1. Structural Family Therapy
Sarah Fender
Emily Hornung
Leslie Hall

2. History & Evolution Founded by Salvado Minuchin
Worked with boys at a school where all boys came from poverty
The boys frequently had no father figures
Put emphasis on family structure, subsystems, and boundaries
Originated in the 1970’s
Expanded in early 1990’s by Aponte to include values and spirituality

3. Structural Family Therapy: 6 Tenets
Families are organized with structural patterns which are important to the dynamic of the family.
Symptoms within families are signs of a family under stress.
Understanding the organizational patterns of families as they relate to the problem at hand is essential to the assessment and treatment process.
There are 3 basic structural dimensions of families:
Boundaries
Alignment
Power
The interaction pattern demonstrated by the family in the family session is a critical source of information and more reliable than a family members in alternative behaviors.
Change occurs through active involvement of family members in alternative behaviors.
The family session is used to enact new behaviors and family change.

4. Goal of Structural Family Therapy
To restructure the family
Allow the family to alleviate stress, resolve conflict, and cope more effectively and efficiently
Role of the therapist = Stage Manager

5. Treatment Principles Focus on concrete issues Locate in the present
Mediate interventions through the client’s experience in the session
Reorganize the structure of relationships
Build on client strengths
Aim at palpable outcomes
Intervene through the active involvement of the practitioner with the family
Initiate, facilitate, and close the enactment

6. Assessment of Family Dysfunction: overaffiliation or underaffiliation
Therapist maps out the family structure:
Leadership
Alignments/Triangles
Boundaries
Power dynamics
Coalitions, conflicts, roles (Ex. nurturers, healers; mother, father, problem child)
Dysfunction: overaffiliation or underaffiliation
Members speak for each other in session, inadequate boundaries
Body language, lack of knowledge of other family members, separateness in lives
Who sits where, who listens to whom about sitting where
Flexibility vs. Rigidity: Roles and Coping

8. Treatment: Challenging Symptoms
Observe structure of family
Reframe the initial problem to reduce blame placed on one family member
The problem is not the one identified; it lies in the interaction patterns
Challenge behavioral, cognitive, and affective responses
Reframe their understandings of the problem(s)

9. Challenge Structure: Enactment/Focus/Intensity
Enact the family patterns while in session
Ask for further explanations in this safe context
Is this always the way it works?
What comes first; what comes after?
Who steps in, what do they do?
Use members’ reactions to identify and transform patterns
Intervene using new structural patterns and behaviors
Focus session on one particular theme, pattern, or behavior
Help family reach a goal in session rather than give up
Persistence

10. Interventions Addressing parents first and more formally by role
Moving around the structure of family seating
Telling permissive parents that they need to LEAD
Providing a new pattern of parenting
Enactment, boundary-making
Reframing, punctuation, unbalancing

11. Treatment: Challenging Reality
The family’s reality will change
Therapist must emphasize the strengths of this new structure
Build security, self-efficacy, skill and confidence
Emphasize or PUNCTUATE positive actions for positive meaning
Increase power through repetition of new patterns
Build boundaries
Unbalancing
Complementarity

12. With Families: Lack of effective leadership Look at subsystems
Building the self-efficacy of parents to parent effectively
Setting ground rules for what will go on in the house
Restructuring the seating arrangements to reduce buffering
Look at subsystems
parental subsystem/couple subsystem
sibling subsystem

13. Some Interventions in Action
Boundary-making:
We see that the father is kept out of the son/daughter interaction because that is for them to negotiate
Chairs are moved so that brother and sister sit side by side, without father as a buffer
Enactment:
Therapist has brother and sister enact their morning argument, without father interceding, so therapist can locate the problem behavior

14. Theory in Practice Leslie “Les”: Dad (38) Cecile “Cessa”: Mom (36)
Note: in actual practice (as of 1982) this therapy was applied in a case where the son/daughter was the identified target of change
Leslie “Les”: Dad (38)
Cecile “Cessa”: Mom (36)
Jackson “Jack”: Son (11)
John: Son (9)

15. DEMO

16. Some ‘Punctuations’
Reframing: “Is this how you all live your lives everyday?”
Makes it a family-wide problem than just a one-child problem
Enactment
Allowing the two boys to run around to see how the parents react
Enact the mother taking the “make it happen” role
Experience of success for mother, successful mother for the family
Boundary-making: movement of seating
Les and Cessa usually talk with the boys fighting in the background, by getting these two together without the boys the pattern can change

17. Ethical Implications
Trying to change the structure of a family could result on it falling in on itself
Families may try to increase rigidity of dysfunctional family structures

18. BINGO

19. References
Colapinto, J. (1982). Structural family therapy. Received from minuchincenter.org/yahoo.../SFT doc
Corcoran, J. (2003). Clinical applications of evidence-based family interventions. New York, NY: Oxford University Press.
Nichols, M. (2009). Family structure therapy. In The essentials of family therapy (4th ed.). Boston, Ma.: Pearson /Allyn and Bacon.
Van Hook, M. P. (2014). Social work practice with families: A resiliency-based approach. 2nd Ed. Chicago, IL: Lyceum Books, Inc.