Family Therapy paper
ashleigh1010
StructuralFamilyTherapySpring2019.pptxStructural Family Therapy
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Structural Family Therapy
Structural Family Therapy
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Born in Argentina, served in Israeli army as physician.
Started his career in the 1960’s as a family therapist
1960: Wiltwyck School for Boys in New York working with low income families
1967: Wrote Families of the Slums
1965: Director of the Child Guidance Clinic in Philadelphia.
Created “Structural Family Therapy”
1974: Families and Family Therapy
Assumptions
Structural Family Therapy
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A family structure is made up of hierarchy, rules, boundaries, and roles, and subsystems
Composed of multiple sub-systems
System structured to patterns/rules
Patterns/rules affect the family’s interactions
Individuals develop symptoms because of the way the family is structured
Theory of Change
Reorganize family structure
Establish strong parental/executive sub-system
Clear, flexible boundaries between subsystems
More functional adaptive patterns towards change
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Structural Family Therapy
Role of the Therapist
Active
Involved
Position of leader or expert
Director
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Structural Family Therapy
Major Concepts
Subsystems
Boundaries
Alliance/Coalition
Disengagement
Enmeshment
Parentified child
Structure
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Structural Family Therapy
Boundaries
Boundaries
Keep people from coming into our space and abusing us
Keep us from come into other’s space and abusing them
Boundaries in families
Hypothetical dividers between or among subsystems
Family members align
Covert/overt rules
Rigid, clear, diffused
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Structural Family Therapy
Boundaries
Distant Enmeshed (Diffused)
Rigid Flexible
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Structural Family Therapy
Boundaries
Rigid Boundary
Disengagement
Clear Boundary
Normal Range
Diffuse Boundary
Enmeshment
In-Class Journal #3: What are some examples in your own relationships of rigid, clear and diffuse boundaries?
Boundaries
Influenced by family of origin/upbringing
Most likely you learn about spatial awareness and what is appropriate spatial separation from the structure in which you grew up
Often feels “normal”
In-Class Journal #3:
What was it like leaving home for the first time?
How often did you keep in contact with your family?
How do you think the types of boundaries in your FOO influenced this?
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Structural Family Therapy
Subsystems
Organized component of a larger system
Parental
Maintains responsibility for nurturing and caring for children
Executive subsystem
Sibling
2 or more siblings
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Structural Family Therapy
When you hear about subsystems they seem so obvious, but I want you to think about how these subsystems could develop. Could you see the starting signs of a problematic subsystem in your own life? Parent/Child relationships. Etc.
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Coalition/Alliance
Problematic subsystem
2 family members form a covert alliance against a 3rd family member (triangles)
Function
Power blocks
Balance
Establish control
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Structural Family Therapy
Think about this in the context of last week. Wouldn’t it be interesting to sculpt this out? What if you sculpted a family around power?
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Enmeshment
Loss of autonomy due to diffused boundaries
Over involved in one another’s emotional lives
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Structural Family Therapy
Parentified Child
Set of behaviors, placement in family, which leads to functional removal of a child from the sibling
Responsibilities
Poorly defined
Developmental capacity
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Structural Family Therapy
What situations do you think could naturally lead to a parentified child?
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Theory of Pathology
Healthy family structure
Clear boundaries, clear hierarchy, identified rules, and appropriate roles. Not to be too rigid or too flexible.
“Unhealthy” family structure
Inflexible family structures, rigid or diffused boundaries, lack of a clear hierarchy
Most families are good in some of these areas and struggle in other areas
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Structural Family Therapy
In-Class Journal #3: With regards to structure and boundaries - what areas did your FOO struggle with? What areas was your FOO good at?
Careful not to over pathologize…
A single mother recently brought her 12-year-old son to the clinic after discovering he had missed 2 weeks of school. “Two weeks!” thought the therapist, “that’s a long time to not know your child’s been skipping school.” A structural perspective would make 2 important points. First, the obvious disengagement between this mother and child is no more significant than the disengagement between the mother and school authorities. Second, a structural analysis might help to get past blaming this woman for failing to know what was going on in her son’s life. If she’s disengaged from her son, what is occupying her elsewhere? Maybe the financial burden of single parenthood is overwhelming. Maybe she’s still grief stricken over the death of her husband.
Remember: If someone is disengaged in one relationship, he/she is likely to be preoccupied elsewhere.
(Nichols & Davis, 2017, p. 116)
Interventions
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Structural Family Therapy
Joining and Accommodating
Enters family hierarchy as leader
Adapts to the system’s rules, patterns and worldviews
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Structural Family Therapy
Structure Map
Structural Family Therapy
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On page 114 of your text, figure 6.1 the symbols for family mapping are displayed.
Genogram
Present, past relationships
Relationship patterns
Structure map
Present family
Structure of the family
Interactions suggested by the therapist as a way to understand and diagnose structure.
A way to open the door for restructuring the hierarchy of the family.
Mapping Family Structure
Assessment tool
Identify each family member’s position, interaction, coalitions, etc.
Balanced parental hierarchy
M F
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C
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Structural Family Therapy
Develop a genogram for someone in the class.
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Volunteer?
Structure map example
Spatial Manipulation
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Structure often manifests in therapy
Moving family members to create appropriate structure
Example: If a mother and daughter had formed a coalition and in turn were sitting by each other in session, he would ask the daughter to switch seats with the father. This physically broke apart the coalition and reinforced the parental hierarchy by having the parents sit together
Clinical Vignette
Dina (age 55) and her husband had 5 children together, and all the kids are adults now. Dina’s husband passed away from cancer 5 years ago, and ever since then, Shawna (the oldest daughter) has been heavily involved in taking care of Dina – taking her out to lunch once a week, dropping in for visits unexpectedly, picking up her prescriptions from the pharmacy, despite Dina being in pretty good physical health. Dina’s husband, Mark, is frustrated about how much time she spends with her mom, and remarks that Dina is married to her mom, not him. Mark blames their marital issues on his mother-in-law, and Dina blames her marital issues on her dad dying and forcing her to take care of her mom instead of her own family.
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Structural Family Therapy
Role play
