Indirect Interventions or Injunctions

The changes that may result from direct interventions, as outlined in the section above, tend to be what are often referred to as ''first order change.'' This implies that although the behaviors of one or more family members have changed, there have not been the more fundamental changes in the family that may be needed and are implied by the term ''second order change.'' Direct interventions may leave the functioning of the family system fundamentally unchanged, even though communication may be clearer, roles better defined, and so on.

The terms "strategic" and "systemic" are used for treatment approaches that aim to bring about more radical changes. These may involve alterations of perspective among the family members, so that some aspects of the way the family functions come to be viewed and understood in new ways. This is the process of "reframing"—the giving of different meaning to behavior, feelings or relationships. In ''developmental reframing,'' for example, the antisocial behavior of an adolescent may be reframed as ''immature,'' rather than "bad." "He's not really a bad kid, he's just having trouble growing up.'' Getting a family, including the young person who is displaying the troublesome behavior, to see the problem behaviors in this light represents second order change. The very process of developmental reframing may affect the young person's behavior. It may not be so acceptable to see oneself as immature, as opposed to being the strong, rebellious young person who does his or her own thing.

Many indirect interventions have been described. Here are brief descriptions of some of them:

• Reframing and positive connotation. Reframing— the giving of a different meaning to a behavior, or a pattern of behaviors—is the basic aim of most, if not all, indirect interventions. We have encountered one form—developmental reframing. Positive connotation is but a form of reframing, although it is an important one. For example, a parent's abusive

Family Therapy behavior toward a child may be reframed (positively connoted) as a laudable attempt to correct the child's behavior. Therapy then can address the question of how the parent can develop better methods of achieving that goal. There are indeed few behaviors that cannot be positively connoted; what is required in doing so is the separation of the behavior from the motive behind it.

• Communication by metaphor. Metaphor is a long-established way of conveying messages indirectly and in a nonthreatening way. Situations may be re-framed, new perspectives offered, and solutions to problems suggested without the issues being raised directly. Stories, anecdotes, other relationships, rituals, tasks, objects, and artistic productions may all carry meaning metaphorically.

• Paradoxical directives and related devices. When direct interventions have failed, it may be effective to suggest that, as "everything" has been tried, it may be better to leave things as they are. This effectively turns responsibility for change over to the family. Moreover, if they have, unconsciously, been trying to "defeat" the therapist, the only way they can now do so is by making the changes the therapist is advising against. Related to this are the declaring of therapeutic impotence and prescribing interminable therapy.

• Prescribing rituals and tasks. As we have seen, these may have metaphorical meaning, but they can also be used to interrupt repetitive, dysfunctional patterns of behavior. Examples are the "odd-days-even-days'' routine, whereby parents take turns putting their children to bed; or the "samesex parenting'' plan, whereby the father is given responsibility for the boys in the family and the mother for the girls,

• Using humor. Helping family members to laugh at what they have been doing can, in the right situation, and in the context of profound rapport, be an effective change-promoting technique.

• Presenting alternative solutions or courses of action. This can be done by having the therapist admit to being uncertain about what is the best course of action and offering two or more; by having a "Greek chorus" observing though the oneway observation screen (a device widely used in family therapy) and sending in varying messages, or disagreeing with the therapist's ideas; or by stag ing a debate in the therapy room, the observers coming in to discuss possible solutions. Such strategies have several potential advantages. They make the point that there are choices to be made and that there is not necessarily only one possible solution to a problem; they invite families to take some responsibility for making changes; and they operate from the "one-down" position, that is, the thera-pist(s) are not presented as all-knowing experts seeking to impose their solutions on the family. • Externalizing the problem. This is a process whereby a symptom is labeled or personified. '' 'Uncertainty' has taken over your life." "How can you win the battle with 'Mr. Anger'?'' The family, or an individual, is then invited to consider ways of defeating or otherwise dealing with the externalized object.

The above are but examples of what are often called strategic therapy techniques. Others have been described and only the creativity of the therapist limits the possibilities. Such techniques are not used only in family therapy; they have application in individual therapy as well as in other fields of endeavor such as teaching and selling.

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