with a minister who was affiliated with a congregation that welcomed participation by LGB individuals. Although this path was not quick or easy, the three family members Intervention skills The structural family therapy model can be used in sessions with all family members present and in separate sessions with individuals and subsystems. There are seven key steps that encompass the assessment and therapeutic interventions of this model (Nichols, 2014). Step 1: Joining and accommodating The first step is for assessment to occur and this is achieved by the family practitioner “joining and accommodating.” This means that because often not all family members will initially welcome the practitioner, or even the idea of family therapy, it is incumbent upon the therapist to build rapport with each member. This is achieved by genuinely soliciting each family member’s view of the problem, which will very likely conflict with the views of other family members. To aid in the joining and accommodating process, the therapist will often talk with each family member separately as well as with all family members together. The therapist solicits each parent’s view of the problem, which they both identify as their son’s fighting. The son says his view of the problem is that everybody is focusing too much on his fighting and making a big deal out of the fighting and that they should just forget it because he isn’t going to do it again, because he will just ignore the people who were bothering him. The daughter says that being home “stresses her out” because of all the arguing and she didn’t fight so she doesn’t know why she needs to even be there. Step 2: Enactment The second step is “enactment.” In this step, the practitioner wants to see the family’s patterns of interaction live and in the moment; the practitioner sets this in motion by asking questions of each family member and seeing the “natural” interplay that occurs. This allows the therapist to observe how family members respond to one another and reveals information about the boundaries and family structure. The therapist observes that when the son is asked why he fought in school, the father interrupts his son and states that his son had a lapse of judgment. Step 3: Structural mapping As the practitioner gains insight into the family structure, it is time to proceed to the third step, “structural mapping.” In structural mapping, the practitioner makes tentative hypotheses about the subsystems and types of boundaries in the family, and views the problem as one that resides in this interwoven system rather than in any particular family member who needs to exclusively undergo all the change. When the parents argue with each other about why their son is fighting, they blame one another, a response that reveals their own disappointments with themselves and each other. In the structural mapping stage the practitioner may suggest to the family that the parents’ fairly rigid boundary with each other has influenced their son’s sense that he could not come out to them in the past and, as a result of not having this support, he had a quicker response to fight at school. Step 4: Highlighting and modifying interactions Following the practitioner’s discovery of these patterns, she or he then identifies them and suggests how to change the interaction. This refers to the fourth step: “highlighting and modifying interactions.” Practitioners use intensity, which is a blunt intervention that challenges family members to reflect on their own roles in the problem. As an alternative intervention, practitioners may use empathy through listening and recognition to help family members become more reflective about their roles in the underlying problem (Nichols, 2014).
became more respectful of each other with increased communication, Danielle’s increased independence, and more mutual re spect.
The therapist shares her observation that the more the mother yells at her son, the more the son ignores her and the more distant they become – mirroring the parental subsystem’s interactions. The son’s fighting, as well as his subsequent self-disclosure in therapy that he is gay, has forced the parents to interact and communicate with each other, which differs from their typical disengagement from each other. Step 5: Boundary making As a family’s insight increases, the practitioner is ready to take the lead on the fifth step, “boundary making.” Boundaries should be “clear” within a family (Minuchin, 1974). With the goal of creating clearer boundaries within the family structure as a whole, the practitioner could point out that disengaged families with rigid boundaries tend to have avoided conflict in the past (Nichols, 2014). The following examples reflect the essence of boundary making. The therapist works with the father (who models enmeshed boundaries with his children) and both children, to help the father provide space for his children to voice their independence. The therapist also works with the mother and children together, as well as with the couple separately, on encouraging each subsystem to open up to each other, discuss their differences, take responsibility for their part in the current family dynamic, and have more positive interactions in trying to create healthy boundaries and more open communication in the family. Step 6: Unbalancing With “unbalancing,” the sixth step, the practitioner focuses on changing the relationship within a subsystem. Because dynamics within a subsystem influence boundaries in the overall family structure, it is the intention of this step to ensure that the subsystem, and its boundaries, are as clear as possible. This is achieved by the practitioner temporarily “siding” with each subsystem member in series. The intention of this intervention is to shift the dynamics so that insight is possible in the final step. The therapist sides with the wife when the husband is chastising her for contributing to their son’s secrecy. When the husband yells at the wife, the therapist interrupts the father and tells him he needs to take responsibility for his part in contributing to the family’s problem. Step 7: Challenging unproductive assumptions The final step, “challenging unproductive assumptions,” draws on the earlier efforts at boundary making and unbalancing by providing opportunities for reflection and insight to reframe the problem. Practitioners can use educational interventions that support positive characteristics and downplay negative characteristics. These and other exchanges have the potential to help families form clearer boundaries and promote healthier family functioning. The therapist empowers the children 1) to speak to their mother about their wishing she was more positively involved in their lives, rather than only becoming involved when there is “a problem” (this reduces the rigid boundary), and 2) to speak to their father about wishing he would not emotionally “smother” them (this reduces the diffuse boundary) and that he would spend more time in positive communication with his wife, rather than always arguing and then relying on his relationships with his children for a sense of connection and camaraderie.
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Book Code: PYCA1423
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