General Family Systems Theory & Structural Family Therapy

Jane F. Gilgun, PhD, LICSWProfessor, School of Social WorkUniversity of Minnesota, Twin Cities USA

Topics

• General Family Systems Theory• Circular causality

• Ecosystems & Culture• Structural Family Therapy

Family Systems Theory

• Definition of system: units that interact and mutually influence each other• Families: “unity of interacting personalities”• Families are persons who interact with each

other and mutually influence each other; • Definition of family: persons related by

blood, legal ties such as adoption or marriage or mutual agreement• Enduring relationships; commitment

Family Systems Theory

• We live our lives in interactional contexts (Hardy)• Re-orients how we think about the world• Interactional terms• A affects B and B affects A• Bidirectionality• Mutual influence• Reciprocity• Circular causality

• Non-productive & frustrating interactions are family systems issues

Family Systems Theory• Family therapy works with systems of interactions• Example: When parents are not family leaders, this

results in children not following rules and violating boundaries that in turn affects parents’ leadership and so on

• Events in one person’s life affects another• Effects of incest—inside family• Father loses job—outside event affects family• Older child bullies younger child

Patterns of Interactions

• Who is in charge?• Where is the power in families & groups?• Who is left out?• Who is allied with whom?• What are the rules of interaction?• What types of interactions?• Chaotic?• Enmeshed?• Disengaged?• Balanced?

Family Systems/Circular Causality

• She is depressed because her partner shows no interest; her partner shows no interest because she is depressed—becomes self-perpetuating.• Metaphor is a “hamster wheel”• “family dance” is the family’s patterns of circular

interactions/causality• Definition & Demonstration of Circular Causality:

Jacob Spillman video at 1.52: https://www.youtube.com/watch? v=2z3EhBqvrPI

Ecosystems & Culture

• Circular influences between culture & individuals• How individuals enact culture is particular & yet

contains cultural themes• People born in other counties• Traditional gender roles may be up-ended• Often have experienced complex trauma• Family ties may have changed• Send money home• Typically work longer hours than others• Typically have lower salaries

Macrosystems Issues inFamilies of Color in US• Poverty common• Unemployment• Some seek other sources of income

• Health & Mental Health Issues• Historical trauma• Gender issues• Some males adopt “cool pose”• Some women adopt their own version of cool pose

• Language issues• Words activate images, have meaning and impact

People of Color in US

• Sources of support & identity & sense of belonging• Everyone wants to experience possibilities to

achieve personal goals• Dignity & worth foundational

• Family & extended family• Community efforts: building communities

People of Color in US

• Organizations that support child and family development: Northside Achievement Zone• Sports—schools and community• Churches• Gangs especially for young people who are fearful and

discouraged

• Lack of opportunity can have serious consequences• Young Somali men who become freedom fighters/terrorists

Structural Family Therapy

• Parents are in charge/Family hierarchy• Key Ideas• Family rules: ex: older children can interrupt & ignore

younger children

• Patterns of Interactions• Non-productive & frustrating interactions are

family systems issues• General Goal: Effective Family Organization &

Processes• Therapists’ Role: Active

Structural Family Therapy

• Grounded in family systems theory• Developed by Minuchin and colleagues for• poor families of color with• organizational difficulties

• Seeks to help families reorganize so that• Parents are in charge• Boundaries are clear & flexible• Healthy patterns of interaction are the goals • Video

https://www.youtube.com/watch?v=shbX4wwzA_s

Components of Family Organization• Family Hierarchy• Parents have more power than children; develop

“rules” & reward following of “rules”• Boundaries• Balanced• Diffuse• Rigid

• Alignment • Power

Principles from Minuchin Center on Family Therapy

• strength-based, outcome oriented treatment modality based on ecosystemic principles:• Context organizes us. Our behaviors are a function of

our relations with others. The structural therapist focuses on what is taking place among people, rather than on individual psyches.• The family is the primary context, the “matrix of

identity” where we develop our selves as we interact with spouses, parents, children, and other family members. The family is in constant transformation, adapting to an ever changing social environment.

Principles from Minuchin Center on Family Therapy• Family's structure • recurrent patterns of interaction that its members

develop over time, as they accommodate to each other

• A well functioning family • Defined not by the absence of stress or conflict,• but by how effectively members handle them

• Therapist helps family• To identify and mobilize underutilized strengths to• actualize of its own resources

Foundation of

•Brief strategic family therapy

•Multisystems family therapy

•& probably most of the others

Basic Ideas• Brief treatment• Behavior problems experienced by one

member of the family system are understood as stemming from the family’s patterns of transactions• Example: A parent who allows an older child

to be overbearing & hurtful to younger children• The younger child or children may be the focus

of parental concern

Basic Ideas 2• Three subsystems• parental• parent-child • sibling

• Seek to help families to develop clear roles and boundaries in family subsystems

Basic Ideas 3• Boundaries—are they flexible?• Balanced—turn taking, respect personal space• Rigid—keep others out: isolated & disengaged• Diffuse—not clearly defined to family enmeshment

& high reactivity and even chaos

• Example of diffuse: waking in on others in bathroom; rummaging through personal effects of others; not listening, interrupting, yelling, name-calling;• Rigid: not sharing person things; silent treatments;

not knowing much about others in family

Procedures

• Joining• a process by which the therapist creates a new

subsystem within the family group

• Enactments• Interact in session what happens at home• Service provider sees and experiences the patterns

of interaction in the sessions

Joining

• Goal: establish trust• Notice family “style”• How they interact• Words they use• Family affect—low key, loud, mixed

• Allow yourself to be part of the family system but also the person charged with facilitating change: keep your analytic stance• Do not ally with any family member

• Technical term: Mimesis

Joining 2

• Explain how the therapy works• I will ask you to try to new things with me

present• I will ask you to try new things at home and

then when we are together again we’ll do a check-in about them• How I do things, no one is blamed• I want to help you work together as a family• Ask them if this is okay with them• Ask them to try it and see how it works for them

Enactments• Have families talk to each other about an issue that they

had been describing• Can then suggest another way of interacting• Example• In the enactment, family members interrupt each

other

Enactments 2• You see that frustrates the person being interrupted

and the interrupter may feel superior but also frustrated• How about a no-interrupt rule?• Have them practice

• Homework• Have them note whether interruptions occur at home

and how persons respond to the interruptions

Enactments 3• The interruptions stop but no one responds to what the

person said but instead brings up another topic• Ask if they’d like to feel as if someone heard what they say• Explain one part of active listening• Have them practice in session

• Homework• Have them note whether anyone appears to hear them at home

• In Session• Help them to interact in these new ways

Reframing

• A different way of looking at/understanding something such as a persons’ behavior or how someone labels a behavior • Involves seeing something from another point of view,

usually more favorable and focused on strengths• Might help family members get unstuck from rigid

patterns of thinking• The reframe must fit with families’ worldviews• Example• “Mary is too sensitive”• “Do you mean she responds well to praise?”

Example of Reframing

• Example: helping family members not scapegoat but to see behaviors of an individual as part of a system• Family member: “Robbie is angry all the

time”• Therapist: “I wonder if this happens

when he feels stuck by something that is happening inside the family”

Illustrations of SFT from Research

• Reciprocity/circularity• Between 40 and 70% of children whose mothers

experience mental health problems meet criteria for a psychiatric disorder• This is more evidence for Importance of family work

• Parents often see linear causality• Don’t see connections between their issues & their

children’s• Think if children’s behaviors improve, they will feel &

function better

Findings from a Research Project•Mothers depression symptomology

improved• No improvement for children

•Problem•Where were therapists’ reports on

changes in family interactions that they witnessed in sessions?

Number of Sessions Important

• Present study: average of 5.6 family sessions. • Every 3-4 weeks (weak dosage)• Clinicians had caseloads of 80-90!!!

• Higher than 4.3 in routine treatment settings• 13-17 sessions are typically required in

efficacy trials (Hansen et al., 2002).

Summary: Seeing SFT

• Principles• Family diagrams• Enactments

• Video: https://www.youtube.com/watch?v=mPW0UZd9gQ4