Systemic and strategic intervention is directed towards change. To create the conditions for change, the systemic therapist uses various techniques such as reframing, questioning and questions with the illusion of alternative, questions relating to the definition of the problem, reformulations, metaphors and evocative language, prescriptions of stain
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Through reframing actions, our objective is to move the patient's perception to open up new perspectives and lead him towards change. Over the course of questions and reformulations, the person gradually visualizes how their problem works and the attempts at redundant solutions implemented which feed it and sometimes even make it worse. The reframing allows him to perceive his situation differently and to prepare to react to it in a more appropriate way via the prescriptions of the task. For a reframing to be effective, it is essential to have taken the time to understand and decode the patient's vision of the world. Without this, the therapist runs the risk of falling into interpretation and generating resistance in the person which will result at best in misunderstanding and at worst in blockage or radical opposition.
Questioning and questions with the illusion of alternatives
By answering questions that lead him to adopt new points of view, the patient discovers new effective solutions that had been invisible to him until then. These new perspectives are suggested to him through the orientation of the questioning. Questions with illusion of alternatives are closed questions that lead to choosing between two possibilities. These are questions that circumscribe the problem. They focus on aspects of the patient's perception in relation to his problem, on his way of interacting with the problematic reality, his attempts at solution and the vision that feeds them. The questioning sequence acts as a funnel and leads the person to feel the need for change.
Examples of problem definition questions
WHO ? “Alone or with others? If with others: "With everyone or with specific people?" »
WHAT ? “Such behavior or its opposite? »
WHEN ? “Always or sometimes? "Under foreseeable or unforeseeable circumstances?" »
OR ? “Everywhere or in certain places? If in certain places: “At home or at work? »
HOW ? “Spontaneously or triggered by something? "Do you tend to drink alone or in company?" »
Examples of questions relating to the operation of the problem
Once the person identifies how their problem functions, the therapist can then question them to identify the TSRs and their impact on the functioning of the problem: “When you are faced with this problem, do you tend to confront or avoid? "Are you hiding or letting yourself be seen?" “Do you talk about it to those around you or do you keep it to yourself? "And when you do that, do things change or do they stay the same?" "And after reacting like that, do you feel better or worse?" "When you do that, would you say your situation tends to get better or worse?" Through questioning, the person begins to doubt the effectiveness of what they have implemented so far to solve their problem and to see other more functional alternatives.
Reformulations
The reformulations will have several objectives:
- Understand what the person is saying, join them in their vision of the world and avoid interpreting. The frequency of reformulations and the use of formulas such as: "If I understood correctly...", "Correct me if I am wrong...", allow the therapist to ensure that he correctly captures the information delivered to him without risking damaging the relationship in the event of misunderstanding.
- Give an interactional vision of the functioning of the problem and bring the patient to "feel" the need to change what feeds his problem.
- Changing the person's vision of the world: by regularly reformulating the answers given by the patient to questions with the illusion of an alternative, the therapist gently reframes his perception and his reaction.
- Introduce therapeutic prescriptions and mobilize the person. This is a summary of everything that has been said and "discovered" about the issue (including persistence mode and TSRs). With this tactic, the person will not feel like they have to venture into the unknown when performing the tasks that the therapist has prescribed.
Metaphors and evocative language
"To convince the mind, it is necessary to touch and predispose the heart" B. Pascal
Reframing is also achieved by integrating, in the reformulations, images, analogies, quotations or metaphors related to the problem. By using this form of communication, the therapist addresses the person's imagination (his unconscious) rather than his logical mind (his conscious). Thus, through the use of images with which she identifies, the therapist leads her to "feel differently rather than think differently" (Wittezaele, Nardone, 2016, p 177) in order to:
- Make recourse to attempts at redundant solutions aversive,
- Mobilize the person to adopt new behaviors. To make this type of communication effective, the wording must be adapted to the style of communication and the personal characteristics of the person. This includes using their vocabulary and images that resonate with their context, areas of interest, etc.,
- Intervene at the right time to bring about the desired effect.
Task prescriptions
“If you want to see, learn to act. » H. Von Foerster
Like the techniques previously described, the therapeutic prescriptions also aim to impact the patient's SPR. They allow the person to experience a new interaction where they no longer use their TSRs and where the problem lessens. Proposed at the end of the session, they result from reframing, reformulations and other strategic interventions which prepare the person to naturally accept an experiment which is at 180° from what he was doing until now.
- The observation tasks allow the patient to take a step back from his problematic situation and to concentrate on certain specific aspects. It is also a way for him and the therapist to acquire a better knowledge of how the problem works and to identify certain TSRs (eg: “the logbook”).
- When they are “solution oriented” the imagination tasks prepare for taking action and reinforce the person's motivation to change. (ex: "the miracle question") They are also used to regulate the intensity of fear, when it is the source of the blockage (ex: "the fantasy of the worst"), or in a paradoxical way (ex: “How to make it worse?”).
- Experimentation tasks lead the patient to implement behaviors that are the opposite of their TSRs. The logic of the attempts at a solution serves as a framework for the therapist to define the strategy to be implemented throughout the accompaniment and to adjust it over the sessions and the feedback from tasks thanks to a self-correcting process.
LACT offers several live certifying web training courses with 50 international trainers.
General systemic training
DU in Relationship Clinic and strategic intervention with the University of Paris 8
Clinical Master's degree with specialization in psychopathology with the CTS of Professor Nardone
Systemic Coach Training
Systemic training in relationship management with the University of Grenoble
Ericksonian Hypnosis training in line
Read also
- Training in the systemic and strategic approach: the fundamentals
- Training in brief therapy: the analysis of the functioning of the problem
- Training in brief therapy: identifying the underlying logics
- Systemic certification training: identifying resistance to change
- That which accompanies change
- Qualitative and quantitative systemic audit of change
- Framing of change objectives
- Change strategies
- The strategic systemic approach in the school environment
- The link as a tool for change by Isabelle GROMETTO
- GENERAL - Dealing with resistance to change
- Dealing with resistance to change - THE CASE OF SCHOOL DIRECTORS by Claudette PORTELLI
- Case study - Dealing with resistance to change
- Dimensions of change - by Claude de Scorraille, psychologist
