Milan's scale or Milan's staircase

In the world of family therapy, there are numerous approaches and techniques that inform the work of therapists. One particularly influential tool that has gained recognition in recent years is Milan’s Scale, also known as Milan’s Staircase. Initially developed by the Milan Systemic Therapy team in the 1970s, this model offers a unique perspective on family dynamics and the process of change within a family system.

The Milan Systemic Therapy team, consisting of therapists such as Mara Selvini Palazzoli, Luigi Boscolo, Gianfranco Cecchin, and Giuliana Prata, sought to understand and address complex issues within families. Frustrated with traditional linear models of therapy, which often focused on blaming individuals, they aimed to view problems as embedded within the family system as a whole. Thus, Milan’s Scale was born.

At the core of Milan’s Scale is the understanding that every family adopts specific patterns of communication and behavior that maintain a certain equilibrium. These patterns, often referred to as “games,” serve as a way for family members to connect and interact with each other. However, these games can also perpetuate dysfunctional dynamics or be resistant to change.

Milan’s Scale offers a framework for therapists to assess the level of family system functioning. It consists of three stages or steps, each representing different levels of family organization. The first step, known as “homeostasis,” describes a functional family system, where communication and interactions are balanced, and conflicts are resolved appropriately. It is important to note that even healthy families may experience moments of dysfunction, but they are capable of restoring balance.

The second step, often referred to as “quasi-chaos” or “dysfunctional homeostasis,” represents a family system that has difficulty maintaining stability. In this stage, family members may engage in repetitive patterns of communication and behavior that perpetuate problems or prevent change. The family may experience ongoing conflicts, power struggles, or a sense of stuckness. It is during this stage that therapists can intervene and support the family in shifting their dynamics.

The third and final step on Milan’s Scale is known as “chaos.” In this stage, the family system has reached a breaking point, with highly escalated conflicts and dysfunctional patterns that seem inescapable. It is important to recognize that chaos is not synonymous with failure; instead, it represents an opportunity for profound change. Therapists utilizing Milan’s Scale see chaos as fertile ground for transformation and work with families to create new meaning and possibilities.

By assessing which step of Milan’s Scale a family falls within, therapists can tailor their interventions accordingly. For example, a family at the first step may benefit from focusing on reinforcing their strengths and building healthy communication patterns. In contrast, a family at the second step might require interventions aimed at disrupting their dysfunctional dynamics and facilitating change. Finally, a family experiencing chaos may require intensive therapeutic support to process the underlying issues and co-create new narratives.

Milan’s Scale has revolutionized the field of family therapy, challenging traditional notions of individual pathology and moving towards a systemic perspective. It recognizes that change occurs within the context of relationships and that families have the inherent capacity to heal and grow. By understanding the complexities of family systems and utilizing Milan’s Scale, therapists can guide families toward transformative change, ultimately fostering healthier and more functional dynamics.

In conclusion, Milan’s Scale, also known as Milan’s Staircase, is a powerful tool used by therapists in family therapy. This model offers a unique perspective on family dynamics and the process of change within a family system. By assessing which step of the scale a family falls within, therapists can tailor their interventions and support families in achieving healthy and functional dynamics. Milan’s Scale has undoubtedly revolutionized the field of family therapy and remains an invaluable asset in helping families heal and grow.