Salvador Minuchin's Impact on Family Therapy

By: Stephanie Kirby

Updated May 06, 2021

Medically Reviewed By: Aaron Horn

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Often, the problems that people are facing and the behaviors that they exhibit are just a piece of the puzzle of what is going on. When you see a person that appears as they could benefit from therapy, there might be more to what is happening than what you can see in that person, and that's where family therapy comes into play. According to an article by healthypsych, family therapy "views problems as patterns or systems that need adjusting, as opposed to viewing problems as residing in the person." Family therapy is a different way of looking at and treating problems within a person, and Salvador Minuchin was one of the leading experts in the field and one of the creators of Structural Family Therapy.

Who Is Salvador Minuchin?

Salvador Minuchin is credited with changing the process of how family therapy works. His past provided him with many examples of how the dynamics of a family routinely change and have an impact on the way the family can function. His family was involved, strict and fair, and worked together to support one another. He witnessed a change in the hierarchy of his family when his father lost his business, and his uncle took over as the figurative head of the household when he wasn't present.

Minuchin attended medical school planning on becoming a practicing pediatrician. However, he ended up enlisting as a physician for the Israeli army in 1948. After serving, he studied child psychology in New York before returning to Israel with his wife. He worked to help disturbed children, many of whom were survivors of the holocaust. After several years, he returned to the United States with a plan to become a psychoanalyst. However, while working at a school for troubled children, he noticed something with New York children living in poor neighborhoods. The treatments that they were taught to use were ineffective in reaching these children. Minuchin and a group of other therapists began to look for a different solution

What Did Salvador Minuchin discover?

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When Minuchin started, his work therapists were using more of a sit back and listened to type of technique. According to Psychology Today, "Minuchin came to realize that successfully treating children and adolescents requires the support and cooperation of parents and other family members. He felt that the root of most childhood problems is not within the child but the family unit. Therefore, to change the child's behavior, the therapist must help change the family dynamics."

He realized what they were doing was not working and wasn't exactly sure what needed to be done differently. He and other therapists developed a study process where they asked other professionals, such as teachers, supervisors, and colleagues, to sit behind a one-way mirror and watch as they interviewed families. They wanted feedback and what they were doing, and from those studies, they began to build the idea of active family therapy.

Structural Family Therapy

Where individual therapy is focused on the individual in therapy and their behaviors, family therapy focuses on the dynamics of the family as a whole and the impact that it has on the individual. Salvador Minuchin saw the impact that the family life played on the individual. He also noticed that using the approach of sitting back and listening to the family was not working to help the family improve their behavior.

In the 1960's Minuchin developed Structural Family Therapy. The form of therapy is useful when providing treatment for at-risk children and families. This includes single-parent families, blended families, extended families, and those that face difficult socio-economic situations. The purpose of this type of treatment is to find and change the disruptive behaviors that exist within a family unit. Then, the therapist works with the family members to learn and practice new and healthy behaviors including establishing proper boundaries.

How Family Structure Therapy Works

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When a therapist is using Family Structure Therapy with a patient, they pinpoint the hierarchy of the family. They are looking to find out what the family rules are, who has the power, and what the structure is. To successfully do this, the therapist must play an active role in working with the family. It will not work if they simply sit back and observe.

There are three key concepts to Family Structure Therapy:

Family Sub-Systems

These are smaller groups that exist within the family. Each group serves its specific purpose. The main groups include:

• Spousal - husband, and wife
• Parental - parent and child
• Siblings - brothers and sisters
• Extended - includes grandparents, aunts, uncles, and other distant relatives

Each person can belong to multiple groups. A married woman with children is a wife to her husband, mother to her children, and daughter to her parents. If she has siblings, then she also belongs to a siblings sub-system. When one of these groups intrudes into another group, it causes dysfunction within the family. For example, when children are constantly intruding in the spousal sub-system, it can cause problems within the marriage. Or, when in-laws are overstepping their role and becoming too involved with the raising of children, it can throw off the family dynamics.

Another issue that can happen is when a new sub-system is formed and excludes others in the family. An example of this would be when one parent and one child have a special bond, and they allow that to cause them to exclude other members of the family.

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Family Structure

Every family has rules that establish the routines of the family structure. Family members understand these rules even though they may be unspoken. When the rules are healthy, and the entire family is on the same page, this can build trust within the family. It can lead to good communication and allow family members to support one another properly. Therapists can see the family structure as they watch the way the family group interacts with each other and how they talk to one another. By doing this, they are also able to observe the hierarchical structure of the family. From this, they can see who holds the authority within the family.

Boundaries

Boundaries are what regulate what is allowed to enter the sub-systems. They help dictate what is allowed to occur within the family. Healthy boundaries help protect the family, and lack of boundaries can destroy sub-systems. There are three types of boundaries:

1. Rigid boundaries - When boundaries are rigid, they are restrictive and very limiting. It allows for minimal contact from those that are outside of the sub-system. These types of boundaries create isolation. Those in the sub-system do not have an environment of support and affection in the family system.
2. Diffuse boundaries - When boundaries are diffused, they are unclear. This is a lack of boundaries that lead to a breakdown in sub-systems. Lack of boundaries allows for other people to intrude the system and become over-involved.
3. Healthy boundaries - Boundaries are healthy when they are clear. A combination of the first two types of boundaries is ideal. They should be established, so everyone understands them, but not so rigid that it becomes unhealthy for family members.

The Goal Of Structural Family Therapy

When Salvador Minuchin developed Structural Family Therapy, it was to help the family recognize the interactions among family members and make the changes they need to improve behavior. The therapists should help to establish healthy boundaries within the family and sub-systems. They also work to establish an appropriate hierarchical structure where the children do not control the parents.

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To accomplish these goals, the therapist has to take an active and involved role within the family structure to help establish proper leadership. After observing how the family interacts the therapist will create a map that shows the current family structure. It will help show the current boundaries, hierarchy, and the sub-systems. With this in place, the family can see where changes need to be made, and the therapist can implement interventions to make the necessary changes so that they can reach a level of healthy functioning.

How The Therapist Helps The Family Reach The Goals

There is a process that the therapist goes through to help the family reach the goals. These include:

• The therapist works at joining and accommodating. This is when the therapist works to build a connection with each member of the family. For the process to work there needs to be trust between the family and the therapist.
• The therapist observes how the family behaves together. During this process, they are watching for which person is leading the family, which ones are defensive, and which one is most likely to attack.
• Then, the therapist maps the underlying structures of the family.
• The family then completes role-playing exercises, so the therapist can watch and intervene to help teach appropriate behavior.
• Work on restructuring to create new boundaries that are necessary for the family to strengthen.
• When needed the therapist goes through an unbalancing process where they join with a sub-system or individual to help break an impasse in the system to help the relationship.

The Impact Of Salvador Minuchin On Family Therapy

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The work of Salvador Minuchin led to the development of a type of family therapy that has helped many family structures function properly. The process is present-oriented, focusing on the current problems and addressing them. Therapists help families get organized, create a proper hierarchical structure and boundaries to create a family environment that each member can flourish in. It is a way to treat the individual by treating the underlying cause of their troubling behavior. It helps improve multiple people instead of just one individual. Salvador Minuchin has made a lasting impact on family therapy that has helped many individuals and will continue to.