Simona Milanese
Does strategic therapy work?
Data collected in the last 30 years confirm the high efficacy of strategic therapy, from a median of 88% for all disorders, to a median of 95% in anxiety disorders.
Three, 6 and 12-month follow-up sessions confirm that positive outcomes are sustained, with minimal incidence of relapse and no symptom displacement.
How long therapeutic sessions last?
Each session varies depending on the problem, phase of treatment and the goal to be reached. First sessions usually last longer, up to 60 minutes or more; following ones range from 20 to 40 minutes.
What is the interval between sessions?
Sessions are usually held every other week, or sometimes weekly, depending on the problem and personal needs. After initial improvement, the interval becomes longer (3, 4 or even 8 weeks), to allow practicing the new resources and abilities, encouraging the person to change and to become less and less dependent on the therapist. After completion of treatment, the therapist schedules 3 follow-up sessions, at 3, 6 and 12 months, to make sure all outcomes are sustained.
How long a course of strategic therapy last?
There is no preset number of sessions: it depends on each situation. An average figure is about 10. After initial improvement, therapy continues by consolidating results and promoting new skills and understanding, to make sure outcomes are maintained over time.
I don’t think I have a serious problem, but I am distressed: do I need psychotherapy?
If a person has no acute or incapacitating problems, he/she can benefit from brief strategic coaching, usually lasting less than 5 sessions. Coaching is especially useful in distressed couples, difficulties with coworkers, parent-child issues, and so on.
A person I love has a problem, but refuses to consult a specialist. What can I do?
Maybe he/she is not aware of having a problem, or perhaps does not want to be helped. It is common with adolescents, which may have an actual disorder (eating disorder, phobia, etc.), difficulties at school or social problems. In these cases, the therapist will meet with the parents first, giving indications on how to manage their son/daughter. Sometimes this is enough, and the therapy will continue “indirectly”, with the parents becoming “co-therapist”. Otherwise, this may be the first step to persuade the adolescent to see the therapist.
With couples, the therapist works with one partner, coaching him/her on how to manage the difficult relationship: again, this may continue as an indirect intervention, or may motivate the other partner to see the therapist as well.
Is strategic therapy good for children?
Yes, it is extremely effective with children. We prefer not to see the child directly, unless absolutely necessary, therefore avoiding any pathological “labeling”. Therapy is conducted through the parents, who become actual “co-therapists”, by giving them clear indications on how to manage their child. A change in the family context and interactions is usually sufficient to rapidly induce the desired change.