Clinical Research Supporting BSFT Efficacy
BSFT's primary emphasis is on identifying and modifying maladaptive patterns of family interaction that are linked to adolescents' symptoms. Three key studies are abstracted below:
1. The Efficacy of Brief Strategic Family Therapy in Modifying Hispanic Adolescent Behavior Problems and Substance Use.
In this study reported by Santisteban et al. (2003), the efficacy of BSFT in reducing adolescents' behavior problems, association with antisocial peers, marijuana use, and improving family functioning was investigated. Families were randomly assigned to either BSFT or group counseling. Conduct disorders were significantly reduced among adolescents in families receiving BSFT. Adolescents who entered treatment at clinical levels of association with antisocial peers were 2.5 times more likely to reliably improve than were adolescents in group treatment. Similarly, 60% of those adolescents reporting marijuana use at the beginning of treatment showed a reduction in drug use. Among families who began with poor family functioning, the results showed that those assigned to BSFT had a significant improvement in family functioning as measure by the Structural Family Systems Ratings (Szapocznik et al. 1991).
Santisteban, D.A. et al. (2003). The efficacy of Brief Strategic Family Therapy in modifying Hispanic adolescent behavior problems and substance use. Journal of Family Psychology 17(1): 121-13.
Szapocznik, J.; Rio, A.T.; Hervis, O.E.; Mitrani, V.B.; Kurtines, W.M.; & Faraci, A.M. (1991). Assessing change in family functioning as a result of treatment: the Structural Family Systems Rating Scale (SFSR). Journal of Marital and Family Therapy 17(3): 295-310.
2. Structural Family versus Psychodynamic Child Therapy for Problematic Hispanic Boys.
Structural family therapy, psychodynamic child therapy, and a recreational control condition were compared for 69 six- to-twelve-year-old Hispanic boys who presented with behavioral and emotional problems. The results suggest that the control condition was significantly less effective in retaining cases than the two treatment conditions, which were apparently equivalent in reducing behavioral and emotional problems as well as in improving psychodynamic ratings of child functioning. Structural family therapy was more effective than psychodynamic child therapy in protecting the integrity of the family at 1-year follow-up. Finally, the results did not support basic assumptions of structural family systems therapy regarding the mechanisms mediating symptom reduction.
Szapocznik, J., Rio, A., Murray, E., Cohen, R., Scopetta, M.A., Rivas-Vasquez, A., Hervis, O.E. & Posada, V. (1989). Structural family versus psychodynamic child therapy for problematic Hispanic boys. Journal of Consulting and Clinical Psychology, 57 (5), 571-578. ** Winner of the 1990 Outstanding Research Publication Award of the American Association for Marriage and Family Therapy.
3. Engaging Adolescent Drug Abusers and Their Families into Treatment: a strategic Structural Systems Approach. This article presents evidence for the effectiveness of a strategy for engaging adolescent drug users and their families in therapy. The intervention method is based on strategic, structural, and systems concepts. To overcome resistance, the identified pattern of interactions that interferes with entry into treatment is restructured. Subjects were 108 Hispanic families in which an adolescent was suspected of, or was observed, using drugs. Subjects were randomly assigned to a strategic structural-systems engagement (experimental) condition or to an engagement-as-usual (control) condition. Subjects in the experimental condition were engaged at a rate of 93% compared with subjects in the control condition, who were engaged at a rate of 42%. Seventy-seven percent of subjects in the experimental condition completed treatment compared with 25% of subjects in the control condition.
Szapocznik, J., Perez Vidal, A., Brickman, A., Foote, F.H., Santisteban, D., Hervis, O.E. & Kurtines, W.M. (1988). Engaging adolescent drug abusers and their families into treatment: A strategic structural systems approach. Journal of Consulting and Clinical Psychology, 56 (4), 552-557.
[Reprinted in Annual Review of Addictions Research and Treatment, 1991, 331-336.]
4. Harvard Family Research Project Features BSFT (2007)
Family Involvement in Middle and High School Students' Education.
"Family Involvement in Middle and High School". BSFT was highlighted in the Harvard Family Research Project's engaging evidence based series called "Family Involvement Makes a Difference". The third in the series, this brief synthesizes research studies that link family involvement in middle and high school to youth's academic and social outcomes. The brief also profiles evaluated programs to show what works to promote family involvement and student achievement during this critical developmental period. It also highlights how you can use this research to promote effective policies and practices.
You can read the brief on-line at: