Structural Versus Strategic Family Therapies Essay.
Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families. Structural Versus Strategic Family Therapies Essay.
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· Compare structural family therapy to strategic family therapy
· Create structural family maps (Refer to Gerlach (2015) in this week’s Learning
Resources for guidance on creating a structural family map.) or LOOK AT THE
· Justify recommendations for family therapy
In a 2- to 3-page paper, address the following:
· Summarize the key points of both structural family therapy and strategic family
· Compare structural family therapy to strategic family therapy, noting the
strengths and weaknesses of each. Structural Versus Strategic Family Therapies Essay.
· Provide an example of a family in your practicum using a structural family map.
Note: Be sure to maintain HIPAA regulations (Refer to Gerlach (2015) in this
week’s Learning Resources for guidance on creating a structural family map.) or
LOOK AT THE ATTACHED ONE.
· Recommend a specific therapy for the family, and justify your choice using the
Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.
- Chapter 5, “Bowen Family Systems Therapy” (pp. 69–88)
- Chapter 6, “Strategic Family Therapy” (pp. 89–109)
- Chapter 7, “Structural Family Therapy” (pp. 110–128)
Gerlach, P. K. (2015). Use structural maps to manage your family well: Basic premises and examples. Retrieved from http://sfhelp.org/fam/map.htm
McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110–120. doi:10.1080/01926187.2011.649110
Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167–174. doi:10.1080/01926187.2013.794046
Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025
Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403–414. doi:10.1080/01926187.2012.727673
Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415–427. doi:10.1111/jmft.12113
Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research, 25(1), 121–133. doi:10.1080/10503307.2013.856044
Psychotherapy.net (Producer). (2010). Bowenian family therapy [Video file]. Mill Valley, CA: Author.
Triangle Productions (Producer). (2001). Brief strategic therapy with couples [Video file]. La Jolla, CA: Author. Structural Versus Strategic Family Therapies Essay.
Structural and Strategic Family Therapy Comparison
Structural and Strategic Family Therapy Comparison
John R. Stafford
Family therapy is not a single theory solution for new family therapists. Although it is common for a young therapist to pick a model that he or she may feel most comfortable with, it is a manner of limiting the scope of learning in the early stages of education and even practice. Gaining a full understanding of the four primary constructs of family therapy can assist a young therapist in not only selecting a model that feels right but also in the ability to employ aspects of multiple models when working with various clients and their diverse spectrum of issues. Although each model has significant differences, they also share some similarities. This paper will examine the differences and similarities of structural and strategic family therapy models.
Keywords: Structural Theory, Strategic Theory, Family Therapy Models
Structural and Strategic Family Therapy Comparison
Understanding the differences and similarities of the different family therapy models enhances the ability of a therapist to determine if a particular model or combination of models are best suited for their practice and the individual needs of the client[s] (Silva, et al., 2003). This paper contrasts and compares the Strategic and Structural models of family therapy by discussion the constructs of both models. By careful examination of the different approaches, development, and intervention styles associated with the two models, we can better understand the core concepts, intervention techniques, processes, social contexts, and outcomes represented in each model.
The Creation of Each Model
Salvador Minuchin and his colleagues at the Wiltwick School residential facility in New York developed Structural family therapy base don their experiences working with inner city delinquents (Issitt, 2013; Gladding, 2007). Pulling from their experiences, Minuchin and his colleagues asserted that passive and historical approaches to working with families posed difficulties in working with families in lower socioeconomic and racial minority families (Gladding, 2007; Nichols, 2013). Based on his observations, Minuchin asserted that the households in this demographic tended to display more aggressive behaviors and place blame on other family members or influences when troubles within the family were present (Issitt, 2013; McAdams et al., 2016). Minuchin further surmised that when a dysfunction within the family arose, that it was the result of an inability for the family structure to adjust to changing conditions and that families incorporate subsystems that establish individual roles and responsibilities (Issitt, 2013; Gladding, 2007). Based on these observations and assertions Minuchin developed the concept that therapists should engage families directly to aid in changing the family structure to facilitate change, and that the particular type of clientele they were working with required active and dramatic interventions to be successful (Issitt, 2013; Gladding, 2007).
In the 1960’s and 70’s Minuchin and his associates expanded on the social context that formed the basis of structural family therapy mainly because the clientele of inner city tended to display a heightened level of crude characteristics (Israelstam, 1988; Issitt, 2013). Structural family therapy also assumes that problems arise when family boundaries are not clear and when difficulties are present within the family hierarchal structure. Furthermore, cross-generational influences like coalitions and alliances add additional challenges within the family (Isrealstam, 1988; McAdams et al., 2016). Sequentially families with diffused boundaries are more likely to be enmeshed while families with rigid boundaries are more likely to be disengaged than households with a healthy set of boundaries and hierarchal structures (Isrealstam, 1988; Gladding, 2007; McAdams et al., 2016).
Gregory Bateson (1904-1980) of the Palo Alto research group developed strategic family therapy in the early 1950’s. His primary focus on treating schizophrenic patients and the problems their families experienced as a result of the illness, and he surmised that schizophrenia was a result of discrepancies in various levels of family communications and interactions (Isrealstram, 1988; Nichols, 2013). Strategic family therapy is primarily composed of two subgroups. The first being Haley’s structural-strategic group and the second being the MRI group (Israelstam, 1998). It is fair to note that while both of these subgroups share much in common, they have strong fundamental differences. One aspect of strategic family therapy is that therapists working with families take a lead role in defining the process fo treatment and design the strategies required to aid families in changing their system (Israelstam, 1998). Also, D. Jackson (1920-1968) and John Weakland (1919-1995) expounded on Bateson’s concepts by describing various communicational strategies as processes an individual uses to escape or define intrafamilial relationships (Israelstam, 1988; Sheehan, & Friedlander, 2015). Based on the focus on specific strategies for intervention aimed at changing the current problem within the family, Jackson and Weakland’s theories also became known as strategic family therapy (Israelstam, 1988; Sheehan, & Friedlander, 2015). The process involves a complete assessment of the family interactions and developing a strategy to disrupt the cycle by providing straightforward or paradoxical interventions. The therapeutic process focuses on changes, and the therapist is responsible for the successful outcome of these processes. It is fair to note that strategic therapists do not make interpretation of current interactions of the therapist themselves or exploration of the past when addressing the family’s current interactions.
The strategic family therapy model significantly impacted by social context, combined ideas, accumulated research, and writings of all the theorists at the Mental Research Institute [MRI] established a strong presence in the psychotherapy community. Although there were various therapists and schools of theory involved in the creation of strategic theory, the collaborative research and shared objectives of all concerned defined the theme used to form the model into a modern family therapy technique.
Mechanics of Each Model
The structural theory asserts that changing the structure of a dysfunctional family will enable the family to interact in a positive manner and overcome the pressing issues. Structural family therapy assumes that problems and solutions develop on a series of hierarchal, subsystem, and architectural influences within the household that affect the behaviors of individual family members (Israelstam, 1988). A further assumption is that people interpret issues like social interactions as patterns of interaction that occur on a repetitive basis (McAdams et al., 2016). The dynamics of a family network or structure ranges from dysfunctional to supportive and based on the level of cohesiveness will either promote negative or positive household interactions (McAdams et al., 2016). The structural interpretation of problems versus solutions provides a systemic comprehension of the family unit as an operational network and provides insight into the routine functionality of both the family system and individual components. If the therapist determines a dysfunction in family operations, he or she assists the family in changing the issues to encourage more positive interactions (Israelstam, 1988; McAdams et al., 2016).
The underlying assumptions about problems in strategic family therapy focus on the family system and how it interacts with a problem instead of identifying the problem itself (Gardner, Burr, & Wiedower, 2006; McAdams et al., 2016). Strategic family therapists attempt to change the household interactional processes by focusing on individual communication patterns and developing strategies designed to aid the family to recognize and change actions and interactions associated with the dysfunction (Horigan, Anderson, & Szapocznik, 2016). Strategic family therapists believe that this manner of intervention will aid in the restoration of active family function and the dysfunction will cease (Lindstrom, Filges, & Jorgensen, 2015).
Model Core Concepts
The fundamental concepts of structural family therapy emphasize a systemic and organizational process where the therapist analyzes the family structure to determine how the household interactions maintain the dysfunction without identifying the solution (McAdams et al., 2016). A primary assumption of Minuchin is that a family network core function centers on functional expectations that establish individual interactions and affect household homeostasis (Issitt, 2013; Lindstrom, Filges, & Jorgensen, 2015). Besides the inner workings of the family itself, the therapist also reviews external social influences that potentially affect the dysfunctional behaviors in a negative manner. Another area of focus is subsystems intertwined with the primary system and hierarchal processes identified as potentially harmful influences, hence allowing the therapist to aid in modifying how individuals relate to one another and create a positive rebalance of the primary system (Issitt, 2013; McAdams et al., 2016).
The fundamental concepts of strategic family therapy emphasize systemic process, hierarchal structure, and understanding the intricacies of individual and family communication patterns (Horrigan, Anderson, & Szapocknik, 2016; Sheehan & Friedlander, 2015). The process includes analyzing invisible and visible family guidelines [rules], family function, and repetitive behavioral patterns that appear to reoccur within the family Israelstam, 1988). Emphasizing that problems are inherent to dysfunctional hierarchies in the family structure; therapists seek to aid families to correct the problems by modifying personal interactions to change the family structure. Other concepts of strategic family therapy include the household’s behavioral sequences and the processes that potentially exacerbate or maintain the dysfunction (Szapocznik, Schwartz, Muir, & Brown, 2012).
Applying unbalancing techniques, aiding individual family members to reframe perceptions, family mapping, joining with the family during sessions, and presenting the dysfunction as a metaphor are core intervention methods employed in structural family therapy (Nichols & Tafuri, 2013). Applying these techniques, a therapist can diagnose the dysfunction and aid the family in restructuring, which allows the process to develop structure and improved esteem within both the individuals and family network (Nichols & Tafuri, 2013). For example, if a therapist is working with a family that has an addiction problem, he or she may choose to use a family structure map to analyze various coalitions to interpret the underlying cause of the addiction (McAdams et al., 2016; Nichols & Tafuri, 2013). The therapist, in this case, objectifies the addiction to detach it from the affected family member and realigns the spousal coalition to strengthen the family’s center of power to combat the influence of the dependency (Nichols & Tafuri, 2013).
Strategic family therapy focuses on a set of planned, practical, and problem-focused strategies to address dysfunctional behaviors and familial structures that are associated with or contribute to the underlying problems (Lindstrom, Filges, & Jorgensen, 2015; Szapocznik, Schwartz, Muir, & Brown, 2012). The unique or core fundamental approaches of strategic family therapy include providing directives, assessing ordeals, and therapeutic paradoxes during interventions. A Therapeutic paradox is a tactic used to engage family members to evaluate unfavorable interactions and to redirect efforts into different interactions or behaviors (Lindstrom, Filges, & Jorgensen, 2015). Directives serve as precise instructions for the family members to enact to facilitate change, whereas ordeals are behavioral prescriptions that direct the family to engage in pernicious behaviors when maladaptive interactions return (Lindstrom, Filges, & Jorgensen, 2015; Szapocznik, Schwartz, Muir, & Brown, 2012).
Considering that both models were primarily developed to treat addiction problems in young family members and provide assistance to the family unit to restructure the family network either by changing the structure or the strategy of the household dynamic, the benefits of both models apply in other therapeutic settings. For example, the application of both models in long-term care facilities and addiction rehabilitation for adults are both viable use-case scenarios. Hybrid models like brief strategic family therapy have combined elements of structural and strategic family therapy models of effecting changes in family networks troubled with dysfunctional addiction and behavioral problems. Using this hybrid model, a therapist can apply proper treatment to a family with an adult member suffering the same dysfunction. Although the primary applications of these models remain to treat families with children suffering from addiction and dysfunctional behavior, the transition to intervention programs for adults is beneficial and practical. Considering the systems and structures of families with dysfunctional children and dysfunctional adults are similar, if not identical, therapists only need make minor modifications to the intervention process to adapt the treatment to fit the needs of the family.
A key factor of consideration in adapting these models to adult therapy is the effect addiction has on the mental state of a patient. Chronic addiction modifies and even retards human maturity, and therefore adult addiction patients may, in fact, have reduced mental capacity, or immature behavioral attributes. In cases of adult addiction or dysfunction, there are factors of treatment that remain relevant. Treating the parental structure or system would be considered a primary aspect of treating the dysfunction or an adult family member. The core processes of joining the family system, providing an in-depth evaluation of dysfunctional personal relationships, and aiding in the adjustment of the family structure or system are all viable approaches when providing therapy to families with dysfunctional adults.
Model Goals and Outcomes
In comparison, the goals of structural and strategic family therapy share similarities of altering the family network via methods of behavior modification, communication enhancement, and disruption and restructuring dysfunctional interactions. In both models, the desired outcome is a change in maladaptive patterns that affect both the individuals and family unit. Assuming that changing the structure to recognize and disrupt dysfunction within the person and the family structure, a proper balance will be achieved and family homeostasis returned. Therapists are usually not dedicated to a particular model. Hybrid therapies like Brief Strategic Family Therapy, which incorporates both structural and strategic theories along with intervention are sound methods to engage families coping with adolescent substance abuse and behavioral dysfunction (Robbins et al., 2012; Szapocznik, Schwartz, Muir, & Brown, 2012).
The strategies for structural and strategic therapy model interventions applied to brief strategic family therapy shifts slightly to focus on reconfiguring the overall strategy to emphasize the transformation of family relationships for dysfunctional to an efficient, mutually supportive process. Therapists using this technique concentrate on helping families develop and enhance conflict resolution skills, behavior management skills, parenting and leadership skills, and blocking, directing or redirecting communications within the family network (Robbins et al., 2012).
The evolution of structural family therapy has made advancements in how therapists understand how relational issues affect areas like attachment theory and evolved the original concepts into new practices. For example, ecosystemic structural family therapy focuses on a systemic process (Lindblad-Goldberg, Jones, & Dore, 2004). Ecosystemic structural family therapists concentrate on an evidence-based process that focuses on families with adolescents and children suffering behavioral dysfunction. The primary goal is to aid families in addressing dysfunction and restore household homeostasis (Lindblad-Goldberg, Jones, & Dore, 2004).
Brief strategic family therapy models incorporate the core concepts of strategic family therapy and structural family therapy. The combination of both core models provides an evidence-based model designed to deliver treatment to families with young addicts (Robbins et al., 2012). By combining aspects of both strategic and structural therapy models, brief strategic family therapy increases therapeutic retention, and aids families comprehend and combat the dysfunction (Robbins et al., 2012; Szapocznik, Schwartz, Muir, & Brown, 2012). It is fair to note that although the model itself has undergone extensive research, there is still question as to the effectiveness on actually combating the actual addiction problem (Robbins et al., 2012).
Models Contrasted and Compared
Structural and strategic family therapy models share numerous similarities in the foundational concepts of practice. A unique identifier of each of these models is the systemic approach employed to understand pathology and by redirecting efforts from a psychoanalytic approach to focus on the individual in conjunction with the family network. In doing so, both models emphasize the importance of understanding how the intrapsychic world affects an individual’s health and integration into the family structure, and how changing interpersonal interactions aids the family in achieving successful outcomes in therapy. Further similarities include the target market [clientele] that both models cater to servicing. Both models emphasize understanding and treatment of dysfunction in family communications and interpersonal relationships that contribute to significant problems in young family members and continue to expand with emerging hybrid therapy models like ecosystemic structural family therapy and brief strategic family therapy (Robbins et al., 2012). A fair comparison of the theoretical approaches of both models is the intervention strategies both employ. In both models, key therapeutic techniques include joining with the family system and assisting the family in restructuring the family dynamic. It is important to state that although these models were developed to combat families with dysfunctional youth, therapists have successfully applied both models to clients outside this demographic.
In contrast to the similarities both models share, there are also fundamental differences. A primary difference between structural family therapy and strategic family therapy is the method in which each model applies changes to the family system. Structural family therapy models assert that relational interactions become altered by focusing on changing the dysfunctional family structure, whereas strategic family therapy models state that family structure will change organically once the relational strategies become modified.
Both models share unique strengths and weaknesses, and although these attributes exist in the similarities of the models, it is appropriate to separate them for comparison. Both models emphasize the importance of systems inside and outside the family structure by exploration, interpretation, comprehension, and modification of dysfunctional relation to environmental factors. Secondarily, the therapeutic objective of assisting the younger family member[s] and the entire family to change the dysfunctional systems and structures are the most important aspects of resolving family conflict and dysfunction. Although these issues are considered shared strengths, they also present weaknesses in therapy. Those weaknesses being the fact that both models focus highly on intrapersonal relations within the family system, they often fail to investigate and address the intrapsychic and emotional factors of individual family members involved in the dysfunctional network. A reasonable assertion of both models is the roots fo where they started. Both models were developed to focus on sociocultural and socioeconomic populations most commonly overlooked (Israelstam, 1988). For various reasons, both models have provided a looking-glass view of these communities by emphasizing the importance of diversity of race and class structure (Nichols, 2013).
In conclusion, one can quickly take note that structural and strategic family therapy models have made revolutionary advancements in the field of family therapy. The emphasis on evaluating and addressing the dysfunction in the family structure or system that allows the structure to operate outside of standard tolerances has not only opened the door to successful treatment of addiction in young family members but also applies to the treatment of adults suffering the same issues. Emphasizing focus on interpersonal relationships, communication, and hierarchal power struggles as a core aspect of family dysfunction and aiding families in implementing proper solutions to address these issues is a critical factor in successful treatment.
Structural family therapy models assert that relational interactions become altered by focusing on changing the dysfunctional family structure, whereas strategic family therapy models state that family structure will change organically once the relational strategies become modified.
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Considering this, what is structural Strategic Family Therapy?
The structural approach emphasizes family organizations composed of subsystems and focuses on boundaries between subsystems. The strategic approach focuses on repeating sequences of behavior, particularly those that break hierarchical rules through cross-generational coalitions.
One may also ask, what is the role of the therapist in structural family therapy? In SFT, therapists work to uncover any habitual patterns, routines, or behaviors that negatively impact family dynamics, and seek to establish healthier routines within family structures in order to create a dynamic, loving, stable home life for everyone.
Simply so, what are the main differences between Bowenian structural and strategic family systems theories?
The difference between the two therapies is that structural views the client and their family issues as symptoms whereas, the strategic therapy sees the issue not as a symptom but a as a real problem that mirrors the family’s functionality (Grand Canyon University, 2014). Grand Canyon University (2014).
What does it mean when a therapist joins a family?
In this form of therapy, the therapist “joins” the family in order to observe, learn, and enhance their ability to help the family strengthen their relationships; Systemic: The Systemic model refers to the type of therapy that focuses on the unconscious communications and meanings behind family members’ behaviors.
What techniques are used in family therapy?
There are a range of counseling techniques used for family therapy including:
- Structural Therapy. Structural family therapy is a theory developed by Salvador Minuchin.
- Strategic Therapy.
- Systemic Therapy.
- Narrative Therapy.
- Transgenerational Therapy.
- Communication Therapy.
- Relationship Counseling.
What are the key concepts of structural family therapy?
Structural family therapy utilizes many concepts to organize and understand the family. Of particular importance are structure, subsystems, boundaries, enmeshment, disengagement, power, alignment and coalition. Each of these concepts will be explored in the following section.
What is the goal of strategic family therapy?
The emphasis of the therapy is not on the individual but on the social situation or structure. The goals of strategic family therapy are to solve problems, achieve the family’s goals, and ultimately, change an individual’s dysfunctional or problematic behaviors.
What are the eight concepts of Bowen Theory?
Beginning with the fundamental concept of the nuclear family as the emotional unit, the other concepts — differentiation of self scale, triangles, cutoff, family projection process, multigenerational transmission process, sibling position, and emotional processes of society — are explained as they evolve out of the
How does change occur in structural family therapy?
Structural family therapy. Structural family therapy (SFT) is a method of psychotherapy developed by Salvador Minuchin which addresses problems in functioning within a family. An essential trait of SFT is that the therapist actually enters, or “joins”, with the family system as a catalyst for positive change.
When was structural family therapy developed?
What is family systems approach?
The family systems approach, also known as family systems therapy, is a form of psychotherapy that helps people resolve issues in the context of the family unit. When the whole family is involved, family system issues are truly addressed.
What are process questions in therapy?
The process question is a question aimed at calming anxiety and gaining access to information on how the family perceives the problem and how the mechanisms driving and maintaining the problem operate.
What is the goal of family systems theory?
Goals of treatment may vary depending on your family’s unique needs, but the main goal of family therapy is to achieve harmony and balance within the family system. This may involve building communication and problem-solving skills. Or it could involve learning to manage conflict.
What are the different types of family systems?
Let’s look closer at several types of family systems: nuclear family, matrifocal families, extended families, and blended families.
What are boundaries in family systems theory?
Families draw boundaries between what is included in the family system and what is external to the system. Boundaries occur at every level of the system and between subsystems. Boundaries influence the movement of people into and out of the system.
What are the basic components of a family system?
The key elements of a family system are its members + beliefs + roles + rules + assets + limitations + goals + boundaries + subsystems (e.g. siblings) + environment – a larger system of systems, or metasystem.
What are the basic goals of Bowen’s approach?
Two basic goals which govern Bowenian therapy, regardless of the nature of the clinical problem, are (1) the reduction of anxiety and relief from symptoms and (2) an increase in each member’s level of differentiation.
Who developed family systems theory?
Murray Bowen (/ˈbo??n/; 31 January 1913 in Waverly, Tennessee – 9 October 1990) was an American psychiatrist and a professor in psychiatry at Georgetown University. Bowen was among the pioneers of family therapy and a noted founder of systemic therapy. Beginning in the 1950s he developed a systems theory of the family.
What is family mapping in structural therapy?
Family mapping is a structure which provides the therapist and the marital couple with information about family of origin issues which can then be used as a therapeutic point of reference.
What is the Bowen family systems theory?
Bowen family systems theory is a theory of human behavior that views the family as an emotional unit and uses systems thinking to describe the complex interactions in the unit. It is the nature of a family that its members are intensely connected emotionally.
What is family system theory PDF?
Family systems theory places primary focus on exchanges of behavior that take place in a given moment of interaction between members of the family. The theory maintains that patterns of interaction between family members call forth, maintain, and perpetuate both problem and nonproblematic behavior.
Family systems therapy draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behavior is both often informed by and inseparable from the functioning of one’s family of origin.
Families experiencing conflict within the unit and seeking professional assistance to address it may find family systems therapy a helpful approach.
THE DEVELOPMENT OF FAMILY SYSTEMS THERAPY
Family systems therapy is based on Murray Bowen’s family systems theory, which holds that individuals are inseparable from their network of relationships. Like other psychoanalysts of his time, Murray Bowen was interested in creating more scientific and objective treatment processes as an alternative to conventional diagnostic frameworks and pathological language. Bowen believed all therapists had experienced challenges within their family of origin and that an awareness of this could help therapists normalize human behavior for people in treatment.
Bowen introduced family systems theory in the late 1960s after years of research into the family patterns of people with schizophrenia who were receiving treatment and the patterns of his own family of origin.
Traditional individual therapy frequently addresses the individual’s inner psyche in order to generate change in relationships and other aspects of life. Bowen’s theory suggests it is beneficial to address the structure and behavior of the broader relationship system, which he believed to play a part in the formation of character. According to Bowen, changes in behavior of one family member are likely to have an influence on the way the family functions over time.
FAMILY SYSTEMS THERAPY APPROACHES
Many forms of family therapy are based on family systems theory. Family systems approaches generally fall under the categories of structural, strategic, or intergenerational:
- Structural family therapy, designed by Salvador Minuchin, looks at family relationships, behaviors, and patterns as they are exhibited within the therapy session in order to evaluate the structure of the family. Employing activities such as role play in session, therapists also examine subsystems within the family structure, such as parental or sibling subsystems.
- Strategic family therapy, developed by Jay Haley, Milton Erickson, and Cloe Madanes, among others, examines family processes and functions, such as communication or problem-solving patterns, by evaluating family behavior outside the therapy session. Therapeutic techniques may include reframing or redefining a problem scenario or using paradoxical interventions (for example, suggesting the family take action seemingly in opposition to their therapeutic goals) in order to create the desired change. Strategic family therapists believe change can occur rapidly, without intensive analysis of the source of the problem.
- Intergenerational family therapy acknowledges generational influences on family and individual behavior. Identifying multigenerational behavioral patterns, such as management of anxiety, can help people see how their current problems may be rooted in previous generations. Murray Bowen designed this approach to family therapy, using it in treatment for individuals and couples as well as families. Bowen employed techniques such as normalizing a family’s challenges by discussing similar scenarios in other families, describing the reactions of individual family members instead of acting them out, and encouraging family members to respond with “I” statements rather than accusatory statements.
FAMILY SYSTEMS THERAPY AND THE GENOGRAM
A genogram, or pictorial representation of a family’s medical history and interpersonal relationships, can be used to highlight psychological factors, hereditary traits, and other significant issues or past events that may impact psychological well-being.
Bowen used genograms for both assessment and treatment. First, he would interview each member of the family in order to create a detailed family history going back at least three generations. Bowen then used this information to help highlight important information as well as any behavioral or mental health concerns repeating across generations. He initially believed it took three generations for symptoms of schizophrenia to manifest within the family, though he later revised this estimate to ten generations.
EIGHT INTERLOCKING CONCEPTS OF FAMILY SYSTEMS THEORY
Eight major theoretical concepts form the foundation of the Bowenian approach. These concepts are interconnected, and a thorough understanding of each may be necessary in order to understand the others.
These theoretical constructions include, in no particular order:
- Differentiation of self, the core concept of Bowen’s approach, refers to the manner in which a person is able to separate thoughts and feelings, respond to anxiety, and cope with the variables of life while pursuing personal goals. An individual with a high level of differentiation may be better able to maintain individuality while still maintaining emotional contact with the group. A person with a low level of differentiation may experience emotional fusion, feeling what the group feels, due to insufficient interpersonal boundaries between members of the family. Highly differentiated people may be more likely to achieve contentment through their own efforts, while those with a less-developed self may seek validation from other people.
- An emotional triangle represents the smallest stable network of human relationship systems (larger relationship systems can be perceived as a network of interlocking triangles). A two-person dyad may exist for a time but may become unstable as anxiety is introduced. A three-person system, however, may provide more resources toward managing and reducing overall anxiety within the group. Despite the potential for increased stability, many triangles establish their own rules and exist with two sides in harmony and one side in conflict—a situation which may lead to difficulty. It is common for children to become triangulated within their parents’ relationship.
- The family projection process, or the transmission of a parent’s anxiety, relationship difficulties, and emotional concerns to the child within the emotional triangle, may contribute to the development of emotional issues and other concerns in the child. The parent(s) may first focus anxiety or worry onto the child and, when the child reacts to this by experiencing worry or anxiety in turn, may either try to “fix” these concerns or seek professional help. However, this may often have further negative impact as the child begins to be further affected by the concern and may become dependent on the parent to “fix” it. What typically leads to the most improvement in the child is management, on the part of the parent(s), of their own concerns.
- The multigenerational transmission process, according to Bowen, depicts the way that individuals seek out partners with a similar level of differentiation, potentially leading certain behaviors and conditions to be passed on through generations. A couple where each partner has a low level of differentiation may have children who have even lower levels of differentiation. These children may eventually have children with even lower levels of differentiation. When individuals increase their levels of differentiation, according to Bowen, they may be able to break this pattern, achieve relief from their symptoms of low differentiation, and prevent symptoms from returning or occurring in other family members.
- An emotional cutoff describes a situation where a person decides to best manage emotional difficulties or other concerns within the family system by emotionally distancing themselves from other members of the family. Cutting emotional connections may serve as an attempt to reduce tension and stress in the relationship and handle unresolved interpersonal issues, but the end result is often an increase in anxiety and tension, although the relationship may be less fraught with readily apparent conflict. Bowen believed emotional cutoff would lead people to place more importance on new relationships, which would add stress to those relationships, in turn.
- Sibling position describes the tendency of the oldest, middle, and youngest children to assume specific roles within the family due to differences in expectation, parental discipline, and other factors. For example, older children may be expected to act as miniature adults within the family setting. These roles may be influenced by the sibling position of parents and relatives.
- The societal emotional process illustrates how principles affecting the emotional system of the family also affect the emotional system of society. Individuals in society may experience greater anxiety and instability during periods of regression, and parallels can be noted between societal and familial emotional function. Factors such as overpopulation, the availability of natural resources, the health of the economy, and so on can influence these regressive periods.
- The nuclear family emotional process reflects Bowen’s belief that the nuclear family tends to experience issues in four main areas: intimate partner conflict, problematic behaviors or concerns in one partner, emotional distance, and impaired functionality in children. Anxiety may lead to fights, arguments, criticism, under- or over-performance of responsibilities, and/or distancing behavior. Though a person’s particular belief system and attitude toward relationships may impact the development of issues according to relationship patterns, Bowen held them to be primarily a result of the family emotional system.
HOW CAN FAMILY SYSTEMS THERAPY HELP?
Family systems therapy has been used to treat many mental and behavioral health concerns. In general, it may be considered an effective approach for those concerns that appear to relate to or manifest within the family of origin. Family systems therapy has been shown to be effective with families, couples, and individuals.
This approach may be helpful in addressing conditions such as schizophrenia, alcohol and substance dependency, bipolar, anxiety, personality issues, depression, and eating and food issues.
LIMITATIONS AND CONCERNS
Though Bowenian family systems therapy is a popular mode of treatment that both therapists and people in treatment have attested to the effectiveness of the approach, at present there is a limited base of empirical evidence backing the approach. Though the evidence base is growing, more data—particularly from objective sources—may help confirm its efficacy.
A second criticism of the approach is the seemingly unwavering neutrality of its practitioners. Some mental health experts believe that by remaining neutral, unaffected, or silent at all costs, practitioners of family systems therapy may be giving tacit approval to any harmful behaviors individuals in therapy may be exposing themselves or other people to.