Structural Family Therapy

Developed by Salvador Minuchin largely as a result of his work with disorganized lower socioeconomic status families which suggested that these families respond best to interventions that use the here-and now directive, concrete approach.

Structural Family Therapy

According to Minuchin, all families have an ______ ___________ that determines how family members relate to one another.

implicit structure

One element of the family's structure is its _______ ___________ which determine how members combine forces during times of conflict. Another element is the family's ___________ such as husband-wife, parent child.

Power hierarchies, subsystems

A family's structure is also defined by its ______ which are "barriers" or rules that determine the amount of _______ that is allowed between family members.

Boundaries , contact

When the boundaries are overtly rigid, family members are _________ from one another, when boundaries are too _____ or permeable, family members are _________ .

Disengaged (isolated), diffuse, enmeshed (0vertly dependent and close)

Firm but flexible and allow family members to maintain a balance between separateness from and connection to other family members

Clear Boundaries

Leads to disengagement between family members and promotes isolation

Rigid Boundaries

Lead to enmeshment and promote excessive dependence

Diffuse Boundaries

Munuchin distinguished between 3 chronic boundary problems or rigid triads

Detouring, stable coalition, triangulation

Occurs when the parents focus on a child either by protecting or blaming scapegoating, the child to distract from the family's problems

Parents might reinforce deviant behavior in the child because it takes the focus off the problem they are having with each other.

Detouring

Occurs when a parent and child form a cross generational coalition and consistently "gang up" against the other parent.

Stable Coalition

Also known as unstable coalition occurs when each parent demands that the child side with him/her against the other parents. In this situation the child is constantly being pulled in two directions

Triangulation

Family dysfunction is viewed as the result of an inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.

View of Maladaptive behavior

For example Munuchin found that "psychosomatic families those w/ diabetes, anorexia, or other condition threatens the life of a child often exhibit a high degree of ____________ that limits individual __________ along with low tolerance for _________ and overprotectiveness. In these families, the child's symptoms help ___________ family conflict by diverting attention away from it

enmeshment, autonomy, conflict , diffuse

Restructuring the family is the primary long term goal of therapy. Therapy may also address symptom relief and other short-term goals using techniques drawn from other forms of therapy. Behavioral techniques for instance, are often used to get a child with anorexia to eat.

Therapy Goals

Structural therapy is based on the premise that action ___________ understanding and it emphasizes changing _______ rather than fostering _______.

Precedes, behaviors, insight

What are the three overlapping steps involved in the process of structural therapy?

Joining, evaluating the family structure, restructuring the family

The therapist’s first task is to develop a therapeutic system by joining the family in a position of leadership. Joining involves "blending" with the family and includes tracking (identifying and using the family's values, life themes, and significant life events in conversations) and minesis (adopting the family's affective communication style.

Joining

Using the content of the family's communication to demonstrate interest and understanding.

Tracking

Once the therapist has joined the family, he is in a position to evaluate the family's structure, including the transactional patterns, power hierarchies, and boundaries. Evaluation enables the therapist to make a structural diagnosis from which specific goals of therapy can be derived (e.g., strengthening boundaries in an enmeshed family), and it may include constructing a family structural map that helps clarify family interaction patterns.

Evaluating the Family Structure

Techniques uses to deliberately unbalance (stress) the family's homeostasis in order to facilitate transformation of the family structure.

Restructuring the Family

4 techniques for restructuring the family include

-Enactment in which family members are asked to role play their relationship patterns so that they can be identified and altered.

-Reframing which involves relabeling behaviors so that they can be viewed in more positive ways,

-Boundary marking to modify family interactions by strengthening, diffusing, boundaries

-Unbalancing- the therapist takes the side of the scapegoated family member or a subsystem to falter they way the family members act toward the person or system