Structural family therapy and person-of-the-therapist training

Domain V · Systemic, relational, group & community · Salvador Minuchin, Braulio Montalvo, Harry Aponte · 1974 · Philadelphia, USA

What it is

SFT is a conjoint family therapy developed by Salvador Minuchin with colleagues including Braulio Montalvo and Harry Aponte (Wiltwyck School, then the Philadelphia Child Guidance Clinic). It treats a symptom as held in place by the family's current organisation (who is close to whom, who decides,…

Format

• Session count. The four-step assessment is described as a two-session model; experts in the 2013 study often covered all four steps in one consultation, and the authors note less experienced therapists may need more than one session. No fixed total length for SFT appears in the sources;…
• How change happens. In SFT, change comes from experience in the session rather than insight: the therapist joins the family as its temporary leader, gets members to enact the problem pattern in the room, and then blocks, intensifies or redirects the transactions so the family experiences a…

Who practises it, and how they are trained or regulated

• Format. Conjoint family sessions with flexible subsystem sessions; Montalvo's live supervision (supervisor behind a one-way mirror, calling in or entering) was a hallmark of structural training.
• No certification, licence or fidelity monitoring is required to practise SFT or to use POTT ideas under those names in the sources. Structural training continues at the Ackerman Institute (e.g. workshops by Jorge Colapinto, who trained with Minuchin); POTT is taught at Drexel.
• Version followed: structural family therapy (SFT) as codified in Minuchin & Fishman, Family Therapy Techniques (1981; chapter structure verified), with the assessment phase organised by the four-step model of Minuchin, Nichols & Lee, Assessing Families and Couples (2007), as operationalised by Nichols & Tafuri (2013); person-of-the-therapist training (POTT) as run in the Drexel University Couple and Family Therapy…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the family citing its own competence.
• the family using the new frame in their own words.
• each member naming their own task, not the others'.
• behaviours that can be seen on video (useful for B4).
• each member describing their own contribution unprompted.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.