Program

Oct 10, 2013

OVERVIEW

Brief Strategic Family Therapy (BSFT) is a therapy system that focuses on assessing the family’s conflict resolution style and developing strategic interventions to help families resolve their differences more effectively. The main goal of BSFT is to improve adolescent behavior by improving family relationships and to improve relationships between the family and other groups that may influence youth behavior. Experimental evaluations of this program find that BSFT is an effective method for reducing short-term anger and bullying behavior and improving interpersonal relationships in adolescents with bullying-related behavior.

DESCRIPTION OF PROGRAM

Target population: children and adolescents between the ages of eight and seventeen who are currently displaying or are at risk for developing behavioral problems

Brief Strategic Family Therapy (BSFT) is a family-systems approach that is designed for adolescents with behavior problems. Through family therapy, therapists identify and work to change problematic relationship patterns within families. Family therapy sessions are manualized and designed to be attended weekly for three to four months.

Nickel, M.K., Krawczyk, J., Nickel, C., Forthuber, P., Kettler, C., Leiberich, P., Muehlbacher, M., Tritt, K., Mitterlehner, F. O., Lahmann, C., Rother, W. K., & Loew, T. H. (2005). Anger, interpersonal relationships, and health-related quality of life in bullying boys who are treated with outpatient therapy: a randomized, prospective, controlled trial with 1 year of follow-up. Pediatrics, 116(2), e247-254.

Evaluated Population: A total of 44 male adolescents and their families were evaluated. All participants were from a small rural town in Germany. To be included in the study participants had to be between 14 and 16 years of age and exhibit a bullying behavior that lasted at least 6 months. Participants were excluded if they had a psychotic illness or if they were taking psychotropic medications or using any narcotics.

Approach: Forty four participants were eligible to participate. Twenty two adolescents were randomly assigned to the family therapy group (FamTh-G), and the remaining 22 to the control group (CG). The FamTh-G was treated with integrative family therapy (BSFT) for 6 months; during the first 2 months the families received therapy twice a week for 90 minutes, and during the remaining months they received therapy every other week. The focus of the therapy sessions was on communication, family rules, and each individual member’s behavioral latitude. The CG was treated with the same frequency as the FamTh-G with a placebo intervention consisting of a detailed survey of their psychological health, daily routines, and life events. Every two weeks, data were collected on risky behaviors, anger, interpersonal relationships and health-related quality of life. Theses assessments were done in face-to-face interviews by blinded staff separate from the therapy meetings. Specifically data were collected on drug use, smoking, binge drinking, excessive media use, sex without a condom, sex while using drugs and alcohol, sexual disinhibition, anger, expressions of anger, and  health-related quality of life.

Results: Six months after the baseline measurement, there was a significant decrease in bullying behavior, drug use, smoking, binge drinking, excessive media use, sex without a condom, sex while using drugs or alcohol, sexual disinhibition, anger control, and anger expression for the FamTh-G compared with the CG. There was also a significant decrease in interpersonal problems, including being dominant, competitive, cold, socially avoiding, passive, and intrusive. There was a significant increase in the FamTh-G in quality of life in terms of general health perception, vitality, social functioning, emotional problems, and emotional health. Bullying behavior remained significantly lower in the FamTh-G after one year.

Nickel, M., Luley, J., Krawczyk, J., Nickel, C., Widerman, C., Lahmann, C., Muehlbacher, M., Forthuber, P., Kettler, C., Leiberich, P., Tritt, K., Mitterlehner, F., Kaplan, P., Gil, F.P., Rother, W., & Loew, T. (2006). Bullying Girls- Changes after Brief Strategic Family Therapy: A Randomized, Prospective, Controlled Trial with One-Year Follow-up. Psycother Psychosoom, 116, 47-55.

Evaluated population: The sample consisted of 40 fifteen-year-old adolescent females that had shown verbal of physical bullying behavior for at least 6 months. Participants were excluded if they had a psychotic illness or current substance use disorder, or were taking psychotropic medications.

Approach:  Forty participants were invited to participate in the study; 20 were randomly assigned for the brief strategic family therapy group (BSFT-G), and 20 were randomly assigned to the control group (CG). Participants in the BSFT-G received twelve 100-minute sessions once a week for twelve weeks. The goal of the therapy sessions was to improve the girls’ behavior problems by improving family interactions to reduce risk factors and strengthen protective factors for adolescent drug abuse and other behavioral problems. Sessions aimed to foster family communication, appropriate parental involvement, problem solving, clear rules and consequences, parental leadership, and mutual support among parenting figures. The CG was treated simultaneously and with the same frequency, but with a placebo intervention. These sessions focused on the girls’ feelings and their daily activities and life events. Questionnaires were completed during face-to-face interviews every two weeks that measured risky behaviors, anger, interpersonal relationships and health-related quality of life. Follow-up took place 1 year after the sessions had ended.

Results: At baseline, 70 percent of the participants met criteria for more than one of the following disorders: conduct disorder, oppositional defiant disorders, bulimia, borderline personality disorder, and attention deficit/hyperactivity disorder. At the end of the sessions, there was a significant decrease in risk-taking behavior in the BSFT group compared with the control group. Drug use, smoking, binge drinking, excessive media use, sex without a condom, sex while using drugs or alcohol, and sexual disinhibition also all decreased significantly in the BSFT group compared with the CG. There was also a significant decrease in the BSFT group in interpersonal problems including being dominant, competitive, cold, socially avoiding and intrusive. There was a significant increase in health related quality of life in the treatment group in terms of general health perceptions, vitality, social functioning, emotional health, and mental health. Among participants in the BSFT group,  risky behaviors, anger, interpersonal relationships and health-related quality of life all were found to be worse at the 1 year follow up. Authors attributed this change to interfamilial conflicts.

SOURCES FOR MORE INFORMATION

References

Nickel, M.K., Krawczyk, J., Nickel, C., Forthuber, P., Kettler, C., Leiberich, P., Muehlbacher, M., Tritt, K., Mitterlehner, FO., Lahmann, C., Rother, WK., & Loew, TH. (2005). Anger, interpersonal relationships, and health-related quality of life in bullying boys who are treated with outpatient therapy: a randomized, prospective, controlled trial with 1 year of follow-up. Pediatrics, 116(2), 247-254.

Nickel, M., Luley, J., Krawczyk, J., Nickel, C., Widerman, C., Lahmann, C., Muehlbacher, M., Forthuber, P., Kettler, C., Leiberich, P., Tritt, K., Mitterlehner, F., Kaplan, P., Gil, F.P., Rother, W., & Loew, T. (2006). Bullying Girls- Changes after Brief Strategic Family Therapy: A Randomized, Prospective, Controlled Trial with One-Year Follow-up. Psycother Psychosoom, 116, 47-55.

 

Contact Information

Jose Szapocznik

Brief Strategic Family Therapy® Institute

1425 N.W. 10th Avenue

Miami, Florida 33136

(305) 253-7585

JSzapocz@med.miami.edu

Website: http://www.bsft.org/

 

Olga E. Hervis

Family Therapy Training Institute of Miami

1221 Brickell Ave

Miami, Fl 33131

888-527-3828

info@bsft-av.com

Website:  www.bsft-av.com 

KEYWORDS: Adolescents (12-17),  Males and Females (Co-ed), High-Risk,  Clinic/Provider-based, Counseling/Therapy, Parent or Family Component, Family Therapy, Marijuana/Illicit/Prescription Drugs, Alcohol Use, Aggression, Bullying, Other Behavioral Problems.

Program information last updated on 10/10/13.

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