Structural family therapy summary

Quick Summary: I am providing a summary of Structural Family therapy. I will define all relevant terms and offer an explanation as to what structural therapy might typically look like.
 
Salvador Minuchin – is the founder of this form of therapy… structural therapy has changed greatly throughout the years. Salvador has been a model of adaptability… he has taken constructive criticism with grace and adapted the theory to best meet the needs of differing types of family systems. http://www.minuchincenter.org/
 
Family Rules, Dynamics, Patterns, Rituals and Structure – The therapist will help the family to isolate all the not so obvious aspects of a family system.

• Family Structure (relationships, hierarchies etc) can be changed.
• Rituals and rules can be examined to see how they impact the problem and the solution.
• New patterns of interaction can be practiced and integrated.

 
Systemic – Systemic theory is based on the idea that parts (individuals) are inseparable from the whole (family, community etc). Structural Family therapy is systemic in that it maintains that the best way to positively affect individuals is to influence change for the entire family.
 
Subsystems – There is a structure to family systems with interaction patterns that are ideal for each of the below subsystem.

• Each subsystem has specific needs that are often best met when there is clear differentiation between the subsystems.
• Often problems arise when a need is being met by another subsystem.
  • Examples: it can create discord if a sibling takes on the role of a parent, or is a child becomes the main source of emotional support for a parent etc.

 

• Spousal – the intimate relationship between the parents.

 

• Parental – the dynamic involved in co-parenting the children.

 

• Sibling – the relationship of the offspring separate from the parents.

 
Boundaries – It is important to have an awareness of the boundaries in a family.

• Boundaries are related to the individual family members and to the subsystems.

 

• Clear – Boundaries are easy to identify and have a comfortable ability to adapt to the needs of the family system.
  • Ex. the parents know when to let the children work things out amongst themselves and when to intervene.
  • Ex. the parents will know when they need to put the needs of the spousal relationship in front of the needs of the parental relationship (they will not allow for parenting to kill the romance in their relationships)

 

• Rigid – The boundaries are set and lack an ability to adapt as needed.
  • Ex. the parents ground the children for even the slightest argument and have unbending rules against letting the children work things out amongst themselves.
  • Ex. The Parents will prioritize the parental ‘responsibilities’ in a way that does not allow for the needs of the spousal relationship to get met.

 

• Diffuse – There are not clear boundaries in the family.
  • Ex. The parents over-involve themselves in the siblings’ interactions or the siblings over-involve themselves in the parenting decisions.
  • Ex. The parent will try and set rules one minute then ask for emotional support from their child the next minute.

 
Triangulation – this is an occurrence in which the family unconsciously creates a “problematic individual” or an “identified patient” instead of defining a problem systemically (having to do with the family as a whole.)
 

• Scapegoat or identified patient – Everyone focuses on one person’s problems and blames that one person for all the other problems of the family.
  • Ex. The family chooses to believe that it was the child’s marijuana addiction that ruined the parents’ romantic relationship.

 

• Detouring – Refocusing attention on a family member to avoid attending to a larger family concern.
  • Ex. A parent over involves themselves in assisting their child’s learning disability to avoid attending to the fact that the other partner is an alcoholic.

 

• Cross-generational coalitions – A parent enlists a child to create a coalition against the other parent.
  • A parent will get all of their emotional support in relation to spousal problems from one of the children.

 
Adaptability to stressors and change – Structural family therapist understand that stress, change and suffering is inevitable… they help to identity ways for the family to increase their ability to adapt to life stress (much of which is developmental – a child getting a license, children becoming married etc)
 
Enmeshed – Automatic emotional transfer -Enmeshment is when there is not a well-defined emotional boundary between two people in a family.

• A person in an enmeshed relationship will feel the emotions of the other person without having the ability to understand that it is not their emotion or that the emotion did not originate with them.
• Ex. A child comes home sad because they lost their soccer game and the mother feels sadness for herself… it is not empathy as she does not feel sadness for the child, instead she believe that it is her own sadness.

 
Coalitions – when family member team up against other family members. These are identified and brought to the attention of the family.
 
Power hierarchies – The structural therapist will help the family to identify the hierarchy of both subsystems and of individual family members.

• Ex. Often it would appear that the children are making rules typically set by parents.

 
Techniques
 

• Unbalancing and disruption of current structure – Structural therapists can be provocative in that they intentionally dismantle the current structure and dynamics of a family system so that the family is strongly encouraged to create new interaction patterns.

 

• Enactment – The therapist will ask for a “live” display of the concern. The family will be encouraged to engage in a difficult communication so that the therapist can best identify the current problematic patterns and dynamics. This is not acting or role playing… the therapist will try and get the family to engage in an authentic interaction which would be typical outside of therapy.

 

• Reframing – The therapist will help the family to place a problem into a different context so that that problem can be more workable. 

 

• Ex. The therapist could reframe a child’s “behavior problems” as a good intentioned attempt to get the parents to join together as the child was well aware of spousal conflict.

 

• Punctuation – When an improvement is noted the therapist will accent the change so that the family can integrate the change into the family structure.

 

• Boundary Formation – The therapist will help the family to create clear boundaries in the family system. This is often done very openly by identifying where boundaries are currently rigid or diffuse.

 
Individual problems often go away when you encourage subtle changes to a family’s boundaries, dynamics, hierarchies, rules and rituals.
 
Often the family was unaware of the structure that was guiding the system…
 
change does not always have to be difficult… often times families are stuck in patterns that they never intended to be in.