The Milan Principles of Hypothesising,Circularity and Neutrality in Dialogical Family Therapy: Extinction,Evolution, Eviction… or Emergence?

The primary aim of the three Milan principles of hypothesising, circularity and neutrality was to proffer an effective methodology for interviewing families, with a secondary aim of casting off the stereotypical personal therapist qualities such as intuition, charisma and concern. The progression of the principles from the original Milan model through to contemporary approaches is intriguing. The following article consists of two sections. First it tracks the progression of the three principles through the Milan, post‐Milan and postmodern approaches to family therapy. Given their recursive nature, they are revealed as responsive to developments in theory and practice, as well as the influence of the wider societal context. The second section of the article explores hypothesising, circularity and neutrality in the contemporary approach of dialogical family therapy. The relevance of the three principles to the therapeutic process, the therapeutic role and the therapeutic relationship is considered. Such an exploration does not seek definitive answers or ‘truths’, but seeks to conceptualise a vague ‘knowing’ that there is continual learning and growth in grappling with the tensions in this field, in remaining ever curious, in asking the questions …     

The influence of the Milan approach—Part 2. The legacy of Boscolo and Cecchin and their Paduan connection: A conversation with Andrea Mosconi

The Milan approach, pioneered by Selvini-Palazzoli, Boscolo, Cecchin, and Prata, has significantly contributed to the field of psychotherapy, particularly in the realm of systemic and family psychotherapy. While rooted in systemic principles and concepts, over time the original Milan group demonstrated differences in their clinical orientations and practices which led to their regrouping into two teams. The paper explores the divergences in their views and directions on family dynamics and the role of symptoms within the system. It delves into the influence of Boscolo and Cecchin, two of the ‘Milan Four’ on the Centro Padovano di Terapia della Famiglia. Drawing from a conversation with Andrea Mosconi, a mentee and collaborator of Boscolo and Cecchin, the paper examines the reconfiguration of the original ‘Milan Four’ team and its impact on their clinical approach. Key Milan principles and concepts such as hypothesising, circularity, and neutrality are examined with particular emphasis on the work of Boscolo and Cecchin's systemic work. These principles, intertwined and interconnected, provide a fertile ground for the construction of multiple hypotheses and circular questioning. The paper also highlights the concept of reflexivity, which originates from Bateson's work and plays a crucial role in family relations and communication while explaining the birthplace of paradox taking place when two levels of meaning are ‘confused.’ The Milan approach continues to be highly regarded, as its early concepts and ideas have evolved and left a lasting impact on the field of family therapy. By reflecting on the distinct contributions of Boscolo and Cecchin, and using examples, Mosconi offers valuable insights into the rich legacy and ongoing relevance of the Milan approach to contemporary therapeutic practice.     

Theory and Practice of Systemic‐Dialogical Therapy

Systemic‐dialogical therapy originates from an evolution of Milan systemic therapy, through a reflection on Bakhtinian dialogue and on power and knowledge dynamics in therapeutic sessions. The model considers both emergent patterns in human interaction and the dialogical nature of human exchanges in which emotions play a relevant part. Such theoretical considerations prompted the creation of specific practices, such as emotional micro‐hypothesising, considering heteroglossia in the session, dialogue with the context, finding one's place in the relational network, and fostering relational responsibility in both therapist and clients. The practice of systemic‐dialogical therapy is illustrated by a clinical case study.     

Key Systemic Ideas as Seen Through the Eyes of First‐Year Trainees

This article offers an introduction to key systemic ideas as seen through the eyes of first‐year trainees in a postgraduate systemic therapy course. Our aim is to present these ideas in user‐friendly, accessible language, with examples to illustrate their use. The article is organised around three main themes: how a family system gets organised; how systemic work helps to effect change in families; and how a systemic therapist creates a context for change. Ideas covered include circular patterns, processes and questions, feedback loops, the importance of context, the interdependence of meaning and action, taking a meta‐perspective, systemic hypothesising, neutrality, curiosity, second‐order change, use of language and the position of the therapist. The article may be of particular interest to those who are new to systemic ideas, as well as for those involved in providing training in systemic practice.     

Troubled Children,Troubled Marriages — Whose Problem Is It?

Therapists working in Child and Adolescent Services commonly face the dilemma of if, how and when to address marital problems when the presenting problem is with a child. This article examines the different ways that some of the central family therapy models approach this issue. The Structural, Haley-Madanes Strategic and Milan Systemic models share the assumption that the child's symptoms are reflective of underlying family disturbance, with marital problems given a central place in the hypothesising. In contrast, the Solution Focused and Narrative approaches avoid assumptions about the deeper purpose of symptoms, focusing instead on the impact of the problem on family relationships, including the marriage. This emphasis ensures that parents do not receive either a direct or indirect message that their marriage is to blame. Consequently, a safe context is provided for addressing marital disturbance and for understanding its broader social base. Therapy is about noticing and expanding solution behaviours and competencies, rather than drawing out deeper pathologies. Case examples are used to illustrate the clinical applications of a Solution Focused-Narrative approach when children's problems emerge in conjunction with marital problems.     

Teaching hypothesising skills from a post-Milan perspective

The Milan model relies upon careful hypothesising, a therapeutic stance of neutrality and circular questioning on the part of the therapist in order to release new information into the family system. Current thinking incorporates a postmodernist perspective which challenges the traditional process of hypothesising. This postmodern challenge is in part due to the use of the term ‘hypothesising’ which is strongly associated with reductionism or structuralism, which relies on the scientific method. As a clinical activity, the actual process of hypothesising is a complex, cognitive task and often a relatively unpopular activity which is difficult to teach to students. This paper discusses the therapeutic benefits and limitations of hypothesising and proposes a structure for teaching hypothesising to students learning to work with couples from a post-Milan perspective.     

The (mis)acquisition of gender identity among transsexuals

Transsexualism suggests questions for sociologists who study gender. Is gender identity always a precursor to role behavior or might it result from the social reactions to deviant behavior? This article considers several theoretical explanations for the (mis)acquisition of gender identity among transsexuals: biological hypotheses, psychoanalytic theories, social learning, and role theory. The author concludes that gender role and gender identity are confounded in past research and that the issue inflexibility of identities needs to be treated more systematically.     

Effects of Spouse Support and Hostility on Trajectories of Czech Couples' Marital Satisfaction and Instability

This article examines differences in the role of spouses' hostile and supportive behaviors in predicting level and change in marital satisfaction and marital instability. We propose 2 competing hypotheses. The first hypothesis proposes that hostility is relatively volatile and support is relatively stable, and that change in hostility affects change in marital outcomes over the course of the study, whereas the overall level of support functions to maintain the level of marital outcomes. The second hypothesis argues that change in marital satisfaction is a function of change in support, whereas change in marital instability is a function of change in hostility. We tested the hypotheses by fitting growth curves to 3 waves of panel data collected from 436 Czech couples between 1994 and 1996. The results offer some support for the first hypothesis. However, the dominant pattern was for level and change in spouses' reports of their hostility to affect both wives' and husbands' level and change in marital instability, respectively, and for the level and change in husbands' reports of their support to predict level and change in wives' marital satisfaction. Other variables suggested by previous research in the United States and by the Czech transition to a market economy are examined.     

Goffman's Interaction Order at the Margins: Stigma,Role, and Normalization in the Outreach Encounter

This article considers Goffman's conceptualization of interaction order at the margins of society in encounters between urban welfare workers and their clients. Observations from these encounters demonstrate practices relating to the situated management of stigma and identity, and the accomplishment of role within these service encounters. A reading of Goffman's theoretical contribution lies in revealing how social actors and social structures are realized in situ within the constraints of the interaction order sui generis. The article discusses three aspects of the outreach encounter, namely, (1) the accomplishment of role and motive, (2) the sequential phases of the outreach encounter, and (3) “the normalization ritual,” and introduces the concept of willful disattention.     

Setting the Agenda

Abstract

Foreign funding for women's non-governmental organizations (NGOs) during democratic transition plays a crucial role in shaping values and attitudes within civil society. Concepts of feminism, gender equality and the role of women in democratic politics are affected by the discourse established by foreign funders. In this article, the role of US and Nordic gender policies are examined in the Estonian context using a feminist constructivist framework. I explore the effects of neoliberal versus social-democratic gender policies and conclude that, while funding for women's NGOs serves to create a necessary discourse on women's equality, these policies may actually serve the funders' needs to gain geopolitical influence in the region.     

Feminized cultural capital at work in the moral economy: Home credit and working-class women

One of the defining features of the home credit sector is the role played by its agents—workers who act as intermediaries between lending companies and borrowers to facilitate lending and collect repayments. There is a prevailing and pervasive narrative in the sector that women make superior agents, largely based on the belief that female agents can manage relationships with borrowers more successfully than their male counterparts. This article analyzes data from 349,078 home credit accounts (loans), as well as 71 interviews with home credit agents and lending company managers, to evaluate both the myths and realities of women's roles in home credit. The data is also used to explore the opportunities for—and potential constraints on—women's career progression in home credit work, based on an understanding of the moral economy in which they operate. By exploring the moral economy of low-income communities, the article highlights the role of working-class women's cultural capital within the labor market. Despite women forming the majority of the agent workforce in home credit, women's capital is undervalued in comparison with their male counterparts' capital. The analysis within this article allows a greater understanding of the highly classed and gendered nature of the moral economy of low-income communities and the exchange value of women's capital within the labor market.     

Migration Decisions Within Dual‐Earner Partnerships: A Test of Bargaining Theory

This article focuses on the problems faced by dual‐earner partnerships arising from the regional coordination of the partners' careers. It is still unknown whether the fact that couples are less mobile than singles is caused by homogeneous preferences within couples or by a process of balancing conflicting interests. Consequently, we analyze the potential conflicts provoked by work‐related migration incentives. We test hypotheses derived from bargaining theory using quasi‐experimental data from a factorial survey of nearly 280 European couples. Our results support the bargaining approach and confirm that asymmetrical shifts in bargaining power drive the potential for conflict. Women's willingness to move is generally less than men's, but the impact of employment prospects differs only slightly by gender.     

Professionalism, educated labour and the state: hospital medicine and the new managerialism

This article examines the degree to which doctors, as members of an autonomous profession, function as organic intellectuals within capitalist society (Abercrombie and Urry, 1983) and, more generally, the complex and ambivalent relations that sustain their role within a ‘service class'. It is in this context that the organization of medical care and its delivery in Britain will be addressed. In particular, the current and intended changes in the organization and control of hospital medicine within the NHS, notably the issues of medical audit, clinical budgeting and the role of the ‘internal market’.     

THE INTEGRATIVE PSYCHOTHERAPY ALLIANCE: FAMILY,COUPLE AND INDIVIDUAL THERAPY SCALES*

The therapeutic alliance concept has been confined primarily to the literature on individual psychotherapy. This paper formally introduces the concept into the family and marital therapy domain and presents various clinical hypotheses about the nature of the alliance and its role in familyand marital therapy. A systemic perspective is brought to bear on the concept within individual psychotherapy. A new, integrative definition of the alliance is presented that conceptualizes individual, couple and family therapy as occurring within the same systemic framework. The implications of this integrative-alliance concept for family, couple and individual therapy research are examined. Three new system-ically oriented scales to measure the alliance in individual, couple and family therapy are presented along with some preliminary data on their methodological characteristics.     

Separate but Equal: Durkheim's Response to the Woman Question*

This article reexamines Durkheim's views on gender relations within the context of nineteenth century French feminism. Durkheim's response to the woman question reflects the sociopolitical discourse on individual rights and responsibilities, the family, and women's roles in the private and public spheres. Durkheim's perspective on gender relations is predicated on a biologically differentiated conception of gender role complementarity that emphasizes the couple, not the individual. This perspective, shared by feminists, is best characterized by the phrase, separate, but equal.     

Clients' Attributions of the Presenting Problem and the Therapeutic Alliance in Couple Therapy: Systemic Versus Intrapersonal Perspectives

The therapeutic alliance is central to couples' therapy success. The current study examined associations between couples' initial agreement and causal attributions of the presenting problem and changes in the therapeutic alliance. To test study hypotheses, 85 couples were recruited from a university training clinic focused on couple and family therapy. Couples completed an intake questionnaire concerning their attribution of the presenting problem, either as systemic or individual, and therapeutic alliance was assessed at the end of sessions 2–8. A dyadic multilevel model revealed that a disagreement in the couple's attributions of the problem (with one viewing it as systemic, the other as individual) was associated with a larger initial discrepancy in the couple's therapeutic alliance, as well as a decline in the discrepancy over time. Findings were discussed in the context of systemic family theory, with implications for improving assessment, treatment, and psychoeducation aimed toward couples in distress.     

Women in the Field: Women,Farming and Organizations

One striking feature of farming as an occupation is that there are few women who farm in their own right. The passing of land from father to son means that women rarely own land. Their typical entry to farming is through marriage. Women's route of entry to farming affects interpersonal relationships within the family, and also women's role in the public space of farming. Women are under‐represented in farming organizations, in training programmes, and in the politics of farming. This article focuses on the position of women within farming organizations and the interaction between (male) farming organizations and women's farming organizations. Farmers are an extremely well‐organized occupation and wield considerable political power because of this effective organization. However, farming organizations are almost entirely male. This article examines how women are treated within farming organizations, and also the interaction between (male) farming organizations and women's farming organizations. Drawing on the theory of organizations, I argue that the inclusion of women in farming organizations and the existence of women's farming organizations reinforce gender divisions within agriculture and do not in any way question the understanding of men as farmers, or the political power they hold.     

Marital Power,Roles, and Solidarity and Husbands' and Wives' Appraisals of Self and Other*

The purpose of this study was to investigate conditions underlying the social self process within marital relationships. Two hypotheses were tested in a mail questionnaire survey of 165 couples: 1) Mead and Cooley's hypothesis that self-appraisal is positively associated with other's view of self, and 2) an extension of this hypothesis suggesting that the association between self-appraisal and spouse's appraisal is greater, and the appraisals are more favorable, when marital power is shared, household role responsibilities are shared, and marital solidarity is high. The first hypothesis was supported: self-appraisal was significantly correlated with other's view of self. The second hypothesis was strongly supported for solidarity: the greater the couple's solidarity, the more favorable and the more similar were self-appraisal and other's appraisal of self. Only partial support was found for a positive association of shared marital power and roles with appraisals of self and other.