Implementation

Philosophy

BSFT is based on the assumption that the family—one of the most important and influential systems in the lives of children and adolescents—provides the foundation for child development. As a result, BSFT conceptualizes and intervenes to change youth behavior problems at the family level. Although BSFT also uses unique interventions to work with individual family members (see “One-Person Family Therapy”), it attempts to include the entire family in treatment. In fact, therapists are very active in trying to engage reluctant family members, particularly during the early phase of therapy. The basic philosophy is that therapists will be able to understand family problems and treat youth behavior problems more effectively if they view the family's patterns of interaction directly.

Although BSFT therapists are active and directive, they never do what the family members can do for themselves. The therapist's goal is to move in and out of family interactions, creating opportunities in the session that will propel the family's interactions in a new, more positive direction. Even in these circumstances, the therapist moves briefly into a centralized role and quickly moves out of it. Ideally, when the therapist leaves the system, the family will be able to respond positively to internal and external challenges. Exceptions are allowed when crises occur or when situations arise that require expert intervention (e.g., suicidal thoughts or behaviors, family violence/abuse).

A fundamental assumption of BSFT is that families enter treatment with their own, naturally occurring, informal networks, including friends, extended family members, schools, and work. BSFT therapists examine these networks to identify potential problems or areas of strength on which to capitalize in therapy. Thus, rather than attempting to hook family members into formal systems, like social services, that tend to be transient in nature, BSFT tries to improve naturally occurring relationships so the family is more likely to maintain positive changes when the therapist (or social services agency) is no longer involved with the family.

Length of Treatment

BSFT is a short-term, problem-focused intervention. The average treatment includes approximately 12–15 sessions and lasts about 3 months. For more severe cases, such as substance-abusing adolescents, the average number of sessions and length of treatment may be doubled. It is important to note, however, that BSFT is not a fixed “package.” Treatment continues until the family achieves changes in key behavioral criteria rather than until it completes a predetermined number of sessions.

Location of Treatment

Most BSFT work with children with behavior problems occurs in the office. However, some treatment of substance-abusing adolescents and their families is conducted in the home or community. The movement to “home-based” treatment results from many factors; therapists must deal with families that are highly disorganized and/or unmotivated to attend treatments and families that lack the necessary resources (e.g., transportation, money) to make it to the office. BSFT does not believe that home or community-based treatment is required for all youth with behavior problems, but finds that it may be required for more severe cases. Therapists should never allow the location of treatment (e.g., home, office, schoolyard) to become an obstacle to treatment.

Brief Strategic Family Therapy	Juvenile Justice Bulletin • April 2000