What Is Structural Family Therapy?
Structural family therapy (SFT) is a type of family therapy that looks at the structure of a family unit and improves the interactions between family members. This approach to therapy was originally developed by Salvador Minuchin and has become one of the dominant forms of family intervention.
It suggests that dysfunctional family relationships can create stress and mental health problems for members of that family.
By addressing how members of the family relate to one another, the goal is to improve communication and relationships to create positive changes for both individual family members and the family unit as a whole.
Techniques
Structural family therapy relies on a technique known as family mapping to uncover and understand patterns of behavior and family interactions. During this process, the therapist creates a visual representation that identifies the family’s problems and how those issues are maintained through family dynamics.
This map diagrams the basic structure of the family, including the members of the family unit, their ages, genders, and relationships to one another. Aspects of the family observed during this process include:
- Family rules
- Patterns of behavior
- Family structure/hierarchies
This process frequently involves having family members themselves make their own maps describing their family. This not only boosts engagement in the therapeutic process but also gives a therapist a better understanding of how individual family members view their place within the family.
“Inviting family members to place the people and write their names inside a circle promotes a recognition of their mutual belongingness, an awareness that ‘these are us,'” explained Salvador Minuchin and his colleagues in Working With Families of the Poor.
After this initial process, the therapist observes the family during therapy sessions and in the home environment to track interactions and develop a hypothesis about the nature of the family’s relationships and interaction patterns.
Other techniques that may be used during SFT include:
- Joining: This technique involves the therapist developing a sharing and empathetic relationship to “join” the family.
- Boundary-making: The therapist will help the family identify, explore, and adopt clear boundaries and hierarchies within the family.
- Role-play: This involves acting out scenarios with the therapist’s guidance to look at certain patterns of behavior, identify dysfunction, and practice enacting alternatives.
- Reframing: In cognitive reframing, the therapist helps family members think about situations in different ways or see things from a different perspective. This can help people see experiences more positively.
What Structural Family Therapy Can Help With
Structural family therapy can be helpful for many families, but it is often recommended in situations or life events that involve:
- Families affected by trauma
- Divorce, separation, or remarriage
- Blended families
- Intergenerational families
- Single-parent families
- When one family member is affected by a mental health condition such as depression, anxiety, substance use, or post-traumatic stress disorder (PTSD)
- Families affected by chronic illness or disability
- Significant life changes such as changing careers, coming out, or moving
Any family that is coping with tension or conflict can potentially benefit from structural family therapy.
Vulnerable families faced with readjustments caused by shifting roles, changed norms, and new demands may benefit from this type of therapy, which has been shown to help empower and strengthen the entire family system.
Benefits of Structural Family Therapy
Families struggling with conflict can benefit from this type of therapy for many reasons. Some of the ways it may help include:
- Corrects imbalances within a family
- Establishes healthy boundaries
- Helps individuals improve their reactions to changing demands
- Improves communication
- Improves hierarchies within the family system
- Increases parental competence and satisfaction
- Improves relationship dynamics
- Reduces anger and resentment
SFT recognizes that many aspects of a family’s structure—including behavior patterns, routines, habits, and communication—can contribute to dysfunction. However, this approach to therapy can help families become more stable and improve support to individual family members who may need extra help by working to address these issues.
It can be beneficial for families that have dealt with some significant change in their lives. For example, this might involve the death of a family member, a change in the family structure through a divorce, or some trauma such as interpersonal violence or an accident.
Effectiveness
Structural family therapy has been shown to be effective at helping to address problems within families. Studies have also demonstrated the efficacy of this type of therapy.
- A 2019 study looking at the impact of family therapy on adolescents with mental health problems and their families found that therapy incorporating SFT offered several benefits. For example, the results indicated that after treatment, teens exhibited fewer externalizing and internalizing symptoms. In terms of other improvements, parents also reported increased family cohesion, better parental practices, and greater perceived efficacy as a parent.
- A small 2020 case study found that structural family therapy was an effective approach for improving marital mediation and reducing marital distress. However, the study authors noted that follow-up was needed to evaluate the long-term effects of treatment better.
Since its initial development in the 1960s, SFT has become one of the predominant family counseling theories.
Things to Consider
The amount of time needed for treatment to be successful often depends on the dynamics of the family and the situation they are facing. Some families may require relatively short-term treatment lasting a few weeks, while others may need more sessions lasting several months.
Participation and cooperation play an important role in the success of this type of treatment. However, some family members may be less cooperative or may refuse to participate altogether.
How to Get Started
If you think that structural family therapy may be helpful, ask your doctor if they can refer you to a professional who practices this type of treatment. You may also search an online directory to locate professionals in your area who specialize in SFT.
Some questions you might ask before you begin treatment include:
- How much experience does the therapist have with SFT?
- How long treatment is expected to take?
- How will progress be measured?
- What happens if some family members miss therapy sessions?
During your first appointment, your therapist will ask you questions to learn more about the problems you are facing and how your family currently functions. They may ask you to create a family diagram to describe relationships between members of the family and work to get a better view of the dynamic between individuals in the family.
After your initial session, your therapist will then be able to provide a fuller view of your family’s treatment plan and what else you can expect during treatment.
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
- Flexibility
- Resonance
- Context
- 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
For more details, visit this link.
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.
