Does structural family therapy really change the family structure?: an examination of process variables

One important deficiency in the current body of family therapy literature is a paucity of studies examining process variables in treatment efficacy. The current study examined whether the effectiveness of structural family therapy varied depending upon the structural interventions employed by a therapist. The study compared pre and post intervention data gathered from approximately 100 families who participated in a university sponsored family intervention project. This study hypothesized that when a therapist focused on elevating the status of a scapegoated child in at least half of all sessions, the parents would report greater improvement in child behavior than when the therapist did not maintain this focus in at least half of all sessions. Specifically, more positive changes would be observed from pretest to posttest on problem behaviors on the Achenbach Child Behavior Checklist (CBCL). The results of the study did not support this hypothesis. Improvements were found from pretest to posttest in terms of observed problem behaviors on the CBCL, but such improvements did not vary depending upon how often the therapist focused on elevating a scapegoated child. This study also hypothesized that when the therapist focused on increasing parental power in at least half of all sessions, a more positive change in family organization and control would be observed than when the therapist did not maintain this focus in at least half of all sessions. This would be evident by more positive change scores on the Control and Organization scales of the Family Environment Scale (FES), 3rd edition. This study found that parental reports of family control changed in a more positive direction when the therapist focused on enhancing parental power in at least half of all sessions than when the therapist did not maintain this focus in at least half of all sessions. This study did not find differences between groups in the degree of change in scores on the FES Organization scale. This study contributes to a small body of research examining process variables in structural family therapy. Replication using larger sample sizes, more experienced therapists, and randomly assigned groups would be useful for substantiating these findings.