In 2007, a survey in the magazine Psychotherapy Networker of 2,600 psychology practitioners named Minuchin as one of the ten most influential therapists of all time. This list is as follows:

1. Carl Rogers
2. Aaron Beck
3. Salvador Minuchin
4. Irvin Yalom
5. Virginia Satir
6. Albert Ellis
7. Murray Bowen
8. Carl Jung
9. Milton Erickson
10. John Gottman

Minuchin’s goal is to promote a restructuring of the family system along more healthy lines, which he does by entering the various family subsystems, continually causing upheavals by intervening in ways that will produce unstable situations which require change and the restructuring of family organization.

Therapeutic change cannot occur unless some pre-existing frames of reference are modified, flexibility introduced and new ways of functioning developed. To accelerate such change, Minuchin manipulates the format of the therapy sessions, structuring desired subsystems by isolating them from the remainder of the family, either by the use of space and positioning (seating) within the room, or by having non-members of the desired substructure leave the room (but stay involved by viewing from behind a one-way mirror).

The aim of such interventions is often to cause the unbalancing of the family system, in order to help them to see the dysfunctional patterns and be open to restructuring. He believes that change must be gradual and taken in digestible steps for it to be useful and lasting. Because structures tend to self-perpetuate, especially when there is positive feedback, Minuchin asserts that therapeutic change is likely to be maintained beyond the limits of the therapy session.

One variant or extension of his methodology can be said to move from manipulation of experience toward fostering understanding. When working with families who are not introspective and are oriented toward concrete thinking, Minuchin will use the subsystem isolation, one-way mirror technique to teach those family members on the viewing side of the mirror to move from being an enmeshed participant to being an evaluation observer. He does this by joining them in the viewing room and pointing out the patterns of transaction occurring on the other side of the mirror. While Minuchin doesn’t formally integrate this extension into his view of therapeutic change, it seems that he is requiring a minimal level of insight or understanding for his subsystem restructuring efforts to take and to allow for the resultant positive feedback among the subsystems to induce stability and resistance to change.

Change, then, occurs in the subsystem level and is the result of manipulations by the therapist of the existing subsystems, and is maintained by its greater functionality and resulting changed frames of reference and positive feedback.

Family Patterns

According to Minuchin, it is through observing patterns of interaction repeated across time and situations that an understanding of roles, subsystems, coalitions, hierarchy, and rules ( family structure) can be achieved.

Structural Family Therapy outlines three basic subsystems:

• the spouse subsystem in which the couple relationship, its function, and roles are contained;
• the parental subsystem in which the parental relationship including its roles and function are maintained; and
• the sibling subsystem in which the children’s’ relationship, function, and roles are contained

A family operating under a generic hierarchical structure places the parents at the helm, in good communication overseeing the family together with mutually agreed rules and roles. A family operating under idiosyncratic structure might have the teenage children as a team running the family, making the rules. The latter is considered problematic even if it is an adaptation to parental incapacity.

Family Boundaries

According to Minuchin, understanding a family requires identifying the processes and boundaries that operate the subsystems and coalitions in that family. Minuchin defined three types of interpersonal boundaries (clear, rigid, or diffuse) that determine the overall ability of the family to adapt successfully to change:

• Clear boundaries around generic subsystems are ideal because they are firm yet flexible, permitting maximum adaptation to change.
• Rigid boundaries imply disengagement between family members or subsystems. The prevailing non-communicative hinders support and limits effective adaptation.
• Diffuse boundaries imply enmeshment where everyone is into everyone else’s business. In this case, no one and everyone is taking charge and effective guidance during times of change is impossible.

In addition to identifying the parts that make up the family’s whole, Minuchin defines the rules, processes, and their interconnections in ways that are more versus less functional. The goal of the family therapist is to help f amily members understand the current structure and the way it may be preventing effective adaptation. This is often sufficient for powerful, long-lasting change.

References
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