Family and Systemic Therapies 349Structural family therapy
Salvador Minuchin developed this approach in the 1960s, working with
deprived ethnic minorities in the USA. It is geared to the present, and
operates in the here and now. Thus, there is no discussion of past history,
or the origins of dysfunctional relationships. Change occurs through action
and not via gaining insight. Problems addressed are in the present day-to-
day world, not unresolved past inner conflicts. It is based on anormative
family modelthat is functioning well, in which there areclear and well-
marked boundaries in relationships. This is especially true in:
1 The marital subsystem – protection of spouse privacy.
2 The sibling subsystem – a hierarchical organisation in which different
tasks and privileges are consonant with the age and gender of the
siblings, as determined by the family culture.
3 The boundary around the nuclear family, which is well demarcated,
while recognising great cultural variations.
It is a fundamental principle that the symptom is the product of a
dysfunctional family system, and that if the family organisation becomes
more normal or functional, the symptom will disappear. Symptoms are
not specific to dysfunctional structures.
Te r m s
Hierarchy. The relative influence of each family member on the outcome
of an activity. This needs to be defined in relation to specific circum-
stances, as it is not a permanent or invariable concept. For example,
parents exercise responsibility and authority. A ‘parentified’ child or
adolescent (who has taken on a parental role within the family) is an
example of abnormality or dysfunction.
Boundary. An invisible line that demarcates a system, subsystem or indi-
vidual from its surroundings. It arises from the rules of who participates
in an operation and how it is carried out, and from the roles each
person takes towards others during a particular family function. The
boundary preserves the integrity of the (sub)system so members can
carry out tasks without interference, but should be permeable enough
to allow interdependence. Thus, boundaries can be construed along a
continuum, with one end too permeable and the other too rigid:
Enmeshment results from boundaries that are undifferentiated, per-
meable, or fluid. Individuals in the relationship are handicapped by
not being able to be autonomous.
Clear boundaries promote healthy relationships.
Disengagement results from rigid, impermeable boundaries, and there
is little interplay or communication between family members.
Alignments. These occur through the joining or opposition of one mem-
ber of a system to another in carrying out an operation; they can be
positive or negative. Structures observed may include:
Coalitions of two family members against a third: for example, father
and son against mother. Coalitions vary in how stable they are. Some