Academic journal article Journal of Marital and Family Therapy

Family-Directed Structural Therapy

Academic journal article Journal of Marital and Family Therapy

Family-Directed Structural Therapy

Article excerpt

Family-Directed Structural Therapy (FDST) is an approach to family therapy built on traditional concepts of Structural Family Therapy, the Strengths Model, and Group Work Theory. The FDST approach is a goal-oriented, time limited approach that enables the family to identify strengths and areas of concern, as well as to enhance family functioning. This process is facilitated via the use of a common vocabulary and a concretely organized, easily administered FDST Assessment Tool that is completed by adult family members. This article presents the essential features of the FDST approach, including the use and scoring of the FDST Assessment Tool. It concludes with an extensive case example.

INTRODUCTION

Family-Directed Structural Therapy (FDST) is an approach to family therapy built upon traditional concepts of Structural Family Therapy (Minuchin, 1974; Nichols & Schwartz, 1995), the Strengths Model (Rapp, 1998; Saleebey, 1996), and Group Work Theory (Anderson, 1997). The influences of these constructs will be explained as the FDST model is described. The FDST model incorporates novel ideas to produce a treatment modality and a concretely organized, easily administered FDST Assessment Tool that is completed by adult family members (see Appendix).

The FDST approach is time-limited and family progress is easily measurable, thus this approach to helping families is particularly useful in the managed care environment in which family therapists now function. FDST is a structured modality that moves beyond the pathological and constrictive conceptualization of a diagnostic profile. Instead, it is a goal-oriented process that empowers the family through identification of strengths and the provision of concrete skills and is designed to be utilized by the family both inside and outside the clinical setting.

Over the past twelve years, FDST was developed and utilized with approximately 450 family members in a rural mental health center in the Midwest. These families represent a highly diverse mix of familial structure, socioeconomic status, ethnic background, and level of education. Parental/adult family members are the focus of FDST, as they are seen as the fulcrum of power and change within the family. Children are directly included in the therapeutic process when parental family members have clarified and started to address core issues, roles, boundaries, and external Stressors.

The FDST approach facilitates the attainment of the goals of accentuating family strengths and decreasing family conflict in a time-limited manner, as the initial assessment generally requires one 90minute session and then seven to nine sessions follow to assist the family in incorporating the process and vocabulary of FDST into their daily lives. These seven to nine sessions occur as family needs dictate, although experience has shown that sessions occurring at six weeks, three months, and six months post-intake can help to reinforce FDST concepts, assist families to assess any new areas of concern, and apply the FDST framework accordingly.

This explanation and examination of FDST will be discussed within the context of the following: (a) definition of terms including core issues, roles, boundaries, external Stressors, and framework of interaction; (b) use and scoring of the FDST Assessment Tool, which includes the scoring of core issues, roles, and external Stressors; and c) use of the FDST Assessment Tool in ongoing assessment and evaluation. Following this explanation, a case study will be presented.

DEFINITIONS

In FDST, core issues serve as the foundation of family functioning. FDST core issues are commitment, credibility, empowerment, control of self, and consistency. The conceptualization of these core issues is influenced by Group Work Theory (Anderson, 1997; Yalom, 1995).

* Commitment - the willingness to see situations through, despite differences and conflicts

* Credibility - communicating what one will or will not do and demonstrating the ability to carry it through

* Empowerment - having a sense that one's individual opinions are valued and respected, and believing one can effect change. …

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