Structural family therapy

A presentation on SFT

1. Structural Family Structural Family
TherapyTherapy
Marriage and Family CounselingMarriage and Family Counseling
Dr. SparrowDr. Sparrow

2. FounderFounder
Salvador Minuchin, born and raised in ArgentinaSalvador Minuchin, born and raised in Argentina
–Child psychiatry, psychoanalytically trainedChild psychiatry, psychoanalytically trained
–Started seeing families at a school for delinquent boys Started seeing families at a school for delinquent boys
in the 50sin the 50s
–Self taught, collaborated with a variety of thinkers, Self taught, collaborated with a variety of thinkers,
including Jay Haley (Strategic Family Therapy) in the including Jay Haley (Strategic Family Therapy) in the
early 60searly 60s
–Became head of the Phil. Child Guidance Clinic in Became head of the Phil. Child Guidance Clinic in
19651965
–Started his own center in NY in 1981Started his own center in NY in 1981
–Retired in 1996Retired in 1996

3. Underlying AssumptionsUnderlying Assumptions
Families (people) are competent and capable of Families (people) are competent and capable of
solving their own problems -- an attitude derived solving their own problems -- an attitude derived
from the existential-humanistic traditionfrom the existential-humanistic tradition
Therapists work collaboratively with families, not Therapists work collaboratively with families, not
as experts who can solve problems, but as as experts who can solve problems, but as
consultants and coaches who can work to bring consultants and coaches who can work to bring
the family’s dormant capacities to the surface.the family’s dormant capacities to the surface.
Therapists respect the family’s unique culture. Therapists respect the family’s unique culture.
The question should be, not “What’s ideal?” but The question should be, not “What’s ideal?” but
“Does it work for them?”“Does it work for them?”
SFT is the beginning of the postmodern SFT is the beginning of the postmodern
approaches, but retains some traditional views approaches, but retains some traditional views
concerning the importance of power and hierarchyconcerning the importance of power and hierarchy

4. SFT PrinciplesSFT Principles
There is an overall organization or structure that There is an overall organization or structure that
maintains a family’s dysfunctional interactions.maintains a family’s dysfunctional interactions.
–Power and hierarchyPower and hierarchy
–Subsystems and boundariesSubsystems and boundaries
»Boundaries can be clear or normal, weak or diffuse Boundaries can be clear or normal, weak or diffuse
(too open), or rigid (too closed)(too open), or rigid (too closed)
Restructuring is based on observing and Restructuring is based on observing and
manipulating interactions within the sessionmanipulating interactions within the session
–Spontaneous behavior sequences -- form the basis for Spontaneous behavior sequences -- form the basis for
hypotheses about family structurehypotheses about family structure
–Enactments -- interactions suggested by the therapist as Enactments -- interactions suggested by the therapist as
a way to diagnose structure, and to provide an opening a way to diagnose structure, and to provide an opening
for restructuring intervention.for restructuring intervention.

5. Concepts and DefinitionsConcepts and Definitions
StructureStructure
–an organized pattern in which families interact, an organized pattern in which families interact,
not deterministic or prescriptive, only not deterministic or prescriptive, only
descriptivedescriptive
–Partly universal, partly idiosyncraticPartly universal, partly idiosyncratic
–Can only be seen when a family is in action, Can only be seen when a family is in action,
because verbal descriptions rarely convey the because verbal descriptions rarely convey the
true structure. (Haley once said that if you ask true structure. (Haley once said that if you ask
a family member what the problem is, what a family member what the problem is, what
they describe is not the problem.)they describe is not the problem.)

6. Concepts, continuedConcepts, continued
Subsystems Subsystems are subgroupings within the are subgroupings within the
family based on age (or generation), gender family based on age (or generation), gender
and interest (or function)and interest (or function)
–parentingparenting
–spousalspousal
–siblingsibling
BoundariesBoundaries are invisible barriers that are invisible barriers that
regulate contact between membersregulate contact between members
»Diffuse, too weak, or “enmeshed”Diffuse, too weak, or “enmeshed”
»Rigid, too fortified, or “disengaged”Rigid, too fortified, or “disengaged”

7. Concepts, continuedConcepts, continued
Boundaries are reciprocalBoundaries are reciprocal
–That means that a weak boundary That means that a weak boundary
(enmeshment) in one relationship usually (enmeshment) in one relationship usually
means that the same person is disengaged from means that the same person is disengaged from
someone else.someone else.
–Example is wife who is enmeshed with child Example is wife who is enmeshed with child
and disengaged from husbandand disengaged from husband
–Example is father who is very close and Example is father who is very close and
enmeshed with older son who hunts with him, enmeshed with older son who hunts with him,
and disengaged with daughter who is quietly and disengaged with daughter who is quietly
depressed and cutting herself.depressed and cutting herself.

8. A Couple’s Challenge: Forming a A Couple’s Challenge: Forming a
Healthy Spousal SubsystemHealthy Spousal Subsystem
Must develop complementary patterns of Must develop complementary patterns of
mutual support, or accommodation mutual support, or accommodation
(compromise) (compromise)
Must develop a boundary that separates Must develop a boundary that separates
couple from children, parents and outsiders.couple from children, parents and outsiders.
Must claim authority in a hierarchical Must claim authority in a hierarchical
structurestructure

9. How Problems DevelopHow Problems Develop
Inflexible response to maturational (or Inflexible response to maturational (or
developmental) and environmental challenges developmental) and environmental challenges
leads to conflict avoidance through leads to conflict avoidance through
disengagement or enmeshmentdisengagement or enmeshment
Disengagement and enmeshment tend to be Disengagement and enmeshment tend to be
compensatory (I’m close here to make up for my compensatory (I’m close here to make up for my
distance elsewhere.)distance elsewhere.)
This leads to what is called the cross-generational This leads to what is called the cross-generational
coalition, which is a triangular structurecoalition, which is a triangular structure

10. Therapeutic GoalsTherapeutic Goals
Therapy is directed at altering family structure.Therapy is directed at altering family structure.
–General goals of family are important, but not as General goals of family are important, but not as
important as creating an effective structure.important as creating an effective structure.
–Creation of Creation of
»effective hierarchyeffective hierarchy
»executive subsystemexecutive subsystem
Structural problems are usually viewed simply as Structural problems are usually viewed simply as
failure to adjust to changes.failure to adjust to changes.
Therapist doesn’t solve problems, that’s the Therapist doesn’t solve problems, that’s the
family’s job. family’s job.
Boundaries must be strengthened in enmeshed Boundaries must be strengthened in enmeshed
relationships, and weakened (or opened up) in relationships, and weakened (or opened up) in
disengaged ones.disengaged ones.

11. Therapist’s RoleTherapist’s Role
Joins the family in a position of leadershipJoins the family in a position of leadership
Maps the family’s underlying structure Maps the family’s underlying structure
(boundaries, hierarchy, subsystems)(boundaries, hierarchy, subsystems)
Intervenes to transform the structureIntervenes to transform the structure

12. Therapeutic GoalsTherapeutic Goals
Not a matter of creating new structures, but activating Not a matter of creating new structures, but activating
dormant onesdormant ones
What distinguishes SFT from other forms of family What distinguishes SFT from other forms of family
therapy is the emphasis on modifying family structure therapy is the emphasis on modifying family structure
in the immediate context of the therapy setting.in the immediate context of the therapy setting.
When new patterns are repeated, and result in When new patterns are repeated, and result in
improvement of family relationships, they will improvement of family relationships, they will
stabilize and replace old patterns without having to stabilize and replace old patterns without having to
keep supporting them. (Similar to the behavioristic keep supporting them. (Similar to the behavioristic
notion of reinforcement.)notion of reinforcement.)

13. Therapeutic InterventionsTherapeutic Interventions
JoiningJoining in a position of leadership, and in a position of leadership, and
accommodatingaccommodating
–Family is set up to resist you. You are a Family is set up to resist you. You are a
stranger, and know nothing about their stranger, and know nothing about their
struggles, and their goodness.struggles, and their goodness.
–Important to join with angry and powerful Important to join with angry and powerful
family membersfamily members
–Important to build an alliance with every Important to build an alliance with every
family memberfamily member
–Important to respect hierarchyImportant to respect hierarchy

14. Therapeutic InterventionsTherapeutic Interventions
Working with Interaction Working with Interaction by inquiring into the by inquiring into the
family’s view of the problem, and tracking the family’s view of the problem, and tracking the
sequences of behaviors that they use to explain it. sequences of behaviors that they use to explain it.
Mapping underlying structure Mapping underlying structure in ways that in ways that
capture the interrelationship of members -- A capture the interrelationship of members -- A
structural map is essential!)structural map is essential!)
–Family structure is manifest only with Family structure is manifest only with
members interactmembers interact
–By asking everyone for a description of the By asking everyone for a description of the
problem, the therapist increases the chances for problem, the therapist increases the chances for
observing and restructuring family dynamics.observing and restructuring family dynamics.

15. Therapeutic InterventionsTherapeutic Interventions
Highlighting and modifying interactionsHighlighting and modifying interactions
–Spontaneous behavior sequencesSpontaneous behavior sequences
–Enactments -- directed by therapistEnactments -- directed by therapist
RestructuringRestructuring
–Use of reframing to illuminate family structureUse of reframing to illuminate family structure
–Use of circular perspectives, e.g. helping each other Use of circular perspectives, e.g. helping each other
changechange
–Boundary settingBoundary setting
–Unbalancing (briefly taking sides)Unbalancing (briefly taking sides)
–Challenging unproductive assumptionsChallenging unproductive assumptions
–Use of intensity to bring about change (not giving up)Use of intensity to bring about change (not giving up)
–Shaping competencyShaping competency
–Not doing the family’s work for them (refusing to Not doing the family’s work for them (refusing to
answer questions, or to step in and take charge when answer questions, or to step in and take charge when
it’s important for the family members to do so.it’s important for the family members to do so.

16. Therapeutic InterventionsTherapeutic Interventions
HomeworkHomework
–Should be to increase contact between Should be to increase contact between
disengaged parties, disengaged parties,
–To reinforce boundaries between individuals To reinforce boundaries between individuals
and subsystems that have been enmeshedand subsystems that have been enmeshed
–Should be something that is not too ambitiousShould be something that is not too ambitious
–While Minuchin rarely used strategic While Minuchin rarely used strategic
interventions, he did caution family members interventions, he did caution family members
to expect setbacks, in order to prepare them for to expect setbacks, in order to prepare them for
a realistic future.a realistic future.