Structural Family Therapy: Analytical Essay

Abstract

When approaching the idea of family counseling, one must decide which approach would be best to recommend as well as an implement with clients. The structural model approach is a unique approach to counseling and is all about organization, family rules, and roles. Using this approach is about focusing on the constructs of the family and identifying solutions based on subsystems, boundaries, and organizational metaphors. This approach identifies functional and dysfunctional patterns through how the family responds to its underlying organizational structure and flexibility in responding to the many changes that occur around it. In its onset, the structural approach helped to change the way in which the family unit and its members were perceived within the mental health field. It was because of this change that the structural approach has been highly regarded within the family therapy experience allowing both the family and the therapist to develop ways in which the family can function that is beneficial to all its members. Also included is a personal integration focusing on the intersection where Christ-centered therapy and Structural Family Therapy meet.

Family Counseling Approach Research Paper: Structural Family Therapy

Part I

How families adapt to change as well as how they interact with each other can be what causes the family to function well or suffer from dysfunction. Structural Family Therapy (SFT), is an approach that focuses on the treatment of familial patterns and interactions as well as mental health issues. Issues such as this are seen as dysfunctional and are treated by viewing the family unit as a whole. SFT doesn’t focus on the members as individuals (Goldenberg, Stanton, & Goldenberg, 2017). When families receive structure-based therapy one of the main goals is to improve interactions and communication between the family members, as well as introduce boundaries and create a family structure that is healthy for everyone involved. What leading figures focused on when creating this approach was the wholeness of the family, the influence of the familial hierarchical organization, and the inter-reliant functioning of the family’s subsystems (Lindblad-Goldberg, & Northey Jr, 2013). This can be an effective approach for all types of families including extended families, blended families, as well as single-parent families.

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The founding of SFT historically was intended to address the distress we have with and within our families as well as the dilemmas in relation to our family dynamics. The only way to truly understand this distress in an individual is to understand the context of the relationships where it arises, such as the family (McAdams III, Avadhanam, Foster, Harris, Javaheri, Kim, Williams, 2016). The same problems that sparked the creation of this technique, we still face today. Families will continue to need structural-based therapy to help identify distress among family members. When using SFT the family is seen as a psychosocial system that functions through patterns. These subsystems may have no boundaries. In order for SFT to be successful, therapists need to help the family to work towards forming a new system within the family group as well as help the family to make changes within the structure (Goldenberg, Stanton, & Goldenberg, 2017). Therapists have learned that joining the family unit is important to therapy success. Therapists must be unbiased in this process; it is important not to take sides, but instead to be a mediator between the “sides”. Individuals currently deal with broken family units and unhealthy familial boundaries, and this will continue until the Lord returns. In the same way, children are and will continue to suffer from disorders that have been linked to familial structure such as depression, asthma, anxiety, diabetes, anorexia, bulimia, and more. Even adults benefit from this therapy because adults are suffering from distress as well. SFT is beneficial because it gives the entire family the opportunity to be assessed and work towards the changes that need to take place for the family members to function at a healthy level. A goal is for families to learn to cope and deal with changes and distress in ways that do not isolate members or cause further damage to members.

Salvador Munich was a prominent leading figure in the founding of SFT. Minuchin was a psychiatrist in the 1960s; he began his work with you in New York that showed signs of being troubled. He started out as a doctor in the military; he seemed to always have a love and passion for working with children (Goldenberg, Stanton, & Goldenberg, 2017). He became interested in studying the familial structure upon working with so many children that had problems he felt were created from the family structure. He began working to create ways to help these students which led to developing a theory as well as a specific intervention technique. Minuchin even reached out to different professionals from different disciplines to help him form structural therapy into what he knew it could be. With the help of his team, Minuchin was able to offer family therapy to families. One of the biggest attention grabbers for Minuchin was psychosomatic conditions within families; he really wanted to focus on urgent medical problems like diabetes and anorexia, where no medical explanations could be found. This led Minuchin and his colleagues to understand that when subsystems are functioning poorly, and boundaries are not strict, it does not allow individual autonomy.

The need to restructure families in low-income areas, specifically African-American and Latino-American adolescents, on the outskirts of the New York City area around the late 1950s and early 1960s gave rise to SFT (Goldenberg, Stanton, & Goldenberg, 2017). The focus of SFT is the ability to actively strive for organizational changes within the dysfunctional family, presuming the individual behavioral changes and symptom reduction follow while the context for family transactions continues (Goldenberg, Stanton, & Goldenberg, 2017). Minuchin became fueled by an article written by Don Jackson in 1959, and he began to look at primarily low-income African-American and Latino-American adolescents in the New York City area. He then began to analyze their families, specifically their family dynamics. Along with his team at Wiltwych School for delinquent youth, Minuchin began composing brief, direct, concrete, action-oriented, and problem-solving intervention procedures to instill change by restricting the entire family (Goldenberg, Stanton, & Goldenberg, 2017). His team consisted of Charles Fishman a psychiatrist, Harry Aponte a social worker, and Marion Goldberg a psychologist. Minuchin began working to include working-class families as well as middle-class families in 1965. Later Minuchin took on the directorship of the Philadelphia Child Guidance Center (Goldenberg, Stanton, & Goldenberg, 2017).

Structural family therapy is a culmination of both theory and techniques that focus on individuals in their social and relational contexts to their families. Therapists who use this technique, assess and explore the family’s structure including, subsystems, boundaries, relationships, and support (Reiter, 2016). They use this assessment to recognize areas of strength and resilience, possible flexibility, and change. It was developed in the context of therapeutic work with families and young children. The structural approach assumes families and family members are subject to inner pressures coming from developmental changes within its own family members and subsystems and to outer pressures coming from demands to accommodate to the significant social institutions that have an impact on family members. Development on how family feedback mechanisms work and how dysfunctional communication patterns develop are what drive this theory even today. How a family copes and adapts to changes really affects members individually and can alter the way that they cope with changes in their individual lives creating distress and medical disorders (Negash, & Morgan, 2016).

According to Aponte and Van Deusen (1981), the structural approach to family therapy devises families as systems and subsystems, roles and rules, boundaries, power, and hierarchy. For example, a functional family is one in which there are clear boundaries between each individual person and the subsystems (Navarre, 1998). Figley and Nelson (1990) made mention that a functional family facilitates individual growth, prevents intrusion, promotes generational hierarchies, and provides flexible rules and roles which are adaptable to the internal and external changes of an evolving family. Minuchin (1974) noted that functional families possess well-organized boundaries. Boundaries are a family’s checks and balances. For married couples, they tend to have closed boundaries to protect their spouse’s privacy. For parents, the boundaries between parent and children must be clear and remain penetrable to ensure parenting is in the best interest of both the children and the parents.

Boundaries do not stop there, siblings have boundaries as well. The boundary surrounding the nuclear family is also one to be respected (Navarre, 1998). Structural family therapy has techniques within the approach that produce structure and change within the family system These techniques include joining, enactment, reframing, and unbalancing (Goldenberg, Stanton, & Goldenberg, 2017). Each of these techniques allows the therapeutic experience to provide respect to the family boundaries while instilling the subsystems necessary for adaptation to change and structure. Structural family therapy offers two things, a theoretical framework for describing the family organization, and a set of techniques to allow for restructuring problematic patterns (Minuchin & Fishman, 1981). It is the change and the new way of living within the family that makes the techniques of structural family therapy stand out from all the rest.

Unique Techniques

There have been numerous reports of research that support that structural family research is effective in many different populations and works for various problems as well. A recent study showed the effectiveness of using SFT techniques on children with acute illnesses such as leukemia and how it enhanced their coping skills as well as their overall mental state.

Dysfunctional families and distressed children are always the focus of the ones who benefit the most from using this technique. Parent-child boundaries and interactions are the main focal point for therapists, and they work to ensure that these boundaries are healthy, coping skills that are effective, and a family structure that allows the family to thrive (Reiter, 2016).

There has also been a study that has shown this technique being used on adolescents who need help resolving externalizing problems or things such as pornography addiction (Goldenberg, Stanton, & Goldenberg, 2017). Infidelity and how it harms the nuclear family have also shown promise. Therapists seek to find better adaptable ways to maintain the family structure and minimize the harmful impact that infidelity has on the family system (Negash, & Morgan, 2016).

Part II. Personal Integration

“How good and pleasant it is when God’s people live together in unity” (Psalm 133:1, NIV). The family unit is so important because it is the first structure that we are introduced to. We do not get to choose what family we are born into, and the structure and value system of our families affect our lives for the remainder of our lives. Families affect the way that we cope, make decisions, as well as communicate. Integrating Christianity into family counseling is definitely a priority. When God created the world, one thing he noticed from the beginning was the loneliness of man. God not only made a woman for a man, he made a woman from a man. Genesis 2:22 (NIV) reads, “Then the Lord God made a woman from the rib he had taken out of the man, and he brought her to the man”. God also made it possible for man and woman to have children. Proverbs 127:3 (NIV) reads, “Children are a heritage from the Lord, offspring a reward from him”. The foundation of the family is one of the many rewards that the Lord as afforded to us. What a shame it would be for us to not include the Lord in the family dynamics.

The Bible holds the most fundamental tools of principle related to child-rearing and the roles of parent and child. It is the bible’s truths that teach us it takes a village to raise a child. It is the bible that teaches us, “Children, obey your parents in the Lord, for this is right. Honor your father and mother” and in return “Fathers, do not exasperate your children; instead, bring them up in the training and instruction of the Lord” (Ephesians 6:1-4, NIV).It is also the bible that teaches us about love, honor, respect, forgiveness, and brotherhood. These are all key attributes in which the therapist provides to families in the SFT approach.

We learn many of our basic skills by watching how our families interact and deal with stressful situations. Many people feel if they can separate themselves from their families and the dysfunction their stress will disappear. The problem with this idea is that we still carry that dysfunction with us, and without therapy and guidance, we can just begin embedding that same dysfunction into our created families.

Many people say that the most important things in life are family and love. Sometimes this concept is a little hard to accept when we are raised in a dysfunctional family that is lacking in love. I can really relate to this technique, and I honestly feel that my family would benefit greatly from group family therapy. Some of us have gotten therapy separately, but it does not help when there are issues we need to discuss as a family. I have been the person to separate myself from my family because the dysfunction was overwhelming. I can still communicate with them and love them, but actually living near them would be greatly difficult. I can see how our dysfunctional family system has affected individuals, and they are not able to cope or create functional lives because our family system is so broken.

We as therapists should not be afraid to offer Christ-centered therapy incorporated with SFT to our clients during their time of healing. I feel it is our duty to provide the best possible service; that does and always will include God. I feel I would be able to use this technique because I understand this technique and how boundaries within families are important. I believe this technique can be effective for children, adolescents, as well as adults. All parts of the familial system are affected and can benefit. Children are easier to guide and mold, but there are adults that are still suffering from dysfunctional family systems as well.

For those clients that have other religious beliefs, we are to respect their chosen way of worship and forgo offering Christianity in the therapeutic experience. The last thing we want as therapists is to offend our clients while we are supposed to be helping our clients work towards healing. If you have a client who has no religious beliefs, however, they may have a skewed view of Christianity, this is where the therapist can assist with shedding new light on Christianity for the client. We as therapists need to be very mindful that we are not there to be a pastor for the client, but we can show the true love and beauty that the Lord has in store for the client. If you have a client that is totally against Christianity being a part of the therapeutic experience, we should not press the issue. It is not our job to make our clients do something they do not want to do; we are to respect their request and continue to offer the best therapeutic experience we can.

Integration of Christ-centered therapy and SFT or any therapy technique can be difficult. It is important that we rely on Christ to lead us through this. He knows every step we take and breath we breathe. He knows exactly what our client needs, so why would we not rely on him to lead us in our leading our client to healing? Integration has shown to be one of the most life-changing experiences for clients, so how much more powerful could it be if we allow God to take the lead in our therapy sessions and process? Allowing clients to use prayer, meditation, and scripture reading during this time opens the doors for not just mental healing but spiritual healing as well. Things like forgiveness and empathy tend to be among the many things that integrating Christianity can help clients to achieve. As the therapist, we must lean on God for guidance when and how to integrate Christ-centered therapy with SFT.

References

1. Aponte, H. J. (8). Van Deusen. JM (1981). Structural family therapy. Handbook of family therapy, 1.
2. Figley, C. R., & Nelson, T. S. (1990). Basic family therapy skills II: Structural family therapy Journal of Marital and Family Therapy, 16(3), 225-239.
3. Goldenberg, I., Stanton, M., & Goldenberg, H. (2017). Family therapy: An overview. (9th ed.). Boston, MA: Cengage Learning. ISBN: 9781305092969.
4. Lindblad-Goldberg, M., & Northey Jr, W. F. (2013). Ecosystemic structural family therapy: Theoretical and clinical foundations. Contemporary Family Therapy, 35(1), 147-160. doi:10.1007/s10591-012-9224-4
5. McAdams III, C. R., Avadhanam, R., Foster, V. A., Harris, P. N., Javaheri, A., Kim, S., . . . Williams, A. E. (2016). The viability of structural family therapy in the twenty-first century: An analysis of key indicators. Contemporary Family Therapy, 38(3), 255-261. doi:10.1007/s10591-016-9383-9
6. Minuchin, S. (1974). Families and family therapy. Harvard University Press.
7. Negash, S., & Morgan, M. L. (2016). A family affair: Examining the impact of parental infidelity on children using a structural family therapy framework. Contemporary Family Therapy, 38(2), 198-209. doi:10.1007/s10591-015-9364-4
8. Navarre, S. E. (1998). Salvador Minuchin's structural family therapy and its application to multicultural family systems. Issues in mental health nursing, 19(6), 557-570. doi: 10.1080/016128498248845
9. Reiter, M. D. (2016). A quick guide to case conceptualization in structural family therapy. Journal of Systemic Therapies, 35(2), 25-37. doi:10.1521/jsyt.2016.35.2.25