Model Description
The approach to the family as a system is reflected in the name of this therapy. The study of the structure of entities and relationships in the system always takes place under the auspices of integrity. Each person in the family is a critical part of the overall picture, and both personal qualities and the nature of interaction with other family members are essential (Minuchin & Nichols, 1998). How, when, and with whom family members interact is critical to understanding and subsequent therapeutic change in family structure.
The history of the creation of the theory and techniques of structural family psychotherapy is inextricably linked with the name of the outstanding psychotherapist Salvador Minukhin. In the late 1960s, S. Minukhin and co-workers conducted psychotherapy at the Wiltwyck School boarding school for boys with delinquent behavior (Colapinto, 2019a). Structural orientation was the best fit for solving the family problems of these adolescents – after all, the vast majority of them came from single-parent families. In addition, the problem-solving psychotherapy developed by Jay Haley and psychotherapy with the participation of the closest social environment of Ross Speck had a noticeable influence on the formation of the structural approach (Colapinto, 2019a). These researchers collaborated with Salvador Minukhin after he, in the early 1970s, led a psycho-educational consultation for difficult children in Philadelphia.
The technique of structural family psychotherapy is based on several critical theoretical positions: the family as a whole human system; the presence of subsystems within the family system; the existence of a system and subsystems of boundaries with specific characteristics; intervening behavior as a factor influencing individual family members; evolution of transaction patterns. Minukhin considered the family not as a sum of individuals or a group of individuals but as a whole, an organism (Colapinto, 2019a). Just as the amoeba is made up of organelles and the human being is made up of organs, the family organism is made up of individual members of the family.
In structural family therapy, therefore, the “patient” in the family and the problem or symptom is considered a reflection of the state of health of the family organism as a whole. Although the family itself may identify one of its members as a patient, a structured psychotherapist will consider him or her merely a carrier of the symptom (Finney & Tadros, 2019). Structural family therapy focuses on the social organization of the family organism. Moreover, the family performs its functions due to the presence of subsystems in it. In chronological order, there are three critical subsystems within the family organism: the marital, parental, and sibling subsystems (Minuchin & Nichols, 1998). Each contains a specific set of patterns, motives, and goals.
The boundaries of a system or subsystem are the rules that determine who and how participates in the interaction. At every moment in the family life cycle, all family members have specific needs related to the maintenance of vitality and age changes, that is, they need food, shelter, and security, as well as emotional participation, support, and care (Minuchin & Nichols, 1998). The family develops functioning methods to satisfy all these complex, sometimes conflicting needs. The requirements for the family system are constantly changing due to changes in its members.
Most of the problems are related to different aspects of these theoretical positions. The role of the family therapist is to assess the situation, the necessary intervention in established patterns of interaction, the combination of control over the situation with neutrality. However, interaction patterns can evolve and move to different levels (Finney & Tadros, 2019). Certain compromises, even unresolved conflicts that do not affect the sustainability of the whole system, are small changes associated with adaptation in the development process or changes of the first level.
Change of the second level involves transformation not only at the operational level but also at the structural level. Thus, it is impossible to correct the compromise found at the previous stage of the family life cycle, as in changing the first level, unmet needs require the search for entirely new ways of interacting (Colapinto, 2019b). Rebuilding the system and searching for alternative options for interaction requires some time. Family therapists of the structural direction consider the family system to function adequately if it provides mutual support and autonomy.
Providing a dynamic balance between multidirectional functions – providing support and autonomy – is always a compromise. The family structure must, first of all, correspond to existing needs (Minuchin & Nichols, 1998). Thus, only the question of whether a given structure can meet the needs of each family member at a given time and in given conditions makes sense (Finney & Tadros, 2019). In the case of a negative answer, the family system is considered dysfunctional, which is the goal of the intervention of family therapists.
Psychotherapy and intervention are inextricably linked to evaluation, as both processes are integrated into each other. In this case, as a rule, the system’s flexibility as a whole, resonant situations, sources of stress, and the possibility of changing patterns for the better are assessed. Since resonant and stressful situations lead to failures in the system and negatively affect each family member, the development of various physical and mental ailments is possible. This model prevents health disorders pathologies seeking to return the family to normal by a particular method.
Cultural and diversity factors have different manifestations in each unit of the system. They are integrated into interaction patterns with varying influences and should be identified during the evaluation phase. The therapist assesses various behaviors, and before the intervention allows the construction of a new therapeutic system, up to the stage of mimesis, the specialist takes into account cultural influences and their boundaries that cannot be crossed (Thayyil & Rani, 2020). This model is consistent with advanced cognitive-behavioral developments in psychotherapy, enabling professionals to apply them within a small community like a family. This model evaluates the problem of the community from the side of scarcity, namely, the lack of satisfaction of needs. However, to solve these problems, the model uses the family’s strengths, which actually defines it as a strength-based model. Examples of intervention contain different techniques: restructuring reality, complementarity, loosening an established system, marking boundaries, and changing the intensity of interaction.
Case Analysis
The advantages of the model, in this case, are manifested in the fact that there are only two people in this system so far. Therefore, aspects of interaction can be considered in the whole picture without involving other people. In addition, the family rests on solid and understanding relationships, which is a fundamental basis for success. The couple agrees to overcome obstacles, is ready for change, and is not mood for conflicts. In this case, there is only one subsystem – the marital one; however, when working with a psychotherapist, it is necessary to create a basis for creating a second parental subsystem for the future. Therefore, it is necessary to assess the boundaries of each family member and how external factors influence them. In addition, the interaction pattern must also be evaluated, according to which its level will be determined.
First of all, it is necessary to start a dialogue with each family member about what goal they have set, what they are doing to achieve it, and what, in their opinion, obstacles are encountered. During a dialogue with a psychotherapist, it is necessary to notice various verbal and non-verbal signs that may indicate hidden problems that are not voiced to the therapist or in general in the family. The inability to conceive a child has likely caused many psychological problems, while the main problem lies deeper. Assessing the prospects of becoming parents is also an essential point of discussion, as perhaps one of the family members does not fully imagine this role or is mentally afraid of receiving it.
The definition of boundaries, in this case, will be complex. First, it is needed to understand how boundaries are distributed within household responsibilities. Secondly, since the couple can interact in the workplace, there are also certain boundaries in this location. Finally, it is necessary to discuss the boundaries of recreation and the parental subsystem in the spare time and the future. By defining roles as a parent, it will be possible to identify potential problems that can be effective and interfere with conception now. Therefore, specific interventions will be required in the model of constructing dialogue or behavior. For example, perhaps one of the attitudes or misunderstandings prevents future parents from focusing on their future role. In this case, it is needed to rebuild or, more precisely, build the parental subsystem based on a successful marital one.
Consequently, despite their strong connection and understanding, this family needs to be reminded of complementarity after the source of the problem is identified. The essence of complementarity lies in the fact that one of the family members can even indirectly and implicitly influence the behavior concerning attempts to have a child. If something interferes at the stage of attempts, the other partner probably feels that it can constantly lead to a decline in the emotional state in the aggregate. A change needs to be made in the pattern of attempts to have a child, which did not bring the proper result for two years. Most likely, the problem lies precisely in this situation.
Diversity and cultural factors that may influence the family system patterns under consideration must be integrated into the process of demarcation and patterning. Full compliance of views and support may hint that fundamentally the couple has no disagreements on cultural aspects, but perhaps it was in the issue of replenishing the family that they could manifest themselves. Against the background of constant good communication, a habit has formed that eliminates conflicts on almost any issue. Accordingly, where these conflicts can and should arise in order for the couple to compromise and a solution, they do not arise, and a stupor form. The reasons likely lie in cultural factors, but only deep psychoanalysis of a specialist during structural therapy can accurately show this fact.
References
Colapinto, J. (2019a). Structural family therapy. Encyclopedia of Couple and Family Therapy, 2820-2828. Web.
Colapinto, J. (2019b). Mapping in structural family therapy. Encyclopedia of Couple and Family Therapy, 1766-1767. Web.
Finney, N., & Tadros, E. (2019). Integration of structural family therapy and dialectical behavior therapy with high-conflict couples. The Family Journal, 27(1), 31-36. Web.
Minuchin, S., & Nichols, M. P. (1998). Structural family therapy. In F. M. Dattilio (Ed.), Case studies in couple and family therapy: Systemic and cognitive perspectives (pp. 108–131). Guilford Press.
Thayyil, M. M., & Rani, A. (2020). Structural Family Therapy with a Client Diagnosed with Dissociative Disorder. Indian Journal of Psychological Medicine, 43(6), 549-554. Web.