Structural Family Therapy is a strength-based, outcome oriented-treatment modality based on ecosystemic principles. The rationale behind this kind of therapy is that the treatment of an individual in some cases is successful only if their dysfunctional families are treated to solve the problem completely.
What is structural family therapy?
Structural Family Therapy (SFT) is a form of family therapy under the umbrella of Family Systems Therapy. SFT was designed by Salvador Minuchin, got its start in the early 1960s and evolved over the years. It observes and addresses patterns of interaction between members of the family in order to find the dysfunctional patterns that create problems.
In structural family therapy, there is a goal established to help improve communication and the way family members interact with each in order to then create healthy communication, appropriate boundaries, and eventually healthier family structure.
Therapists also explore the subsystems of a family, such as the relationships between siblings using role-playing activities in their sessions.
Types of family systems therapy
Structural Family Therapy comes under the umbrella of Family Systems Therapy approaches. Family systems therapy consists mainly of structural family therapy, strategic family therapy, and intergenerational family therapy.
Structural Family Therapy–looks at family relationships, behaviors, and patterns as they are exhibited within the therapy session in order to evaluate the structure of the family.
Strategic Family Therapy– examines family processes and functions, such as communication or problem-solving patterns, by evaluating family behavior outside the therapy session.
Intergenerational Family Therapy– identifies multigenerational behavioral patterns that influence the behavior of a family or certain individuals. Tries to find out how current problems could be caused due to this influence.
These are the main differences between the 3 types of Family Systems Therapy approaches.
How structural family therapy works
There are many that can benefit from SFT to include individuals, single parents, blended families, extended families, individuals suffering from substance abuse, foster families, and those individuals that are seeking help from a mental health clinic or private practice.
The main theory addressed in Salvador Minuchin’s structural family therapy is that in order to change a person's behavior, a therapist must first look at the structure of their family. The belief in SFT is that the root of a problem lies in the structure of the familial unit and how they interact with each other.
So if change is to occur within the individual’s behavior it must first start with changing the family dynamics.
There are specific principles that SFT is based on. These are some of the beliefs that shape SFT:
- Context organizes us. Our relations with others shape our behavior. Therapists focus on the interactions taking place between people instead of individual psyches.
- Family is the primary context. We develop as per our constantly changing interactions with different family members, which also means that the family dynamics are constantly changing.
- Family's structure. Family members accommodate each other and develop recurrent patterns of interaction over time.
- Well-functioning family. Such a family is defined by how effectively it responds to and handles situations of stress and conflict even as the needs and conditions in its environment keep changing.
- A structural family therapist’s job is to help the family realise its strengths so that it can give up interaction patterns that hinder the use of such strengths.
Studies show that targeting families with this therapy is helpful in properly addressing the complex needs and problems faced by families of adolescents facing mental health issues.
Structural family therapy techniques
In SFT, the therapist will use an intervention that is called 'structural family therapy mapping' in order to join the family setting. After observing how your family interacts, the therapist will draw a chart or map of your family's structure.
This chart helps identify the hierarchy, boundaries, and subsystems, or sub relationships, within the family unit, such as the relationship between parents or between one parent and one particular child.
The areas addressed pertain to specific rules within the family, patterns developed, and structure. There are six areas of observation within the family structure that Minuchin describes as being the most important. These include:
- Transactional patterns
- Family development state
- Maintaining family interactions
The model also conceptualizes the problem to find the correct strategy to understand the issue with a sense of clarity and a large emphasis on healthy communication. The therapist may appear to take sides when 'role-playing' in sessions in order to disrupt the negative interaction and to bring light to the situation in order to enact change within the way the family interacts (to learn more about the application of the therapy, visit this link).
Concerns and limitations of structural family therapy
As with any type of therapy, there are criticisms and limitations that arise. Some have stated that this kind of therapy is limited because it only involves members of an immediate nuclear family and does not take into account extended family members, social settings, friends, and neighbors.
Another concern/limitation is the financial and insurance component. Some insurance companies will not cover SFT as a specific therapeutic intervention. This, in turn, leaves the individual/family responsible to privately pay for these sessions and structural family therapy interventions interventions, which, in turn, can become financially difficult due to private pay rates.
Strengths and weaknesses of structural family therapy
- The therapy focuses on making family members realize that applying old solutions may not work on all problems.
- It helps in activating the family members’ own alternative ways of relating:
- It has been critiqued that the therapy does not focus much on the power dynamics within same generational relationships, such as couple relationships.
- Another challenge is that the therapist may see a temporary problem as something bigger
- Too much involvement of the therapist may lead to panic while too little involvement may lead to maintenance of the status quo
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How to prepare for structural family therapy sessions
- To prepare for SFT, it is important to look for a licensed or certified mental health professional with a background in family therapy and training and experience in the SFT model.
- In addition to these credentials, it is important to find a therapist with whom you and your family feel comfortable working with and feel as if they can be open-minded and discuss concerns freely during the sessions.
- If the therapist doesn't feel like a good fit for all members involved, then it is important to find one that is a better fit.
- Be open with the members of your family and check in with everyone.
- Make sure that they feel this is a beneficial experience, that they each feel comfortable individually and as a whole family unit.
- Ensure it is covered by insurance or that you can financially afford the session.
By addressing the family systems unit and structure in structural family therapy, you will not only benefit individually, but the entire family unit will discover positive change that will help them as a whole family for years to come.