Structural Family Therapy

Structural family therapy (SFT) is a treatment that addresses patterns of interaction that create problems within families. Mental health issues are viewed as signs of a dysfunctional family; therefore, the focus of treatment is on changing the family structure rather than changing individual family members. The goal of SFT is to improve communications and interactions among family members and to highlight appropriate boundaries to create a healthier family structure.

When It’s Used

Families and children at risk, including single parents, blended families, and extended families, can benefit from SFT. Settings for SFT include private practice, mental health clinics, substance abuse programs, child welfare agencies, and schools.

What to Expect

After observing how your family interacts, the therapist will draw a chart, or map, of your family’s structure. This chart helps identify the hierarchy, boundaries, and subsystems, or subrelationships, within the family unit, such as the relationship between parents or between one parent and one particular child. Using this outline, the therapist can also see where changes are needed and what type of interventions will help restructure the family. Family members may be asked to role-play a problematic situation and, at times, the therapist may appear to be “taking sides” to help disrupt a negative pattern within a family subsystem and change the dynamic of the relationship.

How It Works

SFT was developed by psychiatrist Salvador Minuchin in the 1960s while he was working with troubled youth in New York City. Minuchin came to realize that successfully treating children and adolescents requires the support and cooperation of parents and other family members. He felt that the root of most childhood problems is not within the child but within the family unit. Therefore, to change the child’s behavior, the therapist must help change the family dynamics. To do this, Minuchin looked closely at family structure, or hierarchy, family subsystems, and boundaries, both rigid and flexible. The therapist is an active member of the treatment group and gets involved in the dynamics between and among family members to effectively promote change and strengthen the family structure.

What to Look for in a Structural Family Therapist

Look for a licensed or certified mental health professional with a background in family therapy and training and experience in the SFT model. In addition to these credentials, it is important to find a therapist with whom you and your family feel comfortable working.