THEORIST: SALVADOR MINUCHIN
Salvador Minuchin is a physician and analytically trained child psychiatrist. He worked with Jay Haley for several years and they were greatly influenced by each other. Structural therapy is designed to release family members from their dysfunctional “stuck” patterns by altering the family structure so that new structures will develop.
- To strengthen the existing hierarchical structure or create a new effective hierarchical structure by helping parents function together as a cohesive executive subsystem
- To reinforce new subsystems and boundaries so that the family is able to solve future problems on its own and adjust the subsystems accordingly when new issues arise
- The primary goal is to alter the family structure, not to “solve problems,” however, once the family structure has been changed, problems are often solved
- Family Structure
- Covert set of rules that determines how the family members interact with one another and with others in their social system; these rules are resistant to change.
- Individuals, dyads, triads, and groups form subsystems within the family that perform specific functions. Some subsystems that individuals may belong to include: spousal, parent-child, sibling.
- Hypothetical dividers between family subsystems that alter throughout the family life cycle depending on circumstances. Boundaries range from rigid to diffuse.
- Rigid Boundaries
- Overly restrictive and permit little contact with outside subsystems; but can result in disengaged family systems.
- Diffuse Boundaries
- No clear boundaries; boundaries are permeable and allow open contact with other subsystems, but can result in enmeshed families.
- Clear (Healthy) Boundaries
- According to Minuchin, healthy boundaries are when there is an executive subsystem, i.e., parents maintain parental roles and children maintain child roles.
- Enmeshed families
- Loss of autonomous development due to blurring of boundaries and unclear subsystems.
- Disengaged Families
- Emotionally distant and disinterested family members.
- Isolation and disconnection that results from overly rigid boundaries.
- A covert alliance between two family members against a third.
- Cross-Generational Coalition
- When parents are unable to resolve problems between themselves, one parent enlists the support of his/her child, creating an alliance between a parent and child against the other parent.
- Parentified Child
- Child takes on the role of “parent” to their parent and/or younger siblings.
- Boundary Making
- A technique in which the therapist eliminates previous rigid or diffuse boundaries and assists the family in forming a functional and clear boundary.
- The technique of joining and forming a therapeutic alliance with the client.
- A form of accommodation in which the therapist mirrors (imitates) the family style and affect.
- Occurs when the therapist establishes rapport with members of the family and temporarily becomes part of the family system.
- A clinical technique where the therapist directs the family to demonstrate and recreate their typical interaction so that the therapist is able to observe and provide direction to modify the interaction.
- Mapping the System (Structural Map)
- An assessment tool used to provide a visual description of the family’s organization, structure, sequences, and interactions. Minuchin devised symbols that illustrate the qualities of the boundaries and coalitions.
- A technique in which the therapist adjusts his/her tone, volume, pacing, and choice of words to impact his/her message.
- Shaping Competence
- A method of increasing family members’ confidence in being able to solve their problems by pointing out what they are doing right, instead of focusing on mistakes.
- An intervention where the therapist joins with one individual or subsystem at the expense of others to unbalance the system. The goal is to interfere and change the relationships of members within a subsystem.
- Challenging Assumptions
- An intervention where the therapist challenges the way family members view their situation by offering an alternative perception. “When did you divorce your wife and marry your work?”
ASSESSMENT AND TREATMENT
- Assessment and treatment are intertwined
- Therapist joins with the family by being empathic and reducing the family’s anxiety
- Trust is built through the process of accommodation
- Therapist observes the family’s patterns of interactions
- Therapist utilizes enactment to allow the family to perform in session a specific problem and how they usually handle it
- Therapist creates a structural map of the family system (does not show the client, only for assessment purposes)
- Does not pathologize client, but defines dysfunction as a failure to adjust to changing circumstances
- Therapist works with structure he/she sees, not what family members describe
- The therapist strengthens existing hierarchical structures or creates effective hierarchical structures by helping parents function together as a cohesive executive subsystem
STANCE OF THE THERAPIST
- Position of Leadership
- Joining and Accommodating (Mimesis)