Structural and Strategic Family Therapy Essay

Week 4: Structural and Strategic Family Therapy
Individuals are born into families, grow and develop in families, and live most of their lives in families. Therefore, it makes sense that clients are best understood within the context of the family system.

——Dr. Candice Knight, Psychotherapy for the Advanced Practice Psychiatric Nurse

The family system is a social unit that is based on unique relationships and roles. Structural and strategic therapies are important, because they offer unique insights to the theoretical underpinnings of this system. As a psychiatric mental health nurse practitioner, a strong theoretical foundation will help you better understand the family unit and family therapy; this understanding will, in turn, improve the effectiveness of your work with clients Structural and Strategic Family Therapy Essay.

This week, as you continue exploring family therapy, you examine structural and strategic family therapies and their appropriateness for client families. You also consider your own practicum experiences involving family therapy sessions.

Photo Credit: [Blend Images/DreamPictures]/[Blend Images]/Getty Images
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

•Chapter 5, “Bowen Family Systems Therapy” (pp. 69–88)
•Chapter 6, “Strategic Family Therapy” (pp. 89–109)
•Chapter 7, “Structural Family Therapy” (pp. 110–128)

Gerlach, P. K. (2015). Use structural maps to manage your family well: Basic premises and examples. Retrieved from http://sfhelp.org/fam/map.htm

McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110–120. doi:10.1080/01926187.2011.649110
Note: Retrieved from Walden Library databases Structural and Strategic Family Therapy Essay.

Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167–174. doi:10.1080/01926187.2013.794046

Note: Retrieved from Walden Library databases.

Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207–215. doi:10.1111/famp.12025
Note: Retrieved from Walden Library databases.

Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403–414. doi:10.1080/01926187.2012.727673
Note: Retrieved from Walden Library databases.

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415–427. doi:10.1111/jmft.12113
Note: Retrieved from Walden Library databases Structural and Strategic Family Therapy Essay.

Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research, 25(1), 121–133. doi:10.1080/10503307.2013.856044

Note: Retrieved from Walden Library databases.

Required Media

Psychotherapy.net (Producer). (2010). Bowenian family therapy [Video file]. Mill Valley, CA: Author.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 118 minutes.

Triangle Productions (Producer). (2001). Brief strategic therapy with couples [Video file]. La Jolla, CA: Author.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 49 minutes.

Optional Resources

Coatsworth, J. D., Santisteban, D. A., McBride, C. K., & Szapocznik, J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Family Process, 40(3), 313–332. Retrieved from http://www.familyprocess.org/family-process-journal/

Golden Triad Films (Producer). (1986). The essence of change. [Video file]. Mill Valley, CA: Psychotherapy.net.

National Institute on Drug Abuse. (2003). Brief strategic family therapy for adolescent drug abuse. Retrieved from https://archives.drugabuse.gov/TXManuals/BSFT/BSFTIndex.html

Navarre, S. (1998). Salvador Minuchin\’s structural family therapy and its application to multicultural family systems. Issues in Mental Health Nursing, 19(6), 557–570. doi:10.1080/016128498248845

Psychotherapy.net (Producer). (2000b). Satir family therapy [Video file]. Mill Valley, CA: Author Structural and Strategic Family Therapy Essay.

Psychotherapy.net (Producer). (2011b). Salvador Minuchin on family therapy [Video file]. Mill Valley, CA: Author.

Radohl, T. (2011). Incorporating family into the formula: Family-directed structural therapy for children with serious emotional disturbance. Child & Family Social Work, 16(2), 127–137. doi:10.1111/j.1365-2206.2010.00720.x

Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., … Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents. Journal of Consulting and Clinical Psychology, 79(6), 713–727. doi:10.1037/a0025477

Santisteban, D. A., Suarez-Morales, L., Robbins, M. S., & Szapocznik, J. (2006). Brief strategic family therapy: Lessons learned in efficacy research and challenges to blending research and practice. Family Process, 45(2), 259–271. doi:10.1111/j.1545-5300.2006.00094.x

Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior. Couple & Family Psychology, 1(2), 134–145. doi:10.1037/a0029002

Szapocznik, J., Zarate, M., Duff, J., & Muir, J. (2013). Brief strategic family therapy: Engaging drug using/problem behavior adolescents and their families in treatment. Social Work in Public Health, 28(3-4), 206–223. doi:10.1080/19371918.2013.774666

Vetere, A. (2001). Therapy matters: Structural family therapy. Child Psychology & Psychiatry Review, 6(3), 133–139. Retrieved from http://www.iupui.edu/~mswd/D642/multimedia/word_doc/StructuralFamilyTherapy_Vetare.pdf

Weaver, A., Greeno, C. G., Marcus, S. C., Fusco, R. A., Zimmerman, T., & Anderson, C. (2013). Effects of structural family therapy on child and maternal mental health symptomatology. Research on Social Work Practice, 23(3), 294–303. doi:10.1177/1049731512470492 Structural and Strategic Family Therapy Essay.

Assignment 1: Structural Versus Strategic Family Therapies

Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.

Learning Objectives

Students will:
•Compare structural family therapy to strategic family therapy
•Create structural family maps
•Justify recommendations for family therapy
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To prepare:
•Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.
•Refer to Gerlach (2015) in this week’s Learning Resources for guidance on creating a structural family map.

The Assignment

In a 2- to 3-page paper, address the following:
•Summarize the key points of both structural family therapy and strategic family therapy.
•Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
•Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
•Recommend a specific therapy for the family, and justify your choice using the Learning Resources.
Structural and Strategic Family Therapy

Family is an important social unit in the contemporary society. Notably, each family member has a specific role to play in accordance to cultural and religious orientations, in the quest to achieve efficacy. However, it is evident that household units experience various predicaments which arise from an array of factors. For instance, economic instabilities, domestic violence ad bereavement of close members lead to development of psychological issues, which may hamper relationships. Based on these aspects, it is important for Psychiatrist Mental Health Practitioners (PMHNPs) to identify the real issues before applying appropriate family therapies. Characteristically, psychiatrists use structural and strategic family therapy approaches to handle family issues. However, there is need to understand the four primary constructs of the models, to warrant effective alleviation of diverse spectrum of issues amongst clients Structural and Strategic Family Therapy Essay.

Structural Family Therapy

Structural family therapy is a treatment intervention employed by PMHNPs in addressing interaction patterns creating problems within families. Notably, structural family therapy works on the basis that families become dysfunctional due to mental issues. According to Weaver, Greeno, Marcus, Fusco, Zimmerman and Anderson (2013), psychological predicaments in a family are most likely to ruin relationships amongst spouses and children, leading to disintegration. Based on this facet, psychologists applyingstructural family therapyapproaches aim to change family structures, rather thanthe individuals themselves.

Structural family therapy was developed by Salvador Minuchin in the 1960s. In fact, the psychiatrist discovered that children and adolescents achieved excellent recovery through the cooperation of their parents. For this reason, Munichindeliberatedon the importance of altering the family dynamics in the quest to warrant effective transition in child behavior change. According to Mcadams et al (2016), psychiatrists achieve the effectivenessof structural family therapy through a closer scrutiny of family structure, hierarchy andsubsystems Structural and Strategic Family Therapy Essay.

Strategic Family Therapy

Strategic Family Therapy is an approach used by PMHNPs in identifying problems affecting individuals within a family. Contrary to structural family therapy which focuses on the overall family setting, strategic family intervention aims engaging individuals in handling the existing issues. Horigian, Anderson andSzapocznik (2016) assert that strategic family therapy aims at devising an immediate solution to family impediments. Notably, therapistssubject their clients to safe environments and prompt interactions which enable the affected individuals torelay the real issue,leading to precise deliberation of applicable solutions.

Comparison

Structural family therapy aims at addressing dysfunctions within households by changing the overall structure of the affected family. Gurman, LebowandSnyder (Eds.). (2015) postulate that altering the setting of a dysfunctional family improves positive interactions in the quest to overcome underling issues. In fact, this aspect is advantageous,sincepsychiatrists engage all the family members in interactive forums. In the process, it is evident that affected clients afford the chance to reveal burning issues, leading to preciseidentification of relevant solutions. The short-coming of structural family therapy entails altering the family structure, which is tantamount to poor adaptation by some household members, an aspect that exposes clients to further conflict.

On the contrary, strategic family therapy aims at incorporating individualized communication among affected clients. According to Karam, Blow, Sprenkleand Davis (2015), the fundamental concepts of Strategic family therapists include understanding intricacies withinfamily and individual communication patterns. The model narrows down to precise analysis of family guidelines, functions andrepetitive behavior trends. Karam et al (2015) assert that through this intervention, personal interactions are improved amongst affected clients. Strategic familytherapy is essential, since it is more individual-based, as the constructs aim at improving inter-personal communication, in the quest to improve behavior. However, its major weakness entails poor incorporation of attributes to improve communication amongst individuals Structural and Strategic Family Therapy Essay.

Despite the two models having significant distinctdifferences, it is evident that they share similarities in their manner of providing stability to clients. In fact, one of the unique identifiers within the two approaches is the application of systematic frameworks which focus on an individual in conjunction withfamily network.According to Gurman, Lebowand Snyder (Eds.). (2015), structural and strategic family therapies strive to identify the effects of the intra-psychic world on individuals and families. Based on this facet, psychiatrists applying the interventions change the perceptions of individuals within families, leading to stability. Notably, the two interventions advocate for a change in maladaptive patterns affecting families and individuals within a household unit. Gurman et al (2015) state that the models aim at changing the structure in the quest to recognize and disrupt any dysfunction within an individual. Resultantly, proper balance in the family is achieved Structural and Strategic Family Therapy Essay.

Structural Family Map

The Costa Family

Douglas Rice

FatherMother

Ex- Husband Ex-Wife

Has VisitationHas child custody

Fred

Son

Student

Figure 1 Displayingthe family structure of Mr. Douglas Costa

Therapy for Costa’s Family

From the example presenting Costa’s family, it is evident that the unit was experiencing a disagreement. Evidently, the husband and the wife had individual misunderstandings, a factor that led to their separation, with Costa taking custody of the son. In my opinion, application of strategic family therapy would be the most effective approach. According to Sheehan and Friedlander (2015), strategic family therapy constructs advocate for individual interactions. Application of this methodology would allow the adults in the family unit to air their grievances, leading to deliberation of amicable solutions.

Conclusion

PMHNPs apply various therapeutic interventions in the quest to achieve stability in families. Notably, structural and strategic family therapies are commonly preferred. The two interventions aim at identifying the underlying predicaments within families. For this reason, PMHNPs ensure improved interactions amongst the affected clients, leading to family stability.

References

Gurman, A. S., Lebow, J. L., & Snyder, D. K. (Eds.).(2015). Clinical handbook of couple therapy.Guilford Publications.

Horigian, V. E., Anderson, A. R., &Szapocznik, J. (2016).Taking brief strategic family therapy from bench to trench: Evidence generation across translational phases. Family Process,55(3), 529-542. doi:10.1111/famp.12233

Karam, E. A., Blow, A. J., Sprenkle, D. H., & Davis, S. D. (2015). Strengthening the systemic ties that bind: Integrating common factors into marriage and family therapy curricula.Journal of Marital and Family Therapy, 41(2), 136-149. https://doi.org/10.1111/jmft.12096 Structural and Strategic Family Therapy Essay.

Mcadams, C. R., Avadhanam, R., Foster, V. A., Harris, P. N., Javaheri, A., Kim, S., . . . Williams, A. E. (2016). The viability of structural family therapy in the twenty-first century: An analysis of key indicators. Contemporary Family Therapy,38(3), 255-261. doi:10.1007/s10591-016-9383-9

Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy,41(4), 415-427. doi:10.1111/jmft.12113

Weaver, A., Greeno, C. G., Marcus, S. C., Fusco, R. A., Zimmerman, T., & Anderson, C. (2013). Effects of structural family therapy on child and maternal mental health symptomatology. Research on Social Work Practice, 23(3), 294–303. doi:10.1177/1049731512470492 Structural and Strategic Family Therapy Essay

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