Theory and Practice of Couples and Family Counseling. James Robert Bitter
be the editor-in-chief for a decade. His first wife, Elizabeth, aided Jay in editing the journal. Haley (1963) published Strategies of Psychotherapy in the early 1960s. He also met and collaborated with Lynn Hoffman while at MRI, and together they would publish Techniques of Family Therapy (Haley & Hoffman, 1967), a set of conversations with family counselors and therapists about their initial sessions with families.
In 1967, Haley left MRI to join Salvador Minuchin at the Philadelphia Child Guidance Clinic. It was Jay who insisted on live supervision at the clinic and who developed a training model complete with a map for individual sessions.
Jay and Cloe Madanes, his second wife, were both at the Philadelphia Child Guidance Clinic until 1976, when they left to form the Family Therapy Institute of Washington, DC. What is perhaps Haley’s best work came from this period (see Haley, 1976, 1980, 1984) with his emphasis on problem-solving and family developmental processes. This is also when Cloe Madanes came into her own as a scholar-practitioner (see Madanes, 1981, 1984, 1990), bringing a humanistic-spiritual aspect to strategic interventions. The endpoint in strategic family therapy is always behavior change, the solving of family problems. Both Haley and Madanes embraced the belief that the problem was the problem—and when the problem was solved, counseling was over.
If the 1970s belonged to the structural family model, the 1980s belonged to strategic family therapy (Nichols & Davis, 2017). And indeed, most new practitioners in the 1980s were working from a hybrid of the structural-strategic models. In the 1990s, Haley moved back to Southern California with his third wife, Madeleine Richeport-Haley. Much of their work in this decade resulted in the production of films on anthropology and psychotherapy. In the last years of his life, Madeleine helped Jay to publish the last two books of his career, The Art of Strategic Therapy and Directive Family Therapy (Haley & Richeport-Haley, 2003, 2007). A retrospective of Haley’s career and influence was also published posthumously (Richeport-Haley & Carlson, 2010).
The Milan Model
Another strategic family center was located in Milan, Italy. The initial counseling team included Mara Selvini Palazzoli, Luigi Boscolo, Gianfranco Cecchin, and Guiliana Prata (1978). This team was influenced by the writings of Gregory Bateson and the training methods of Jay Haley. Using a team approach similar to the Haley-Madanes model, one of the therapists would conduct an extended interview with a troubled family. The interviewer would rely primarily on circular or relational questions: for example, “When you initiated a fight with your mother, who in the family was most upset by it?” or “Who is closer to your father, your daughter or your son?” Observing team members would watch family processes for games, rituals, and family transactions that seemed to present themselves in counseling paradoxically; that is, the family came to change, but everything they did seemed to be aimed at keeping family processes just as they were. The job of the observing team members was to prescribe a counterparadoxical intervention aimed at changing family process by telling family members to stay just the same. In addition to counterparadoxes, the Milan group would use hypothesizing and reframing through positive connotations to move the family along in the change process.
The original team separated in 1980. Boscolo and Cecchin would stick with their original model and spend the next quarter century refining the process. Selvini Palazzoli and Prata formed a separate group and for a couple of years experimented with what they would call the invariant prescription. The invariant prescription was given to all families that were seen: “We would like the two of you as a couple to go out for the evening, not tell your children where you are going or when you will be back, and leave them to handle life themselves while you have a good time.” This directive to the family had the clear goal of strengthening the bond between the parents and breaking up the parent-child coalitions that were responsible for maintaining the family’s games. By 1982, however, Selvini Palazzoli lost interest in the invariant prescription, and she and Prata also split up. Selvini Palazzoli would spend the last decade of her career working with clients in long-term, insight-oriented counseling.
Solution-Focused/Solution-Oriented Models
The bridge between the era of structural-strategic family processes and postmodern approaches to family counseling starts with the work of Steve de Shazer and his partner Insoo Kim Berg. John Weakland had introduced Steve to Insoo when Steve was studying at MRI. In 1978, Steve and Insoo moved to Milwaukee, Wisconsin, with the intent of reinventing MRI in the Midwest. Initially they joined with colleagues at a community mental health agency in Milwaukee in an effort to achieve this goal, but when the constraints of that agency got in the way, they left to start their own Brief Family Therapy Center. They took a number of colleagues with them, including Jim Derks and Eve Lipchik, and the center opened in 1979. The center had a training program that attracted students who would become second-generation leaders of solution-focused therapy: Michele Weiner-Davis, Yvonne Dolan, Scott Miller, John Walter, and Jane Peller.
Over the years, de Shazer (1982, 1985, 1988, 1991) focused more on the development of the model and its underlying theory while Berg developed training and focused her work on the practical application of the model to the most pressing family problems. Originally influenced by John Weakland and the MRI approach as well as the writings of Milton Erickson, de Shazer began to question some of MRI’s assumptions and positions: (a) MRI focused on the problem and how it was being maintained, believing that a shift in family perspective would unleash new possibilities for solving the problem. de Shazer turned this notion around, believing that focusing on the negative language of the problem actually held change back. A focus on solutions was a focus on positive languaging, on possibilities, on the future, and on hope. (b) MRI assumed a one-down position in initial therapeutic practice, but it did not give up the notion that the therapist knew what needed to happen for the family and its members. de Shazer came to believe, like most postmodern therapists, that the person and the family was an expert on what was needed, both in terms of change and help. In practical terms, this meant that counseling moved from giving directives (as in the MRI model) to asking questions. (c) MRI therapists handled resistance indirectly, using paradox and other Ericksonian interventions. With a focus on individual- or family-developed solutions, de Shazer declared the end to resistance. He truly believed that people wanted to change, and given a clear goal they would move toward it.
The techniques developed in this model of assessment are some of the most innovative in the field. They include the Miracle Question, scaling questions, exceptions, coping questions, and compliments. These interventions make possible the construction of solutions from the life experiences of the person or the family (de Shazer & Berg, 1993). Insoo Kim Berg would team up with Scott Miller to apply solution-focused therapy to the treatment of alcoholism—and by extension to other forms of substance abuse (Berg & Miller, 1992). Her work also focused on couples counseling and family counseling with the poor. Eve Lipchik (2002) too was involved in the development of the model from the beginning, and her focus on emotions and the therapeutic relationship is one of the more significant contributions to the model.
From their base in Chicago, John Walter and Jane Peller (1992, 2000) focused on exception questions and wrote two of the more compelling process books for solution-focused therapy. Similarly, Yvonne Dolan, a leader of the Solution-Focused Brief Therapy Association, worked closely with Steve de Shazer over the years; applied the model to those who had experienced trauma or abuse; and coauthored Steve’s last book, which was published posthumously (de Shazer & Dolan, 2007).
Perhaps one of the best known students of this model is Michele Weiner-Davis, who has published very popular books on couples counseling as well as more scholarly efforts. Michele teamed up with Bill O’Hanlon to create solution-orient- ed therapy, a hybrid model that did not completely eschew talking about problems (W. H. O’Hanlon & Weiner-Davis, 2003). For a while in the late 1990s and early 2000s, these two approaches to solution work coexisted, with O’Hanlon, who never directly worked out of the Milwaukee center, becoming a major spokesman for solution work. O’Hanlon and Weiner-Davis would eventually split too, with Bill moving to New Mexico and calling his work possibility therapy.
Steve de Shazer died in 2005. Two years later in 2007, Insoo Kim Berg also died.