Structural Family Therapy Marriage and Family Counseling Dr. Sparrow

Structural Family
Therapy
Marriage and Family Counseling
Dr. Sparrow
Founder
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Salvador Minuchin, born and raised in Argentina
– Child psychiatry, psychoanalytically trained
– Started seeing families at a school for delinquent boys
in the 50s
– Self taught, collaborated with a variety of thinkers,
including Jay Haley (Strategic Family Therapy) in the
early 60s
– Became head of the Phil. Child Guidance Clinic in
1965
– Started his own center in NY in 1981
– Retired in 1996
Underlying Assumptions
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Families (people) are competent and capable of
solving their own problems -- an attitude derived
from the existential-humanistic tradition
Therapists work collaboratively with families, not
as experts who can solve problems, but as
consultants and coaches who can work to bring
the family’s dormant capacities to the surface.
Therapists respect the family’s unique culture. The
question should be, not “What’s ideal?” but “Does
it work for them?”
SFT is the beginning of the postmodern
approaches, but retains some traditional views
concerning the importance of power and hierarchy
SFT Principles

There is an overall organization or structure that
maintains a family’s dysfunctional interactions.
– Power and hierarchy
– Subsystems and boundaries
» Boundaries can be clear or normal, weak or diffuse
(too open), or rigid (too closed)
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Restructuring is based on observing and
manipulating interactions within the session
– Spontaneous behavior sequences -- form the basis for
hypotheses about family structure
– Enactments -- interactions suggested by the therapist as
a way to diagnose structure, and to provide an opening
for restructuring intervention.
Concepts and Definitions
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Structure
– an organized pattern in which families interact,
not deterministic or prescriptive, only
descriptive
– Partly universal, partly idiosyncratic
– Can only be seen when a family is in action,
because verbal descriptions rarely convey the
true structure. (Haley once said that if you ask
a family member what the problem is, what
they describe is not the problem.)
Concepts, continued
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Subsystems are subgroupings within the
family based on age (or generation), gender
and interest (or function)
– parenting
– spousal
– sibling
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Boundaries are invisible barriers that
regulate contact between members
» Diffuse, too weak, or “enmeshed”
» Rigid, too fortified, or “disengaged”
Concepts, continued

Boundaries are reciprocal
– That means that a weak boundary
(enmeshment) in one relationship usually
means that the same person is disengaged from
someone else.
– Example is wife who is enmeshed with child
and disengaged from husband
– Example is father who is very close and
enmeshed with older son who hunts with him,
and disengaged with daughter who is quietly
depressed and cutting herself.
A Couple’s Challenge: Forming a
Healthy Spousal Subsystem
Must develop complementary patterns of
mutual support, or accommodation
(compromise)
 Must develop a boundary that separates
couple from children, parents and outsiders.
 Must claim authority in a hierarchical
structure
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How Problems Develop
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Inflexible response to maturational (or
developmental) and environmental challenges
leads to conflict avoidance through
disengagement or enmeshment
Disengagement and enmeshment tend to be
compensatory (I’m close here to make up for my
distance elsewhere.)
This leads to what is called the cross-generational
coalition, which is a triangular structure
Therapeutic Goals
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Therapy is directed at altering family structure.
– General goals of family are important, but not as
important as creating an effective structure.
– Creation of
» effective hierarchy
» executive subsystem
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Structural problems are usually viewed simply as
failure to adjust to changes.
Therapist doesn’t solve problems, that’s the
family’s job.
Boundaries must be strengthened in enmeshed
relationships, and weakened (or opened up) in
disengaged ones.
Therapist’s Role
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Joins the family in a position of leadership
Maps the family’s underlying structure
(boundaries, hierarchy, subsystems)
Intervenes to transform the structure
Therapeutic Goals
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Not a matter of creating new structures, but activating
dormant ones
What distinguishes SFT from other forms of family
therapy is the emphasis on modifying family structure
in the immediate context of the therapy setting.
When new patterns are repeated, and result in
improvement of family relationships, they will
stabilize and replace old patterns without having to
keep supporting them. (Similar to the behavioristic
notion of reinforcement.)
Therapeutic Interventions
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Joining in a position of leadership, and
accommodating
– Family is set up to resist you. You are a
stranger, and know nothing about their
struggles, and their goodness.
– Important to join with angry and powerful
family members
– Important to build an alliance with every
family member
– Important to respect hierarchy
Therapeutic Interventions
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Working with Interaction by inquiring into the
family’s view of the problem, and tracking the
sequences of behaviors that they use to explain it.
Mapping underlying structure in ways that
capture the interrelationship of members -- A
structural map is essential!)
– Family structure is manifest only with
members interact
– By asking everyone for a description of the
problem, the therapist increases the chances for
observing and restructuring family dynamics.
Therapeutic Interventions
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Highlighting and modifying interactions
– Spontaneous behavior sequences
– Enactments -- directed by therapist
Restructuring
– Use of reframing to illuminate family structure
– Use of circular perspectives, e.g. helping each other
change
– Boundary setting
– Unbalancing (briefly taking sides)
– Challenging unproductive assumptions
– Use of intensity to bring about change (not giving up)
– Shaping competency
– Not doing the family’s work for them (refusing to
answer questions, or to step in and take charge when
it’s important for the family members to do so.
Therapeutic Interventions
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Homework
– Should be to increase contact between
disengaged parties,
– To reinforce boundaries between individuals
and subsystems that have been enmeshed
– Should be something that is not too ambitious
– While Minuchin rarely used strategic
interventions, he did caution family members
to expect setbacks, in order to prepare them for
a realistic future.