Family therapy theories view symptoms as expressions of dysfunction within the family system. Developed by Salvador Minuchin, Structural Family Therapy (SFT) is centered on the idea that families have an underlying organization, or structure, that influences interactions among family members. The elements of this structure (ie the roles, rules, hierarchies, and boundaries) either promote healthy interactions or dysfunctional ones.
Structural family therapists take a straightforward active role in reorganizing the family structure so that healthier interactions can emerge. Rather than remaining neutral or distant, the therapist often "joins" the family system. This allows the therapist to become a temporary part of the family structure, making it easier to guide changes from within the family. During the joining process, the therapist asks questions about the family, shows support, and sets expectations for treatment using the emotional tone and communication style of the family to build rapport.
SFT-specific interventions include:
Mapping – The therapist collaboratively creates a visual depiction of the family’s rules, structures, patterns, and interactions between the subsystems.
Unbalancing- This intervention involves the therapist intentionally aligning with one family member or subgroup to temporarily shift the balance of power. The purpose of this is to empower a marginalized member, challenge a dominant member’s control, and break up dysfunctional alliances.
Enactment – The therapist will have family members act out interactions or situations rather than just talk about the problem. This allows the therapist to observe the interactions and problems that emerge in real-time. As the family acts out the scenario, the therapist may intervene by providing feedback or redirection. Enactment can also be used to practice new, healthier ways of interaction.
SFT can be particularly effective with high-conflict families, adolescent behavioral problems, and difficulties connected to major family transitions.