Strategic family therapy

Domain V · Systemic, relational, group & community · Jay Haley, Cloé Madanes · 1976 · Washington, DC

What it is

What it is: a directive, problem-focused family therapy developed by Haley after his years with Bateson's project and the Mental Research Institute and a decade (from 1967) with Minuchin and Montalvo at the Philadelphia Child Guidance Clinic, then developed with Madanes at the Family Therapy…

Format

• There is no session-by-session manual. The model is a set of planned stages within each case.
• Stage A. The first interview (one session, whole household). Haley treats the first session as decisive: a therapy that ends well must begin well. Everyone living in the home or closely involved in the problem is asked to attend. Four stages, in order:

Who practises it, and how they are trained or regulated

• Stage D. Ending. Therapy ends when the presenting problem is solved; the goal was defined so that therapist and family both know when that is. Giving the family the credit, predicting that some old behaviour may return, and leaving the door open are recommended here as good practice; restraining and relapse prediction are described in the sources mainly for the MRI model.
• Typical count and format. Brief, problem-focused outpatient therapy, with flexibility about place, length and who attends; whole family at the start, then sub-groups (parents, couple, individual) as the strategy requires. No typical number of sessions is stated in any source, so none is given here. A practical local choice is to agree an initial block of sessions and review it against the agreed goal. Training and…
• Certification and licensing. Not a licensed or trademarked programme: no certification is required to practise it. Historical training was at the Family Therapy Institute of Washington, DC; current private trainings (e.g. iAST) state that their certificates confer no licensure.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• families who feel their success is doubted; keep the caution warm.
• shaming, which damages the alliance; the aim is to take tasks seriously, not to punish.
• reframes the family hears as excusing violence or abuse; never reframe harm to others as benign.
• the family feeling watched or discussed; keep interruptions few and the therapist clearly in charge in the room.
• any pressure on the victim to forgive, reconcile or comfort the offender; ritual apology that substitutes for accountability.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.