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Comparison of Milan and Structural analysis of treatmet team functioning

8 April 1988


This dissertation includes a presentation of two different approaches to family therapy, the Milan Method and the Structural approach. It describes the experience of a particular family therapy team and explains the team's functioning and eventual dissolution of their original membership, from the two points of view. The explanatory principals drawn from the two orientations illustrates that, while they are similar in both embracing systems theory, they are different from one another. Only the Milan approach includes the cybernetic paradigm. The Milan approach suggests that the team's behavior was guided by a team map; initially developed out of the internal maps of each team member, combined to form a new team map. In this view, the team system had no objective reality apart from that constructed from members perceptions, and was constantly evolving. Dysfunction is seen as resulting from the team's failure to evolve a well shared belief system. The Milan approach claims to not embrace a standard of normality against which the team's evolution is compared. In order for adaptive change to occur the team can be seen as having to find a way out of their momentary epistemology. The accomplished this by introducing "new" behaviors and patterns which were meaningful and allowed for self-correction and alteration of the way in which they changed. The major analysis of the Structural approach includes the team's behavior being regulated by "codes" or form which can be seen in patterns of communication. The team's adjustment was determined by looking at how well their structure allowed them to function in achieving the team's purpose. It proposes that there is an innate structuring force which provides direction and rules that regulate the relationships of the team members. Dysfunction in the team was attributed to the dysfunctional structure it was most closely connected with: boundary, alignment, or power. The goal of the structural intervention would be to change the team structure so that team members could become more functional and solve problems. There is a standard of normality against which the team's structure was compared. It viewed change as occurring when patterns were constructed where there was structural insufficiency, or existing patterns broadened and functional existing structures reinforced. A change in structure is seen as bringing about an accompanying change in functioning. In considering what led this family therapy team to break up, unresolved interpersonal conflict and differing personal goals concerning which the team members wanted from this experience seem to be central. The impact of team members having different theoretical orientations is not clear. Gaining a better understanding of the functioning of family therapy teams seems to be an important issue in the field of psychology in that the team's functioning impacts their therapy with families. It is recommended that further research focus on rigorously on how differences in theoretical orientation between members in the same team impact team functioning.


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