Salvador Minuchin's structural family therapy: effectiveness and limitations

Structural Family Therapy (SFT) was developed by Salvador Minuchin in the latter half of the 20th century and is still considered a viable and effective therapy approach today (Connell, 2010, p.1). It involves encouraging healthy proactive change within the family, with the therapist acting as the agent of change and taking into consideration the multicultural perspectives within a family (Connell, 2010, p.1). Structural family therapists believe that problems within the family are the result of a dysfunctional family structure, therefore, correcting the structure should alleviate the problems (Hecker & Wetchler, 2003, p.78).

Advantages and Disadvantages

Because of its focus on family structure and the roles of individuals within that structure, SFT has proven a promising means of treatment for many childhood and adolescent problems, especially when used to treat young adults who still maintain close contact with their families (Hecker & Wetchler, 2003, p.87). The therapy appears to be effective when dealing with young adolescents experiencing substance abuse, delinquency, or psychosomatic disorders such as anorexia (Hecker & Wetchler, 2003, p.90). However, its use for couples and marital problems has not yet been proven effective. There is also little that the therapy can offer to people who are not in close contact with their original family or in one-on-one situations.

Size and Age of Family Members

The size of a family can be particularly problematic for a therapist using SFT. Each family has its own structure and that could become more difficult to determine when there are a number of people all playing different roles within the structure. Similarly, age can become an issue with the therapy, especially if the roles have become so ingrained that the structure of the family becomes difficult to alter. However, SFT has been shown to be highly effective in treating drug addicts and anorexics, even when they are up to thirty years old if the parents are in charge of controlling the addicts' behaviors (Hecker & Wetchler, 2003, p.88).

Collaboration with Therapists from Different Theoretical Orientations

Many times structural family therapy must be used with other types of therapy that require a more one-on-one approach. A structural family therapist can work closely with a therapist in another discipline who is working individually with a family member to incorporate certain aspects into family therapy. Many times a person will be more willing to express him or herself in individual therapy than in family settings. In a family setting, multidimensional family therapy (MDFT) has expanded upon the SFT model and has been shown to be effective (Diamond, Hogue, Liddle, & Dakof, 1999, p.357). Since this method builds upon SFT, it is a natural fit for working together to build solutions. It is possible, of course, that many of the solutions another therapist suggests could be in direct conflict with the SFT methods. Therapists in other orientations could influence a change in an individual's role within the family, thereby undermining the work that has been made in an SFT setting. It is important for therapists in all orientations to agree on a course of action before proceeding and to work effectively together if they are going to be successful.