Therapeutic interventions for troubled families often sound and appear unusual or abstract, such as “Structural Family Therapy” or “SFT,” for example. This isn’t a name that instantly rolls off your tongue, or a therapy you hear used frequently in the press or in movies, such as the more ubiquitous techniques of psychoanalysis and psychotherapy.
But SFT is similar to other types of therapies categorized under the psychological framework of family systems therapy. These types of therapies view the family unit as a system that lives and operates within larger systems, such as a culture, the community, and organizations. This system – ideally – grows and changes over time. But sometimes a family gets “stuck,” often resulting from behavioral or mental health issues of one of its family members.
Rather than focus on the individual’s pathology, however, SFT considers problems in the family’s structure – a dysfunction in the way the family interacts or operates. SFT does not maintain that the family’s interactions, or “transactions” cause the pathology, but rather that the family’s transactions support or encourage the symptoms.
Transactions are simply patterns of how family members routinely interact with each other. For example, a mother’s transaction with her daughter could be controlling and overprotective, or an older brother’s transaction with a younger brother could be one of bullying and overpowering.
Through its transactions, a family establishes a set of rules for its daily functioning, and these rules form its “structure.” A marriage and family therapist employing SFT must first assess the family’s interactions, figuring out the family’s hierarchy, alliances within the family, such as a mother and son against a father, or siblings against another sibling or siblings. The therapist composes a map or flow chart describing the process that a family unconsciously follows.
Ultimately, the therapist’s goal is to change or modify the family map or structure – to get it “unstuck” from its harmful transactions that are supporting and amplifying certain issues or problems.
Forms of family dysfunction
Therapists using SFT delineate proper “boundaries” between family members and their transactions or interactions. For example, parents establish boundaries for the healthy growth and development of children, such as curfews, household responsibilities, and limits for appropriate social behaviors.
When boundaries are crossed, ignored, and distorted, the family’s structure becomes dysfunctional. If a teenager starts experimenting with illegal substances, for example, dictating her own curfews and social activities, and a mother refuses to or prevents a father from setting up appropriate consequences for such behaviors, a dysfunctional transaction between the mother and daughter develops.
Structural family therapists identify a wide range of family dysfunctional transactions. The two main types at each end of a behavioral spectrum are:
- Enmeshed. This dysfunction identifies a family structure that is smothering and overly close.
- Disengaged. This dysfunction identifies a family structure that is extremely distant.
A third type of dysfunctional pattern therapists often encounter is:
- Triangulation. This dysfunction identifies a structure where one family member gets torn between two others, as in the case of parents placing a child between them while fighting.
How does SFT Work?
Unlike more traditional approaches that prescribe a supportive, listening-empathetic approach to therapy, therapists working with the SFT model get involved with a family’s transactions, and, as some theorists describe it, metaphorically become a member of the family.
In this unique role, and in the context of the therapeutic setting, the therapist will provoke the family members to interact and speak about the problem or issue. The therapist asks questions, points out harmful transactions, and uncovers not only dysfunctional patterns, but positive behaviors or personal qualities that are ignored or overlooked by the family.
During the interactions that take place in therapy, hidden conflicts become apparent, inappropriate or counterproductive transactional patterns observed, and finally, ways to help the family change or restructure interactions are made. However, the therapist works from the premise that all individuals and families have the resources to bring resolution to these issues themselves. The art of SFT becomes the therapist’s ability to help the family discover its own talents and capacities to effect the change that needs to take place to get the family back on a more productive path.
According to Jorge Colapinto, in the article “Structural Family Therapy,” published in Family Counseling and Therapy, therapists employing SFT concentrate on three main areas:
- The family
- The presenting problem
- The process of change
Colapinto stated that change in the family structure usually means changes in “the relative positions of family members: more proximity may be necessary between the husband and wife, more distance between mother and son. Hierarchical relations and coalitions are frequently in need of a redefinition.”
A Different Approach
One of the essential points of the SFT model, according to Colapinto, is that this approach does not advocate a list of interventions or techniques – as is more common with other types of therapies. Instead, SFT requires a consistent way of thinking, thinking that places all human problems within a context. In other words, symptoms of the problem behavior are viewed within a family structure that supports rather than effectively deals with the behavior.
The therapist is viewed as an “agent of change,” according to Colapinto, which presents special challenges. This role “is paradoxical” because the therapist must find the right equation of accommodation and challenge.
For this reason, special training in SFT is required. If you are interested in practicing this form of therapy, your first step is to become a , or a Marriage and Family Therapist (MFT). Many schools have elective coursework in SFT.
To become a family therapist, a master’s or Ph.D. is required, and states have additional licensing requirements. If you want to work with families, helping them with a range of issues affecting them today, request information from schools offering degrees in family therapy.