MRI+brief+therapy

toc =I. Distinguishing Ideas= Change occurs at two levels: the first involves a system's behavior (state to state); the second involves the system's way of behaving (transformation to transformation). Change at the first level occurs within the system, but the system remains unchanged. Change at the second level changes the system itself (Watzlawick, Weakland & Fisch, 1974).
 * = Distinguishing Ideas ||= Contributors ||= Theory Conceptualization ||= Therapeutic Process ||= References ||= External Links ||

//Terrible simplifications// result when clients deny the existence of a problem and behave as though the problem does not exist. As a consequence, any attempt to acknowledge or solve the problem gets labeled as //madness// or //badness//; furthermore, subsequent problems are likely to arise through the mishandling of the original problem (Watzlawick, Weakland & Fisch, 1974).

In order to avoid the //utopian syndrome//, therapy should remain focused on the relief of suffering, not on "an ideal of happiness that may never be realized" (Watzlawick, Weakland & Fisch, 1974). The utopian syndrome is the belief that if we resolve a person's problem, everything will be perfect and they will live an idealized life. We know this cannot happen because we do not live in a Utopia, a society where we can experience the ideal, perfect, way of living.

According to Evans (1989) MRI theory defines behaivior as: (1) subjective in nature - Behavior is subjective and not linear and is based on our perceptions and (2) socially embedded - Problems are viewed relative to the "immediate context" (p. 49).


-Problems are interactional, not intrapsychic, in nature. -Persistence and change are interdependent (Watzlawick, Weakland & Fisch, 1974). -All problems are unique and contextual, i.e, each problem depends on the situation (Weakland, Fisch, Watzlawick, & Bodin, 1974). -Promoting insight into the problem is not helpful. Rather, creating changes in behavior will help to resolve the problem (Weakland, Fisch, Watzlawick, & Bodin, 1974). -Through human interactions, influence is inevitable (Weakland, Fisch, Watzlawick, & Bodin, 1974). -In order for an event to be a problem, (1) the event must be mishandled and (2) a solution is attempted when the problem is not solved, more of the same is applied (Evans, 1989). = = =II. Contributors= [|Don Jackson] , Richard Fisch, [|John Weakland] (article about [|John's life and contributions] ), [|Jay Haley], [|Paul Watzlawick] [|Watzlawick's Interactional View] [|MRI Professionals]

= = =III. Theory Conceptualization= = =

A. Problem Formation
Problems are formed when people mishandle normal life difficulties. Problems are interactional and occur as a result from the attempted solution to the difficulty. Some problems arise wholly as a result of the client attempting to change an existing difficulty, but going about it the wrong way. Problems are formed when one solution does not fix the problem and these issues persist and become problems in other areas of an individual's life.
 * 1) Client takes action when NO action needs to be taken.
 * 2) Client does NOT take action when the action needs to be taken.
 * 3) Client performs action at the wrong level (need more effort). (i.e., The client attempts a first-order change when a second-order change is warranted and vice versa.) (Watzlawick, Weakland & Fisch, 1974).

B. Problem Maintenance
Problems are maintained when people repeat unsuccessful solution attempts and these attempts are part of the interaction with those involved in the interaction. People use more of the same unsuccessful behaviors that contribute to the formation and maintenance of the positive feedback loop. The positive feedback loop occurs when a person's attempts to solve problems actually increases the problem behavior. An example would be the mother who recently lost her child and feels very depressed and sad. As a result she cries alot and people around her are always asking if she is okay. The more they ask if she is okay the more depressed and sad she becomes. Thus, in more general terms, the more of A leads to B and the more of B leads back to more of A.

C. Problem Resolution
Problems are resolved by changing or eliminating the unsuccessful solution attempt pattern, which can be done by either doing something different or breaking the positive feedback loop (cycle). Additionally, resolution can occur if the clients' perception of the problem changes and they are no longer in a state of distress. When this process occurs, clients do not see any further reason to continue treatment. > <span style="font-family: 'Times New Roman',Times,serif">[|Positive and negative feedback loops of a problem-gambling behavior] > <span style="font-family: 'Times New Roman',Times,serif">[|Positive Feedback Loop of a Couple’s Case]
 * <span style="font-family: 'Times New Roman',Times,serif">Samples of Feedback Loops:

=IV. Therapeutic Process=

A. Therapist's Role
<span style="font-family: 'Times New Roman',Times,serif">(according to Weakland, Fisch, Watzlawick, & Bodin, 1974): 1. Focus on the behaviors that occur between all parties involved with the problem. 2. Directly change this interaction. 3. The therapist's duty is to find out how to influence the client's behaviors and perceptions in the problem.

__Goals for Therapists during the First Session__: 1. Gather information regarding the complaint. In other words, what problem prompted the client to seek therapy? This involves listening to the problem presentation and working with what the client offers. This provides a picture of the problem and provides concrete information on what the client. wishes to work on and also serves as a marker to view progress made. 2. Identify how the client has tried to deal with the problem. What attempts has the client made to solve the situation on his/her own? 3. Inquire what small amount of change needs to occur before he/she will acknowledge things are improving. 4. Strive to get the client's position, in regards to the complaint and treatment process and/or therapist. In addition, it is important to recognize the language the client uses when he/she is talking about the problem.

B. Interventions
<span style="font-family: 'Times New Roman',Times,serif">Therapists begin the process of intervening the moment they make contact with clients. In their manual, Fisch, Weakland, Watzlawick, Segal, Hoebel and Deardorff (1975) described seven MRI interventions planned to help move clients towards termination:
 * 1) <span style="font-family: 'Times New Roman',Times,serif">**One-down Position –** This intervention relies on the therapist attitude towards the client(s). The attitude taken by the therapist should be a modest one. The therapist should be perceived by the client as a human being with flaws, as opposed to a higher, powerful, or a wise figure. One way the one-down position can be accomplished is by introducing yourself with the client by your first name.
 * 2) <span style="font-family: 'Times New Roman',Times,serif">**Go Slow** – The go slow intervention can be utilize when a problem is complex and a rapid change make cause another or more problems to arise. In such an instance, the therapist can take a “go slow” position by asking the client what would be the smallest thing they would like to see happening by coming to therapy? “Go slow” can also be utilized as a paradoxical intervention given that it usually accelerates the process of change. Many times, this intervention is the only one utilized by therapists because clients resolve the issue that initially brought them into therapy. Another example of this intervention is when the therapist explains to clients how crucial it is for them to not do anything different between now and their next appointment. The therapist will rationalize his/her request by explaining how change is a slow process; therefore, clients should not move quickly to ensure their change will be "long-lasting."
 * 3) <span style="font-family: 'Times New Roman',Times,serif">**Pessimism** - This is also similar to some of the other common interventions in the sense that the therapist takes a certain stance to speed up the process of change. This stance can also be helpful with increasing clients' motivation to take action so they can move closer to termination. Pessimism can also be utilized when clients come back and report zero improvements or that things have gotten worse (particularly when the therapist suggested a particular task). The therapist may respond and express how he/she was afraid the task may have been too much, too soon. Or the therapist may choose to direct the pessismism towards clients and point out how their failure to improve is a sign that they are not quite ready to move towards resolving the problem. In both instances, clients inability to improve is not seen as a weakness, but simply as a sign that they are not ready to change. It is not uncommon to have clients get bothered when therapists use this technique and their level of motivation increases as a result.
 * 4) <span style="font-family: 'Times New Roman',Times,serif">**“Dangers” of Improvement** – This can be seen as an extension to the "go slow" intervention; however, its use can serve other purposes. For instance, this technique can be used to get clients to comply with future tasks or also be used to increase clients' motivation. In therapy, this can be seen when a therapist will point out how it is common for others to resent clients simply because they are bettering themselves by making productive changes in their lives. This would be one example of how improving can be dangerous; although, this intervention typically increases one's motivation to strive to do whatever is necessary to reach their goal.
 * 5) <span style="font-family: 'Times New Roman',Times,serif">**Prescribing Symptoms** - <span style="font-family: 'Times New Roman',Times,serif"> The therapist can approach this intervention when the nature of the problem is vague or when the client does not have control over it. For example, when the client cannot predict when the problem will happen. The therapist may introduce this intervention by asking the client to collect or gather information before the next appointment in order to understand the problem better. The therapist may ask the client to do or to act the undesired behavior at a specific place or at a specific time.
 * 6) <span style="font-family: 'Times New Roman',Times,serif">**Credibility Gap** – <span style="font-family: 'Times New Roman',Times,serif">This intervention can be utilized when one or more family members have lost their hope that the identified client can do better. <span style="font-family: 'Times New Roman',Times,serif">The therapist may ask the client to act out the desired and undesired behavior interchangeably during the coming week(s). The family member(s) should be asked to make note of the times when they notice both behaviors. The client and family member(s) should not tell what they have done or noticed.
 * 7) <span style="font-family: 'Times New Roman',Times,serif"><span style="font-family: 'Times New Roman',Times,serif">**Collusion -** <span style="font-family: 'Times New Roman',Times,serif">This intervention is usually utilized when parents-children conflicts exist.

C. Assessment Issues
<span style="font-family: 'Times New Roman',Times,serif">
 * <span style="font-family: 'Times New Roman',Times,serif">Assessment should focus on interaction.
 * <span style="font-family: 'Times New Roman',Times,serif">View the problems that people bring as situational difficulties between people.
 * <span style="font-family: 'Times New Roman',Times,serif">Obtain descriptive data of the "problem" situation.
 * <span style="font-family: 'Times New Roman',Times,serif">Focus on what the person is //doing// in a given context in interactions with others as opposed to the way a person //is//.
 * <span style="font-family: 'Times New Roman',Times,serif">Positive feedback loops - Once a difficulty begins to be seen as a "problem", the continuation, and often exacerbation results from the creation of a positive feedback loop. (Hoyt, 1994).

<span style="font-family: 'Times New Roman',Times,serif">
<span style="font-family: 'Times New Roman',Times,serif"><span style="font-size: 10pt; font-family: 'Times New Roman',Times,serif">The treatment plan develops from three pieces of information: the definition of the problem, what has been done to solve the problem, and the definition of the smallest goal to be accomplished.

__Problem Definition Questions__ (Weakland, Fisch, Watzlawick, & Bodin, 1974): -What problem brings you in today? -How is it a problem? -How did you decide to seek treatment at this time, rather than sooner or later? -What are you doing now that you would not like to be doing anymore? -"What would you like to do that your problem inteferes with doing now?" (Weakland, Fisch, Watzlawick, & Bodin, p.152, & Frisch, Weakland, & Segal, 1982).

__Setting Goals__ (Weakland, Fisch, Watzlawick, & Bodin, 1974): -Goals should be set in specific, concrete, behavioral, observable, and realistic terms. -What small, behavioral change would show you that progress has been made on your problem? <span style="font-family: 'Times New Roman',Times,serif">- <span style="font-family: 'Times New Roman',Times,serif">What would be the smallest thing you would hope to see different as a result of coming to therapy today? __Termination__ (Frisch, Weakland, & Segal, 1982): -This is not viewed as a special event and the process of termination is handled briefly and strategically. -The idea of termination is typically initiated by the therapist, although clients can choose to discontinue treatment at any time for a variety of reasons. -Many times the therapist will warn clients to expect problems to resurface, so that if they do, clients will not view the situation negatively. In addition, this tactic typically eases clients' anxieties about terminating treatment. -If clients are hesitant they will not be able to continue having success without the therapist, the therapist may choose to schedule another appointment with the clients and insist they keep the appointment regardless if the problem resurfaced. Again, the scheduled appointment puts clients' minds at ease and usually takes their mind off looking for the problem to reoccur. =V. References=

<span style="font-family: 'Times New Roman',Times,serif">Dagirmanjian, S., Eron, J., & Lund, T. (2007). Narrative solutions: An integration of self and systems perspectives in motivating change. //Journal of Psychotherapy Integration, 17 (1),// 70-92.

Evans, T. D. (1989). Brief therapy: The tradition of individual psychology compared to MRI. //Individual Psychology, 45// (1 & 2), 48-56.

Fisch, R., Weakland, J. H., Watzlawick, P., & Segal, L. (1982). //The tactics of change: Doing therapy briefly.// San Francisco, CA: Jossey-Bass Inc.

Fisch, R., Weakland, J. H., Watzlawick, P., Segal, L., Hoebel, F. C., & Deardorff, C. M. (1975). //Learning brief therapy: An introduction manual.// Palo Alto, CA: Mental Research Institute.

Hoyt, M. F. (1994). //Constructive Therapies I.// New York: The Guilford Press.

Watzlawick, P., Weakland, J. H., & Fisch, R. (1974). //Change: Principles of problem formation and problem resolution.// New York: W. W. Norton & Company.

Weakland, J. H., Fisch, R., Watzlawick, P., & Bodin, A. M. (1974). Brief therapy: Focused problem resolution. //Family Process, 13,// 141-168. = = =VI. External Links= ==