Structural Family Therapy: A Case Presentation
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Structural Family Therapy: A Case Presentation Elaine Shpungin, Ph.D. Director, Psychological Services Center [email protected] Tentative Agenda . Try It On : A taste of family assessment Family Systems Perspective (brief theory and definitions)

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Structural Family Therapy: A Case PresentationElaine Shpungin, Ph.D.Director, Psychological Services [email protected]

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Tentative Agenda

  • Try It On: A taste of family assessment

  • Family Systems Perspective (brief theory and definitions)

  • Structural Family Therapy (brief overview of theory and techniques)

  • Case Presentation with input from You

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Try It On

  • Most individuals have a “role” they play in their family

    • Ex: “peacemaker”, “troublemaker”, “successful one”, “helper”

  • Write down one role you’ve had in your family (“family” as defined by you)

  • Now, for the big question…

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The Family Systems Perspective

  • System = set of components acting upon each other (interacting) which are mutually dependent upon each other (interdependent). Ex: Ecosystem

  • Family System = set of individuals who interact and have interdependent roles, relationships, and functions

  • Individual family member difficulties (“acting out”, depression) seen as symptoms of difficulty/dysfunction within family system (may even serve “useful” function)

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Structural Family Therapy (SFT)

I was born in Argentina and trained to be a psychiatrist in NYC

I saw the failure of doing individual therapy with inner city boys in trouble with the law - and started involving their families in treatment



Over time, with colleagues Jay Haley and Palo Alto, I helped to develop SFT, a whole-family approach to working with hard to reach kids and families in inner-city Philadelphia

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Structural Family Therapy Theory

  • Family Structure = invisible set of rules governing family transactions (family members’ interactions with each other)

  • Family Structure made up of

    • Subsystems (Sibling subsystem, Parent subsystem)

    • Boundaries (Family alliances, family rules)

    • Roles (repetitive patterns, “jobs”)

  • Family Systems function poorly when subsystems, boundaries and roles:

    • do not adapt to changing needs (developmentally) and/or

    • do not support healthy balance of closeness AND autonomy between members

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Step 1: Structural Assessment

Therapist uses family enactments, re-enactments, seating arrangements, in-session activities to assess:

  • Subsystems – what are the dynamics between family “clusters”? who aligns with whom? who gets left out?

  • Boundaries – how close are family members? how flexible are the rules?

  • Roles – what repetitive patterns do family members play out with each other? who has what “job” in family? are roles adaptive between members and clusters?

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Step 2: Therapy

Goal: To “join” family and help re-align family subsystems, boundaries and roles to be more adaptable for whole family

Sample Techniques:

  • Creating new communication channels (“Tell her, not me.”) (“Interpreting”)

  • Creating disequilibrium; escalating stress (Why?)

  • Assigning new roles (e.g., more responsibility)

  • Shifting patterns (e.g., seating at meals)

  • Establishing new boundaries (e.g., teen door)

  • Providing support, education, guidance, hope

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Garcia Family: A Case Example

Mrs. Garcia



Mr. Garcia

(1st gen


Spousal discord

Spousal discord

Emotional adjust.

Sylvia (12)



at birth

Jeremy (16)



Physical aggression


“Bad attitude” (towards mom)

Alex (6)


Adopted 1 yr before

Sergei (5)


Adopted 1 yr before

Behavior probs

Emotional adjustment

Katya (15)



1 mo before

Olga (7)



1 mo before

Emotional adjustment Language difficulty

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Elaine Shpungin

[email protected]