Boundaries
Rules for managing physical and psychological distance between family members and for defining the regulation of closeness, distance, hierarchy, and family roles.
Goal: Create clear and healthy boundaries that allow for individual and familial well being; modeled by cohesion in couple and spousal subsystem that have power over sibling subsystem.
Restructuring
General term that refers to reorganizing family boundary and hierarchy to improve family dynamics. This can be achieved through various interventions, such as asking family members to switch seats, stop interruptions, separate sessions with subsystems, etc.
Boundary Making
(Structural Therapy)
Is a special form of enactment that targets over-involvement or under-involvement to help families soften rigid boundaries or strengthen diffuse boundaries. Structural therapists use this technique to direct who participates and how.
Enmeshment
Diffuse or weak boundaries that lead to over involvement of all family members in the affairs of any one member.
Subsystems
A family as a single system that also has multiple subsystems. Some of these can be found in almost every family: couple, parent, sibling, and each individual as a separate subsystem.
Cross-generational Coalitions
An unhealthy subsystem that forms between a parent and child against the other parent or other key caretaker.
Hierarchy
Refers to power differentials in the family.
Regarding parents and children, three basic forms exist:
- Effective
- Insufficient
- Excessive
Role of the Symptom
(Structural Family Therapy)
Describes the relationship between the symptom and the family system:
- Family as “ineffectual challenger” of the symptom
- Family as “shaper” of the individual’s symptom
- Family as “beneficiary” of the symptom
Joining and Accommodating
Refers to how structural therapists build the therapeutic relationship; more of an attitude than a technique. Process invovles accommodating the family’s style: how people talk, what words they use, how they walk, and so forth.
Involves talking about commonalities and using family’s language while maintaining distance to become part of family; create trust with the family members to challenge them in the future.
4 Structural Goals
Structural family therapists have four clearly defined goals for treatment, which include:
- Clear boundaries between all subsystems
- Clear distinction between the marital and parental subsystems
- Effective parental hierarchy
- Family structure that promotes the healthy development of individuals and the family.
Enactments
Technique where therapist prompts family to reenact a conflict or other interaction and then coaches the family to have healthier interactions
This Occurs in three phases:
- Observation of Spontaneous Interactions
- Eliciting Transactions
- Redirecting Alternative Transactions
3 phases of enactments
- Observation of Spontaneous Interactions
- Eliciting Transactions
- Redirecting Alternative Transactions
Unbalancing
In structural family therapy, a technique for altering the hierarchical relationship between members of a system or subsystem by temporarily aligning with a disenfranchised member and thus upsetting family homeostasis.
Challenging Family Worldview
Challenging the certainty of this and unproductive assumptions can include rigid definitions of the problem, available solutions, and individual member’s identity. Structural therapists often challenge these assumptions by overtly questioning whether they are actually having the effect family members anticipate. The challenge can be delivered softly or strongly, depending on what will be most effective with a particular family’s structure.
Shaping Competence
From structural therapy, a method of increasing family members’ confidence in being able to solve their problems by pointing out what they have done right, rather than focusing on mistakes.
Systemic Reframing
Used to alter interaction and behavior patterns related to the problem by offering new relational frameworks for viewing the problem. This is typically done by highlighting how the symptom operates within the broader systemic dynamics to maintain homeostasis.
Example: A child’s acting out serves to distract parents from troubled marriage.
3 Key Concepts of Structural Family Therapy
- Focus on familial interactions to understand the structure/organization and hierarchies of the family.
- Symptoms/presenting problem is viewed as a byproduct of structural failings.
- Structural changes must occur before the individual’s symptoms can be decreased.
Family Structure
Invisible rules for relating (functional demands) that organize how each individual understands their role and relationship to others. Formed by the accommodation of the couple’s family of origin values that guide their behaviors as a couple and/or parents with subsystems.
Function of Therapist
- Help families move from a dysfunctional stage to a functional stage by processing the familial dynamics.
- Actively engage with the family by joining (talk about commonalities that are shared with family) and accommodating (use their language while maintaining distance).
- Challenge rigid transaction processes.
Types of Boundaries
- Rigid
- Diffused boundaries
- Clear
Rigid boundaries
Restrictive rules that permit minimal physical and emotional contact with other subsystems that lead members to develop a sense of independence and isolation.
Clear boundaries
Generational and hierarchical rules that allow family members to maintain their healthy, developmentally appropriate rules and transactional patterns. Allows for both closeness and independence.
Diffused Boundaries
Overly flexible rules that permit greater physical and emotional contact between subsystems at the expense of individual autonomy. These boundaries lead family members to be “connected,” but often at the expense of independence. Often, there is significant pressure to think, feel, and believe like others in the system; controlling behaviors, such as guilt and shame, are often used to maintain high levels of closeness.
Disengagement
Characterized by rigid boundaries and they have little contact or commitment to one another
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DSM-5-TR Diagnosis129
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Mental Status and Clinical Assessment52
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Law, Ethics, and Crisis43
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General Treatment, Tx Planning, and Termination32
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Systemic and Cybernetic Foundations38
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Strategic and Systemic Theories35
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Structural Family Therapy35
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Intergenerational/Bowen Therapy31
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Psychodynamic and Contextual Family Therapist34
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Satir Family Therapy22
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Symbolic-Experiential Family Therapy17
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Emotionally Focused Couple and Family Therapy22
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CBT/CBFT41
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Gottman's Couples Therapy21
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Narrative, SFT, and Collaborative41
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Feminist Therapy22
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Rogers, Gestalt, and DBT49
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Family Development Theories35
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Research and Statistics39
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Genogram Symbols52
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Family Mapping (Structural Family Assessment)31
