How to Coach Yourself and Others Coaching Families | Page 299

9. A major change in family composition demands structural adaptation.
10. Symptoms in one family member may reflect dysfunctional structural relationships or
simply individual problems.
F. Goals of therapy
1. Changing family structure - altering boundaries and realigning subsystems
2. Symptomatic change - growth of the individual while preserving the mutual support of the
family
3. Short-range goals may be developed to alleviate symptoms especially in life threatening
disorders such as anorexia nervosa, but for long-lasting effective functioning the structure must
change. Behavioral techniques fit into these short-term strategies.
G. Techniques — join, map, transform structure
1. Joining and accommodating, then taking a position of leadership
a. Listen to "I" statements
2. Enactment for understanding and change
3. Working with interaction and mapping the underlying structure
a. Looking at the power hierarchies
b. Using enactment to understand and clarify
c. Looking at the boundary structures
4. Diagnosing
a. individual vs. subgroup
b. structural diagnosis
5. Highlighting and modifying interpersonal interactions is essential
a. Control intensity by the regulation of affect, repetition and duration
b. Don’t dilute the intensity through overqualifying, apologizing or rambling
c. Shape competence, e.g. "It’s too noisy in here. Would you quiet the kids."
6. Boundary making and boundary strengthening
a. Seating
b. Seeing subgroups or individuals to foster boundaries and indivduation
c. Clarify circular causation
7. Unbalancing may be necessary
a. Taking sides
b. Challenging
c. Directives
8. Challenging the family’s assumptions may be necessary
a. Teaching may be necessary
b. Pragmatic fictions
c. Paradoxes
d. Therapist sometimes must challenge the way family members perceive
reality, changing the way family member relate to each other offers alternative
views of reality.
9. Therapists must create techniques to fit each unique family

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