Structural/Strategic Family Therapy

Founded on the immediacy of the present reality Oriented to solving problems Above all-contextual: referring to the social environment that is both a part of and the setting for an event

Psychological structure of the individual is viewed as interdependent with the person’s social structure Structure of that social system, in relation to its function, provides the parameters by which the family’s adjustment is measured

The whole and the parts can be properly explained only in terms of the relations that exist between the parts

Structural Dimension of transactions Boundaries – defines who participates and how Alignment – joining or opposition of members Power – relative influence of each member on outcome of an event/activity

Boundaries Defined by levels of differentiation, permeability, rigidity Enmeshed – boundaries among some or all family members are relatively undifferentiated, permeable and fluid Disengaged – family members behave as if they have little to do with one another due to boundaries being so firm, impermeable Violation of function boundaries – inappropriate intrusion of members into functions that are the domain of others

Alignment Defined by dysfunctional coalitions Stable coalition – joining together of family members against another so the pattern becomes dominant and inflexible Detouring coalition – stable coalition with the intent of diffusing the stress between the members by designating another source of their problem Triangulation – each of two opposing parties seeks to join with the same person against the other

Power Defined by who as the power in relation to whom about what Lack of functional power – individuals/groups who are unable or not allowed to exercise the force necessary to carry our appropriate functions for their positions within the family weak executive functioning – parents have no leverage to carry out duties of parenting inhibition of developmental potential – individual, due to family organization, cannot act age appropriately

The ability of a family to function well depends on the degree to which the family structure is well defined, elaborated, flexible and cohesive.

Techniques Joining – relating personally for professional purposes Tracking – therapist adopts symbols of family’s life -“lead by following” Accommodation – therapist relates to the family in congruence with their transactional patterns Mimesis – therapist becomes like the family in manner or content

Techniques Restructuring – change the structure of the transactions due to system conflict and/or structural insufficiency System recompensation – techniques that address structural change by adding to or taking away power from those systems involved in the creation and/or maintenance of the problem Symptom focusing – techniques approach change directly through the symptom Exaggerating the symptom Deemphasizing the symptom Moving to a new symptom Relabeling the symptom Changing the symptom’s affect Structural modification – techniques are aimed at the structural composition of the ecosystem that serves as the locus of control for the problem disassemble construct reinforce reorganize

Emphasis on directives is the cornerstone of the Strategic approach

Another way to describe human behavior is to say that any act has a meaning in a context of other acts.” – Madanes & Haley (1977)

TEchniques “Go with” the resistance, avoiding power struggles. The intent is to deal with the problem as it is defined by the family. Make explicit what is implicit in interaction patterns. Interpretations are not intended to bring about “understanding,” but to shift views of reality re-label

Techniques (con’t) Paradoxical Interventions – prescribing strategy – keep doing the problem restraining strategy – discourage or deny the possibility of change positioning – intensify/exaggerate the issue Positive Interpretation – ascribe positive motives to clients because doing the opposite creates resistance and immobilizes the therapist

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