Important Questions for IGNOU PGDCFT MSCCFT MCFT003 Exam with Main Points for Answer - Unit 9 Structural Family Therapy

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Unit 9 Structural Family Therapy

1. Describe the main goals of structural family therapy.

The main goals of structural family therapy are described as follows:

i) Creating an effective hierarchical structure in the family,

ii) Restructuring an effective parental subsystem,

iii) Effective functioning of the sibling subsystem as peers,

iv) Increasing the frequency of interactions and nurturance, if the family is disengaged, and

v) The differentiation of family members, if the family is enmeshed.

2. Enumerate the characteristics of enmeshed and disengaged families.

Enmeshed families have diffuse boundaries. These families encourage dependence, and members often expect to have their needs met by the family. There is little autonomy in these families as the sense of belonging to the family is prioritized. Additionally, members of these families are often hesitant to form relationships outside of the family. Enmeshed families struggle to adapt to stress and are sensitive to even minor events that occur within the family.
Disengaged families have overly rigid boundaries. These inflexible boundaries separate family members, resulting in independence but little interdependence. Communication is limited between family subsystems in disengaged families. Members of disengaged families may struggle with relatedness and can become disconnected from other family members. Individual problems may not be acknowledged until they become severe.

3. What is triangulation? Illustrate 'conflict detouring' and 'cross-generational coalitions" by drawing structural diagrams.

Triangulation is a process in which two family members lower the tension level between them by drawing in a third member. Conflict detouring and cross-generational coalitions are two types of triangulation.
Conflict detouring occurs when parents who are unable to resolve problems between them identify a child as the source of their issues. This can manifest in two ways:

Detouring-attacking: Parents focus negativity on the child, blaming them for the family's problems. This can also be referred to as scapegoating as the child's well-being is sacrificed to avoid marital conflict.
Detouring-supportive: Parents mask their differences by overprotecting a child who is perceived as "sick".

Cross-generational coalitions involve inappropriate alliances between members of two different generations, often excluding a member of one of those generations.

For example, one parent may become overly involved with a child while the other parent withdraws.
This can perpetuate an enmeshed relationship between the parent and child, while the other parent disengages.

4. Describe the initial "joining" stage in structural family therapy.

The initial "joining" stage in structural family therapy is a crucial process in which the therapist establishes a strong therapeutic relationship with the family. This stage has two main aspects:

Preparing the family for change
Gaining a position of leadership within the family

Joining starts from the first contact with the family and continues throughout the therapeutic process. It involves the therapist demonstrating respect and support for each family member to gain their trust. This can be accomplished through a number of techniques, including:

Presenting oneself as an ally: The therapist aligns with the family's perspective and goals to build rapport.
Appealing to family members with the greatest dominance: The therapist acknowledges and respects the family's existing hierarchy to gain acceptance.
Attempting to fit in with the family: The therapist mirrors the family's communication style and behaviours to establish a sense of connection. For example, in a jovial family, the therapist might adopt a jovial and expansive manner, while in a more reserved family, the therapist might adopt a calmer and more formal approach.

The goal of joining is to be accepted as a "special temporary member" of the family for the purpose of treatment. The sources describe three specific techniques the therapist can use to join the family:

Maintenance: The therapist allows the family's rules and patterns to organise the therapeutic process. For example, in a rigidly hierarchical family, the therapist might address the most senior member first.
Tracking: The therapist closely observes the family's interactions, paying attention to both the content and the process of their communication.
Mimesis: The therapist matches the family's communication style and behaviours to build rapport, such as mirroring their body language or tone of voice.

Joining is not simply a matter of being accepted by the family but rather being accepted as a therapist with the authority to advocate for change. The therapist must strike a balance between accommodating to the family's dynamics and maintaining a professional distance to effectively guide them towards change.

5. Discuss the processes of family mapping and making a structural diagnosis.

Family mapping is a technique used in structural family therapy to visually represent the family's structure and dynamics. The therapist uses symbols to depict family members, subsystems, boundaries, and relationships.

The structural diagnosis is a hypothesis about the relationship between the family's structure and the presenting problem. The therapist uses information from the family map, the family's history, and observations of their interactions to develop the structural diagnosis. The therapist then shares the structural diagnosis with the family in a way that is understandable and acceptable. This helps the family to understand their own dynamics and to participate in the therapeutic process.

The process of family mapping and structural diagnosis typically involves the following steps:

Gathering Information: The therapist gathers information about the family's history, structure, and interactions through interviews and observations. This process can involve the construction of a genogram as part of family assessment, discussed in source.
Identifying Subsystems: The therapist identifies the different subsystems within the family, such as the parental subsystem, the sibling subsystem, and any cross-generational coalitions.
Assessing Boundaries: The therapist assesses the boundaries between subsystems, noting whether they are enmeshed (overly diffuse) or disengaged (overly rigid).
Analysing Relationships: The therapist analyses the relationships between family members, noting the nature of their interactions, the power dynamics, and any instances of triangulation.
Developing the Family Map: The therapist uses symbols to create a visual representation of the family's structure, including subsystems, boundaries, and relationships.
Formulating the Structural Diagnosis: The therapist develops a hypothesis about the relationship between the family's structure and the presenting problem.
Sharing the Diagnosis with the Family: The therapist translates the structural diagnosis into language that is understandable and acceptable to the family.

Family mapping and structural diagnosis are ongoing processes that continue throughout treatment. As the family changes, the therapist will need to update the family map and revise the structural diagnosis.

6. What are some of the restructuring techniques used in structural family therapy? Illustrate with examples.

Reframing
Enactment
Boundary Making
Punctuation
Unbalancing
Task Assignments
Support, Education and Guidance

7. Discuss the key assumptions of structural family therapy.

Structural family therapy focuses upon the person within the family system, rather than solely on the individual (Colapinto. 1982; Minuchin, 1974).
The underlying philosophy of the structural family therapy approach is that "man is not an isolate" (Minuchin, 1974).
Structural family therapy focuses on the present rather than on the past.
Structural family therapy attributes problems to dysfunctional family structures
Structural family therapy assumes that family dysfunction arises out of difficulties in adapting to the changing demands of various developmental stages
Structural family therapy also recognises the strengths and inner resources of the family to participate in the change process with the therapist's assistance.
Structural family therapy is an approach with an active therapist role where families are directed and challenged to realign structural relationships and learn more effective conflict resolution.

Important Points

1. In family therapy, the therapist must attend to all of the following:

- Each member of the family in interaction with other family members.

- Subgroups within the family in interaction with each other.

- The family as a whole.

2. Structural family therapy originated in the work of Minuchin

3. Structural family therapy is most concerned with identifying and changing the underlying organisation of the family.

4. The role of the structural family therapist is involved, active and directive.

5. The way coalitions mask tensions by focusing on a third party as the problematic family member is called conflict-detouring.

6. Families that have diffuse boundaries are called enmeshed families.

7. An inappropriate family alliance that contains members of two different generations is called a cross-generational coalition.

8. In disengaged families, the boundaries are found to be rigid

9. The subsystem including the children in the family is called the sibling subsystem

10. The symbol (three parallel horizontal lines) indicates an affiliation that is over involved

11. The following characteristics are considered as relative contraindications for structural family therapy;

- Very severe and chronic family disturbance

- Lack of motivation for participation and change

- Precarious family equilibrium and vulnerability for decompensation of individual family members

12. Adoption of the family members' mood, tone of voice, posture and behaviour by the therapist is called Mimesis.

13. The therapist's perception and adaptation to the family's hierarchical structure is called Maintenance.

14. The therapist's close attention to the content of communication within the family system is called Tracking.

15. According to Minuchin, when the therapist deliberately supports one family member against the rest of the family, the technique used is called unbalancing.

16. A family is seeing a structural family therapist because there are huge arguments at home every time the topic of the daughter's career choices comes up. The therapist tells the family, "I want you to act out exactly what happens when this topic is raised by your daughter." The structural family technique being used is enacting.

17. The structural family therapist might try to alter boundaries by changing the seating arrangement during sessions.

18. Techniques used in structural family therapy.

a) Reframing

b) Enactments

d) Unbalancing

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