Structural versus Strategic Family Therapies

Introduction
From the onset, it would be prudent note that the family systems theory serves as a basis upon which diverse family therapy forms are founded. It therefore follows that examples of family therapy forms are inclusive of; structural therapy, strategic therapy, and intergenerational therapy. This text concerns itself with two forms of family therapy, i.e. structural therapy and strategic therapy. In so doing, it will not only highlight how they differ, but also the strengths and weaknesses of each approach. Further using a structural family map, an example of a family in my practicum will be provided and the most appropriate therapy for the said family recommended.
Discussion
According to Jimenez, Hidalgo, Baena, Leon, and Lorence (2019), in systemic family intervention, structural family therapy - which was originally formulated by Minuchin - happens to be a rather dominant approach. In the words of the authors, this particular approach focuses “on achieving a healthy hierarchical family organization, where there are different subsystems with their limits and boundaries” (Jimenez, Hidalgo, Baena, Leon, and Lorence, 2019, p. 125). Thus, the main concern on this front happens to be the patterns, behaviors, as well as relationships within families and how they are portrayed within therapeutic sessions. Such an understanding comes in handy in attempts to not only come up with a family structure, but also conduct an evaluation of a family. It should also be noted that as Shueman and Wolman (2012) point out, the family structure does have subsystems. Subsystems in this case could be inclusive of, but they are not limited to, sibling or parental subsystems. In seeking to examine the said subsystems, a therapist could apply a wide range of activities – with one example being role play in session. On the other hand, when it comes to strategic therapy (which was developed by, amongst others, Cloe Madanes, Milton Erickson, and Jay Haley), the focus is on what Winek (2009) refers to as the examination of “family processes and functions, such as communication or problem-solving patterns, by evaluating family behavior outside the therapy session” (p. 97). Towards this end, according to the authors, some of the therapeutic techniques that could be deployed on this front are inclusive of problem scenario redefinition or reframing. Further, the authors also observe that in seeking to come up with desired change, paradoxical interventions could also be deployed.
Each of the approaches highlighted above has unique strengths and weaknesses. To begin with, when it comes to structural therapy, one of the main goals is to promote positive interactions within the family with the overall intention of ensuring that pressing issues are overcome. This is accomplished by pursuing structural changes within the dysfunctional family. In my opinion, this approach could help because in some instances, and as Shueman and Wolman (2012) point out, “problems and solutions develop on a series of hierarchal, subsystem, and architectural influences within the household that affect the behaviors of individual family members” (p. 107). The approach, thus makes it possible for the therapist to shift power dynamics. As a matter of fact, Metcalf (2011) points out that the approach could be very effective in scenarios whereby there is a concern about the unhealthy behaviors being exhibited by children. However, it would be prudent to note that the approach does have some weaknesses, this is more so the case given that it largely makes use of interventions that could be deemed active, i.e. role plays. Some participants may feel uncomfortable with such interventions. This could frustrate therapeutic goals given that each member may be required to participate. On the other hand when it comes to strategic family therapy, one strength of this particular form of family therapy is that change could be achieved in a rapid manner. Indeed, according to Rasheed, Rasheed, and Marley (2010), “strategic family therapists believe change can occur rapidly, without intensive analysis of the source of the problem” (231). However, the avoidance of in-depth analysis of the concern could leave a number of potent emotional concerns unexplored. However, the approach makes it possible for the therapist to be rather direct. Also, in this case, the change experienced in the family realm could have a more ‘naturalistic’ feel owing to the approach’s focus on the own awareness of the family. It should, however, be noted that the approach could be ineffective in those instances where there is no clear definition of family goals. This could occur when family members do not share the same perspectives of key goals. Further, without active commitment of family members outside of the therapeutic sessions, the approach might be ineffective.
Structural Family Map
John is 9 years old. He is the eldest of three children. John’s mother and father divorced 10 years ago. John’s mother remarried. John claims that his step father does not love him. He claims that he is often discriminated against in the family and that his step-father loves his sisters more and gives them his undivided attention. John’s grades at school have been on the decline. His teachers point out that he likes to keep to himself while in school. John is a member of a children’s choir in the church the family attends. John’s father says john does not respect him and has in the past told him, to his face, that he is not his real dad.
(See map below)
Real Mother
John
9 years
Father
Sister 1
6 years
Sister 2
4 years
Church
School
Stepmother
I would recommend the structural family therapy in this case. This is because the approach would largely focus on an evaluation of the family structure and examine key patters, behaviors, as well as relationships within the family. In my opinion, this would offer the best opportunity ensure that dysfunctional relationships within this particular family are disrupted.
Conclusion
The text above demonstrates that family systems theory is a basis for various therapy approaches. It would be prudent to note that each of the approaches highlighted in this text has its own unique weaknesses and strengths. Towards this end, the selection of one approach over another ought to be founded on the specific presenting concerns as well as therapeutic objectives.
References
Jimenez, L., Hidalgo, V., Baena, S., Leon, A. & Lorence, B. (2019). Effectiveness of Structural–Strategic Family Therapy in the Treatment of Adolescents with Mental Health Problems and Their Families. Int J Environ Res Public Health, 16(7), 125-127.
Metcalf, L. (2011). Marriage and Family Therapy: A Practice-Oriented Approach. Springer Publishing Company.
Rasheed, J.M., Rasheed, M.N. & Marley, J.A. (2010). Family Therapy: Models and Techniques. SAGE Publications.
Shueman, S.A. & Wolman, B.B. (2012). Handbook of Family and Marital Therapy. Springer Science & Business Media.
Winek, L.N. (2009). Systemic Family Therapy: From Theory to Practice. SAGE Publications.