Second Thoughts on the Theory and Practice of the Milan Approach to Family Therapy

In the original paper, Working with the Milan Method: Twenty Questions, Question 1 ('What is the minimum needed in the work setting to work in this way?') and Question 20 ('How would you introduce this method to a traditional clinic?') addressed issues about the treatment setting that we would now answer differently.

Our thinking in response to these questions has changed considerably over the past few years. If we were asked them now, we would ask a question in return: 'What do you need to understand about your work setting, in order to create a systemic approach?' Instead of having an idea about a way of working and trying to create a setting for it, we would want to ask people about developing a way of working that is responsive to that setting, and arises from within that system. We might suggest that a person could ask his or her manager, 'What are your most important aims and objectives in running a service?' and, 'What kind of view of families is it important for the agency to maintain?' and, 'How do you see family therapy fitting in?' The answers to these questions will then create the beginnings of a way of working systemically in that context, and will have evolved through the relationship with the manager.

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