public's awareness, and therefore acceptance and critique, of the field more vocal (Shields, et.al., 1994). This new structure, ironically, resulted in the implementation of a number of what were considered to be too radical ideas of the 1950s and 1960s. This view holds that the interdisciplinary nature of strategic theory, and the establishment of a clear and conceptual framework, was necessary to integrate training programs in psychiatry, social work, and even anthropology and sociology as viable components of family therapy (Broderick and Schrader, 1991, 3-4).

It is possible to also see this form of therapy as overly simplistic and too attuned to popular culture. One must ensure that the theory used is not "Therapy Du Jour," with sound bites and elements attuned to popular approaches, and still retain a robust psycho-analytical model (Nichols, 2009). For instance, some strategic therapists believe one should not emphasize the past, and that the past (actions and events) has very little to do with the manner of appropriate change for the future, noted psychologist, author and successful family therapist Salvador Minuchin commented:

I think [this is wrong and this is right]. I am an old man, but I still have memories of my childhood that cannot be erased. Some of them are uncomfortable and I would like to erase them, but they don't go away even though I have changed and am experientially much richer. I know the way in which these early experiences still organize my thinking today. But to a certain extent, I am able to marginalize them so that they are not significant in the way in which I function. Still they are part of me, and I really do believe in the importance of understanding the past in order to give people the freedom to take their blinders off and see how the past organizes the present. From this perspective, I would disagree with Jay. But I also think he is right. There is something else that happens when you deal with memory. Not only do you change how people look at the present, you also rearrange the past (Minuchin in Simon, 1996).