Structural Family Therapy

What most important about the structural family theory is that it provides a framework that helps “discover what stands in the way of a family reaching its goals,” and helps a therapist join with the family “in a vision of how to get from where they are to where they want to be” (Minuchin, Nichols & Lee, 2007, p. 9).

The use of structural mapping technique allows a family therapist “broaden the problem beyond individuals to the family system” (Nichols & Schwartz, 2006, p. 186). For example, if after observing the family’s interactions, a structural family therapist will develop a hypothesis that the mother and her teenage son are enmeshed and the father is disengaged, the interventions will be aimed at modifying the family structure by helping the couple get emotionally closer to each other; thus, promote change in the family structure when the husband becomes more responsive to his wife’s needs and the wife is able to express her needs more openly and directly.

By learning to better communicate with each other, spouses will be able to let go of resentment and hostility, thus, create an atmosphere of love and acceptance.

In addition, a structural therapist may promote change in every family member’s behavior by altering boundaries between husband and wife and realigning the spousal subsystem. Thus, instead of expecting the son to satisfy her need for emotional closeness, the mother will have her husband to satisfy this need. As a result, the teenager may stop rebelling against his mother in the struggle for freedom and autonomy, and may actually have a better relationship with both parents.

As for parental subsystem, with improved communication, both parents may establish a hierarchical structure and agree on mutually acceptable ways (that includes both consequences and rewards) to discipline their son.

What is incredible about this theory is that there are many ways to help families resolve their problems. A structural family therapist may as well concentrate on the dynamics between mother and her son or father and son. Looking at the family problems from circular perspective allows seeing how each family member is affected and affects other family members.

Unbalancing and changing the diffused boundaries within a mother-son enmeshed subsystem or rigid boundaries within a father-child disengaged subsystem may promote change in all family member’s behavior. Consequently, “altering the underlying structure will have ripple effects on all family transactions” (Nichols & Schwartz, 2006, p.173).

All parents and couples have complementary patterns, which when exaggerated, may lead to dysfunctional subsystems. For example, when a husband sees his wife being permissive, he becomes stricter when it comes to disciplining his children.

The mother undermines her husband’s authority by becoming protective and even more permissive with the children. Parents criticize each other’s way of handling the children and constantly fight. As a result, children get mixed messages from their parents and their behavior does not improve or gets worse.

When looking at the family interactions, a structural therapist may hypothesize that a cross-generational coalition consists of the mother and the children, with the father being excluded. Some of the goals of the structural therapy will be to create a hierarchical structure, “help parents function together as a cohesive executive subsystem” (Nichols & Schwartz, 2006, p.181).

It was interesting for me to understand how the structural family therapists define a normal family. According to Nichols and Schwartz (2006) all families face problems at one time or another, but what distinguishes a normal family is its ability to be flexible in order to adjust to environmental and developmental stressors.

Failure to realign diffused or rigid interpersonal boundaries may result in family dysfunction. Structural family therapy is “directed at altering family structure so that the family can solve its problems” (p. 181) by using their own resources.

Assessment

The first step will be “opening up the presenting complaint” ( p. 9), joining with the family by asking each member of the family to express their view of the problem, reflectively listening to their concerns and showing respect for each family member. Before the family members are ready to look at the problem from a circular perspective, they need to feel understood and accepted by their therapist. To make an assessment, information about the family through joining, accommodating and enactment techniques needs to be collected.

The second step of the family assessment model will be to “explore family pattern that maintains presenting problem” (Minuchin, Nichols & Lee, 2007, p. 11). A structural therapist will go beyond the presenting problem and I will start mapping the family’s underlying structure early in the session by paying attention to the seating order of the family members, “the boundaries that define affiliations, alliances, and coalitions begin to appear” (Minuchin, Lee & Simon, 2006, p.14).

As Nichols (2006) wrote “A structural assessment is based on the assumption that a family’s difficulties often reflect problems in the way the family is organized” (p.183). According to Minuchin, “the first, or perhaps most important, question a systemic therapist asks is: What are family members doing that helps maintain the identified patient’s symptoms?” (Minuchin, Nichols & Lee, 2007, p. 17). To answer this question, parents’ interactions, their parental styles and how their parental styles complement each other need to be analyzed.

It is also important to focus on a couple’s relationship, to explore how spouses relate to each other, how they address problems, how they agree and disagree.

The third step will be to explore parents’ past in order to understand how they developed their parental styles and ways of relating to each other.

A structural therapist will ask each of the parents to briefly talk about their childhood. Often family members think that their parental styles and ways of relating to others are unchangeable, but when they find out that they actually inherited them from their parents, they realize that they can unlearn old dysfunctional behaviors and learn new more effective ones (Minuchin & Fishman, 1981).

Goals and Interventions

The fourth step will be to redefine the problem and explore alternatives (Minuchin, Nichols& Lee, 2007). A structural therapist will use joining, accommodating and enactment not only to observe the family’s interactions but also modify them.

The family therapist will use reframing to help the family members see how their actions may maintain the problem. Then the structural family therapist will slowly start shifting the focus from the problem child to the spousal subsystem.
The interventions will be aimed at realigning interpersonal boundaries within a spousal subsystem. According to Minuchin (2007), spouses need to express their built up negative emotions before they feel closer to each other. The complementarity concept by asking both spouses to help each other to change can be used.

The following questions can be addressed to partners: “Your wife needs to know that you are a loving and nurturing father.” “How can you help your husband to be a father you want him to be?” “Can you give your wife permission to express her feelings of frustration?” This will open up an opportunity for the husband and the wife, who used to avoid a conflict, to learn to communicate with each other without fear of the confrontation.

When partners reestablish clear boundaries within the spousal subsystem, the structural family therapist will concentrate on reestablishing an effective hierarchical parental subsystem and creating clear generational boundaries in the family.
The realignment of boundaries within the wife-husband subsystem will affect the mother-son subsystem. For example, the wife’s need for emotional closeness will be satisfied by her husband, and not her son. Therefore, the emotional proximity between the mother and the son will change as well.

Second, the family therapist may intervene by encouraging parents to explore if their approach to changing their child’s behavior is effective or not. To challenge the family members’ unproductive assumptions, the family therapist may comment on the process: “I noticed that when dad started talking to his son about his behavior, you, mom, jumped in to protect your son. Do you think your husband can hurt your son?” Then the family therapist will guide the family to develop a more a balanced approach to parenting and disciplining their son.

The parents will discuss and agree on the ways they want to discipline their child. Alternative ways of disciplining their son, such as consistency, positive reinforcement, setting reasonable limits and expectations will be explored during the session.

The child’s longing for affection may also be addressed by saying” “Your son says that he feels that you love other children better than him. How would you respond to your son?” The father may tell his son that he loves him as much as he loves other children.

Then the family therapist may ask the son to help his stepdad express his love. The son may say that he wants to spend more time with his father, and they may schedule to do something fun at least once a week.

Finally, focusing on children, parents’ and stepparents’ subsystems by using the following reflections of feelings may help the son express his feelings about his dad and improve family’s relationship on overall: “It seems like it hurts you when your mom and step dad say negative things about your dad.” Hopefully, the mom will understand that by undermining her former husband’s authority, she is hurting her own son.

A final result of the counseling will be to see the family reorganizing its structure. The stepfather will earn his son’s respect and affection by emotionally connecting with his stepson.

Now the son is excited to talk to his stepdad about his interests. They have time together playing a game or going on a special outing. The father finds time to spend with other children as well. Even if it is only ten minutes a day, he devotes his attention and time to one of the children completely. The mother and father defined their son’s chores so there is no misunderstanding of what is expected of their son.

The partners are not afraid to discuss problems anymore. The brilliance of the structural family theory is that it provides a step-by-step outline for assessment, problem conceptualization, and structural change. When counseling a family, a family therapist needs to remember to treat a family as a unit and that “psychological symptoms are often related to family conflict,” as “human problems are interactional”.

 

2017-07-11T01:12:41+00:00 July 10th, 2017|