Structural family therapy
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Structural family therapy

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    Structural family therapy Structural family therapy Presentation Transcript

    • Structural FamilyStructural FamilyTherapyTherapy
    •  Families (people) are competent and capable ofFamilies (people) are competent and capable ofsolving their own problems -- an attitudesolving their own problems -- an attitudederived from the existential-humanisticderived from the existential-humanistictraditiontradition Symptoms are a bi-product of a structuralSymptoms are a bi-product of a structuralsystem 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 asconsultants and coaches who can work toconsultants and coaches who can work tobring the family’s dormant capacities to thebring the family’s dormant capacities to thesurface.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 structurethat maintains a family’s dysfunctionalthat maintains a family’s dysfunctionalinteractions.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), orrigid (too closed)rigid (too closed) Restructuring is based on observing andRestructuring is based on observing andmanipulating interactions within the sessionmanipulating interactions within the session Spontaneous behavior sequences -- form the basisSpontaneous behavior sequences -- form the basisfor hypotheses about family structurefor hypotheses about family structure Enactments - interactions are suggested by theEnactments - interactions are suggested by thetherapist as a way to understand and diagnose thetherapist as a way to understand and diagnose thestructure, and to provide an opening forstructure, and to provide an opening forrestructuring intervention.restructuring intervention.SFT PrinciplesSFT Principles
    •  StructureStructure an organized pattern in which families interact, not deterministican organized pattern in which families interact, not deterministicor 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 verbaldescriptions 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 betweenmembersmembers 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 sameperson 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 anddisengaged from husbanddisengaged from husband Example is father who is very close andExample is father who is very close andenmeshed 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 quietlydepressed and doesn’t speak up.depressed and doesn’t speak up.Concepts, continuedConcepts, continued
    •  Inflexible response to maturational (orInflexible response to maturational (ordevelopmental) and environmentaldevelopmental) and environmentalchallenges leads to conflict avoidancechallenges leads to conflict avoidancethrough disengagement or enmeshmentthrough disengagement or enmeshment Disengagement and enmeshment tend toDisengagement and enmeshment tend tobe compensatory (I’m close here to makebe compensatory (I’m close here to makeup 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 atriangular structuretriangular structureHow Problems DevelopHow Problems Develop
    •  Therapy is directed at altering the familyTherapy is directed at altering the familystructure.structure. General goals of family are important, but not asGeneral goals of family are important, but not asimportant 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 viewedsimply 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 thefamily’s job.family’s job. Boundaries must be strengthened inBoundaries must be strengthened inenmeshed relationships, and weakened (orenmeshed relationships, and weakened (oropened 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 structureTherapist’s RoleTherapist’s Role
    •  Not a matter of creating new structures, butNot a matter of creating new structures, butreforming existing onesreforming existing ones What distinguishes SFT from other forms ofWhat distinguishes SFT from other forms offamily therapy is the emphasis on modifyingfamily therapy is the emphasis on modifyingfamily structurefamily structure in the immediate context of thein the immediate context of thetherapy setting.therapy setting. When new patterns are repeated and result inWhen new patterns are repeated and result inimprovement of family relationships, they willimprovement of family relationships, they willstabilize and replace old patterns without havingstabilize and replace old patterns without havingto keep supporting them and symptoms ofto keep supporting them and symptoms ofdysfunction 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, andaccommodating other members of the familyaccommodating other members of the family The family may resist, it’s important toThe family may resist, it’s important tojoin with angry family membersjoin with angry family members Important to build an alliance with everyImportant to build an alliance with everyfamily memberfamily member Important to respect the hierarchyImportant to respect the hierarchyTherapeutic InterventionsTherapeutic Interventions
    •  Working with InteractionWorking with Interaction by inquiring intoby inquiring intothe family’s view of the problem, andthe family’s view of the problem, andtracking the sequences of behaviors that theytracking the sequences of behaviors that theyuse to explain it.use to explain it. Mapping underlying structureMapping underlying structure in ways thatin ways thatcapture the interrelationship of members -- Acapture the interrelationship of members -- Astructural 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, thetherapist increases the chances for observing and restructuringtherapist increases the chances for observing and restructuringfamily 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 otherchangechange 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 toanswer questions, or to step in and take chargeanswer questions, or to step in and take chargewhen it’s important for the family members to dowhen it’s important for the family members to doso.so.Therapeutic InterventionsTherapeutic Interventions
    •  HomeworkHomeworkShould be used to:Should be used to:increase contact between disengaged partiesincrease contact between disengaged partiesTo reinforce boundaries betweenTo reinforce boundaries betweenindividuals and subsystems that have beenindividuals and subsystems that have beenenmeshedenmeshedIncrease contact between disengagedIncrease contact between disengagedpartiespartiesShould be something that is realistic andShould be something that is realistic andnot too ambitiousnot too ambitiousExpect setbacks in preparation for aExpect setbacks in preparation for arealistic futurerealistic futureTherapeutic InterventionsTherapeutic Interventions
    •  The technique that we will be using during theThe technique that we will be using during thetherapy session is where the children draw out atherapy session is where the children draw out afamily map. This technique is very beneficial forfamily map. This technique is very beneficial foryounger children since it allows them to expressyounger children since it allows them to expresshow they view and feel about the family’show they view and feel about the family’sstructure. This is very similar to the technique thatstructure. This is very similar to the technique thatwe saw in the video during class, in which eachwe saw in the video during class, in which eachfamily member physically moves and arranges thefamily member physically moves and arranges thefamily; however, drawing the family map can befamily; however, drawing the family map can beeasier for younger children, as it is similar to playeasier for younger children, as it is similar to playtherapy. Also, it is less likely that other familytherapy. Also, it is less likely that other familymembers will influence them when performing themembers will influence them when performing theexercise by speaking to them or even through bodyexercise by speaking to them or even through bodylanguage or facial expressions.language or facial expressions.