Chap 12 - Structural

Question 1

Structural Family Therapy major theorists

Answer 1

• Founder: Salvador Minuchin
o Worked at Wiltwyck Institute with inner city delinquents
• Active and aggressive family members who tended to blame others and react quickly called for dramatic and active interventions (helps avoid possible shootings and/or shankings/shivings)
• Founded Institute for Family Counseling
• Training program for community paraprofessionals
• Highly effective for providing mental health services to the poor

Question 2

Premises of Structural Theory

Answer 2

o Pragmatic (practical), emphasizes individuals interacting with their environment
o Every family has a structure
• Can only be discovered through observations of repeated interaction patterns between and among family members
o Emphasizes family as a whole and interactions between subunits of the family
• Dysfunctional thing that may arise in the dysfunctioning dysfunction of a dysfunctional family
o A major thesis: person’s symptoms are best understood as rooted in the context of family transaction patterns
• Put simply the family as a whole is the client: fix the system, fix the one with the problem

Question 3

Family structure

Answer 3

an indivisible set of functional demands that organizes the ways in which family members interact

Question 4

Coalition

Answer 4

alliance between specific members against a third (aka a triangle)

Question 5

Stable coalition

Answer 5

fixed and inflexible alliance that becomes a dominant part of the family’s everyday functioning (dysfunctioning)

Question 6

Detouring coalition

Answer 6

a coalition in which members hold another member responsible for their difficulties or conflicts, thus decreasing the stress on themselves and their relationship (like parents blaming a child for all their problems or some shit like that)

Question 7

Subsystems

Answer 7

• smaller units of the system as a whole
  • Their mission-to explore strange new….I mean….carry out various family tasks
  o Some tasks are temporary: painting a room or some other shitty project
  o Some are more permanent: like parenting a child (God help them)
  • Important ones: spousal, parental, and sibling

Question 8

Spousal subsystem

Answer 8

• may consist of a single parent or any possible combination of two parents
  o Work best when there is complementarity of functions
  • Reciprocal role relationships that typically constitute an important element in the family organization
  • Like one spouse responsible the inside chores and one the outside chores

Question 9

Parental subsystem

Answer 9

those responsible for the protection, care, and socialization of the children
o Functions better if there isn’t a cross-generational alliance

Question 10

Cross-generational alliance

Answer 10

• members of two different generations entering into an alliance to obtain certain objectives or needs
  • Like a mother and child colluding to steal daddy’s special soda (thanks VANESSA!!!)
  • Need clear boundaries that still allow access to other members

Question 11

Sibling subsystem

Answer 11

unit in which the members are of the same generation (age greatly affects this-duhhhh)

Question 12

Boundaries

Answer 12

physical/psychological factors that separate and organize people

Question 13

Clear ones

Answer 13

• rules and habits that allow members to enhance their communication and relationships with one another because they encourage dialogue (and togetherness shit)
  • Good communication and feedback, negotiation and accommodation occur, facilitate change while maintaining the stability

Question 14

Rigid ones

Answer 14

• inflexible rules and habits that keep people separated from one another
  • Difficulty relating in an intimate way-lead to emotional detachment

Question 15

Diffuse ones

Answer 15

• rules and habits that do not have enough separation between members
  • Some members are “fused” (not literally obviously-do you know how effed up that would be?)
  • Encourages dependence-discourages autonomy

Question 16

Triangulation

Answer 16

• child[ren] (love those symbols :]) that have become involved in parents’ conflicts by taking sides, distracting parents, or carrying messages to avoid or minimize conflicts
  • Child becomes parentified

Question 17

parentified

Answer 17

given privileges and responsibilities that exceed what would be considered developmentally consistent with his or her age

Question 18

Alignments

Answer 18

• ways members join together or oppose one another in carrying out an activity
  • Completely normal-non pathological-ways of interacting
  • Like disagreements, arguments, death threats that arise while playing monopoly

Question 19

Roles of Structural

Answer 19

• positions under which members are operating
  • Difficulties can arise if the expectations of members are outdated and ineffective
  • Example: youngest of the family is not taken seriously because they are the baby

Question 20

Rules of Structural

Answer 20

-provide structure via an organized pattern that becomes predictable and manifests itself in repeated patterns
• Not good if main breadwinner gets laid off but still insists on buying everything with the money they don’t have

Question 21

Power

Answer 21

• the ability to get something done
  • Authority and responsibility (one who makes and one who carries out the decision respectively)
  • Dysfunction occurs when only a small number of members hold the power (think of your least favorite government)
  • The members who don’t have the power can become disenfranchised and cut ties with the family (think of your favorite revolution)

Question 22

Treatment Techniques

Answer 22

o “Structural family therapy is sometimes referred to as a way of looking at families.”
o Dysfunction occurs because of the development of dysfunctional sets

Question 23

Dysfunctional sets

Answer 23

reactions in response to stress that are repeated without modification whenever there is a family conflict

Question 24

Joining

Answer 24

process of “coupling” that occurs between the family and the therapist

Question 25

Tracking

Answer 25

therapist follows the content of the family (the facts)

Question 26

Mimesis

Answer 26

therapist starts talking like the family (becomes “one of them”

Question 27

Confirmation

Answer 27

using an affective word or phrase to reflect (and thereby affirm) an expressed or an unexpressed feeling of a family member. Can also be done by a non-judgmental description of that individual’s behavior

Question 28

Accommodation

Answer 28

therapist makes personal adjustments to achieve a stronger therapeutic alliance

Question 29

Disequilibrium techniques

Answer 29

changing a family system (another list-this time there are eleven)

Question 30

Reframing

Answer 30

- changing perception by explaining a situation from a different context-facts are examined from a new perspective • New wording or more positive wording can make all the difference

Question 31

Punctuation

Answer 31

a selective description of a transaction in accordance with the therapist’s goals

Question 32

Unbalancing

Answer 32

therapist supports one subsystem against the rest of the family-uses the therapist’s inherent authority as “the expert” to upset the balance of power in the family

Question 33

Enactment

Answer 33

get the family to interact while the therapist observes without interfering

Question 34

Working with spontaneous interaction

Answer 34

focusing spotlight on some behavior-like a dysfunctional behavior the family displays while in session

Question 35

Boundary making

Answer 35

helping the family redefine and modify the boundaries in the family to accommodate any change occurring within the family

Question 36

Intensity

Answer 36

therapist makes statements that raise the affect and pressure on the family-with the idea of changing maladaptive transactions-have to be forceful and carefully worded

Question 37

Restructuring

Answer 37

- the heart of the structural approach-involves the change of the structure in the family • Alters the existing hierarchy via enactment, unbalancing, and boundary formation

Question 38

Shaping competence

Answer 38

highlight positive behaviors and reinforce them even if they only succeed temporarily

Question 39

Diagnosing

Answer 39

- observe interactions and label them if they are maladaptive • i.e. triangulation, coalition, etc. • Done before the therapist becomes part of the system

Question 40

Adding cognitive constructions

Answer 40

include advice, information, pragmatic fictions, and paradoxes

Question 41

Advice and information

Answer 41

- offering the therapist’s experience as advice to the family-such as if the family asks if they’re normal o Say that “your family is unique, but the problems are common among families that I see”

Question 42

Pragmatic fictions

Answer 42

statements that help the family gain a better understanding of reality and helps the family achieve change

Question 43

Paradox

Answer 43

confusing message meant to frustrate and motivate them to find alternatives

Question 44

Role of the therapist in Structural

Answer 44

* Like a theater director-an active observer and expert * Role changes as therapy progresses * Therapist maintains a “middle-distance” as opposed to a proximal distance

Question 45

Process and Outcome of Structural

Answer 45

o Process is gradual but steady o General patterns • Symptom resolution and structural changes if successful • Significant change occurs in the first few sessions because of the specific techniques used to change the interactions • Emphasizes action over insight • Family is often given homework (they define homework-even though we’re graduate students in counseling, apparently we have no idea what homework is-therapeutic or academic)

Question 46

Homework

Answer 46

activities to do outside of the session

Question 47

Emphasis of Structural

Answer 47

* Versatility * Clearly defined terms and procedures * Approach is defined in such a way that it is easily accepted by the medical community * Emphasizes symptom removal and reorganization of the family * Pragmatic, problem-solving approach

Question 48

Comparison with other theories

Answer 48

* Criticism is that it is not complex enough to deal with the complexities of family systems * The focus of the theory lends itself to reinforcing sexism and sexual stereotypes * Focuses on the present and ignores past data * Hard to distinguish from strategic family therapy * Families are not as empowered because the therapist is so active