Handbook of Family Therapy: The Science and Practice of Working with Families and Couples

By Thomas L. Sexton; Gerald R. Weeks et al. | Go to book overview

CHAPTER 9

Structural-Strategic Approaches to Couple and Family Therapy

VICTORIA BEHAR MITRANI, PhD

MARIA ALEJANDRA PEREZ, BA
University of Miami


INTRODUCTION

Other textbooks on family and couple therapy have had separate chapters for the structural and strategic approaches. In this volume, the two models, structural family therapy, as developed by Salvador Minuchin, and strategic family therapy, as developed by Jay Haley, are presented together because of their common emphasis on systems and structure. Both approaches aim to realign family organization to produce change in the entire system, and both are focused on the hierarchical organization of the family. We have chosen to highlight the branch of strategic family therapy developed by Jay Haley because of its structural framework. Other strategically oriented approaches are no less influential than Haley's and have, in fact, been precursors to many of the dominant movements in modern family therapy approaches.

There are key points of divergence between Minuchin's and Haley's approaches, however. The structural approach emphasizes family organizations composed of subsystems and focuses on boundaries between subsystems. The strategic approach focuses on repeating sequences of behavior, particularly those that break hierarchical rules through cross-generational coalitions. Structural therapists focus on resolving structural problems in the family, whereas strategic therapists focus on the presenting symptom. Although both therapeutic approaches are action- and present-oriented, structuralists utilize interpretation and tasks in the form of enactment, whereas strategists shun interpretation and utilize both straightforward and paradoxical directives. Minuchin and Fishman (1981) highlight another key difference: “The strategic therapist sees the symptom as a protective solution: the symptom bearer sacrifices himself to defend the family homeostasis. The structuralist, regarding the family as an organism, sees this

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