WEEK 2: SYSTEMIC, STRATEGIC AND STRUCTURAL FAMILY THERAPY
Strategic Family Therapy
- Strategic Family Therapy is a group of approaches to family therapy in which the focus is
on identifying and applying novel interventions to produce behavioural change rather
than on helping the family gain insight into the sources of their problems.
- Strategic family therapy is a brief form of therapy characterised by the clinician’s specific
focus on changing family behaviour associated with the identified problem.
Key Concepts of Strategic Family Therapy
- All behaviour is communication at some level.
Metacommunication
- Communication may occur simultaneously at many levels.
- Every communication has a report (content) and a relationship (command) aspect.
- Relationships are defined by command messages.
Complementary and Symmetrical Patterns
- Relationships may be defined as being symmetrical or Complementary
- Relationships among equals and un-equals;
- equals = symmetrical, each sibling tries to become competent in tasks necessary
to the family.
- un-equals = asymmetrical, family roles are rigidly different. Family more deeply
affected with cessation of role action of a family member.
- Symmetrical relationships risk becoming competitive.
- Complimentary communication involves one person who assumes a superior position and
another who assumes an inferior one.
- Complimentary communication inevitably involves one person who assumes a superior
position, and another who assumes an inferior one.
- Each person punctuates a sequence of events in which they are engaged in different ways.
- Problems develop and are maintained within the context of interactive patterns and
feedback loops.
Double Blind Theory
- A repeated experience where a negative injunction is paired with a second, equally
powerful, contradictory injunction.
- The double bind occurs when the person cannot confront the inherent dilemma, and
therefore cannot resolve it.
Examples of double blind
, - ‘I don’t want you to do it because I asked you to; I want you to do it because you
want to’. [partner/child completes a given task] ‘That doesn’t count because I had
to ask you to do it.’
- ‘Be spontaneous’ [it isn’t spontaneous if it has been directed].
- The parent says to their child: ‘I love you’, then stiffens when the child tries to
hug them. The child reacts to the parent’s body language and withdraws. The
parent then accuses the child of being cold or unloving.
- ‘Do what you want.’ [delivered from a parent with crossed arms, and a glare].
Goals of Strategic Family Therapy
Therapists seek to alter the dynamics of the system in order to bring about change:
- The therapeutic goal is to resolve the presenting problem, which is an interactional
problem
- Individual symptoms are located within the larger network of family and social systems;
……no single person is to blame.
- Therapeutic stance is non-blaming, non pathologising, in relation to all members of the
family.
Therapist seeks to understand family attempts to resolve the problem, and identify the
problematic feedback loops that are reinforcing the problem:
- Loop: Problem – attempted solutions – more problems – more attempted solutions.
- Families become stuck in the repetition of unsuccessful solution attempts;. Healthy
adaptive families flexibly modify and adjust solution strategies until resolution occurs.
- A totally new solution is required to interrupt the cycle; change is required not only in the
problem behaviour, but also in the underlying rule (communications; relational patterns).
- Reframing: Therapist provides an alternative but believable explanation for the same
events – from the client’s perspective. Therapist intervention can involve giving family
members a reframe task to complete in the coming week, reinforcing the reframe.
- Strategic Family therapy is intended to be a change focused Brief therapy; interested in
creating change in behavior rather than change in understanding of the behavior.
Role of Therapist
Respect and trust the system:
- The family is an entity that has its own way of seeing the world.
- Trust that the system can reorganise itself – without this forcing this change.
Establish a positive, trusting relationship - Adapting to client language, communication style and
viewpoint .
Maneuverability – therapist is free to determine their positioning in relation to the family –
expert/ one-down stance; emotionally engaged/ distant, ‘the bad guy’.
, Structural Behavioural Therapy
Structural family therapy is a method for understanding And treating behavioural problems
within the context of The family. Its central features are:
- An emphasis on interactional context as the organizer of individual behaviours.
- The central role assigned to the family as the protagonists of therapy.
- Reliance on action techniques for eliciting change.
Basic Premises
- Based in the framework of Systems Theory, Structural Family Therapists
- View families as a system.
- Every family has a structure; an invisible set of rules that inform family members
how to interact.
- Subsystems operate within the whole system; which is an organism in itself.
Structure
Families have hierarchical structure
- where adults and children have different amounts of authority.
- Established appropriate open hierarchy supports adaptive structure.
- Very little structure can disassemble effective and meaningful communication within the
family.
Developmental or situational events lead to crisis and increase family stress
- Appropriate open hierarchy supports adaptive response and recovery.
Rules provide and reveal structure – organized and repeating pattern of family function
- Rules established through overt and covert communication
- Cultural differences and norms influence structure/ patterns
- Gender and marital patterns, role expectations of children
Subsystems
Developmental stages in relationships lead to additional subsystems
- Couple without children – to arrival of first and subsequent children
- First born – to arrival of siblings
- Empty nest
- Sub-systems that become covert coalitions within a family system, can be a source of
conflict where this contradicts or Undermines structural elements of the family hierarchy.
The Healthy System
, The healthy system
- Generational Hierarchy
- Parental Coalition
- Spousal Subsystem
- Clear boundaries between individuals and subsystems
Boundaries
- Invisible barriers –psychological and physical – that regulate the amount, as well as the
type of contact one has with others.
- Clarity of the boundary is demonstrated through the level of communication, and the
nature of the family interaction.
- Boundaries can be clear, rigid, or diffuse.
Clear boundaries:
- Foster healthy independence and interdependence; adaptive communication; clear
boundaries required for healthy family functioning.
Rigid:
- inflexible, low communication; keep people separated.
- Members in a family with rigid boundaries have trouble relating in an intimate way with
one another and therefore become emotionally detached.
Diffuse:
- Intense levels of communication and over involvement – encourages dependence; can
promote enmeshment/codependency.
- One member's behavior can immediately impact the entire system.
Detouring
- occurs when parents, rather than directing anger or criticism toward each other, focus the
negativity on the child and the parent-child conflict thus serves to distract from the
tension in the marital subsystem
Symbols
Strategic Family Therapy
- Strategic Family Therapy is a group of approaches to family therapy in which the focus is
on identifying and applying novel interventions to produce behavioural change rather
than on helping the family gain insight into the sources of their problems.
- Strategic family therapy is a brief form of therapy characterised by the clinician’s specific
focus on changing family behaviour associated with the identified problem.
Key Concepts of Strategic Family Therapy
- All behaviour is communication at some level.
Metacommunication
- Communication may occur simultaneously at many levels.
- Every communication has a report (content) and a relationship (command) aspect.
- Relationships are defined by command messages.
Complementary and Symmetrical Patterns
- Relationships may be defined as being symmetrical or Complementary
- Relationships among equals and un-equals;
- equals = symmetrical, each sibling tries to become competent in tasks necessary
to the family.
- un-equals = asymmetrical, family roles are rigidly different. Family more deeply
affected with cessation of role action of a family member.
- Symmetrical relationships risk becoming competitive.
- Complimentary communication involves one person who assumes a superior position and
another who assumes an inferior one.
- Complimentary communication inevitably involves one person who assumes a superior
position, and another who assumes an inferior one.
- Each person punctuates a sequence of events in which they are engaged in different ways.
- Problems develop and are maintained within the context of interactive patterns and
feedback loops.
Double Blind Theory
- A repeated experience where a negative injunction is paired with a second, equally
powerful, contradictory injunction.
- The double bind occurs when the person cannot confront the inherent dilemma, and
therefore cannot resolve it.
Examples of double blind
, - ‘I don’t want you to do it because I asked you to; I want you to do it because you
want to’. [partner/child completes a given task] ‘That doesn’t count because I had
to ask you to do it.’
- ‘Be spontaneous’ [it isn’t spontaneous if it has been directed].
- The parent says to their child: ‘I love you’, then stiffens when the child tries to
hug them. The child reacts to the parent’s body language and withdraws. The
parent then accuses the child of being cold or unloving.
- ‘Do what you want.’ [delivered from a parent with crossed arms, and a glare].
Goals of Strategic Family Therapy
Therapists seek to alter the dynamics of the system in order to bring about change:
- The therapeutic goal is to resolve the presenting problem, which is an interactional
problem
- Individual symptoms are located within the larger network of family and social systems;
……no single person is to blame.
- Therapeutic stance is non-blaming, non pathologising, in relation to all members of the
family.
Therapist seeks to understand family attempts to resolve the problem, and identify the
problematic feedback loops that are reinforcing the problem:
- Loop: Problem – attempted solutions – more problems – more attempted solutions.
- Families become stuck in the repetition of unsuccessful solution attempts;. Healthy
adaptive families flexibly modify and adjust solution strategies until resolution occurs.
- A totally new solution is required to interrupt the cycle; change is required not only in the
problem behaviour, but also in the underlying rule (communications; relational patterns).
- Reframing: Therapist provides an alternative but believable explanation for the same
events – from the client’s perspective. Therapist intervention can involve giving family
members a reframe task to complete in the coming week, reinforcing the reframe.
- Strategic Family therapy is intended to be a change focused Brief therapy; interested in
creating change in behavior rather than change in understanding of the behavior.
Role of Therapist
Respect and trust the system:
- The family is an entity that has its own way of seeing the world.
- Trust that the system can reorganise itself – without this forcing this change.
Establish a positive, trusting relationship - Adapting to client language, communication style and
viewpoint .
Maneuverability – therapist is free to determine their positioning in relation to the family –
expert/ one-down stance; emotionally engaged/ distant, ‘the bad guy’.
, Structural Behavioural Therapy
Structural family therapy is a method for understanding And treating behavioural problems
within the context of The family. Its central features are:
- An emphasis on interactional context as the organizer of individual behaviours.
- The central role assigned to the family as the protagonists of therapy.
- Reliance on action techniques for eliciting change.
Basic Premises
- Based in the framework of Systems Theory, Structural Family Therapists
- View families as a system.
- Every family has a structure; an invisible set of rules that inform family members
how to interact.
- Subsystems operate within the whole system; which is an organism in itself.
Structure
Families have hierarchical structure
- where adults and children have different amounts of authority.
- Established appropriate open hierarchy supports adaptive structure.
- Very little structure can disassemble effective and meaningful communication within the
family.
Developmental or situational events lead to crisis and increase family stress
- Appropriate open hierarchy supports adaptive response and recovery.
Rules provide and reveal structure – organized and repeating pattern of family function
- Rules established through overt and covert communication
- Cultural differences and norms influence structure/ patterns
- Gender and marital patterns, role expectations of children
Subsystems
Developmental stages in relationships lead to additional subsystems
- Couple without children – to arrival of first and subsequent children
- First born – to arrival of siblings
- Empty nest
- Sub-systems that become covert coalitions within a family system, can be a source of
conflict where this contradicts or Undermines structural elements of the family hierarchy.
The Healthy System
, The healthy system
- Generational Hierarchy
- Parental Coalition
- Spousal Subsystem
- Clear boundaries between individuals and subsystems
Boundaries
- Invisible barriers –psychological and physical – that regulate the amount, as well as the
type of contact one has with others.
- Clarity of the boundary is demonstrated through the level of communication, and the
nature of the family interaction.
- Boundaries can be clear, rigid, or diffuse.
Clear boundaries:
- Foster healthy independence and interdependence; adaptive communication; clear
boundaries required for healthy family functioning.
Rigid:
- inflexible, low communication; keep people separated.
- Members in a family with rigid boundaries have trouble relating in an intimate way with
one another and therefore become emotionally detached.
Diffuse:
- Intense levels of communication and over involvement – encourages dependence; can
promote enmeshment/codependency.
- One member's behavior can immediately impact the entire system.
Detouring
- occurs when parents, rather than directing anger or criticism toward each other, focus the
negativity on the child and the parent-child conflict thus serves to distract from the
tension in the marital subsystem
Symbols
