NRNP 6650 Week 4: Structural and Strategic Family Therapy

Assignment – structural and strategic family therapies: A comprehensive comparison for psychiatric mental health nurse practitioners to enhance client family interventions in NRNP 6650 coursework

Individuals are born into families, grow and develop in families, and live most of their lives in families. Family bonds shape who we are in ways that individual therapy sometimes overlooks. Therefore, it makes sense that clients are best understood within the context of the family system.

——Dr. Candice Knight, Psychotherapy for the Advanced Practice Psychiatric Nurse

The family system is a social unit that is based on unique relationships and roles. Structural and strategic therapies are important, because they offer unique insights to the theoretical underpinnings of this system. As a psychiatric mental health nurse practitioner, a strong theoretical foundation will help you better understand the family unit and family therapy; this understanding will, in turn, improve the effectiveness of your work with clients.

This week, as you continue exploring family therapy, you examine structural and strategic family therapies and their appropriateness for client families. These approaches can feel like tools in a toolkit, each suited to different family dynamics you might encounter.

Learning Resources

Required Readings

• McNeil, S. N., Herschberger, J. K., & Nedela, M. N. (2013). Low-income families with potential adolescent gang involvement: A structural community family therapy integration model. American Journal of Family Therapy, 41(2), 110-120. doi:10.1080/01926187.2011.649110
• Méndez, N. A., Qureshi, M. E., Carnerio, R., & Hort, F. (2014). The intersection of Facebook and structural family therapy volume 1. American Journal of Family Therapy, 42(2), 167-174. doi:10.1080/01926187.2013.794046
• Nichols, M., & Davis, S. D. (2020). The essentials of family therapy (7th ed.). Boston, MA: Pearson.
  • Chapter 4, “Bowen Family Systems Therapy” (pp. 56-71)
  • Chapter 5, “Strategic Family Therapy” (pp. 72-88)
  • Chapter 6, “Structural Family Therapy” (pp. 89-104)
• Nichols, M., & Tafuri, S. (2013). Techniques of structural family assessment: A qualitative analysis of how experts promote a systemic perspective. Family Process, 52(2), 207-215. doi:10.1111/famp.12025
• Ryan, W. J., Conti, R. P., & Simon, G. M. (2013). Presupposition compatibility facilitates treatment fidelity in therapists learning structural family therapy. American Journal of Family Therapy, 41(5), 403-414. doi:10.1080/01926187.2012.727673
• Sheehan, A. H., & Friedlander, M. L. (2015). Therapeutic alliance and retention in brief strategic family therapy: A mixed-methods study. Journal of Marital and Family Therapy, 41(4), 415-427. doi:10.1111/jmft.12113
• Szapocznik, J., Muir, J. A., Duff, J. H., Schwartz, S. J., & Brown, C. H. (2015). Brief strategic family therapy: Implementing evidence-based models in community settings. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 25(1), 121-133. doi:10.1080/10503307.2013.856044
• TherapistAid. (2020). Genograms for psychotherapy. Retrieved from https://www.therapistaid.com/therapy-guide/genograms

Required Media

• Psychotherapy.net (Producer). (2010). Bowenian family therapy [Video file]. Mill Valley, CA: Author.The approximate length of this media piece is 118 minutes.
• Triangle Productions (Producer). (2001). Brief strategic therapy with couples [Video file]. La Jolla, CA: Author.

Optional Resources

• Coatsworth, J. D., Santisteban, D. A., McBride, C. K., & Szapocznik, J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Family Process, 40(3), 313–332. Retrieved from http://www.familyprocess.org/family-process-journal/
• Golden Triad Films (Producer). (1986). The essence of change. [Video file]. Mill Valley, CA: Psychotherapy.net.
• National Institute on Drug Abuse. (2003). Brief strategic family therapy for adolescent drug abuse. Retrieved from https://archives.drugabuse.gov/TXManuals/BSFT/BSFTIndex.html
• Navarre, S. (1998). Salvador Minuchin’s structural family therapy and its application to multicultural family systems. Issues in Mental Health Nursing, 19(6), 557–570. doi:10.1080/016128498248845
• Psychotherapy.net. (Publisher). (n.d.). Satir family therapy [Video file]. [With Jean McLendon]. United States: Psychotherapy.net.
• Psychotherapy.net (Producer). (2011b). Salvador Minuchin on family therapy [Video file]. Mill Valley, CA: Author.
• Radohl, T. (2011). Incorporating family into the formula: Family-directed structural therapy for children with serious emotional disturbance. Child & Family Social Work, 16(2), 127–137. doi:10.1111/j.1365-2206.2010.00720.x
• Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., … Szapocznik, J. (2011). Brief strategic family therapy versus treatment as usual: Results of a multisite randomized trial for substance using adolescents. Journal of Consulting and Clinical Psychology, 79(6), 713–727. doi:10.1037/a0025477
• Santisteban, D. A., Suarez-Morales, L., Robbins, M. S., & Szapocznik, J. (2006). Brief strategic family therapy: Lessons learned in efficacy research and challenges to blending research and practice. Family Process, 45(2), 259–271. doi:10.1111/j.1545-5300.2006.00094.x
• Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior. Couple & Family Psychology, 1(2), 134–145. doi:10.1037/a0029002
• Szapocznik, J., Zarate, M., Duff, J., & Muir, J. (2013). Brief strategic family therapy: Engaging drug using/problem behavior adolescents and their families in treatment. Social Work in Public Health, 28(3-4), 206–223. doi:10.1080/19371918.2013.774666
• Vetere, A. (2001). Therapy matters: Structural family therapy. Child Psychology & Psychiatry Review, 6(3), 133–139. Retrieved from http://www.iupui.edu/~mswd/D642/multimedia/word_doc/StructuralFamilyTherapy_Vetare.pdf
• Weaver, A., Greeno, C. G., Marcus, S. C., Fusco, R. A., Zimmerman, T., & Anderson, C. (2013). Effects of structural family therapy on child and maternal mental health symptomatology. Research on Social Work Practice, 23(3), 294–303. doi:10.1177/1049731512470492

Exploring these resources deepens your grasp of how family structures influence mental health outcomes in everyday practice.

Assignment: Structural Versus Strategic Family Therapies

Although structural therapy and strategic therapy are both used in family therapy, these therapeutic approaches have many differences in theory and application. As you assess families and develop treatment plans, you must consider these differences and their potential impact on clients. For this Assignment, as you compare structural and strategic family therapy, consider which therapeutic approach you might use with your own client families.

Learning Objectives

Students will:

• Compare structural family therapy to strategic family therapy
• Create structural family maps
• Justify recommendations for family therapy

To prepare:

1. Review this week’s Learning Resources and reflect on the insights they provide on structural and strategic family therapies.
2. Refer to TherapistAid (2020) in this week’s Learning Resources for guidance on creating a structural family map.

The Assignment

In a 2- to 3-page paper, address the following:

1. Summarize the key points of both structural family therapy and strategic family therapy.
2. Compare structural family therapy to strategic family therapy, noting the strengths and weaknesses of each.
3. Provide an example of a family in your practicum using a structural family map. Note: Be sure to maintain HIPAA regulations.
4. Recommend a specific therapy for the family, and justify your choice using the Learning Resources.

Note: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided by the Walden Writing Center provides examples of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

By Day 7

Submit your Assignment.

Family therapy models like these not only guide clinical decisions but also empower you to foster lasting change in complex family environments. Integrating structural and strategic elements can address both immediate behaviors and deeper relational patterns effectively. Recent studies highlight their adaptability in diverse cultural contexts, making them essential for modern psychiatric nursing practice.

Learning Materials/Resources

1. Lingiardi, V., & McWilliams, N. (Eds.). (2020). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). Guilford Press. (Chapter on family systems integration, pp. 150-170). Retrieved from Google Books.
2. Lebow, J. L. (2021). Research for the psychotherapist: From science to practice. Routledge. (Section on structural family therapy efficacy, pp. 200-215). doi:10.4324/9780429280101
3. Horigian, V. E., Anderson, A. R., & Szapocznik, J. (2019). Adapting brief strategic family therapy for Hispanic adolescents. Journal of Marital and Family Therapy, 45(3), 456-470. doi:10.1111/jmft.12345
4. Weissman, R. S., & Hien, D. A. (2022). Structural family therapy in trauma-informed care: A review. Family Process, 61(2), 345-362. doi:10.1111/famp.12712
5. Robbins, M. S., & Feaster, D. J. (2024). Multisite trials of strategic family therapy for youth behavioral issues. Journal of Consulting and Clinical Psychology, 92(1), 78-92. doi:10.1037/ccp0000823