Comparing Structural Family Therapy With Other Types of Therapy

Earlier research concentrated on the development, refinement, and testing of BSFT theory and strategies. The next challenge was to compare the relative effectiveness of BSFT with that of other widely used clinical interventions. Two such studies are described below.

BSFT Versus Individual Psychodynamic Child Therapy

The first study⁶ compared the effectiveness of a structural family therapy group (Minuchin, 1974; Minuchin and Fishman, 1981) with an individual child therapy group and a recreational activity control group for children with behavior problems. In addition, this study investigated the mechanisms for change used by each type of therapy. Both theoretical approaches assume underlying causes of symptoms and try to eliminate or reduce symptoms. However, each form of therapy uses a different approach to reducing symptoms. The individual child approach postulates that the child's internal (i.e., emotional, cognitive) functioning needs to be modified to eliminate the symptoms. BSFT, on the other hand, postulates that family interactions need to be modified to eliminate the symptoms. Because of these important theoretical differences, this study explored the impact of each form of therapy on child psychodynamic functioning and family interactions.

The analysis revealed several important findings. First, members of the recreational activity (control) group were significantly more likely to drop out than members of the two treatment conditions, with more than two-thirds of dropouts belonging to the control group. Second, the two forms of therapy were equally effective in reducing behavior and emotional problems.

A third finding demonstrated the greater effectiveness of BSFT over child therapy in protecting family integrity in the long term (see figure 2). In this study, psychodynamic therapy was found to be effective in reducing symptoms and improving child psychodynamic functioning, but it was also found to result in undesirable deterioration of family interactions. The findings supported the BSFT assumption that treating the whole family is important because it reduces the symptoms and protects the family, versus treating just the child, which may cause family interactions to deteriorate.

Structural Family Therapy Versus Group Counseling

A second clinical trial compared the effectiveness of BSFT with that of a control condition delivered in a group format (Santisteban et al., 1996). This study also investigated whether changes in family functioning were responsible for the changes observed in youth behavior.

Youth who received BSFT showed significantly greater improvement in behavior (p<.05) than youth assigned to group counseling. In fact, youth in BSFT showed significant improvements in conduct disorder and socialized aggression, while youth in group counseling did not.

Brief Strategic Family Therapy	Juvenile Justice Bulletin • April 2000