Introduction
Clinical psychologists apply different models to every unique case based on how appropriate they are to resolving their clients’ problems. Structural family therapy (SFT) and solution-focused brief therapy (SFBT) are among the models widely applied by clinical psychologists. Although their focus is similar, the two models utilize different methods and intervention techniques to help the patient. This paper explores the SFT and SFBT frameworks and critically analyzes their therapy objectives, assessment methods, and intervention techniques based on the case of Ann, a 27-year-old client experiencing family and work problems. Furthermore, it proposes structural family therapy as the best model to apply in Ann’s case.
Structural Family Therapy
The fundamental principle in the structural family therapy model is the focus on structural change. It involves an assessment of the family foundation and hierarchical relations between the members. Based on its direct interaction nature, structural family therapy aims to assess the boundaries within a household and the interaction of the members. From these considerations, it is essential to establish a therapy relationship between the patient and the psychologist through transparent communication and mutual collaboration. According to Tadros and Finney (2018), it is necessary to form a trustworthy connection between the therapist and the family members for the SFT method to be effective and provide valid results. Furthermore, individual family members would be encouraged to develop cordial and supportive interaction patterns. Advancing productive systems of interactions among family members would mitigate the high stress levels.
Therapy Goals
The SFT model is supported by establishing specific goals and methods to achieve them. As the initial step of the therapy, the psychologist has to conceptualize the problems of the client during the first session. For that purpose, it is essential to comprehend the structure of the family, potential problems that might create conflicts within the system, and the history of mental health, alcohol addiction, and other relevant issues that might affect the relationships within the family. Analyzing these factors, the therapist should be able to conceptualize the problems of the client and create a structural map or a genogram to present visual information to the patient. With the transparent demonstration of the client’s issues, the next step is to choose the appropriate objectives of the SFT model. The structural map allows the psychologist to properly assess the problems of the patient and emphasize certain goals accordingly. Overall, conceptualization and mapping are necessary to form a clear objective of the treatment and enhance the therapy relationship between the psychologist and the patients.
Assessment
Assessment is one of the most significant steps in the proper utilization of the structural family therapy framework. The therapist should be well educated and fully aware of the intricacies in his or her line of work to be able to thoroughly assess the family interactions and reveal hidden boundaries to a functioning system within the family. Assessment is primarily executed via observation, communication, and collaboration with the patients. The objectives of such evaluation concern the formation of ultimate goals of the treatment and providing useful insights concerning family structure and relationships. Furthermore, according to Tadros and Finney (2018), assessment is a continual process throughout the whole therapy and is vital to the ultimate success of the treatment. Overall, assessment is essential to the structural family therapy model and uses diverse kinds of methods.
The first approach to the assessment concerns the investigation of the family’s structure as a fundamental principle that influences interactions. This framework reveals the hierarchical organization from the parents to children and other members. Individuals in every family have behavioral patterns that influence the structure, which must be subject to assessment. In a healthy family, there should be boundaries that guide interactions among members. However, in the current case study, the family organization is flawed and brings discomfort to the patient. A dysfunctional structure would highly disorient the cordial relations resulting in deteriorating the interactions among the household members.
A notable goal of structural family therapy is to ensure a flexible family structure that supports friendly relations. A functional structure would be, in most cases, hierarchical headed by parents. In Ann’s case, parents are responsible for setting guidelines and asserting the members’ roles. The unique nature of every family should be a critical aspect to consider when investigating the structure. Although a working family structure does not entirely help avoid crises, it helps to recover from them if the members experience such situations (Van Hook, 2019). Besides, the structure determines power and influence in a family which are vital in determining interactions. Ann’s family reflects a non-functional structure that is rigid and does not accommodate all members.
Secondly, the assessment should include subsystems that every family has. A flaw in the spousal subsystem of a family would likely affect the parent-child interactions, and, according to the case study, this subsystem in Ann’s family is flawed and, therefore, affects the siblings’ and parent-child relationships. Further, the parent-child subsystem derives authority from a functional spousal subsystem. Another critical aspect is the siblings’ subsystem. Interactions between siblings depend on a functional subsystem set by their parents. subsystems. Another critical aspect is the siblings’ subsystem which influences the interactions between siblings.
Third, the structural family therapy model involves assessing the boundaries that define family members’ roles. Boundaries are psychological and serve to organize family members in the desired role-playing structure. The spousal subsystem often sets the boundaries, which should accommodate other members without critically high levels of rigidness. Boundaries differ across families and are set with appropriate targets. In Ann’s family, boundaries are not clear and do not encourage open interactions and conversations. The rigid boundaries in the family result in potential disengagement characterized by members’ separations. Disengagement implies individual members have challenges interacting among themselves. Overall, the mentioned methods of assessment are necessary for the functioning SFT model.
Interventions and Techniques
The therapist can employ diverse strategies when applying structural family therapy. First, the therapist can use joining as an intervention. Joining involves setting cordial relationships among the family members. It involves assessing family members who are not on cordial terms to create an understanding among them and strengthen the bond. Based on the therapist’s understanding of the family’s disputes, they can enlighten members about the positives while making a case for their cooperation. The therapist would enlighten members of their strengths and privileges while emphasizing that every family member should appreciate the role of change in their interactions.
In Ann’s case, the therapist would apply to join in Ann and her mother’s case. This effort would address Ann’s concern and relieve her burdens of not getting the family’s necessary encouragement. Joining the two would eliminate Ann’s parents’ blaming her for not taking great care of them back in Malaysia and fix the relationship of Ann and her sister with whom she rarely talks. Constant and healthy communication among siblings is a fundamental success factor in the family. The evident misunderstanding between Ann and her sister, therefore, compromises their good relations. Besides, it causes dysfunction in the siblings’ subsystem. Therefore, this method presents a viable intervention to ensure that Ann and her sister embrace a loving relationship.
Besides joining, the therapist can apply an enactment intervention strategy or technique. Through enactment, the therapist attempts to make changes to the family members’ interaction. It involves encouraging family members to transform to better behaviors. Every member should have a chance to express his or her frustrations and possible intimidations they experience. The therapist should highlight the flaw in the family’s structure, hoping that every member will reform their characters. In Ann’s case, enactment would involve reorganizing Ann’s family structure to accommodate her. Ultimately, these techniques might help Ann to recover from psychological traumas concerning her family.
Diversity Issues
Diversity issues, such as race, ethnicity, gender, religion, and age, are of high significance to the successful implementation of the SFT framework. For the particular case study, the most relevant parameters are the gender and age of the patient. Ann believes that being an elder sibling has had a profound impact on how her mother perceives her in the hierarchical structure leading to stricter regulations and responsibilities. Furthermore, the patient puts additional emphasis on gender, since she has both a younger brother and a sister and believes that the relationships within the family might be affected by gender issues. The SFT model attempts to equalize the subsystems based on the diversity parameters and recover the healthy relationships within the family with no emphasis on age or gender. This is executed via conceptualizing the problems, identifying the disengaged boundaries within the family, and mending the relationships according to the therapy objectives.
Solution-Focused Brief Therapy (SFBT)
The solution-focused brief therapy (SFBT) model concentrates on the future while disregarding a client’s past. It is a strategy that outlines the goals and solutions without emphasis on the particular issues. It invokes a sense of hope in the patient and inspires them to depict a potential situation without the existing problems. Therefore, the nature of this therapy relationship is collaborative, and the psychologist merely guides the patient to recovery without strict regulations and directives. In the SFBT framework, the client should acknowledge that they have a vital role in restoring hope and determination, and, thus, the therapy relationship is established. The psychologist praises the client for their achievements rather than denouncing him or her for what they are not doing correctly. Such a healthy and nourishing relationship between the practitioner and the patient is the essence of the SFBT approach and crucial to the successful implementation of the method.
Therapy Goals
The SFBT approach focuses on the goals of creating change and transforming the client’s current condition, and, therefore, the objectives of the therapy vary vastly from case to case. According to the SFBT framework, to conceptualize the problems of the client, it is necessary to properly evaluate the mental strengths and weaknesses of the patient and propose a recovery plan according to them. Except for a review of what worked well for the client in the past, the SFBT’s objective is not to focus on the negatives. Haron, Bakar, and Suranata (2020) note that a primary goal of the SFBT model is to implement effective measures to ensure that the client adjusts in the future. Fundamentally, the SFBT model focuses on endorsing strategies that work and are beneficial to the client.
Assessment
The most fundamental assessment according to the SFBT model relates to what would successfully work to the client’s benefit and is executed in a similar way to the SFT framework. The primary methods of assessment include observation and communication and the main objective is to identify certain mental strengths and weaknesses that might be implemented in the treatment. The SFBT approach involves convincing the client that they can be free from their present state of worries and depression. The therapist would assess Ann’s situation and encourage her to have quality social relationships and ensure that she can improve her psychological well-being.
The major part of the assessment occurs in the initial stage of the therapy when the patient thoroughly describes his or her problems and personal background. In this particular case, it is evident that Ann is a strong-willed individual and has moved to another country to achieve her dreams. Such dedication to the objectives demonstrates that the patient has the inner strength to recover from the psychological issues concerning career and family problems. Nevertheless, through discussion, it is also apparent that Ann has several highly complicated complexes concerning the relationship with her mother. Therefore, the practitioner is able to assess the problems of the patient during the initial stages of the therapy via communication.
Nevertheless, some mental issues might be hidden deep in the subconscious mind of the patient and cannot be exploited via collaboration. That is the reason why the therapist needs to continually assess the condition of the patient, thoroughly observe his or her behavior, and make corresponding notes. This form of assessment is necessary for the psychologist to provide guidelines and recommendations to the patient according to the SFBT model. Overall, assessment is an essential part of the framework and is necessary to properly identify the strengths and weaknesses of the client and propose a recovery plan.
Techniques and Interventions
A critical technique applied in solution-focused brief therapy is the concept of goal clarification. This technique is based on the assumption that the client can perceive a future when the problem does not exist. The therapist, therefore, questions and coaches the client to envision the goal in a clear perspective. In Ann’s case, it would involve assisting Ann to focus on her future. She should think of herself as a regional manager in the next five years. It would involve making Ann rethink her determination and the much she would lose if she would not concentrate on her present work as a manager.
Miracle questioning is another critical technique applied in SFBT. It sets the client to have a perspective of the desired condition in which there is no problem. In Ann’s case, a miracle question would include asking her what would be best for her. If she were to concentrate on her career, how much would she achieve? Would she achieve her dream of being a regional manager if she maintains her hard work and record performance? If she stops worrying, gets sleep at night, and concentrates during the day, would she be able to perform better than currently? These miracle questions would prompt Ann to rethink her life and perceive a situation without all of her present problems. She will not have trouble concentrating at work and start engaging in various activities.
Furthermore, therapists apply the scaling questions technique in SFBT. In this technique, the therapist takes the client through a virtual journey towards achieving the ideal situation. On a scale, the therapist helps the client identify their present stage and provides recommendations to them on how to achieve their goals. The current case would involve asking Ann that, on a scale ranging from zero to ten (ten being the absolute confidence), where is your condition presently? Depending on the answer, the therapist will guide Ann through the steps she has remaining to get to ten and achieve happiness.
SFBT interventions also include coping questions to remind them that there is a positive deed and have had determination besides the challenges. It prompts the client to explain their resilience and continue living even when they feel depressed and less motivated. Similar questions to Ann would include how she has managed to keep good performance at work in her depressed state. She would answer how, at her age, she managed to get a promotion in two years. How has she managed life as an international student and now working away from her family based in Malaysia? The questions remind Ann that she has challenges but still can make them and record positive progress. She will realize her resilience and build on them to attain different results. Overall, these techniques are a great way to assist the patient in the recovery from mental traumas.
Diversity Issues
As mentioned before in the SFT sub-chapter, the patient believes that the primary diversity issues in the family structure concern gender and age. Considering the SFBT framework, the therapist might attempt to utilize coping questions to further emphasize the struggle the patient went through in her youth being an elder child. However, the practitioner needs to make sure not to further traumatize the client but rather invoke a sense of accomplishment that, despite the various troubles, Ann was able to endure the situation in the family and pursue her dreams. Such implementation of the coping questions might help the patient to evaluate the diversity issues and positively reflect on them. Therefore, the SFBT approach is an effective method to relieve the problems of the patient concerning age and gender.
Conclusion
Considering the potential implementation of the two models in Ann’s case, it is evident that structural family therapy would be more appropriate. Ann’s problem derives from her young age and relates to the behavior of her parents and sister. Although the SFBT model would help Ann relieve the anxiety issues, increase her engagement in various activities, and help her to have a healthy sleep pattern, structural family therapy would best suit her case due to the origin of the problems. The fact that Ann’s issues involve the entire family structure makes a strong case for choosing the SFT model. Unless the other family members adopt a behavior change, Ann’s problems cannot be solved in isolation using the SFBT model. Therefore, the structural family model is the most preferred approach in the current case.
References
Haron, R., Bakar, A. Y. A., & Suranata, K. (2020). Application of Solution-Focused Brief Therapy (SFBT) to help clients with anxiety issues. BISMA The Journal of Counseling, 4(1), 16-20. Web.
Tadros, E., & Finney, N. (2018). Structural family therapy with incarcerated families: A clinical case study. The Family Journal, 26(2), 253-261. Web.
Van Hook, M.P. (2019). Social work practice with families: A resiliency-based approach (3rd ed.). Oxford University Press.