Brief strategic family therapy

Domain V · Systemic, relational, group & community · José Szapocznik, Olga Hervis · 2003 · Miami, USA

What it is

Brief Strategic Family Therapy (BSFT®) is a manualised, trademarked, time-limited family therapy for children and adolescents aged about 6 to 17/18. It targets drug use together with conduct problems, delinquency, antisocial peers, aggression, bullying, truancy and risky sexual behaviour. It blends…

Format

• Format and dose. The manual gives 8–24 sessions depending on severity. The Clearinghouse profile and the 2020 APA book description give 12–16 weekly sessions, adjusted to need. This guide follows the current 12–16 weekly standard and treats the manual's range as the outer limits. Sessions are…
• A video-based supervision practicum of 4–6 months, ideally weekly 2-hour sessions with trainees in pairs. Trainees must start BSFT with 3–5 families. One state contract sets 5 families as the minimum to qualify for the panel.

Who practises it, and how they are trained or regulated

• Sequence. The manual's text does not label formal treatment phases; its chapters run engagement, joining, diagnosis, then restructuring. The developers' training slides give the change sequence as joining, enactment, interactional diagnosis, treatment planning, restructuring, change. The phase labels and transition criteria below are this guide's arrangement of that sequence, except where a source is cited.
• Delivering under the BSFT name. BSFT® is trademarked and licensed by FTTIM / the BSFT Institute (Miami). An organisation may advertise as a BSFT provider only after it holds a site licence and has a team trained to full competency. The full-competency pathway works as follows:
• The site licence renews yearly if at least two therapists stay in adherence.

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

• members phoning you between sessions with information.
• the identified-patient pattern hiding the parent's use [manual p. 22].
• sliding into collecting stories. It is working when patterns repeat in front of you.
• a reversal delivered sarcastically. It is working when the other person's reply changes too.
• your own urge to fix things. It is working when the family describes the new pattern in its own words.

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.