Structural Flashcards
What makes Structural Family Therapy different from Strategic therapy and other modalities?
Rather than focus on the individual’s pathology, SFT considers problems in the family’s structure – a dysfunction in the way the family interacts or operates. Unlike Strategic Therapy, SFT does not maintain that the family’s interactions, or “transactions” cause the pathology, but rather that the family’s transactions support or encourage the symptoms.
Through its transactions, a family establishes a set of rules for its daily functioning, and these rules form its “structure.” A marriage and family therapist employing SFT must first assess the family’s interactions, figuring out the family’s hierarchy, alliances within the family, such as a mother and son against a father, or siblings against another sibling or siblings. The therapist composes a map or flow chart describing the process that a family unconsciously follows.
What is the goal of Structural Family Therapy?
Goals are:
- To establish healthy boundaries within the family and sub-systems. - To establish an appropriate hierarchical structure where the children do not control the parents, and outer circles are not intruding.
What is a transaction, in structural therapy?
Transactions are simply patterns of how family members routinely interact with each other. For example, a mother’s transaction with her daughter could be controlling and overprotective, or an older brother’s transaction with a younger brother could be one of bullying and overpowering.
What are important elements to consider in a family’s structure?
- Roles
- Subsystems
- Hierarchies
- Alliances (coalitions)
- Rules
- Boundaries
- Whether relationships are enmeshed, balanced, or disengaged
- Triangulation
What is the therapist’s role in structural therapy?
The therapist metaphorically becomes a member of the family.
In this unique role, and in the context of the therapeutic setting, the therapist will provoke the family members to interact and speak about the problem or issue. The therapist asks questions, points out harmful transactions, and uncovers not only dysfunctional patterns, but positive behaviors or personal qualities that are ignored or overlooked by the family.
What is the stance of the therapist in Structural Family Therapy?
- Active in sessions
- Views families as resilient
- Views families/people as NOT fundamentally flawed, but instead needing key adjustments to flourish
- Pays attention to both content and process of relational interactions
- Oscillates between first and second order cybernetic stances
What are the core assumptions of Structural Family Therapy?
- Families engage in consistent and predictable ways (patterns)
- These patterns indicate they have a certain structure
- Identifying this structure allows therapists to effect change in families in systemic and organized
ways
What is Family Structure, in Structural Family Therapy?
Family Structure is the way a family is organized into subsystems and how the interaction among those subsystems is regulated by boundaries.
Family structure manifests in the way family members interact:
* The process of a family’s interaction is like the patterns of conversation at the dinner table
* The structure of the family is like where family members sit in relation to one another
What is Structure, in Structural Family Therapy?
The relative positioning and alignment of family members within a family.
Families are differentiated into subsystems based on generation, gender, and function, which are demarcated by interpersonal boundaries, which are invisible barriers that regulate contact with others.
What is a Boundary, in Structural Family Therapy?
Boundaries are invisible barriers that regulate contact with
others
What makes a boundary rigid?
Rigid boundaries are restrictive and limiting. They allow for minimal contact from those that are outside of the sub-system, resulting in isolation and disengagement (but can also be safer in some situations).
A person with rigid boundaries prioritizes independence and autonomy, over closeness and intimacy.
What makes a boundary diffuse?
Diffuse boundaries are permeable and promote too much contact with other systems, resulting in enmeshment. A person with diffuse boundaries prioritizes intimacy and closeness over independence and autonomy.
(Think of “diffuse” as having dissolved or diffused – so the boundary is invisible and not even there anymore.)
When boundaries are diffused, they may be unclear. The sub-system in the family may lack limits that lead to unhealthy behaviors. A lack of boundaries could allow others to intrude on the system and become over-involved.
What is Boundary Making/Setting, in Structural Family Therapy?
In Boundary Making or Boundary Setting, the therapist defines areas of interaction that he rules open to certain members but closed to others, or prescribes physical positions or movements.
What is a subsystem in Structural Family Therapy?
Subsystems are groupings of family members based on generation, gender, and function, which are demarcated by interpersonal boundaries (invisible barriers that regulate contact with
others).
What are key strategies used in Structural Family Therapy?
Modifying structure (creating disequilibrium):
* Structural mapping
* Boundary setting
* Systemic reframing (including punctuation)
* Crisis Induction
* Unbalancing
* Intensity
*Enactments – i.e. realigning/restructuring family interactions by having family members enact or re-enact interactions, and then shaping competence by highlighting and modifying interactions
Joining and Accommodating:
* Compliments
* Expanding family truths
* Challenging the family’s worldview & unproductive assumptions
What is “punctuation” in Structural Family Therapy?
Punctuation is the selective description or reframing of an interaction, in accordance with the therapist’s goals – to emphasize successfully meeting a goal, for example.
What is viewed as healthy development, within Structural Family Therapy?
- All families have structure that is
developed through repetition and
through influence of external context - Healthy families are able to be flexible and adapt when the situation calls for it
- Developmental phases are
particularly difficult for families
What is the source of problems, in Structural Family Therapy?
Family Systems function poorly when…
* Subsystems, boundaries and roles do not adapt to changing needs (circumstances, developmental stages)
* Subsystems, boundaries and roles do not support a healthy balance of closeness AND autonomy between members
* The usual way of responding has become rigid without adaptation.
* Poor structural experiences happen, which often lead to symptoms
Why does Structural Family Therapy value spontaneity?
If a therapists’ interventions are to
be effective, they cannot be preplanned or rehearsed.
What are the three overlapping phases or steps in Structural Family Therapy?
1) Join with the family (alliance building) in a position of leadership
2) Map their underlying family
structure – including boundaries, hierarchies, and interactional
patterns (can be done observing spontaneous interactions & using
structural maps)
3) Intervene to transform this structure and reduce symptoms
***May have to repeat phases 2 and 3 until goals are accomplished
Alternate steps:
1. The therapist joins and accommodates the group. Trust between the family and the therapist should develop for the process to work.
2. The therapist then observes how the family behaves together. During this process, they watch for which person is leading the family, which is defensive, and which may be most likely to cause conflict.
3. Next, the therapist maps the underlying structures of the family.
4. The family then completes role-playing exercises, so the therapist can watch and intervene to teach appropriate behavior.
5. Work on restructuring to create new boundaries is often necessary for the family to strengthen their bonds. The therapist may assist in this process.
6. When needed, the therapist may go through an unbalancing process where they join with a sub-system or individual to help break an impasse in the system to support the relationship.
What is joining, in Structural Family Therapy?
Joining is the empathic connection which opens the way for family members to begin listening to each other and establish a bond with the therapist; allowing them to accept challenges to come.
The family therapist is an unwelcome outsider. After all, why did he or she want to see the
entire family? Family members expect to be told they are doing something wrong. The therapist
must disarm these defenses and ease anxiety.
What is mimesis, in Structural Family Therapy?
Mimesis refers to the therapist’s attempts to mirror and match the family’s attitudes, behavior, and
posture to further communicate that they are temporarily a part of the system. (Think: mim from mimic or mimeograph, and “sis” for family – the therapist is copying the family)
What is tracking in Structural Family Therapy?
Tracking refers to the therapists’ observation of the family’s patterns of communication, behavior, and attitudes/values.
How are enactments useful in Structural Family Therapy?
Enactments are used early and often in SFT. Family structure manifests in the way family members interact. Families often describe themselves more as they think they should be than as they are. So, using enactments to get family members to interact among themselves runs counter to their expectations.
* Pick a specific issue for response!
* Families demonstrate enmeshment by frequently interrupting, speaking for each other, doing things for children that they can do for themselves, or constantly arguing.
* In disengaged families, one partner may sit passively while the other partner cries.
