“ ..every family has a structure,
and this structure is revealed only when the family is in action.”
Nichols & Schwartz, 2008: 208
“Using the concept of family structure enables therapists to intervene
in a systematic and organised way.”
Nichols & Schwartz, 2008: 183
“The therapist doesn’t solve problems; that’s the family’s job.
The therapist helps modify the family’s functioning so that family members can solve their own problems.”
Nichols & Schwartz, 2008: 193
As family therapists, one of our central tasks is to help families navigate their relationships so that they can function more effectively and contentedly. Structural Family Therapy, pioneered by Salvador Minuchin, offers a powerful framework for understanding and shifting family dynamics. Structural Family Therapy focuses on family structures, hierarchies, rules, roles, and boundaries, recognising that what maintains problems is often patterns of interaction and not individuals. Rather than viewing dysfunction as an issue within an individual, Structural Family Therapy sees problems as arising from maladaptive structures within the family system. The goal is to alter structures and create new patterns of interaction that promote healthier family functioning.
For example, Salvador Minuchin (and his colleagues) proposed this simple but enduring point: Children thrive when parents/carers collaborate in looking after them. It’s important that parents are family leaders, “steering the ship” and providing a sense of “we’ve got this”. This type of leadership enables patterns of interaction that promote healthy, thriving families.
But how do trainee family therapists go about knowing what to do to help families with structures and patterns, and how to do it? “Beginners tend to get bogged down in the content of family problems because they don’t have a blueprint to help them see the pattern of family dynamics” (Nichols & Schwartz, 2008:185). Structural family therapy provides a blueprint for understanding the family and intervening to help promote the wellbeing of individual family members and the family as a whole.
So what are the basics of Structural Family Therapy and how can you incorporate them into your practice? Let’s start with an overview of the key elements of the approach.
Key Elements of Structural Family Therapy
What is Structural Family Therapy? Structural Family Therapy is a systemic therapy approach that examines and restructures family organisation to promote healthier functioning. It views families as dynamic systems where problems are maintained by rigid, loose, chaotic, or unhelpful structures, rather than individual deficits. By working directly with the family’s structure, therapists help members develop new ways of relating to one another.
“The fundamental view is that alterations made to the organisational structure of a family will change the symptomatic behaviour.”
Dallos & Draper, 2024: 49
Why is it helpful? Structural Family Therapy provides clear strategies to address power imbalances, boundary confusion, and problems with parental leadership. Families often get stuck in repetitive patterns that reinforce distress, with these patterns becoming the taken for granted norm. Structural Family Therapy offers a way to disrupt these cycles. By making tangible shifts in structure, the family system becomes more flexible and adaptive.
Who are the Key Figures? Salvador Minuchin is the founding figure of Structural Family Therapy, with contributions from Braulio Montalvo, Harry Aponte, and Charles Fishman. Minuchin’s work emphasised the importance of therapist-directed interventions, active participation, and the restructuring of family interactions as the key to therapeutic success.
How Does the Therapist Position Themself? The therapist is active and directive, joining the family system to assess structures and enact change. Unlike traditional talk therapies that rely heavily on insight, Structural Family Therapists engage in real-time interventions, often directing interactions between family members in session to help shift patterns. This means therapists must be engaged and strategic, assessing, hypothesizing, and stepping in to challenge unhelpful dynamics and also reinforcing positive dynamics and change. Salvador Minuchin had a particular presence, but you don’t have to emulate him and become a “mini-Minuchin”. It’s important that you find your own style, as did this student of Minuchin’s.
“Mary Poppins transforms the lives of the Banks family precisely because she enters their family system without accepting their rules. It is her intention from the first moment to stay only “until the winds change”, and her brisk, self-assured, enigmatic way of relating to the family communicates that she is essentially separate from them. I knew that modeling myself after her would give me the maneuverability and authority that I currently lacked”
From a Student of Minuchin,
Minuchin, Reiter & Borda, 2014: 199
What is the Theory of Change? Change occurs through changing behaviours, e.g., restructuring family interactions, shifting hierarchies, strengthening parental leadership, establishing clear boundaries, and changing beliefs that support unhelpful behavioural sequences. Structural Family Therapy does not prioritize insight as a mechanism of change; instead, it focuses on modifying behaviour and relational patterns directly within the session, e.g., noticing and amplifying helpful interactional sequences and blocking unhelpful sequences. The belief is that families experience change not by simply understanding their problems, but by engaging in new, healthier ways of interacting. For example, by physically altering seating arrangements, reinforcing appropriate hierarchies, and facilitating real-time corrective experiences, Structural Family Therapy promotes sustainable change from the inside out.
“Structural therapy changes behaviour by opening alternative patterns of interaction that can modify family structure.”
Nichols & Schwartz, 2008: 193
“In some cases, it is presumed that beliefs will only change as an accompaniment to changes in behaviours – seeing is believing.”
Dallos & Draper, 2024: 49
Now, let’s explore three common family struggles through an Structural Family Therapy lens and how we can support change.
1. When Parents Are Walking on Eggshells
AKA Inverted Hierarchy
Scenario:
Rebecca (15) has been struggling with emotional outbursts, that impacts how the household runs. Her parents, Jason and Emily, avoid conflict with her, afraid of triggering her distress and being especially fearful of doing anything that might push her over the edge to self-harm. They love her dearly and are scared. And so, they find themselves giving in to her wishes and demands—whether about dinner choices, screen time, or school attendance—to keep the peace. Over time, this pattern has reinforced Rebecca’s behaviours, making it even harder for her parents to set limits without facing significant pushback. They are just too anxious to rock the boat.
What’s Happening from a Structural Family Therapy Lens?
This is what the theory calls an inverted family hierarchy. Instead of Jason and Emily leading with confidence, Rebecca holds more power, setting the emotional tone for the household and enacting a level of power that is just not healthy for her. When parents become hesitant to assert authority out of fear of emotional reactions, children can experience heightened anxiety rather than security. Rebecca may not feel truly in control, but rather overwhelmed by the burden of managing the emotional climate at home.
Therapeutic Interventions:
Joining & Strengthening: This involves acknowledging the parents’ fears, validating the difficulty of change, and helping them understand that their leadership is necessary for Rebecca’s emotional security. Strengthening their ability to tolerate Rebecca’s distress without backing down is crucial.
Restructuring Authority: In a situation like this, a Structural Family Therapist would help Jason and Emily reclaim their leadership by setting clear, consistent, firm yet compassionate boundaries. Parents need to shift from reacting to Rebecca’s distress to confidently and compassionately maintaining structure, even in the face of pushback.
Spontaneous Enactments: Enactment is the term Structural Family Therapy uses to describe when a family shows us how they really are. A Structural Family Therapist would observe how the family naturally interacts in session and coach them in the session. If Rebecca challenges a parental decision or the parents hesitate in setting limits, the therapist coaches the parents in real-time to reinforce healthier structures, e.g., supporting Jason and Emily in confidently holding their ground while remaining emotionally present for Rebecca.
Practical Tip: Encourage parents to respond with calm consistency. If Rebecca refuses to go to school, rather than pleading or negotiating, they maintain a neutral stance and enforce logical consequences, such as switching off the internet.
2. When Parents Are Steering the Ship in Different Directions
AKA Executive Subsystem Disunity
Scenario:
Toby is a 5-year-old boy reported to be oppositional and defiant, and his parents Mark and Sarah are considering an ADHD assessment. Mark and Sarah have different parenting styles—Mark is firm and structured, while Sarah is more permissive. Toby has quickly learned that if Dad says no, Mum will most likely say yes. This inconsistency leads to daily power struggles, frustration for both parents, and confusion for Toby, who is left unsure about which rules to follow, and he communicates his distress via his behaviour.
What’s Happening from a Structural Family Therapy Lens?
Mark and Sarah aren’t on the same page so the parental subsystem lacks unity. Children feel more secure when they experience consistency, and Toby is learning to navigate the divide between his parents in ways that increase family tension. The mixed messages from his parents make it difficult for him to internalise rules, as the family structure remains unpredictable, leading Toby to be viewed as being the problem or having problems.
Therapeutic Interventions:
Aligning the Parental Subsystem: A Structural Family Therapist would guide Mark and Sarah in developing shared parenting strategies and core values, and establish consistent responses, presenting a unified front to Toby.
Spontaneous Enactments: The Structural Family Therapist would observe real-time interactions where Mark and Sarah give conflicting instructions or undermine each other’s authority and coach them in-session to pause, check in with each other, and agree on a unified response before addressing Toby. The therapist can also set homework tasks for the parents to reinforce this e.g., asking parents to set aside time for a coffee date to discuss their values and brainstorm united ways of responding to Toby.
Practical Tip: Introduce a ‘pause button’—if Toby asks one parent for something, that parent checks in with the other before giving a response. This ensures they present consistent messaging and prevents Toby from being impacted any inconsistencies.
3. When Kids Co-Captain the Ship
AKA A Coalition between a Child and a Parent
Scenario:
Twelve-year-old Mia has become increasingly anxious and started to become reluctant to attend school. Her parents separated recently and Mia has become her mother’s confidante since then. She aligns with her mum Lucy, frequently criticising her dad, Tom. When Tom enforces rules, Mia defends her mum, telling him he’s being unfair. Over time, Mia has become enmeshed in her mother’s emotions and positioned in an adult role within the family, even at times to the point of soothing her mum’s distress and having a go at her dad for his behaviour.
What’s Happening from a Structural Family Therapy Lens?
Mia has been elevated into an inappropriate role, forming a coalition with her mother against her father. This triangulation places her in an emotionally burdensome position, making it difficult for her to focus on her own developmental needs. Instead of being a child, she has been drawn into adult concerns, which can create stress, anxiety, and confusion about her place in the family.
Therapeutic Interventions:
Dismantling the Coalition: A Structural Family Therapist would gently support Mum in recognising the impact of this dynamic on Mia and encourage her to seek emotional support from other adults so that Mia can focus on being a child. Mia might even be playfully “fired” by the therapist from the role of her mother’s helper.
Restoring Generational Boundaries: If possible, it would be helpful to work with both parents to strengthen their co-parenting relationship so Mia is not forced to ‘side’ with one parent. A structural approach would be to help Tom and Lucy keep their adult conflicts for themselves and not Mia.
Spontaneous Enactments: The Structural Family Therapist would observe interactions in session where Mia steps into an adult-like role, such as speaking for her mother or correcting her father and gently coach the parents to redirect Mia into an age-appropriate position, reinforcing their parental position.
Practical Tip: Encourage parents to use language that reassures Mia that she does not need to carry adult burdens. For example, they might say, “This is a grown-up matter. You don’t need to worry about this—we’ve got it handled.” This can help Mia gradually step back into a more developmentally appropriate role.
Some Final Thoughts
“Families often describe themselves more as they think they should be than as they are.”
Nichols & Schwartz, 2008: 198
Structural Family Therapists adopt a systemic perspective, looking beyond the presenting problem and beyond the individual to examine how the family system has attempted to resolve the issue, identifying structures and patterns that are perpetuating problems. And then the therapist intervenes actively e.g., by encouraging family members to deal directly with each other. Structural Family Therapy provides concrete strategies to help families regain balance. Whether reinforcing parental leadership, fostering alignment between caregivers, or restoring generational boundaries, small but intentional changes can create profound shifts in family functioning.
For therapists, an active, directive approach is key. By observing and intervening in real-time family interactions, we help families reshape their structures, ensuring the right people are steering the ship. In contemporary practice Structural Family Therapy still has an important place, but the approach would keep in focus strengths and capacities, non-pathologizing language, transparency and collaboration.
Points for reflection
What resonated with you? What didn’t?
What would you like to learn more about?
How would incorporating Structural ideas into your approach support the work you do?
Leonie
Dr Leonie White
Clinical Family Therapist and Psychologist
Director Phoenix Family Therapy Academy
Helping people grow, connect and thrive in life’s unique journey.
Please note - this article is educational in nature and does not constitute therapy advice.
Please seek help from a professional if you require support.
Photo Attributions:
All photos are from Canva Pro and Vecteezy Pro, except for the picture of Mary Poppins from https://charactercommunity.fandom.com/wiki/Mary_Poppins_(character)
References:
Becvar, D. S, & Becvar, R. J. (2013). Family Therapy: A Systemic Integration (8th ed.). Pearson: USA
Dallos, R., & Draper, R. (2024). An Introduction to Family Therapy: Systemic Theory and Practice (5th ed) McGraw Hill Open University Press.
Hayes, H. (1991). ). A Re-Introduction to Family Therapy: Clarification of Three Schools. ANZJFT, 12(1), 27 – 43.
Lappin, J. (1988). Family Therapy: A Structural Approach. In Dorfman, R. (Ed.) Paradigm of Clinical Social Work, New York: Brunner/Mazel.
Minuchin, S. (1974). Families & Family Therapy. Harvard University Press
Minuchin, S. & Fishman, H.C. (1981). Family Therapy Techniques. Harvard University Press.
Minuchin, S., Reiter, M. D. & Borda, C. (2014). The Craft of Family Therapy: Challenging Certainties. Routledge.
Nichols, M. P. & Schwartz, R. (2008). Family Therapy: Concepts and Methods (8th ed). Allyn and Bacon; Boston.
Rivett, M & Street, E. (2009). Family Therapy: 100 Key Points & Techniques. Routledge
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