STRUCTURAL AND STRATEGIC FAMILY
THERAPY
The theoretical and operational facets of our
therapy are derived primarily from structural family therapy and
certain aspects of strategic therapy.* While there are differences
between these ap-proaches, they also share certain commonalities.
As a rule, both schools subscribe to the following view of the family or couple:
1.
People are seen as
interacting within a context—both affecting it and being
affected by it.
2.
The family life cycle and developmental stage are
im-portant both in diagnosis and in
defining therapy strategy—a problem
family being seen as stuck at a particular stage in its development.
3.
Symptoms are both system-maintained and
system-main-taining.
4.
The family or couple can change, allowing new
behaviors to emerge, if the overall
context is changed. Further, in order for individual change to occur, the interpersonal system itself must change. This would permit different aspects of such
family members' (potential)
-character- to come to the fore.
Both schools also regard
therapy and the therapist in the follow-ing ways:
1.
Treatment is viewed pragmatically, with an eye
toward what -works.-
2.
Emphasis is on the present rather than the past.
3.
Repetitive behavioral sequences are to be changed.
4.
While structural therapists may not be as symptom-focused as strategic therapists, both are much
more symptom-oriented than
psychodynamic therapists.
5.
Process is emphasized much more than content. This includes interventions that are nonverbal and
noncognitive—in a sense, -doing away
with words.- Such interventions are derived from viewing the system from a -meta- level and recognizing that verbalizations, per se, by therapist or
family are often not necessary for
change.
6.
The therapist should direct the therapy and take
re-sponsibility for change.
7.
Diagnosis is obtained through hypothesizing, interven-ing, and examining feedback.
8.
Therapeutic contracts, which relate to the problem
and the goals of change, are
negotiated with clients.
9.
Interpretation is usually employed to
"relabel- or re-frame- rather
than to produce -insight.-
10.
Behavioral tasks (homework) are routinely assigned.
11.
Considerable effort may go into -joining" the
family positively and reducing
apparent -guilt- or defensiveness. This is more than simply -establishing rapport,- as it is often done selectively with particular family members and in
line with specific therapeutic goals.
12.
Therapy cannot usually progress from the initial
dys-functional stage to a "cure-
stage without one or more inter-mediate
stages, which, on the surface, may appear dysfunctional also. For instance, a therapist may have to take
sides with a spouse, thereby "unbalancing- the couple in a way
opposite from which it entered treatment, in
order to restabilize at a point of equality.
13.
Therapy tends to be brief and typically does not
exceed 6 months.
It may be apparent that some of these points are
shared by other, more active interpersonal
therapies also, such as the behavioral and
