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Structural FamilyStructural Family
TherapyTherapy
 Families (people) are competent and capable ofFamilies (people) are competent and capable of
solving their own problems -- an attitudesolving their own problems -- an attitude
derived from the existential-humanisticderived from the existential-humanistic
traditiontradition
 Symptoms are a bi-product of a structuralSymptoms are a bi-product of a structural
system that is failingsystem that is failing
 Therapists work collaboratively with families,Therapists work collaboratively with families,
not as experts who can solve problems, but asnot as experts who can solve problems, but as
consultants and coaches who can work toconsultants and coaches who can work to
bring the family’s dormant capacities to thebring the family’s dormant capacities to the
surface.surface.
 Therapists respect the family’s unique culture.Therapists respect the family’s unique culture.
The question should be, not “What’s ideal?”The question should be, not “What’s ideal?”
but “Does it work for them?”but “Does it work for them?”
Underlying AssumptionsUnderlying Assumptions
 There is an overall organization or structureThere is an overall organization or structure
that maintains a family’s dysfunctionalthat maintains a family’s dysfunctional
interactions.interactions.
 Power and hierarchyPower and hierarchy
 Subsystems and boundariesSubsystems and boundaries
 Boundaries can be clear or normal, weak or diffuse (too open), orBoundaries can be clear or normal, weak or diffuse (too open), or
rigid (too closed)rigid (too closed)
 Restructuring is based on observing andRestructuring is based on observing and
manipulating interactions within the sessionmanipulating interactions within the session
 Spontaneous behavior sequences -- form the basisSpontaneous behavior sequences -- form the basis
for hypotheses about family structurefor hypotheses about family structure
 Enactments - interactions are suggested by theEnactments - interactions are suggested by the
therapist as a way to understand and diagnose thetherapist as a way to understand and diagnose the
structure, and to provide an opening forstructure, and to provide an opening for
restructuring intervention.restructuring intervention.
SFT PrinciplesSFT Principles
 StructureStructure
 an organized pattern in which families interact, not deterministican organized pattern in which families interact, not deterministic
or prescriptive, only descriptiveor prescriptive, only descriptive
 Can only be seen when a family is in action, because verbalCan only be seen when a family is in action, because verbal
descriptions rarely convey the true structure.descriptions rarely convey the true structure.
 SubsystemsSubsystems are subgroupings within the family based on ageare subgroupings within the family based on age
(or generation), gender and interest (or function)(or generation), gender and interest (or function)
 parentingparenting
 spousalspousal
 siblingsibling
 BoundariesBoundaries are invisible barriers that regulate contact betweenare invisible barriers that regulate contact between
membersmembers
 Diffuse, too weak, or “enmeshed”Diffuse, too weak, or “enmeshed”
 Rigid, too fortified, or “disengaged”Rigid, too fortified, or “disengaged”
ConceptsConcepts
 Boundaries are reciprocalBoundaries are reciprocal
 That means that a weak boundary (enmeshment)That means that a weak boundary (enmeshment)
in one relationship usually means that the samein one relationship usually means that the same
person is disengaged from someone else.person is disengaged from someone else.
 Example is wife who is enmeshed with child andExample is wife who is enmeshed with child and
disengaged from husbanddisengaged from husband
 Example is father who is very close andExample 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 quietlyand disengaged with daughter who is quietly
depressed and doesn’t speak up.depressed and doesn’t speak up.
Concepts, continuedConcepts, continued
 Inflexible response to maturational (orInflexible response to maturational (or
developmental) and environmentaldevelopmental) and environmental
challenges leads to conflict avoidancechallenges leads to conflict avoidance
through disengagement or enmeshmentthrough disengagement or enmeshment
 Disengagement and enmeshment tend toDisengagement and enmeshment tend to
be compensatory (I’m close here to makebe compensatory (I’m close here to make
up for my distance elsewhere.)up for my distance elsewhere.)
 This leads to what is called the cross-This leads to what is called the cross-
generational coalition, which is agenerational coalition, which is a
triangular structuretriangular structure
How Problems DevelopHow Problems Develop
 Therapy is directed at altering the familyTherapy is directed at altering the family
structure.structure.
 General goals of family are important, but not asGeneral goals of family are important, but not as
important as creating an effective structure.important as creating an effective structure.
 Creation of an effective hierarchyCreation of an effective hierarchy
 Structural problems are usually viewedStructural problems are usually viewed
simply as failure to adjust to changes.simply as failure to adjust to changes.
 Therapist doesn’t solve problems, that’s theTherapist doesn’t solve problems, that’s the
family’s job.family’s job.
 Boundaries must be strengthened inBoundaries must be strengthened in
enmeshed relationships, and weakened (orenmeshed relationships, and weakened (or
opened up) in disengaged ones.opened up) in disengaged ones.
Therapeutic GoalsTherapeutic Goals
 Joins the family in a position of leadershipJoins the family in a position of leadership
 Maps the family’s underlying structureMaps the family’s underlying structure
(boundaries, hierarchy, subsystems)(boundaries, hierarchy, subsystems)
 Intervenes to transform the structureIntervenes to transform the structure
Therapist’s RoleTherapist’s Role
 Not a matter of creating new structures, butNot a matter of creating new structures, but
reforming existing onesreforming existing ones
 What distinguishes SFT from other forms ofWhat distinguishes SFT from other forms of
family therapy is the emphasis on modifyingfamily therapy is the emphasis on modifying
family structurefamily structure in the immediate context of thein the immediate context of the
therapy setting.therapy setting.
 When new patterns are repeated and result inWhen new patterns are repeated and result in
improvement of family relationships, they willimprovement of family relationships, they will
stabilize and replace old patterns without havingstabilize and replace old patterns without having
to keep supporting them and symptoms ofto keep supporting them and symptoms of
dysfunction will be reduced or disappear.dysfunction will be reduced or disappear.
(Similar to the idea of behavioral reinforcement)(Similar to the idea of behavioral reinforcement)
Therapeutic GoalsTherapeutic Goals
 JoiningJoining in a position of leadership, andin a position of leadership, and
accommodating other members of the familyaccommodating other members of the family
 The family may resist, it’s important toThe family may resist, it’s important to
join with angry family membersjoin with angry family members
 Important to build an alliance with everyImportant to build an alliance with every
family memberfamily member
 Important to respect the hierarchyImportant to respect the hierarchy
Therapeutic InterventionsTherapeutic Interventions
 Working with InteractionWorking with Interaction by inquiring intoby inquiring into
the family’s view of the problem, andthe family’s view of the problem, and
tracking the sequences of behaviors that theytracking the sequences of behaviors that they
use to explain it.use to explain it.
 Mapping underlying structureMapping underlying structure in ways thatin ways that
capture the interrelationship of members -- Acapture the interrelationship of members -- A
structural map is essential!)structural map is essential!)
 Family structure is manifest only with members interactFamily structure is manifest only with members interact
 By asking everyone for a description of the problem, theBy asking everyone for a description of the problem, the
therapist increases the chances for observing and restructuringtherapist increases the chances for observing and restructuring
family dynamics.family dynamics.
Therapeutic InterventionsTherapeutic Interventions
 Highlighting and modifying interactionsHighlighting and modifying interactions
 Spontaneous behavior sequencesSpontaneous behavior sequences
 Enactments that the therapist directsEnactments that the therapist directs
 RestructuringRestructuring
 Use of reframing to illuminate family structureUse of reframing to illuminate family structure
 Use of circular perspectives, helping each otherUse of circular perspectives, helping each other
changechange
 Boundary settingBoundary setting
 Unbalancing (briefly taking sides)Unbalancing (briefly taking sides)
 Challenging unproductive assumptionsChallenging unproductive assumptions
 Shaping competencyShaping competency
 Not doing the family’s work for them (refusing toNot doing the family’s work for them (refusing to
answer questions, or to step in and take chargeanswer questions, or to step in and take charge
when it’s important for the family members to dowhen it’s important for the family members to do
so.so.
Therapeutic InterventionsTherapeutic Interventions
 HomeworkHomework
Should be used to:Should be used to:
increase contact between disengaged partiesincrease contact between disengaged parties
To reinforce boundaries betweenTo reinforce boundaries between
individuals and subsystems that have beenindividuals and subsystems that have been
enmeshedenmeshed
Increase contact between disengagedIncrease contact between disengaged
partiesparties
Should be something that is realistic andShould be something that is realistic and
not too ambitiousnot too ambitious
Expect setbacks in preparation for aExpect setbacks in preparation for a
realistic futurerealistic future
Therapeutic InterventionsTherapeutic Interventions
 The technique that we will be using during theThe technique that we will be using during the
therapy session is where the children draw out atherapy session is where the children draw out a
family map. This technique is very beneficial forfamily map. This technique is very beneficial for
younger children since it allows them to expressyounger children since it allows them to express
how they view and feel about the family’show they view and feel about the family’s
structure. This is very similar to the technique thatstructure. This is very similar to the technique that
we saw in the video during class, in which eachwe saw in the video during class, in which each
family member physically moves and arranges thefamily member physically moves and arranges the
family; however, drawing the family map can befamily; however, drawing the family map can be
easier for younger children, as it is similar to playeasier for younger children, as it is similar to play
therapy. Also, it is less likely that other familytherapy. Also, it is less likely that other family
members will influence them when performing themembers will influence them when performing the
exercise by speaking to them or even through bodyexercise by speaking to them or even through body
language or facial expressions.language or facial expressions.

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Structural Family Therapy: Restructuring Relationships for Change

  • 2.  Families (people) are competent and capable ofFamilies (people) are competent and capable of solving their own problems -- an attitudesolving their own problems -- an attitude derived from the existential-humanisticderived from the existential-humanistic traditiontradition  Symptoms are a bi-product of a structuralSymptoms are a bi-product of a structural system that is failingsystem that is failing  Therapists work collaboratively with families,Therapists work collaboratively with families, not as experts who can solve problems, but asnot as experts who can solve problems, but as consultants and coaches who can work toconsultants and coaches who can work to bring the family’s dormant capacities to thebring the family’s dormant capacities to the surface.surface.  Therapists respect the family’s unique culture.Therapists respect the family’s unique culture. The question should be, not “What’s ideal?”The question should be, not “What’s ideal?” but “Does it work for them?”but “Does it work for them?” Underlying AssumptionsUnderlying Assumptions
  • 3.  There is an overall organization or structureThere is an overall organization or structure that maintains a family’s dysfunctionalthat maintains a family’s dysfunctional interactions.interactions.  Power and hierarchyPower and hierarchy  Subsystems and boundariesSubsystems and boundaries  Boundaries can be clear or normal, weak or diffuse (too open), orBoundaries can be clear or normal, weak or diffuse (too open), or rigid (too closed)rigid (too closed)  Restructuring is based on observing andRestructuring is based on observing and manipulating interactions within the sessionmanipulating interactions within the session  Spontaneous behavior sequences -- form the basisSpontaneous behavior sequences -- form the basis for hypotheses about family structurefor hypotheses about family structure  Enactments - interactions are suggested by theEnactments - interactions are suggested by the therapist as a way to understand and diagnose thetherapist as a way to understand and diagnose the structure, and to provide an opening forstructure, and to provide an opening for restructuring intervention.restructuring intervention. SFT PrinciplesSFT Principles
  • 4.  StructureStructure  an organized pattern in which families interact, not deterministican organized pattern in which families interact, not deterministic or prescriptive, only descriptiveor prescriptive, only descriptive  Can only be seen when a family is in action, because verbalCan only be seen when a family is in action, because verbal descriptions rarely convey the true structure.descriptions rarely convey the true structure.  SubsystemsSubsystems are subgroupings within the family based on ageare subgroupings within the family based on age (or generation), gender and interest (or function)(or generation), gender and interest (or function)  parentingparenting  spousalspousal  siblingsibling  BoundariesBoundaries are invisible barriers that regulate contact betweenare invisible barriers that regulate contact between membersmembers  Diffuse, too weak, or “enmeshed”Diffuse, too weak, or “enmeshed”  Rigid, too fortified, or “disengaged”Rigid, too fortified, or “disengaged” ConceptsConcepts
  • 5.  Boundaries are reciprocalBoundaries are reciprocal  That means that a weak boundary (enmeshment)That means that a weak boundary (enmeshment) in one relationship usually means that the samein one relationship usually means that the same person is disengaged from someone else.person is disengaged from someone else.  Example is wife who is enmeshed with child andExample is wife who is enmeshed with child and disengaged from husbanddisengaged from husband  Example is father who is very close andExample 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 quietlyand disengaged with daughter who is quietly depressed and doesn’t speak up.depressed and doesn’t speak up. Concepts, continuedConcepts, continued
  • 6.  Inflexible response to maturational (orInflexible response to maturational (or developmental) and environmentaldevelopmental) and environmental challenges leads to conflict avoidancechallenges leads to conflict avoidance through disengagement or enmeshmentthrough disengagement or enmeshment  Disengagement and enmeshment tend toDisengagement and enmeshment tend to be compensatory (I’m close here to makebe compensatory (I’m close here to make up for my distance elsewhere.)up for my distance elsewhere.)  This leads to what is called the cross-This leads to what is called the cross- generational coalition, which is agenerational coalition, which is a triangular structuretriangular structure How Problems DevelopHow Problems Develop
  • 7.  Therapy is directed at altering the familyTherapy is directed at altering the family structure.structure.  General goals of family are important, but not asGeneral goals of family are important, but not as important as creating an effective structure.important as creating an effective structure.  Creation of an effective hierarchyCreation of an effective hierarchy  Structural problems are usually viewedStructural problems are usually viewed simply as failure to adjust to changes.simply as failure to adjust to changes.  Therapist doesn’t solve problems, that’s theTherapist doesn’t solve problems, that’s the family’s job.family’s job.  Boundaries must be strengthened inBoundaries must be strengthened in enmeshed relationships, and weakened (orenmeshed relationships, and weakened (or opened up) in disengaged ones.opened up) in disengaged ones. Therapeutic GoalsTherapeutic Goals
  • 8.  Joins the family in a position of leadershipJoins the family in a position of leadership  Maps the family’s underlying structureMaps the family’s underlying structure (boundaries, hierarchy, subsystems)(boundaries, hierarchy, subsystems)  Intervenes to transform the structureIntervenes to transform the structure Therapist’s RoleTherapist’s Role
  • 9.  Not a matter of creating new structures, butNot a matter of creating new structures, but reforming existing onesreforming existing ones  What distinguishes SFT from other forms ofWhat distinguishes SFT from other forms of family therapy is the emphasis on modifyingfamily therapy is the emphasis on modifying family structurefamily structure in the immediate context of thein the immediate context of the therapy setting.therapy setting.  When new patterns are repeated and result inWhen new patterns are repeated and result in improvement of family relationships, they willimprovement of family relationships, they will stabilize and replace old patterns without havingstabilize and replace old patterns without having to keep supporting them and symptoms ofto keep supporting them and symptoms of dysfunction will be reduced or disappear.dysfunction will be reduced or disappear. (Similar to the idea of behavioral reinforcement)(Similar to the idea of behavioral reinforcement) Therapeutic GoalsTherapeutic Goals
  • 10.  JoiningJoining in a position of leadership, andin a position of leadership, and accommodating other members of the familyaccommodating other members of the family  The family may resist, it’s important toThe family may resist, it’s important to join with angry family membersjoin with angry family members  Important to build an alliance with everyImportant to build an alliance with every family memberfamily member  Important to respect the hierarchyImportant to respect the hierarchy Therapeutic InterventionsTherapeutic Interventions
  • 11.  Working with InteractionWorking with Interaction by inquiring intoby inquiring into the family’s view of the problem, andthe family’s view of the problem, and tracking the sequences of behaviors that theytracking the sequences of behaviors that they use to explain it.use to explain it.  Mapping underlying structureMapping underlying structure in ways thatin ways that capture the interrelationship of members -- Acapture the interrelationship of members -- A structural map is essential!)structural map is essential!)  Family structure is manifest only with members interactFamily structure is manifest only with members interact  By asking everyone for a description of the problem, theBy asking everyone for a description of the problem, the therapist increases the chances for observing and restructuringtherapist increases the chances for observing and restructuring family dynamics.family dynamics. Therapeutic InterventionsTherapeutic Interventions
  • 12.  Highlighting and modifying interactionsHighlighting and modifying interactions  Spontaneous behavior sequencesSpontaneous behavior sequences  Enactments that the therapist directsEnactments that the therapist directs  RestructuringRestructuring  Use of reframing to illuminate family structureUse of reframing to illuminate family structure  Use of circular perspectives, helping each otherUse of circular perspectives, helping each other changechange  Boundary settingBoundary setting  Unbalancing (briefly taking sides)Unbalancing (briefly taking sides)  Challenging unproductive assumptionsChallenging unproductive assumptions  Shaping competencyShaping competency  Not doing the family’s work for them (refusing toNot doing the family’s work for them (refusing to answer questions, or to step in and take chargeanswer questions, or to step in and take charge when it’s important for the family members to dowhen it’s important for the family members to do so.so. Therapeutic InterventionsTherapeutic Interventions
  • 13.  HomeworkHomework Should be used to:Should be used to: increase contact between disengaged partiesincrease contact between disengaged parties To reinforce boundaries betweenTo reinforce boundaries between individuals and subsystems that have beenindividuals and subsystems that have been enmeshedenmeshed Increase contact between disengagedIncrease contact between disengaged partiesparties Should be something that is realistic andShould be something that is realistic and not too ambitiousnot too ambitious Expect setbacks in preparation for aExpect setbacks in preparation for a realistic futurerealistic future Therapeutic InterventionsTherapeutic Interventions
  • 14.  The technique that we will be using during theThe technique that we will be using during the therapy session is where the children draw out atherapy session is where the children draw out a family map. This technique is very beneficial forfamily map. This technique is very beneficial for younger children since it allows them to expressyounger children since it allows them to express how they view and feel about the family’show they view and feel about the family’s structure. This is very similar to the technique thatstructure. This is very similar to the technique that we saw in the video during class, in which eachwe saw in the video during class, in which each family member physically moves and arranges thefamily member physically moves and arranges the family; however, drawing the family map can befamily; however, drawing the family map can be easier for younger children, as it is similar to playeasier for younger children, as it is similar to play therapy. Also, it is less likely that other familytherapy. Also, it is less likely that other family members will influence them when performing themembers will influence them when performing the exercise by speaking to them or even through bodyexercise by speaking to them or even through body language or facial expressions.language or facial expressions.