Brief Strategic Family Therapy

Prevention; Ages 8–17

Effectiveness

• Effective delinquency program

Description

Brief Strategic Family Therapy (BSFT) adopts a structural family systems framework to improve a youth’s behavior problems by improving family interactions that are presumed to be directly related to the youth’s symptoms. The target population in general is children and adolescents between 8 and 17 years of age displaying or at risk for developing behavior problems, including substance abuse.

BSFT is a short-term, problem-focused intervention with an emphasis on modifying maladaptive patterns of interactions. Typical sessions last from 60 to 90 minutes, with 12–15 sessions over three months. Therapy is based on the assumption that each family has unique characteristics that emerge when family members interact and that this family “system” influences all members of the family; thus the family is viewed as a whole organism. The repetitive interactions, or ways in which family members interact and behave with regard to one another, can be either successful or unsuccessful. BSFT targets these interaction patterns that are directly related to the youth’s behavior problems and establishes a practical plan to help the family develop more effective patterns of interaction.

The three primary components of the intervention are:

• Joining—understanding resistance and engaging the family in therapy.
• Diagnosis—identifying the interaction patterns that encourage problematic youth behavior.
• Restructuring—developing a specific plan to help change maladaptive family interaction patterns by working in the present, reframing, and working with boundaries and alliances.

BSFT adolescents showed significant reductions in conduct disorder and aggression from pretreatment to posttreatment, while group therapy adolescents showed no significant changes. There were also significant clinical changes in conduct disorder and aggression favoring the treatment group over the control group.

Risk Factors

Individual

Conduct disorders (authority conflict/rebellious/stubborn/disruptive/antisocial)

Early and persistent noncompliant behavior

Early onset of aggression/violence

High alcohol/drug use

Physical violence/aggression

Family

Antisocial parents

Child maltreatment (abuse or neglect)

Delinquent siblings

Family violence (child maltreatment, partner violence, conflict)

Having a teenage mother

High parental stress/maternal depression

Low parental attachment to child/adolescent

Parental use of physical punishment/harsh and/or erratic discipline practices

Poor parental supervision (control, monitoring, and child management)

Poor parent-child relations or communication

Peer

Association with antisocial/aggressive/delinquent peers; high peer delinquency

Endorsements

Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services: Model program

Society for Prevention Research: Presidential award

Center for Substance Abuse Prevention: Research award

OJJDP Blueprints Project: Promising program

Contacts

Family Therapy Training Institute of Miami
Ninth Floor
1221 Brickell Avenue
Miami, FL 33133
Phone: (888) 527-3828
Fax: (305) 661-5172
E-mail: ohervis@bsft-av.com
Web site: http://www.brief-strategic-family-therapy.com/

Training Contact

Kathleen A. Shea, Ph.D.
Family Therapy Training Institute of Miami
Ninth Floor
1221 Brickell Avenue
Miami, FL 33133
Phone: (305) 668-0850
Fax: (305) 661-5172
E-mail: kshea@bsft-av.com
Web site: http://www.bsft-av.com/

References

Robbins, M. S., and Szapocznik, J. (2000, April). “Brief Strategic Family Therapy.” Juvenile Justice Bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention.

Szapocznik, J., and Williams, R. A. (2000, June). “Brief Strategic Family Therapy: Twenty-Five Years of Interplay Among Theory, Research and Practice in Adolescent Behavior Problems and Drug Abuse.” Clinical Child and Family Psychology Review, 3(2):117–134.