Family Directed Structural Therapy:A Brief Summary

By Tom Smith, Ph.D.

 

Since 1982, Don McLendon, collaborating with the University of Kansas, developed and enhanced a family therapy modality named Family Directed Structural Therapy. FDST is a goal-oriented, time limited approach to family therapy built on the traditional concepts of Structural Family Therapy (Salvador Minuchin in the early 70’s followed later by Nichols and Schwartz, et. al) and group theory developed by Irving Yalom. McLendon with Tara McClendon is currently collaborating with the University of Kansas to document the effectiveness of this modality in specific clinical settings, including the use of this model in a therapeutic wilderness family camp. A manuscript outlining this family therapy model is currently submitted for publication.

This approach is time limited and is initiated by the administration of the FDST Assessment Tool to the adults in the family. The FDST Assessment Tool provides a context and vocabulary for the family to begin recognizing core issues, roles, boundaries and the external stressors that are at the root of family conflict. The core issues addressed using the tool are commitment to resolving family problems, credibility in declaring what one will or will not do, empowerment of all family members that their views, feelings and opinions are to be valued and respected in order to effect change in family relations, the importance of maintaining self-control and consistency in behavior and expression, surrendering unproductive behavior and adapting to new behaviors that improve relations and finally, a focus on family strengths to build upon them.

Roles that are explored are husband, wife, parent, father, mother, individual and child, much like traditional structural therapy. The needs, wants, demands and conflicts contingent upon the various roles are also clarified and addressed.

Boundaries in the FDST model are not so much concerned with the traditional ones between sub-systems, but rather the delineations between the different roles identified above as well as the role of the family as it relates to the relationships and dynamics external to the family. Use of the Assessment Tool enables the family to actually visualize the boundaries, or lack thereof, in the family system.

External stressors (positive, negative, supportive or destructive) considered outside of the internal family structure are numerous. These include the so called, “ex’s” as in “My ex-husband, wife, in-law, etc.”, finances, living conditions, legal concerns, church obligations, friends, school, health, disabilities, addictions and others.

When using the FDST Assessment Tool, adult family members not only assign scores to the core issues, roles and external stressors, but they also assign meaning and priority to the scores and thus progress is easily measurable.

Once the results of the Assessment are evaluated, a framework of family interaction not so different from basic psychotherapeutic techniques is provided to aid the family in discussing the above components. This framework starts by identifying strengths so the family begins their exploration and discovery with a sense of hope. Everybody has a right to expression in an appropriate way; that is to say, there are “rules of engagement” that encourage and discourage certain behaviors; for example, everyone agrees not to get physically or verbally violent, not to use profanity or act out in other destructive or unproductive ways. These “rules” are different for every family.

Family members are encouraged to use “I” statements and talk about self and not the “other” in order for everyone to take responsibility for there own feelings and needs. Additionally, it is pointed that even in the most healthy of family systems not everyone’s needs are met at all times. Perfect, trouble free relations are not the goal, but rather a positive working relationship between family members is sought. That is to say, when there are disagreements, sometimes it is okay to agree to disagree also when offering a positive statement about another it is important not to negate it using underhanded language; for example, “George is good at helping out in the evening, BUT he NEVER takes out the garbage.”

Very often, when families start to realize their conflicts, competing needs and goals and other aspects of family life that brought them into therapy in the first place, they also realize that many of the expectations that they have for one another are not reasonable. “Reality checks” are an important part of getting the family back into a reasonable frame of mind to arrive at reasonable solutions to problems that have been put into reasonable perspective. The old Latin dictum, “Nemo dat quod non habet” comes to mind. We cannot expect something from someone who cannot give it because she does not have it. Children need to be approached and worked with in a manner that is commensurate with their stage of development. We do not ask a three year old to go get the fire starter for the grill. If we have a four year old who is still throwing tantrums, we cannot expect a change in behavior in a few days or even weeks and sometimes it may take months if there is an emotional disturbance involved.

The FDST approach is most useful for families that are not terribly disturbed or steeped in domestic violence, self-destructive behaviors or major addictions. The family must have some modicum of civility and an ability and willingness to communicate and resolve problems for the FDST approach to be effective. The FDST model is not for all families. For a complete discussion of the Assessment tool and how to use it, as well as a case study see the McLendon citation below.

References

McLendon, D., McLendon, T., Petr, C. G. (2005). FAMILY-DIRECTED STRUCTURAL THERAPY.Journal of Marital and Family Therapy 31 (4), 327–339. doi:10.1111/j.1752-0606.2005.tb01574.x

Minuchin, S. (1974). Families and Family Therapy. Cambridge, MA: Harvard University Press.

Nichols, M. P., & Schwartz, R. C. (1998). Family therapy: Concepts and Methods. Needham Heights, MA: Allyn & Bacon.

Yalom, I. D. (1995). The theory and Practice of Group Psychotherapy. New York: Basic Books.