The Milan school of family therapy developed an approach based on systems theory and complexity. Key aspects included circular questioning to challenge problem maintaining beliefs, end of session interventions like paradoxes and rituals, and a team approach with co-therapists. The goal was to alter family interaction patterns and beliefs supporting problems like schizophrenia. Over time the Milan school split into more strategic and non-directive branches but both retained a focus on flexibility, feedback and challenging existing family constructs.
Describe the family life cycle
Distinguish the shift from linear to circular thinking.
Describe the influence of Bateson
Describe the core concepts of systemic therapy: phase 1 & 2
General Family Systems Theory & Structural Family TherapyJane Gilgun
Ever wondered what general system theory has to do with circular causality and structural family therapy? These slides represent the most clarity I could come up with regarding these important ideas.
http://www.Cunninghamtherapy.com
2835 Camino Del Rio South, Ste. 120-C
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Describe the family life cycle
Distinguish the shift from linear to circular thinking.
Describe the influence of Bateson
Describe the core concepts of systemic therapy: phase 1 & 2
General Family Systems Theory & Structural Family TherapyJane Gilgun
Ever wondered what general system theory has to do with circular causality and structural family therapy? These slides represent the most clarity I could come up with regarding these important ideas.
http://www.Cunninghamtherapy.com
2835 Camino Del Rio South, Ste. 120-C
San Diego, CA 92108
A Strength-Based Model of Therapy for Individuals and Couples!
Evening Hours
Affordable Rates!
Dr. Murray Bowen, a pioneer in the field of marriage and family therapy, offered 8 interlocking concepts as a way to think about relationship functioning, especially in one's extended family, nuclear family, and couples' relationships. This is a model that assumes that problems can come from too much togetherness. It assumes that if one feels secure in one's ability to remain separate, one can go the distance in one's effort to remain connected to important people in one's life.
Week 6Contextual Family Therapy modelFor this assignment, .docxmelbruce90096
Week 6
Contextual Family Therapy model
For this assignment, you will write a reflection paper that includes a summary of the constructs from the Contextual Family Therapy model and an application of those concepts to your own (or another person’s if this is too difficult) family of origin.
Include the following in the model summary:
1) The major assumptions for change in the contextual approach.
2) Use your own words to identify, define, and describe the major concepts of the contextual approach.
3) Address what makes this approach different from some of the other Marriage and Family Therapy approaches you have studied.
Include the following in your application of this model to your family of origin:
1) The important family legacies that are a part of your family of origin
2) The intergenerational transmission of the family culture
3) The invisible loyalties that exist in your family of origin
4) How justice has been applied in your family of origin
5) How these have impacted your development and that of any siblings, including how you/they exited (grew up) the family of origin
6) How these concepts, if at all, influence your current life
Length: 5-7 pages
Gehart, D. R. (2014) Mastering Competencies in Family Therapy Chapter 7
Intergenerational and Psychoanalytic Family Therapies
Lay of the Land
Although distinct from each other, Bowenian intergenerational therapy and psychoanalytic family therapy share the common roots of (a) psychoanalytic theory and (b) systemic theory. A psychoanalytically trained psychiatrist, Bowen (1985) developed a highly influential and unique approach to therapy that is called Bowen intergenerational therapy. Drawing heavily from object relations theory, psychoanalytic or psychodynamic family therapies have developed several unique approaches, including object relations family therapy (Scharff & Scharff, 1987), family-of-origin therapy (Framo, 1992), and contextual therapy (Boszormenyi-Nagy & Krasner, 1986). These therapies share several key concepts and practices:
• Examining a client’s early relationships to understand present functioning
• Tracing transgenerational and extended family dynamics to understand a client’s complaints
• Promoting insight into extended family dynamics to facilitate change
• Identifying and altering destructive beliefs and patterns of behavior that were learned early in life in one’s family of origin
Bowen Intergenerational Therapy
In a Nutshell: The Least You Need to Know
Bowen intergenerational theory is more about the nature of being human than it is about families or family therapy (Friedman, 1991). The Bowen approach requires therapists to work from a broad perspective that considers the evolution of the human species and the characteristics of all living systems. Therapists use this broad perspective to conceptualize client problems and then rely primarily on the therapist’s use of self to effect change. As part of this broad perspective, therapists routinely consider the three-.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Milan school of family therapy
1. MILAN SCHOOL OF FAMILY
THERAPY &
PARADOX
PRESENTER: Dr Virupaksha
2. “Life is not just happiness there is something
called marriage”
-ANONYMOUS
"The essence of life is the progression of
such changes as growth, self-
duplication, and synthesis of complex
relationships."
(Odum 1983: 87)
3. Model based on complexity
• System theory – von Bertalanffy(1967)
• „pattern which connects‟ –Bateson (1979)
• cybernetics
• Double bind hypothesis – Bateson 1950s
• Family homeostasis hypothesis – Jackson
( 1957) –> conjoint FT ( similarity to
homeopathy) -> paradoxical intervention ->
strategic approach.
4. Model based on complexity
• Brief therapy- > problem oriented therapy ->
behavioural oriented
• Systemic approach emphasize on meaning (
Batesonian concept)-> Milan school
5. Contd…
• Systematic search of difference in ,
– Behaviour
– Individuals
– Relationships
Whats keeps family together?
7. EARLY MILAN MODEL
• Paradoxes
• Counter paradoxes
• Positive connotation
• Long brief therapies
• Team of therapists
8. Formulation…
1. Families in schizophrenia transactions – games
2. Family members unilaterally try to control each
others behaviour
3. Therapist to discover and interrupt these
games
10. Milan school- salient features
• Five part therapy sessions.
• The use of co-therapy and a team behind a screen.
• Commitment to the guidelines of hypothesizing.
• Circularity and neutrality & circular questioning.
• End of session interventions involving positive
connotation and the prescription of rituals, some of which
were apparently paradoxical.
11. FEATURES
• Long gaps between sessions
• Goal of therapy was altering the family belief system
so as to end the symptom –maintaining interactional
patterns
14. period Ten months, divided into ten sessions spaced at monthly
intervals
Initial contact Usually telephonic Therapist ties to maintain neutrality in order
not to be seen by other family members as being in a coalition
with the whoever made the initial call Questions phrased in
social terms
Calls between sessions Neutral stance of therapist maintained In case of emergency
calls (e.g. suicide attempts) therapist assumes role of social
control agent rather than that of therapis
Resources Therapist brings in other members of the therapeutic team
Supervision Observatio
Therapy session – five components Team discusses the family Family interview with other team
members observing Team discussion of the family and the
session Conclusions of the team presented to the family with
other team members observing Post-session where team
sums up
Termination Mutual agreement by therapist and family Respect for family‟s
decision to terminate Warning of possibly of relapse or doubt
15. PROCESSES
• Odd days and even days
• Positive connotation
• Problem of the referring person
• Rituals
• Constancy in mission
16. INTERVENTION
• Restructuring (+ve connotation)
• The simple prescription
(counter paradox, Meta communication)
• Metaphoric prescription
17. Team split in 1980
• Selvini Palazzoli and Prata • Cecchin and Boscolo have
developed the strategic evolved a non-interventionist
aspects of the original model style premised on social
further by outlining the constructionism where the
development of particular types therapist‟s use of circular
of problem maintaining questioning opens up space
interaction patterns that they for the client and therapist to
referred to as family games. co-construct multiple new
perspectives on the problem
• stratergic therapy style-> situation
highly directive)
18. Section Points of cybernetic consistency
Bateson‟s Influence Change in one part of the system affects the whole system
Circular epistemology Patterns of information and
relationships Importance of context
Feedback and Importance of recursiveness and feedback Acknowledgement
Equifinality/Equipotentiality of negative feedback Original acknowledgement of principles
of equifinality and equipotentiality, but later moved away from
this model and took history into account
The Strategic Element Importance of communication patterns in a relational context
Reframing Multiversal view points Multidimensional approach
to therapy that developed out the their dilemma with
cybernetic consistency concerning history
The Linguistic Element and Finding a language/way of saying things that was consistent
Indeterminacy with a multiversal worldview No one truth or healing
whole/union Replace dichotomies with multiversal perspective
19. Section Points of cybernetic consistency
Structure and Organisation Acknowledging problems that might arise as a result of
structural/organisational changes within family systems
Circular Questioning Recursive method that allows for feedback Principle of mutual
co-arising or co-evolving Focus on „What?" rather than „Why?‟
Neutrality and Support Principle of the non-summative nature of systems Room to find
alternative ways of thinking and behaving
Prescription of rituals No black box metaphor – therapist and family as one system
Metatherapy Multiple levels of functioning Perturbations of
communication patterns in families Negotiation of meanings
between subsystems
Mental Phenomena as Mental phenomena as seated in relationships rather than
Social Phenomena intrapsychically
Health and Dysfunction Freedom from labelling – „the map is not the territory‟ Changes
originating within families and not attributed to the therapeutic
process
20. SUMMARY
• Each family system develops a unique set of
relationships, patterns of interactions and belief
systems
• In healthy families these are sufficiently flexible to
promote adaptation to the changing demands of the
family lifecycle and the wider ecological system.
• Unhealthy families hold belief systems that are not
sufficiently flexible to promote adaptation.
21. SUMMARY
• Circular questions asked from positions of curiosity and
irreverence (neutrality) to bring forth the family‟s
construction of the problem.
• Challenging the family belief system that underpins
problem maintaining interaction patterns.
• Circular questioning within sessions and end of session
interventions are used to promote change.
22. PARADOX
• " …the specific tactics and maneuvres which are in apparent
opposition to the goals of therapy, but are actually designed to
achieve them" (Rohrbaugh, in Palazzoli et al 1989: 3)
• “. . . paradox not only can invade interaction and affect our
behaviour and our sanity, but also it challenges our belief in the
consistency, and therefore the ultimate soundness of our
universe”
-Hugh Jenkins 1980
23. When to prescribe?
1. Presupposes an intense complementary relationship, with a high
degree of survival value for the patient
2. Within this context an injunction is given which is structured so that it
• (i) reinforces the behaviour that the patient expects to be changed
• (ii) implies that this reinforcement is a vehicle of change, and
• (iii) creates a paradox by telling the patient to change by remaining unchanged.
3. The therapeutic situation prevents the patient from withdrawing or
revealing the paradox by commenting on it, by virtue of (1) and (2).
24. STRATEGIES
• Prescribing the symptom
• Positively appraising the symptom
• Attaching positive connotations to symptoms,
• Encouraging symptoms
• Expressing fears that certain symptoms might
disappear to quickly,(Palazzoli et al 1989: 3).
25. • Identify the family nodal point
• Use different strategies
• Used cautiously
• Outcome not predictable
26. PRINCIPLE
• Double bind - ability to communicate different, and often
conflicting, messages simultaneously
• While all relationships are governed by „rules‟ they frequently
lack rules to change the rules about how members deal with
each other
(Jackson, 1965)
• Therapist takes charge of symptom and prescribes
• The person(s) no longer do(es) it because he „cannot help it‟, but
„because my therapist told me to‟.
27. References
• FAMILY THERAPY Concepts, Process and
Practice Second Edition .Alan Carr John Wiley & Sons Ltd, 2006.
• The Milan Approach to Family Therapy. Guido L
burbatti, Laura Formenti.Jason Aronson Inc.1988
• Mastering family therapy: journeys of growth
and transformation By Salvador Minuchin, Wai-Yung Lee,
George M. Simon
• ‘Paradox: a pivotal point in therapy’
Hugh Jenkins, 1980, JFT
Cybernetics is most applicable when the system being analysed is involved in a closed signal loop; that is, where action by the system causes some change in its environment and that change is fed to the system via information (feedback) that causes the system to adapt to these new conditions: the system's changes affect its behavior. This "circular causal" relationship is necessary and sufficient for a cybernetic perspective.[citation needed] System Dynamics, a related field, originated with applications of electrical engineering control theory to other kinds of simulation models (especially business systems) by Jay Forrester at MIT in the 1950s