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Post-Milan/Post-Modern & Narrative
revision
Post Milan Family Therapy
Focus on how the observer constructs that which is being observed, acknowledging that therapists
themselves contribute their own perceptions and prejudices to the therapeutic process
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Everyone has a unique history with its own meaning so our realities are slightly different
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Instead it is argued that truth is based on an
intersubjective reality that is co-constructed by therapists and clients in the therapeutic process
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What is emphasized is the interaction between the observed and the observing systems; the
therapist is seen as a collaborative explorer (Milan sees the therapist as in charge/a
conductor)
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Self-reflexivity:
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Self-reflexivity – is the process of the therapist’s own self-reflection about his or her
communications & interactions with the client(s)
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Post-Milan & post-modern therapists will be self-reflexive, continuously mindful of their own
position in relation to this multi-level & multi-contextual view of a family's predicament
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Therapists were no longer assumed to
be objective observers and were encouraged to adopt an ‘observing system’ stance
(Hoffman, 1985, p
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In this perspective, therapists include themselves in their thinking, for example, how they
are influenced within the therapeutic system, their own personal, familial and societal
contexts and how these impact on their practice
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This includes the
therapist’s ability to reflect on their own beliefs and emotions and use them in therapy (for

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example, Flaskas, 2005; Pote et al
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Social Graces involve mapping your own influences
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SG has been applied to training and supervision
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281)
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This essay will highlight 3 of these key ideas and discuss the limitations of
FST
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Here the idea of personal narratives is important
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Helps clients and families to create new stories about their lives
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Family & therapist co-construct new ways of describing and thinking about problems
The postmodern narrative therapist has faith that, in the course of telling and re-telling one's story,
in the course of listening and being listened to, in the course of responding and being responded to
with thoughtfulness, care, and passion, alternatives to the troubling story, the problem-saturated
story (White & Epston, 1990)
This idea is particularly important to/for practitioners treating, families that have experienced
trauma
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Using this approach helps to not only understand the wide reaching effects of the trauma, but also
to rebuild the individual stories to empower the family to again hold identities are people, not just
victims (Arulampalam et al
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In contemporary practice the rebuilding of a shattered identity is a key aspect of current PTSD
treatments (Chu, 2011)
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This is essential to families (For current practice) as culturally sensitive care leads to better outcomes
(Huey et al
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Externalising the problem
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Externalisation of problems (White, 1997) is a popular technique used by narrative
therapists
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In this process, the problem becomes a separate
entity and thus external to the person or relationship that was ascribed as the problem
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Helps the individual to dissociate
from the problem
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Research suggests that stigma can be reduced when individuals are able to separate
themselves as a person from their illness (ex: a person with schizophrenia, not a
schizophrenic) (Gray, 2002)
Furthermore, helping people to externalise problems is effective in promoting healing,
decreasing depression, and reducing blame (Robertson et al
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They try to help clients to separate their lives and relationships from stories they find impoverishing
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As such, the therapist is no longer an
expert
McNamee & Gergen (1992) “The 'reality' that therapists observe is 'invented'
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The only
thing which we can be really certain about the existence of is language
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”
Anderson (1990) developed the idea of reflecting teams
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Different
perspectives are introduced and the family are invited to reflect on the different reflections
of the team
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This translates to the construction of alternative meanings to create change
in the relationships
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, 1992)
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The not knowing stance and subsequent use of reflective teams are imperative to families in
distress because they model to families that no one person has the “correct” solution (which
lifts the burden of responsibility for finding this elusive accurate fix) and that multiple
perspectives are useful (which can lead to an increased ability to seek help and external
resources) (Madsen, 2007)
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Evaluation
Strengths:
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Reduces stigma by not placing blame on the client and by externalising the problem
Uses the ‘not knowing’ stance
Impacted on clinical practice

Weaknesses:
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Post-Modern approaches move away from the scientific approach but adopting a social
constructivism viewpoint
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Minuchin (1998) expressed concerns about postmodern family therapy
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However, he stated
that postmodern therapies lost the information that family dialogues produced, the
spontaneity of therapist-directed enactments, the focus on the therapist as a positive and
helpful, that the therapist can make a family feel more connected, and the
acknowledgement that the therapist must function with personal bias
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