Structural Family Therapy Interventions - A Roadmap via Circular Questioning, Enactments and more

If you are looking for Structural Family Therapy Interventions, don't miss the video and PDF Handout that goes with it.

Understanding Family Systems Therapy Interventions

Family Systems Therapy is a unique approach to mental health treatment and psychotherapy that views the family as a complex system with its own rules, roles, and power dynamics. It is not a therapy that can be improvised or conducted without a clear strategy. Salvador Minuchin, a pioneer in the field, compared being a family therapist to a chess master entering a competition with a strategy and a plan. This article aims to provide a comprehensive understanding of Family Systems Therapy, its goals, techniques, and the essential tools required for effective therapy sessions.

Strategy in Family Systems Therapy

Family Systems Therapy is not a process that can be conducted on the fly. It requires a well-thought-out plan and strategy. The therapist must have a clear understanding of the family dynamics, the roles of each family member, and the issues that need to be addressed. This approach is fundamentally different from individual therapy, where the therapist works one-on-one with a client. Family therapy can be chaotic due to the number of people involved, making it crucial to have a roadmap and a clear direction.

Understanding the Goals of Family Systems Therapy

The broad goals of Structural Family Systems therapy are:

• Modify The Role Of The IP
• Push for Clearer Boundaries
• Increase Flexible Transactions
• Improve Conflict Negotiation Skills

If you are looking for Structural Family Therapy Interventions, don't miss the video and PDF Handout that goes with it.

How Do You Assess A Family In Structural Family Systems Therapy?

Assessment is a critical initial step in Family Systems Therapy. It involves gathering comprehensive data about the family's dynamics, structure, and patterns of interaction. The therapist uses both the intake data and observations from the initial sessions to understand the family's organization and hierarchy, communication patterns, resonance, the position of the identified patient (IP), and their conflict resolution skills. For instance, the therapist might observe who initiates conversations, who interrupts, who speaks the most or least, and how family members respond to conflict. The therapist also pays attention to subtler cues, such as seating arrangements during sessions, which can reveal underlying power dynamics and relationships within the family. This assessment phase is crucial as it provides the foundation for the therapist's understanding of the family and informs the subsequent therapy process.

The tool that I highly recommend you use as part of your assessment is Family Mapping, this creates a visual image of the whole family, highlighting where the adults and children are in relationship to each other, in terms of boundaries and distance.

Structural Family Therapy Interventions

This video and blog is an overview of some of the more fundamental structural family therapy techniques and do not include other important interventions like reframing or paradoxical interventions. If you leave me a comment and want more on how to create a reframe or strengthening your understanding of paradoxical interventions, I'll get on it!

Assessment and Observation

Assessment and observation are crucial in the initial stages of therapy. The therapist uses the intake data and observations from the first few sessions to understand the family dynamics. This includes observing the family's organization, communication, resonance, the position of the identified patient (IP), and their conflict resolution skills.

I think observational data is really underrated but in structural family systems therapy we still use it a fair amount when I was running a treatment center for teenagers I used observational data every week so I surveyed every member of Staff whether they were clinicians or not and asked them to answer various questions about the clients that were staying with us questions about what they had observed and seen so you didn't need to be a clinician to do this I was asking questions like

• How would you rate their mood on a scale of one to ten this week?
• Did you notice if they were eating healthily this week?
• How did they seem to get on with other clients?

These were all put on a scale of one to ten and this overly complicated spreadsheet would crunch all of those numbers from every staff member, average the data out and then it would spit out these very lovely charts that gave us another way to think about how clients were progressing over their stay. Parents would love this I think I drove my team nuts when I was building it but that was valuable data to go alongside our more traditional ways of measuring such as you know the OQ and MMPI. Structural Family Systems is quite famous for having us think about observations um in the form of where people sit in the room a family can't tell us what their structure and hierarchy are like because they're not thinking about it and they've no idea really what we mean they can often show us and the idea is that where people sit in the room is showing us a little bit about the structure

Joining

Joining is the process of building trust and rapport with the family. It involves connecting with the family members and understanding their perspectives. This process is crucial for the therapist to become a part of the system and facilitate change.

The family is most likely to change when they trust you and know you so joining is a vital skill but it's also not something that you have to learn how to do because you're a therapist and can be social and interactive - so ... you've got this one already.

Joining isn't really one technique or method is encompasses a variety of strategies and techniques that we use to connect with the family. Joining might not necessarily mean joining with all of the family all of the time. One variation of joining might involve me aligning with one family member and sometimes aligning with one family member against another family member. I might join with a silent and moody teenager if I notice one parent starting to lay into them asking this team to answer my questions or to sit up straight or explain something to me.

I'd join the teenager and say "You know, I don't I don't really think Jimmy wants to talk right now"...." Is that right Jimmy? Yeah? Is it ok if I check in with you later though?"

Jimmy's hopefully gonna feel that I'm on his side in that moment but I've also joined with him against mom who might not be used to Jimmy having backup like that so you're going to get lots more information here and does she look offended does she look flustered is there a flicker of anxiety there and if so that might mean that there is some friction which is a sign that the system is pushing back against a change that you tried to make

Circular Questioning

Other Blog Posts You Might Like: How to Use Circular Questioning in Family Therapy

Circular questioning is a technique used to uncover the underlying dynamics within the family. It involves asking questions that encourage family members to consider their relationships and interactions from different perspectives.

I've made an entire video and a $9.00 mini course on circular questioning because is that important but I still have to include it in this blog post because it is such a vital skill that you will need in your sessions. Especially if you want to find out what the problem is that you're going to be focusing on during treatment and the ways that people interact around that problem.

The opposite of circular questioning is linear questioning and linear answers are sort of one-dimensional and flat:

"We are here because Johnny is depressed"

Circular Questioning invites multiple dimensions and interactions between other family members if you're very persistent and ask these questions you might get an answer that sounds more like this:

"When my partner and I fight Johnny seems to act in a very depressed manner retreating to their bedroom which makes us feel very concerned so we turn our focus to Johnny and help them, now that you mention it actually stops us from fighting I notice I remain more worried about Johnny over the next few days but my partner seems to give up on our relationship when I do that which often creates more emotional distance and more conflict"

With just the way you ask questions you can get so much more information out of your first sessions and you can set up the rest of your treatment because you know already some of the patterns of interactions that you need to replace.

Some Circular Questioning Examples

Some of the circular questions I might ask to get a response like that include

• What is going on before Johnny acts depressed?
• Has it always been this way?
• What happens after Johnny is depressed and goes to his room?
• Who does what when Johnny goes to his room in a depressed state?
• Who's the first person to check on him?
• Then what happens?
• Who agrees with that?
• ...and what happens after that?

The big Mantra there is and then what happens and then what?... and then what?

Definitely Check out the other things I've written and made about Circular Questioning here

Restructuring

Restructuring involves reshaping the family dynamics to promote healthier interactions. Restructuring in Family Therapy is kind of like being a traffic cop for family interactions, it is about stepping in to make adjustments in the patterns of interactions that you are seeing going on in the session.

If you've got a family where the members are so tightly connected, so enmeshed that they lose their individuality - and FYI I can probably imagine this family sitting all together on the same sofa with the IP in the middle. This is the sort of family in which every time you ask little Johnny a question his mom or dad will jump in and answer for him whenever somebody speaks on behalf of another person it's a pretty solid sign of a measurement restructuring would be blocking her and saying

"hold on a second mom I would love to hear your thoughts in just one minute"

The restructuring part would be me encouraging Johnny to answer the question himself so I'm helping establish a boundary between Mom and Johnny I'm telling Mom that Johnny doesn't need her to speak for him anymore and we're making them more separate so I'm restructuring because I'm firming up that boundary

Enactment,

We've all heard of the term enactments and I tend to find that therapists are a bit reluctant to use them some of the myths I hear in my supervision groups are things like:

• well we have to give up control of our session and turn it over to the family
• things get more intense if we let the family talk without interrupting when it gets to a certain level
• we're not keeping a safe space we're not keeping the peace
• other people think that they're just legitimately complicated and hard to implement successfully

Hopefully, this discussion is going to help you see that none of that is necessarily true. Enactments in the broadest sense of the word are anyway that a therapist can get a family to interact with each other to observe natural family dynamics as if you weren't there.

I tend to put things on spectrums with very simple enactments at one end of the spectrum: these are things that you probably do already without even knowing their enactments. And far more structured and complicated ones at the other end.

A really easy example of something at this lower end is just asking the family to discuss amongst themselves what they think the problem in the family is and then looking at your shoes or looking down so that they don't make eye contact and talk to you. That's a way to encourage them to talk to each other.

You can be a little more transparent or a little more clear and say "

"I would like you to discuss amongst yourselves what do you think the problem is in your family while you do that I will be silent and just observe for a few minutes"

At the more complicated end you can assign them a task like discussing a vacation nation that they would all agree on and watch as they discuss to notice patterns and roles.

The therapist plays a crucial role in Family Systems Therapy. They are responsible for guiding the family through the therapy process, facilitating communication, and helping the family restructure their dynamics. The therapist uses various techniques and interventions to help the family understand their issues and work towards resolving them.

FAQs

Q1: What is the main goal of Family Systems Therapy?

A1: The main goal of Family Systems Therapy is to address issues within the family structure and hierarchy and create a healthy family structure with clear boundaries and roles.

Q2: What is the role of a therapist in Family Systems Therapy?

A2: The therapist in Family Systems Therapy guides the family through the therapy process, facilitates communication, and helps the family restructure their dynamics.

Q3: What is 'joining' in Family Systems Therapy?

A3: Joining is the process of building trust and rapport with the family. It involves connecting with the family members and understanding their perspectives. Joining is the process of building trust and rapport with the family. It involves connecting with the family members and understanding their perspectives. This process is crucial for the therapist to become a part of the system and facilitate change.

Q4: What is 'circular questioning' in Family Systems Therapy?

A4: Circular questioning is a technique used to uncover the underlying dynamics within the family. It involves asking questions that encourage family members to consider their relationships and interactions from different perspectives.

Q5: What is 'restructuring' in Family Systems Therapy?

A5: Restructuring involves reshaping the family dynamics to promote healthier interactions. It is a crucial part of the therapy process in Family Systems Therapy. Restructuring involves reshaping the family dynamics to promote healthier interactions. Restructuring in Family Therapy is kind of like being a traffic cop for family interactions, it is about stepping in to make adjustments in the patterns of interactions that you are seeing going on in the session.