EP85 Clinical Presentation 11 - Strategic Therapy - Cloe Madanes

Description:

Educational Objectives:

1. To understand the efficacy of the "behind the mirror" technique
2. To show how understanding systems leads to effective strategic interventions

*Sessions may be edited for content and to preserve confidentiality*

Outline:

Case Introduction

• Session on strategic therapy with Cloe Madanes.

• Case presented by Neil Schiff (therapist/supervisor) involves a 17-year-old girl referred by the court for stealing $2,500.

• Background: history of suicide attempts, poor school performance, learning difficulties.

• Family includes older brother in college, younger sister in school, and parents with health issues.

Initial Impressions and Family Dynamics

• Therapist adjusts his approach after initial interview and consulting with a behind-the-mirror observer.

• Girl appears generous and social but may be exploited.

• She feels jealous of her siblings and overwhelmed by peer and family pressure.

Girl's Self-Image and Parental Conflict

• Girl admits to stealing from many people and names school, jealousy, and theft as her main issues.

• Therapist considers whether she’s more rebellious teen or wounded child.

• Mother is angry and exhausted; father tries to maintain school contact.

Parental Frustrations and Family Breakdown

• Parents describe past punishments and even attempts to place daughter in foster care.

• Mother expresses a desire to leave due to stress.

• Therapist stresses the importance of the family staying intact and supporting the daughter.

Therapeutic Intervention

• Therapist addresses girl’s self-destructive behavior and repositions her as central to family function.

• Asks parents to commit to staying together.

• Suggests girl take a break from household duties while siblings take on more responsibility.

Sibling Involvement

• Brother and sister asked to support each other and help at home.

• Therapist encourages parents to notice and appreciate the siblings’ contributions.

• Emphasizes unified family effort to support the struggling daughter.

Conclusion and Family Strategy

• Family agrees to new structure where siblings rotate being the “life ruiner” to deflect parental stress.

• Focus shifts to restoring balance and happiness in the home.

• Family commits to working together as a team going forward.