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Structural Family Therapy

Class 4

Patricia Jaegerman

on 26 September 2017

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Transcript of Structural Family Therapy

Structural Family Therapy
IP expresses symptomatic behavior that is representative of a dysfunctional family system
The symptomatic behavior must always be understood in terms of the context in which it occurs.
The IP expresses the family’s disequilibrium or dysfunction
Systemic Understanding
Symptomatic Behavior:
IP expresses symptomatic behavior that is representative of a dysfunctional family system
The symptomatic behavior must always be understood in terms of the context in which it occurs.
The IP expresses the family’s disequilibrium or dysfunction
Systemic Foundations
Structural Theory
Uses spatial and organizational metaphors for describing problems and identifying solutions.
Therapist: Active role as instrument of change
Rules: make up the structure of the family
Families develop patterns of interaction that solidify and become rules.
Invisible rules limit the members’ behavioral repertoire and determine transactions
Isomorphism:Therapist client interaction replicate family patterns
Support the individuation and growth of individual family members, while maintaining their sense of belonging
How? The family’s structure and adaptability will determine their success in achieving such function through
Accommodation and Negotiation.
Essential Tasks of the Family
Minuchin and Fishman, 1981
Core Elements
Family Structure
Functions per Subsystem
Family Structure

Ensure that the functions of the family are carried out
Development of each family member’s self as they perform their functions in their subsystems
Maintain each member's separateness while maintaining their belongingness

Rigid boundaries
Disengaged systems
Diffused boundaries
Enmeshed systems
Clear Boundaries: Firm and Flexible
Ability to reorganize it’s structure in response to it’s changing needs, which emerge as it evolves (Colapinto, 1991). "Ideal Family"
Pathological Families: unable to adapt… respond by increasing the rigidity of historical patterns of transaction. E.G. respond to stress by locating the problem to 1 member, rigidly applying transactions to “fix” the IP, not exploring other alternatives.
To change the family’s definition of the problem from being the IP
(symptomatic behavior) to being their dysfunctional family structure (patterns of transaction)

To reorganize the dysfunctional structure so family can use alternative transactions
, that don’t require the symptomatic behavior of the IP and nurture the growth of it’s members.
Goals of Therapy
Composition of the family’s subsystems and their ability to carry out their functions
Permeability of Current Boundaries
Existence and Function of alignment and coalitions.
“Joining is more of an attitude than a technique and it is the umbrella under which all therapeutic transactions occur. Joining is letting the family know that the therapist understands and is working with and for them. Only under his protection can the family have the security to explore alternatives, try the unusual and change”
Minuchin and Fishman, 1981 (pp.31-32)
Mimesis: tempo, language, posture
Affiliation and Confirmation
Techniques of Joining
Reframing and Restructuring Techniques
1. Focusing
2. Enactment
3. Teaching Complementarity
4. Boundary Making
5. Unbalancing
6. Achieving Intensity
7. Challenging Cognitive Constructs
Selection of elements of information that seem relevant to therapeutic change.
Example: Family focuses on IP symptoms, while therapist focuses on information related to transactions.
E.g.: “What does Mary want from Whitney”
1. Focusing
Is the actualization of transactional patterns under the control of the therapist.
The family therapist directs the family to interact in an area related to the defined problem or structural goal.
Therapist observes and studies sequence of processes.
Example: “can you talk to Whitney? I am a stranger and you’ve come to see me about something that is very significant for your family. May be you can talk together, and that’ll help me to know how you deal with each other”
2. Enactment
Pointing out to family members the mutuality and reciprocity of their interactions.
Example: “Your wife tries to relax her surveillance of Whitney, but then Whitney does something that says ‘look at me’ and Mary is hooked again. They’re both caught. Whitney needs Mary to look at her, and Mary is hooked into observing and responding to Whitney. It’s a circle. Can you help them?”
“You are acting like a 4 year old… How do you manage to keep him that young” (Minuchin and Fishman, 1981)
3. Teaching Complementarity
To change subsystem membership or distance between subsystems, to modify patterns of over-underinvolvement.
Introducing rules (“talk to her about how she can be freer to become your wife”)
Assigning Tasks (“do you have space that are your own?”)
Use of Space (ask Whitney to wait ouside)
Use of Self
4. Boundary Making Technique
To challenge and modify a rigid family hierarchy.
Affiliating with family members
Ignoring of family members
Entering coalitions against family members
5. Unbalancing Techniques
Increase the level of Challenge to the current family structure
Repetition of the same message
Repetition of transactions that highlight a pattern
Reducing or extending the length of interactions beyond what generally permitted by the family rules.
Changing the level of proximity between family members.
Resisting the family’s invitation to focus on content and process that is not considered therapeutically relevant.
6. Techniques that Increase Intensity
The structure and the belief system legitimize each other in an interactive fashion.
Change in client’s experience comes by brief punctuations and reframing of enacted transactions.
Cognitive constructs: universal truths
The use of paradox
Highlighting strengths instead of the family’s focus on deficits.
7. Challenging Cognitive Structures
"Pathology might be inside the patient, it it's social context, or in the feedback between them" Minuchin, 1974.
Phases of Therapy, Minuchin '74

1. Therapist
the family and assumes a leadership position
2. The therapist ascertains the underlying
3. The therapist
the family structure.
Structural Theory
Full transcript