MFT_NE_Structural-Family-Therapy_03_23.pdf

Quick Study: Structural Family Therapy Founder ● Salvador Minuchin Underpinnings ● ● Action-oriented approach that teaches action precedes understanding. Symptoms are viewed as a consequence of family transactional patterns and for those symptoms to change, the family structure must be reorganize...

Quick Study: Structural Family Therapy Founder ● Salvador Minuchin Underpinnings ● ● Action-oriented approach that teaches action precedes understanding. Symptoms are viewed as a consequence of family transactional patterns and for those symptoms to change, the family structure must be reorganized. Theory of Change ● Change occurs by remodeling the family’s organizational structure to include clear boundaries and a proper family hierarchy. Role of the Therapist ● ● ● Active and involved (stage director) Work in collaboration with the family Joins with family by adapting to their style of interaction, including their affective range, mannerisms, and language. Main Concepts ● ● ● ● ● ● ● Family Structure: The invisible set of functional demands that organizes the ways in which the family members interact. (Minuchin, 1974) Alliances: Subgroups based on gender, generation, and developmental tasks. Alignment: This refers to how family members group together or relate to one another. They may include affiliations or splits from individuals or subsystems; they could be short-term or ongoing; however, they all develop for the purpose of maintaining homeostasis. Coalitions: Alignments where two or more family members join together to form a bond against another family member. Subsystems: How a family partitions itself based on different needs and tasks. They consist of two or more members of the system based on common characteristics such as gender, generation, interests, or function. Power Hierarchy: Leadership and direction must be provided by adults, typically parents. Boundaries ○ Rigid/Inflexible: Boundaries are clearly defined and not open to change. Disengagement is caused by rigid/inflexible boundaries. ○ Diffuse: Boundaries are blurred and there is little sense of separateness within the family system. Enmeshment is caused by diffused boundaries. MFT National Exam © 2023 Therapist Development Center 1 Clear: Balance between separateness (I) and belonging (we) in the family system. Family Mapping: A diagram, developed and used by the therapist outside of the therapeutic session, to identify boundaries, structures, and relationships within the family system. Complementarity: When two or more individuals function as a team and recognize that they depend on each other to achieve particular tasks. Mimesis: The therapist tracks the family’s style of communication and behaviors, and then copies (mimics) it in order to be accepted by the family. Joining: Therapist gains temporary acceptance into the family by engaging with individual members and subsystems. This process allows the therapist to eventually disrupt and alter dysfunctional aspects of the system Reframe: A technique used by the therapist that redefines the original interpretation of an issue and offers a new, more constructive perspective. Enactments: An intervention that encourages the family to act out a relationship dynamic during the therapeutic session. Provides the therapist an opportunity to observe dysfunctional aspects of the system that can eventually be restructured. Tracking: The therapist pays close attention to family members and how they relate to one another during an enactment or spontaneous behavioral sequence. ○ Notice boundaries, coalitions, roles, rules, etc. Unbalancing: Supporting someone who is in a one-down position with the goal of altering their hierarchical position. ○ ● ● ● ● ● ● ● ● Treatment Goals ● ● ● ● ● Help the family understand how family structure (relationships and hierarchies) can be changed. Help create clear and healthier boundaries. Strengthen the spousal subsystem and the family’s hierarchy. Restructure the family system to allow for symptom relief and constructive problem-solving. Alter dysfunctional transactional patterns. Interventions ● ● ● ● ● ● ● Acts like a “distant relative” through the process of joining with the family. Deliberately increases the level of stress through the use of enactments. Observes the interactions during enactments and spontaneous behavioral sequences. Reframes presenting symptoms as responses to the family structure. Disrupts dysfunctional patterns of communication and replaces them with more functional interactions. Reinforces healthy boundaries and disrupts unhealthy ones through boundary making. Challenges the family’s rules that continue to exist even though they are no longer of use. MFT National Exam © 2023 Therapist Development Center 2 ● Explores how new patterns of interaction can be integrated into the family. Phases of Treatment This is considered a shorter-term treatment modality. Beginning: Joining and accommodating; assess family interactions through use of family mapping; learn about coalitions, subsystems, alliances; reframe presenting problems as a function of the system. Early/Middle: Highlight and modify interactions; utilize enactments of issues to challenge participants and unbalance the system. End: Review progress made; reinforce structural change; provide tools for future. MFT National Exam © 2023 Therapist Development Center 3