Ch 5. Structural Family Therapy Flashcards
1
Q
Basis for Structural FT
A
- Minuchin worked with troubled boys and found that his analytic skills did not help their immediate survival based issues
- conceptualizes families as operating according to consistent, learned, underlying structures
- therapy is designed to unfreeze families from rigid habits, creating the opportunity for new structures to emerge
2
Q
Structural therapists are interested in
A
(Like strategic therapists)
- behavioral sequences
- rules that govern interactions
- and the contexts that influence the rules
3
Q
Role of therapists
A
(Like strategic)
- directive
- attend more to process than content
- observe reactions to current interventions in order to plan future interventions
- use techniques such as joining, reframing, and paradox
- believe that in order for there to be significant lasting change, the basic organization of the family must change
- alter behavioral sequences that occur in the session rather than assign out of session homework (like strategic therapists do)
4
Q
Goals of structural therapy
A
- to correct dysfunctional hierarchies by putting parents in charge of their children and to differentiate between subsystems within families
- change the family structure by changing the interactional patterns so that the improvements the family makes in the sessions will persist
- solving problems isn’t the goal, though it is often a result of treatment.
5
Q
Theory of Normal Development and Dysfunction: buzzwords
A
- Family structure
- subsytems
- boundaries
6
Q
Theory of Normal Development and Dysfunction: family structure
A
- every family has a specific structure that determines how members interact with one another and with outsiders and with other systems
- structure develops partly through repetition and partly through influence of the external context
- forms when partners couple… interrelated process of accommodation and boundary-setting bind them into a spousal subsystem
- each partner brings a familiar, learned styles of interaction from their FOO
- Family structure = “covert set of rules that governs transactions in the family… rules that are self-perpetuating and resistant to change.”
- Once a behavior is repeated, it is likely to continue
- Developmental stage or change in the external environment presents challenges to which the family structure must accommodate – causes disruption and anxiety… don’t mistake growing pains for pathologhy
7
Q
Theory of Normal Development and Dysfunction: subsystems
A
- individuals, dyads, triads, and groups form subsystems or units within the family that perform certain functions
- may be determined by generation, role, gender, age or interest
- each person is part of multiple subsystems
- maturity = vary behavior to fit each subsystem
8
Q
Theory of Normal Development and Dysfunction: boundaries
A
- separates subsystems
- hypothetical line of demarcation “serves to protect the autonomy of a family and its subsystems by managing proximity and hierarchy”
- rigid (leads to disengagement) or diffuse (lead to enmeshment)
- healthy families boundaries are clear enough to protect the separateness and autonomy, and permeable enough to ensure mutual support and affection – clear boundaries let parents be parents and kids be kids
- structural therapists do no pathologize families… they define dysfunction as a failure to adjust to changing circumstances (like when kids are in charge and parents aren’t)
9
Q
Disengaged v. enmeshed
A
disengaged systems - rigid boundaries:
- independent but isolated
- children learn to be self-sufficient and resourceful
- at the extreme the families are not warm or nurturing
enmeshed systems - diffuse boundaries:
- receive affection and nurturance, but can be at the expense of autonomy and ability to relate to others outside of the family
- enmeshment and disengagement may be reciprocal… mother may be enmeshed with kids and father disengaged. Suggests that family need some parental teamwork and some level of differentiation between subsystems
- may lead to cross-generational coalition
10
Q
How families manage conflict
A
- based on rules of their structure
- disengaged families avoid contact with on another… parents may no notice kid is having school hard time at school and will fail to provide help he needs
- enmeshed families tend to deny and suppress differences… if kid has even a minor problem, parents may intervene excessively, not allowing kid to learn to find his/her own solutions
11
Q
Cross-generational coalition
A
- structural therapy
- a stable coalition between a parent and child against the other parents
12
Q
Assessment and Treatment basics
A
- assessment and treatment are closely intertwined
- trust has to be won by the T in order to observe the unguarded family interactions
- observation is facilitated by enactments
13
Q
Assessment and treatment buzzwords
A
- accommodation
- joining
- enactment
- mapping the system
- intensity
- shaping competence
- boundary making
- unbalancing
14
Q
Assessment and treatment: Accommodation
A
“the adjustments a therapist may make to a family… in order to achieve a therapeutic alliance with them”
- Structural therapy requires strong, often confrontational challenges to the family, but the challenges will not be tolerated unless each family members feels accepted and understood by the therapist
- can be achieved through “mimesis” - T matches the mood or behaviors of the family members
15
Q
Assessment and treatment: Joining
A
- T build rapport and temporarily joins the family
- goal is to establish a trusting and familiar connection with the family so that the T can effect changes from within the system
