Structural

Question 1

Major Concepts of Structural:

Answer 1

1. Alliances
2. Boundaries (individuals, subsystems, and whole family)
3. Coalitions (ex. cross-generational)
4. Disengagement
5. Detouring
6. Enmeshment
7. Parentified child
8. Restructuring
9. Structural map
10. Triangles

Question 2

Theory of Dysfunction in Structural:

Answer 2

1. Inflexible family structures not adequately adjusting to/accommodating developmental or situational changes.
2. Rigid or diffuse boundaries between subsystems.

Question 3

Theory of Change in Structural:

Answer 3

1. Reorganization of family structure through interactional patterns.
2. Establish strong parental subsystem.
3. Create clear but flexible boundaries between subsystems.
4. Enable more functional adaptive patterns toward change.
5. Help families find resources and strengths.

Question 4

Stages of Therapy in Structural:

Answer 4

1. Entire family present for initial and subsequent interviews.
2. Join with family in a position of leadership.
3. Map underlying structure.
4. Intervene to transform the structure.

Therapy tends to be brief.

Question 5

Stance of Therapist in Structural:

Answer 5

1. Active, involved
2. Position of leader
3. Nonjudgmental - therapist’s purpose is to create more options, not to criticize what is wrong

Question 6

Methods/Techniques of Structural:

Answer 6

1. Joining and accommodating
2. Mapping the structure
3. Shaping Competence - change interactions by highlighting what clients do right
4. Boundary making
5. Unbalancing
6. Challenging intensity
7. In-session enactments
8. Reframe
9. Behavioral tasks
10. Therapeutic paradox

Question 7

Diagnosis/Assessment in Structural:

Answer 7

1. Consider family structures (covert set of rules that govern transactions in the family).
2. Observe system’s flexibility, capacity for elaboration and restructuring.
3. Family system’s resonance, sensitivity to individual members’ actions.
4. Range of enmeshment or disengagement.
5. Family’s life context; sources of support and stress in family’s ecology.
6. Family’s developmental stage and performance of the tasks appropriate for that stage.
7. Data from observation during interaction stage.

Question 8

Theorists of Structural:

Answer 8

1. Minuchin
2. Montalvo
3. Fishman
4. Aponte

Question 9

Goal of Structural:

Answer 9

Correct dysfunctional hierarchies by putting parents in charge of their children and to differentiate between subsystems within families so the family can solve its own problems.

Question 10

What are boundaries?

Answer 10

Structural

Hypothetical separation that serves to protect autonomy of family and its subsystems by managing proximity and hierarchy.

Rigid (disengagement) to diffuse (enmeshment).

Question 11

Describe healthy and dysfunctional disengagement:

Answer 11

Structural, rigid

Healthy - independent, children learn to be self-sufficient and resourceful

Dysfunctional - isolated, may not relate well to others, lack warmth and nurturance; avoid acknowledging problems

Question 12

Describe healthy and dysfunctional enmeshment:

Answer 12

Structural, diffuse

Healthy - receive affection and nurturance

Unhealthy - lack autonomy and may not learn to rely on themselves; deny or suppress problems

Question 13

Define Accommodation:

Structural technique

Answer 13

Adjustments a therapist makes to achieve a therapeutic alliance. Critical for later intervention.

1. Joining - Establishing rapport and temporarily becoming part of the family
2. Mimesis - Matching the mood or behaviors of the family members

Question 14

Define Enactment:

Answer 14

Structural assessment and intervention

Directing clients to interact so therapist can observe dysfunctional transactional patterns in session rather than relying on vague reports.

Therapist maps the system.

Focus on process, not content.

Question 15

Define Unbalancing:

Answer 15

Structural intervention

Supporting one family member and interfering with homeostasis.

Question 16

Define Detouring:

Answer 16

Structural

Two family members often preserve harmony in their relationship by diverting the conflict onto a third person.

Ex. Parents avoid conflict between each other by focusing on problematic child. Similar to projection.

Question 17

What are the similarities between Strategic and Structural models? (8)

Answer 17

1. Interested in behavioral sequences and rules that govern behavior.
2. Consider impact of life cycle stage.
3. Symptom oriented.
4. Therapist is directive and therapy is brief.
5. Use in-session interactions to assess and emphasize process over content.
6. Focus on the present.
7. Use techniques of joining, paradox, and reframe.
8. Goals: alter repetitive, dysfunctional behavior sequences and restructure family to establish clear boundaries.

Question 18

What are the major differences between Strategic and Structural models? (4)

Answer 18

1. Strategic focuses on changing positive feedback loops (target maladaptive behavioral sequences). Structural focuses on changing the homeostatic structure or negative feedback loop (target structure).
2. Strategic therapists are indirect and non-confrontational while Structural tend to be more confrontational and straightforward.
3. Strategic interventions are typically given as homework tasks while Structural interventions occur within session.
4. Strategic less adamant about seeing whole families.