Ch. 7 Nichols – Structural Family Therapy – Flashcards

began his career as a family therapist in 1960. In 1965 he became the director of the Philadelphia Child Guidance Center. In 1981 he established a center for the practice and training of structural family therapy in New York which is now known as The Minuchin Center for the Family.

• The model provides a blueprint for understanding the patterns of family dynamics. • The therapist joins with the family, assesses structure and then proceeds to activate dormant structures using techniques that alter alignments and shift power within and between subsystems.

• The most important tenet of the model is that every family has a structure and this structure is revealed only when the family is in action. Lasting change is believed to occur due to intervening with the entire family structure, not just with one or more subsystems.

Family Structure, Subsystems, and Boundaries

composed of organized patterns in which family members interact. Specifically, structure is concerned with the ways in which the tasks of system are divided into subsystems and with the coordination of those units. Additionally, patterns of authority, communication and interactions are considered. Structure becomes evident when you observe interactions among family members

groups based on generation, gender, and function. These subsystems are demarcated by interpersonal boundaries. Subsystems that are not adequately regulated by boundaries limit the development of relationship skills.

invisible emotional barriers that regulate contact with others. Boundaries may be rigid, effective or loose.

Rigid boundaries are restrictive. Disengaged subsystems are independent, but isolated. Disengagement fosters autonomy, but limits affection and support.

Enmeshment offers closeness and support but at the expense of independent competence. Loose boundaries cripple initiative.

• Inflexible family structures not adequately adjusting to maturational or situational challenges lead to dysfunction. • Rigid or diffuse boundaries between subsystems lead to dysfunction.

• Reorganize family structure • Establish a strong parental subsystem • Create clear but flexible boundaries between subsystems • Enable more functional adaptive patterns toward change • Help families find resources and strengths

• The therapist is active, involved, and takes the position of leader. The therapist gains influence by joining with the family and by the inherent power of techniques.

• The entire family comes to therapy. Lasting change is believed to happen only if the entire system is addressed, not just a subsystem.

• Therapy is relatively brief. The focus is on observing the family in action; focus is not on what members describe but how they actually interact. History is addressed selectively.

• The therapist joins with the family in a position of leadership. Joining is an empathetic connection to each member of the family allowing them to be heard and to begin to listen to each other. The therapist initially connects with individuals based on respect for hierarchy. • The therapist accommodates the style of the family and the point of view of the most challenging members of the family. • The therapist assesses the family structure. • The clinical focus of the observation will be on the following: • the system's flexibility and its capacity for elaboration and restructuring • the family system's sensitivity to actions of individual members • the range of boundaries from enmeshment to disengagement • the family life context and the sources of support and stress • the family's developmental stage and performance of the tasks appropriate for that stage • The therapist maps the underlying structure of the family. • The therapist intervenes to transform the structure. • If the therapist determines that an issue originates with a particular member of the family referral is made for that member

Creates an empathetic bond

Getting family members to interact with one another in a manner that illuminates problematic sequences

Preliminary assessments based on the interaction in the first session. Structural assessments take into account both the problem the family presents and the structural dynamics they display

Identification of problematic transactions. Focus on process and not content.

Designed to strengthen boundaries. Family members are urged to speak for themselves, interruptions are blocked, and dyads are used to help conversations finish without intrusion

Emphasis on the realignment of relationships in subsystems. The therapist joins one individual or subsystem to upset the status quo

Focus on changing the way family members relate to each other and offering alternative views of their situation

• Straightforward and simple guidelines that are practical and easily grasped were articulated by founding members • Specific techniques and stages of therapy are provided • The founder was a highly adaptive and dynamic individual, as a result the theory itself lends well to flexibility and broad application • The model provides the therapist with a direct way of challenging the assumption that there is an identified patient • The model has evolved with the field of family therapy and is currently still the most widely used model for understanding what happens in the nuclear family

• The 'Minuchin myth' confuses the man with the practice • The model was once considered aggressive and confrontational and it can be misused unless applied with a gentler intervention approach • The therapist must be mindful to remain objective about family interaction and not become enmeshed with the system.