Milan systemic family therapy: a review of ten empirical investigations

Abstract

Ten empirical investigations of Milan Family Therapy (MFT) are reviewed in this paper. The studies include both single and comparative group outcome trials; investigations of therapeutic process; clinical audit and consumer satisfaction surveys. Substantive findings and methodological issues are discussed in the light of family therapy and individual psychotherapy research generally. Findings indicate that MFT may lead to symptomatic change in two‐thirds to three‐quarters of cases and to systemic change in half the treated cases. Engagement of fathers may be important for positive outcome. Technical aspects of MFT, such as the use of screens and teams, may lead to client dissatisfaction in some cases. MFT‐based consultation may be effective in resolving therapeutic impasses. Coupled with short‐term residential placement, MFT may reduce the risk and complexity of cases as rated by referring social workers.

Audit and family systems consultation: evaluation of practice at a child and family centre

“…These results are consistent with widely obtained findings on therapist variables associated with therapeutic success in individual and family therapy, despite the diversity of rating scales used in this burgeoning literature (Carr, 1991;Keuhl et al, 1990;Kazdin, 1991).…”

“…Apart from complex cases assigned to the Adolescent Programme and the Child Protection Programme, each case received an average of 6 hours' consultation. This is congruent with the finding that brief therapeutic contact of between 6 and 10 hours has been reported in reviews of family therapy and a variety of other child therapies (Kazdin, 1991;Carr, 1991).…”

“…These results in combination with the staff ratings of outcome suggest that the clinic offers a useful service to between a half and threequarters of its patients, a finding consistent with more tightly controlled research on family therapy outcome (e.g. Carr, 1991).…”

The Reflecting Team approach: convergent results of two exploratory studies

“…These results may be due to the chronicity of such family problems as parental mental disorder or inadequate intrafamilial communication. Therapeutic strategies using more directive interventions, like the Milan approach or structural family therapy, may be more helpful in overcoming such problems (Carr, 1991;Szapocznik et al, 1989).…”

Whatever happened to Freud? A commentary on Prata and Raffin

“…In such knowledge lies the seed of rapprochement, which is essential for remaining in the mainstream. Empirical evaluation of the Milan approach is at an early stage; Carr (1991) outlines ten studies meeting 'minimal methodological requirements', most of which had been carried out since 1985. Only four were comparative studies, and three of these had sample sizes of eleven or less.…”