Nursing

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.

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.

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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.

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.

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.

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

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

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.

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