Chap 12 - Structural Flashcards
Structural Family Therapy major theorists
• 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
Premises of Structural Theory
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
Family structure
an indivisible set of functional demands that organizes the ways in which family members interact
Coalition
alliance between specific members against a third (aka a triangle)
Stable coalition
fixed and inflexible alliance that becomes a dominant part of the family’s everyday functioning (dysfunctioning)
Detouring coalition
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)
Subsystems
- 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
Spousal subsystem
- 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
Parental subsystem
those responsible for the protection, care, and socialization of the children
o Functions better if there isn’t a cross-generational alliance
Cross-generational alliance
- 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
Sibling subsystem
unit in which the members are of the same generation (age greatly affects this-duhhhh)
Boundaries
physical/psychological factors that separate and organize people
Clear ones
- 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
Rigid ones
- inflexible rules and habits that keep people separated from one another
• Difficulty relating in an intimate way-lead to emotional detachment
Diffuse ones
- 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
Triangulation
- 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
parentified
given privileges and responsibilities that exceed what would be considered developmentally consistent with his or her age
Alignments
- 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
Roles of Structural
- 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
Rules of Structural
-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
Power
- 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)
Treatment Techniques
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
Dysfunctional sets
reactions in response to stress that are repeated without modification whenever there is a family conflict
Joining
process of “coupling” that occurs between the family and the therapist
Tracking
therapist follows the content of the family (the facts)
Mimesis
therapist starts talking like the family (becomes “one of them”
Confirmation
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
Accommodation
therapist makes personal adjustments to achieve a stronger therapeutic alliance
Disequilibrium techniques
changing a family system (another list-this time there are eleven)
Reframing
- 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
Punctuation
a selective description of a transaction in accordance with the therapist’s goals
Unbalancing
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
Enactment
get the family to interact while the therapist observes without interfering
Working with spontaneous interaction
focusing spotlight on some behavior-like a dysfunctional behavior the family displays while in session
Boundary making
helping the family redefine and modify the boundaries in the family to accommodate any change occurring within the family
Intensity
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
Restructuring
- 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
Shaping competence
highlight positive behaviors and reinforce them even if they only succeed temporarily
Diagnosing
- observe interactions and label them if they are maladaptive
• i.e. triangulation, coalition, etc.
• Done before the therapist becomes part of the system
Adding cognitive constructions
include advice, information, pragmatic fictions, and paradoxes
Advice and information
- 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”
Pragmatic fictions
statements that help the family gain a better understanding of reality and helps the family achieve change
Paradox
confusing message meant to frustrate and motivate them to find alternatives
Role of the therapist in Structural
- 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
Process and Outcome of Structural
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)
Homework
activities to do outside of the session
Emphasis of Structural
- 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
Comparison with other theories
- 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
