Techniques and Interventions

 

There are a few ways the therapist interacts with the family system. He or she could see himself or herself as a teacher who offers advice and input but allows the family to then digest the information and find ways to put it into practice that fit their context and personality. The SFT wants to build a mutual respect and therapeutic alliance with each member in the family individually so these corrective sandwiches provide a time to offer feedback while still maintaining a working relationship. SFT’s are goal-oriented and strengths based so there treatment plans need to reflect progress towards the family’s goals. There are seven techniques specifically used in Structural Family Therapy:
 

Joining and accommodating—As mentioned in the Role of the Therapist section, joining means forming a relationship with each individual family member and giving them equal respect while also keeping in mind the structural hierarchy such as parents and siblings.

 

Enactment- A common tool used in enactment is role plays. A therapist might ask the participants to reenact a situation that occurred and then can implement a change by providing input and ask them to try it over again. After role-plays occur, the family reflects on how the changes produced different results compared to their initial reactions.

 

Structural mapping- A common tool used in mapping is a family genogram. In addition to being extremely helpful in finding the structure and hierarchy of the family a genogram can also be used to display the type of relationships that occur in each family system.

 

Highlighting and modifying interactions—This will largely be dependent on the therapist’s observation skills. Here the therapist is pointing out inconsistencies in what is said or people’s reaction and behaviors compared to what they have said. They might also point out when individuals are blaming or forming triangles to manipulate a situation. The therapist may need to interrupt a family member if that person keeps interjecting and not allowing others to finish. The main point of this technique is to consider the process of how things are being said rather than the content of what is necessarily being said.
 

Boundary making-Often times boundaries need to be re-drawn within families. Sometimes these conversations will take place in private with a therapist but only after beginning sessions where everyone has provided input so the therapist doesn’t appear to be taking sides. Families that are too reliant or intrusive and dependent on each other may need to foster greater independence. This could be true when an adult child gets married and makes a new family with their spouse but the parent is unhappy with the new distance and finds themself unsatisfied with the family dynamic. A therapist might need to encourage this family to create new boundaries that are more understanding to the life cycle of their family growing.
 

Unbalancing- Unbalancing may see counterintuitive to SFT since there is emphasis placed on mutual respect for each individual but in balancing the therapist might temporarily take sides with one person to help exaggerate a solution or create an environment of greater understanding. The therapist will use their authority as the facilitator and mediator to realign the relationships if needed and possible.
 

Challenging underproductive assumptions— There may be times when a therapist does need to correct or challenge the way an individual might be perceiving their family interactions. Sometimes the SFT may offer a “corrective sandwich,” where they initiate with a positive comment, then give a constructive criticism and again end with a positive comment. Similarly a “stroke and kick,” is when the therapist might shed one characteristic in a positive light to the individual it pertains to but points out how it is dis-helpful to the others when talking to the ones it effects. The hope is that as the family member’s views are corrected it might also help how they interact with the others in their family.

 

(Nichols, 2014 and Stupart, 2015)