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Running head: STRUCTURAL AND STRATEGIC FAMILY THERAPY

Structural and Strategic Family Therapy

Structural and Strategic Family Therapy

Families are collections of individuals who affect each through the interactions between them; these interactions form the basis of their structural framework that brings order and meaning to their relationship. The concept of family structure enables therapists to intervene in a systematic and organized way when issues arise. When families seek help for a specific problem, the therapists look beyond the specifics of those problems. Instead, the therapist will examine the dynamics of their interaction (Bitter, James Robert 2014).

Structural family therapy (SFT) is a treatment that addresses patterns of interaction that create problems within families. Normal families are not families without problems; they have established a functional structure for dealing with their problems. Couples as the foundation of families must learn to adjust to each other, raise their children, deal with their parents, earn a living, and fit into their communities (Bitter, James Robert 2014). The focus of treatment is on changing the family structure rather than changing individual family members by improving communications and interactions among family members and highlighting appropriate boundaries to create a healthier family structure.

Although every family is unique, families have some common structural goals. A foundation needed for a smooth parent-children relationship is the creation of an effective hierarchy (Coatsworth et al. 2001). Parents are expected to be in charge, not to relate as equals to their children (Structural Family Therapy By On Prezi. (n.d.). Retrieved from https://prezi.com/z0isvqzrdazi/structural-family-therapy/). The therapist use these common goals as guide during therapy, therapist will observe interaction between family members and then draw a chart, or map to understand and identify the hierarchy, boundaries, and subsystems within the family unit, such as the relationship between parents or between one parent and one particular child. Using this outline, the therapist can also see where changes are needed and what type of interventions will help restructure the family. By adjusting boundaries and realigning subsystems, the therapist changes the behavior and experience of each of the family members and thus opens alternative patterns of interaction that can modify family structure (Bitter, James Robert 2014).

In strategic models, family problems are viewed in 3 different ways. The first is cybernetic: Difficulties are turned into chronic problems by misguided solutions, causing positive-feedback escalations. The second is structural: Problems are the result of incongruous hierarchies. The third is functional: Problems result when people try to protect or control one another covertly so that their symptoms serve a function for the system. The therapist assess the situation and identify the problem by asking questions Once the problem has been defined, the therapist tries to determine who has tried to solve it and how in most cases, the solution is the problem and the therapist works from this angle (Szapocznik, Schwartz, Muir & Brown 2012).

The MRI approach identified 3 solution types; one is to deny that a problem exists; action is necessary but not taken. For instance, parents do nothing despite evidence that their teenage son is using drugs. The second is an effort to solve something that isn’t really a problem; action is taken when it shouldn’t be (Bitter, James Robert 2014). For example, parents punish a child for masturbating. The final one is an effort to solve a problem within a framework that makes a solution impossible; action is taken but at the wrong level. For instance, a husband buys increasingly expensive gifts for his wife, when what she wants is affection.

Both models use information from the family to identify a pattern of interaction within the family as well as to create goals and establish treatment plans. In Structural Family Therapy the therapist’s role is collaborative, he does not impose his solution, and he remains dynamic, making changes from time to time as dictated by the interaction. The Strategic Family therapist’s role is however supervisory, acting as an expert giving a prescription for an identified problem. Some scholars have described this approach as manipulative.

Comparing the outcome of the approach, structural approach is more efficient, takes about 8-10 sessions and has a measurable outcome. It is however not suitable for situations involving domestic violence or harm to self. Strategic approach provides a limited time effectiveness, some have described this as a short-term fix. The solution relies on common sense as against a multicultural perspective.

Johnson Family Map

GF1GM1

M  F - - - - - - C   C C

GF2  GM2

The Johnson family presented for therapy following the arrest and release of their son Kimmel. Kimmel is a 12th grader; he plays basketball and has been having issues at on and off school for some time. He is an average student but recently, his grades have dropped, and he does not seem interested in discussing the problem. He has always shown sign of bad temper and sometimes lashes out at his two sisters at home. He was arrested following an altercation at school where he pushed a friend who was sitting on a platform. The victim broke his arm and had to be taken to the hospital where he spent more than a week. When the police were called, he showed signs of intoxication; blood test confirmed that he has been smoking illegal drugs.

Treatment

The problem identified in the case of Kimmel may be related to peer pressure and the need to feel accepted by his age group. There are no member of the family that is using illegal substances. Therefore he did not get any encouragement from home for this habit. His violent temper at home and in school may be an expression of frustration or gang involvement, therefore is important to have a broad perspective for therapy (McNeil, Herschberger, & Nedela 2013). The behavior expressed by Kimmel should be explored as a part of a larger system including the school system, and if the gang involvement is confirmed, the therapy should extend beyond the family. I would recommend the Structural community family therapy model. The success of this model is dependent on the development of a “therapeutic resource network” between therapist and community service providers and leaders. This is necessary for the development of a deeper understanding of and appreciation for the strengths, needs, and characteristics of the community (McNeil, Herschberger, & Nedela 2013).

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Reference

Bitter, James Robert. (2014). Theory and Practice of Family Therapy and Counseling. Retrieved from Bitter, James Robert, CCMH565, University of Phoenix website.

Coatsworth, J. D., Santisteban, D. A., McBride, C. K., & Szapocznik, J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Family Process, 40(3), 313–332. Retrieved from http://www.familyprocess.org/family-process-journal/

McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-Income Families With Potential Adolescent Gang Involvement: A Structural Community Family Therapy Integration Model. American Journal Of Family Therapy, 41(2), 110-120.

Santisteban, D. A., Suarez-Morales, L., Robbins, M. S., & Szapocznik, J. (2006). Brief strategic family therapy: Lessons learned in efficacy research and challenges to blending research and practice. Family Process, 45(2), 259–271. doi:10.1111/j.1545-5300.2006.00094.x

Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior. Couple & Family Psychology, 1(2), 134–145. doi:10.1037/a0029002