Structural Family Therapy, Research Paper Example

The theory of structural family therapy can be broken down into two basic steps. Firstly, there is an attempt to delineate the precise structure of a given family unit, grasping the various relations and interactions that constitute its form. Secondly, therapy – understood as a certain intervention with the intent to ameliorate the lives of families with problems – attempts to change this very structure, insofar as such a change is viewed as a means of improving the situation. As Levin et al. clearly recapitulate the concept, “Structural family therapy is an approach that seeks to elucidate and change the structure of the family system.” (2001, p. 172) Accordingly, whereas structural family therapy is clearly based on a concept of change and the attempt to re-wire family relations and interactions, such change cannot be initiated without a clear account of the given family structure itself. In this regard, the theory is not primarily or foundationally based on the possibility of change, but rather is grounded on the notion that there are clear and stable interactions and relations that constitute the family structure, in other words, interactions and relations that allow the family to be posited as a structure. This entails that the stability of the structure itself is the pre-condition for change and the affectivity of change. In a further sense, however, effectiveness of change concomitantly presupposes another structural stability –the successful family unit can be changed to a different structure that maintains constant and healthy interactions and relationships. In this regard, let us suggest that family structure therapy is based on a notion of change that presupposes two static structures in order to be effective: firstly, the stability of the structure that it must identify in its negativity, i.e., the reasons for therapy, and the problems in the familial relationship; secondly, the stability of the proposed structure that will resolve the tensions of the initial structure. Change in family structure therapy is merely in this sense the shift from one stable family structure to another. The following essay shall argue for this account by both taking into consideration and critically evaluating the steps that constitute what may be termed the process of family structure therapy, which is the movement from one clearly defined structure to another through the means of change.

Ostensibly, for family structure therapy to have theoretical and practical merit, the presupposition that the dysfunctional family structure has a consistent set of relationships and interactions must be justified. Accordingly, this approach moves away from individualistic accounts of family therapy, realizing that interaction and relation is the key issue to be identified and resolved in theory and practice.

In other words, the therapist who practices this form of therapy must attempt to delineate exactly what such relationships and interactions are in a given case. The success of the approach therefore rests on the therapist’s ability to identify these structuring elements of family life; furthermore, the therapist presupposes that such a structure exists. For Lee, family structure in this approach “represents the power, patterns, and the organization in the family. Each family has its own rules of interacting (or not interacting) with each member. Family structure is formed on the basis of interaction patterns and dynamics. Each family member has roles and functions in varied positions within different family subsystems.” (2011, p. 230) In this regard, the task of the therapist is basically to bring to light this complex nature of relationships that constitute the familial unit, in order to identify where possible problems lie: this structure is key precisely because “the way a family is structured defines how the family deals with a problem from inside or outside the family.” (2011, p. 230)

Accordingly, this theory essentially makes key presuppositions in its account, which are abstracted by the concepts of power/hierarchy and the key notion of boundaries – all families are comprised of various notions of power and its conceptual corollary of boundaries. The discernment of the location of power in this structure is crucial insofar as “in a family, the person with the most power makes all of the final decisions and takes responsibility for the outcome of the family dynamics.” (Lee, p. 231, 2011) In other words, it is the possibility of power itself that makes the structure possible, that is, that gives the family structure its own continuity and allows one to discern stable patterns. In this regard, power and hierarchy prevents the very possibility of change in the family structure. This is clearly what leads to problems: the consolidation and constancy of power prohibits the change towards an ameliorated situation and family interactions; the family structure by its very nature restricts change. Another crucial related concept is thus that of boundaries, which can be viewed as a certain symptom of power within the structure. As Lebow notes, “boundaries are the rules defining who participates and how they participate in various operations, thus regulating the amount and kind of contact between family members.” (2008, p. 314) In this regard, boundaries are the real manifestation of the power that is present in the family unit – the structure appears precisely because power concomitantly needs to form such boundaries. Two extremes of such boundaries, as Lebow notes, are termed in the literature as “enmeshment” and “disengagement” respectively. (2008, p. 314) In the case of the latter, “families act like they have little to do with each other, leaving the individuals substantially disconnected” (Lebow, 2008, p. 314), whereas in the case of the former “family members intrude into functions that are domain of other family members.” (Lebow, 2008, p. 314) It is important to note, however, that such a concept of boundaries, to maintain any consistency, needs a constant source of power and hierarchy that allows for these boundaries to remain in their current state.

As Lebow observes, “structural family therapy aims to move families away from the extremes of enmeshment and disengagement toward boundaries that are flexible and fit with the family’s life and situation.” (2008, p. 314) In other words, the notion of change at stake seeks to replace one notion of structure with a more therapeutically “healthy” account of structure. There is thus a structure which is more conducive to successful family life – this is a structure that is not radical, but essentially more conservative in its very structure, following such a notion of flexibility. Change, in this sense, relies on the re-shaping of structural lines.

Accordingly, change must result from a critique of power within the structure, because it is precisely a given power structure that allows the boundaries to exist as they are. In other words, the boundaries themselves are not contingent appearances; they are the byproduct of the particular power and hierarchy that is present in the family structure. This can help clarify how change functions within this setting, and how the therapist defines and utilizes change. The therapist has to work in three steps: he/she has to identify the problems; he/she has to identify the resolution; he/she has to realize the passage from the problem to the resolution. This third step is the locus of change that exists between the lines of the theory.

In Dufang’s account of Munchkin’s view of family structure therapy, the latter is summarized as follows:  “therapy is directed toward changing the organization of the family. When the structure of the family group is transformed, the position of members in that group is altered accordingly. As a result, each individual’s experiences change.” (2001, p. 134) At the same time, it is crucial to note that the change experienced is a shift from one given family organization to another. Whereas the theory and techniques to realize this change result in a different family structure, it is nonetheless a movement from one structure to another – a new form of organization is the desired teleology of this approach. Change is therefore effective in realizing this new structure. For example, the question of which member of the structure is most likely to bring about change thus seeks to identify the constant source of power and hierarchy within the family unit – change occurs by shifting this locus of power, or re-construing the attempts at its possibilities to form boundaries, and moreover, the type of boundaries it realizes. In this regard, we can understand change in family structure therapy as a certain re-inscription of the very site of power within the family structure, with the clear consequences of re-structuring organization.

In this regard, change within family structure therapy operates between two staticities of structure, and furthermore, according to the presupposition of such constancy of family structure in their relations and interactions. Change for the structural family therapist is essentially merely a temporary phase in the therapeutic process: the therapist realizes that change is essentially a means towards an end. For insofar as the anterior and posterior structures of the process need to be identified in terms of problem identification and resolution, change becomes a means by which to realize the movement from one static structure to the next; change is a step from one static picture to the next. Whereas obviously, as Lebow stresses, the family structural therapist may attempt to pursuer more lax notions of powers and boundaries as an approach to improve the life of the family, this nevertheless does coincide with an attempt to eliminate any notion of power and boundary whatsoever. In this regard, the family is primarily a static structure and must always maintain a basic consistency. Rather, such structure must be not made so rigid, it must remain malleable and plastic, while still maintaining its basic form and integrity as a structure – this can be understood as the basic aim of change within this therapeutic theory and practice, namely, as a point of transition from one form of organization to another.

References

Dufang, C. (2001). Family Therapy of Alcoholism. In: S. Zimberg, J. Wallace, S.B. Blume (eds.) Practical Appraoches to Alcoholism Psychotherapy. New York: Plenum. 134.152.

Lebow, J. (2008). Twenty-First Century Psychotherapies: Contemporary Approaches to Theory and Practice. Hoboken, NJ: John Wiley and Sons,

Lee, Y.T. (2011). Structural Family Therapy. In: L. Metcalf (ed.) Marriage and Family Therapy: A Practice-Oriented Approach. New York: Springer. 229-254.

Levin, J.D., Culkin, J. and Perrotto, R.S. (2001). Introduction to Chemical Dependcy Counselling. North Bergen, NJ: Jason Aronson Inc.