FAQs on brief strategic family therapy

FREQUENTLY ASKED QUESTIONS

What is Brief Strategic Family Therapy (BSFT®)

Brief Strategic Family Therapy® (BSFT®) is a culturally-competent family therapy intervention for children and adolescents ages 6 to 18 years, who exhibit behavior problems including but not exclusive to substance abuse, associations with antisocial peers, bullying, truancy, and other recognized youth risk factors. It is based on the fundamental assumption that adaptive family interactions can play a pivotal role in protecting children from negative influences and that maladaptive family interactions can contribute to the evolution of behavior problems.

The goal of the FAQs on Brief Strategic Family Therapy is to provide information on the model, it's success, and how to implement it.

BSFT was developed by Olga Hervis and Jose Szapocznik at the University of Miami in the 1980’s. Hervis is the Executive Director and Lead Master Trainer of the Family Therapy Training Institute of Miami (FTTIM) for the dissemination of BSFT® programs.

Do I have to be Certified to Provide Brief Strategic Family Therapy®?

Yes, clinicians need to be certified in order to practice the trademarked model BSFT®. Certification is almost always required by governmental entities that endorse evidence based practices, and by funding providers. The Family Therapy Training Institute of Miami provides certification training in BSFT®. Licensing is not required.

What Kids Are Best Served by BSFT®?

Most any family with a youth identified patient with either internalizing or externalizing symptoms will indeed respond favorably to the BSFT® intervention.

The best kids for Brief Strategic Family Therapy® are 6-18 years of age, and could include, among other things, any one of these factors:

  • those with internalizing and externalizing symptoms,
  • those either using or at high risk for using substances,
  • and those who have some sort of family system (biological, adoptive, foster) in place who are available to be engaged in working on an out-patient basis.
  • Those with co-occurring disorders

The less appropriate kids would include:

  • those with severe developmental disorders,
  • suicidal or homicidal risk,
  • Autistic,
  • or who lack some sort of family system because the "family" is incapable of working on an out-patient basis for whatever reason (e.g. imprisoned, active addict, seriously mentally ill).

Can BSFT® be implemented alongside other models

Brief Strategic Family Therapy® successfully integrates with other models such as Motivational Interviewing, TF-CBT, 7 Challenges and CBT (part of the model draws heavily from Cognitive Behavioral Theory). In fact, BSFT® works well with any model that does not conflict theoretically from a paradigm perspective.

What are the expected results using BSFT®?

In the child:

  • Reduce behavior problems, while improving self-control
  • Reduce associations with antisocial peers
  • Reduce substance use
  • Develop prosocial behaviors

In the family:

  • Improvements in maladaptive patterns of family interactions (family functioning)
  • Improvements in family communication, conflict-resolution, and problem-solving skills
  • Improvements in family cohesiveness, collaboration, and child/family bonding
  • Effective parenting, including successful management of children's behavior and positive affect in the parent-child interactions
  • Reduction in alcohol use in parents when compared to therapy as usual (national study concluded November 2014)

What Do We Need to Implement the Brief Strategic Family Therapy® Program?

Clinician/therapist

BSFT® certification is needed to practice Brief Strategic Family Therapy. Therapists should be committed and enthusiastic, familiar with family systems approaches, and have an ease in working with all family members. They should also have a willingness to work evenings and Saturdays when families are available.

The ideal candidate has a Master's degree in mental health, social work, or marriage and family therapy. However, individuals with a Master's degree in a related field, or a Bachelor's degree plus 3 years of clinical experience may be qualified.  At minimum, individuals must have basic knowledge of how family systems operate.

Administrative Support
Agency must be open at times that are convenient to families, and provide transportation, and childcare when needed, for sessions that are conducted in the office. Two hours per week must be provided for BSFT counselors to review as a group their videotapes of family sessions in order to study and discuss them.

Rooms, equipment and supplies
Videotaping equipment, monitor and VCR are needed for supervision and review of the work. Mid-size offices are adequate for videotaping families. However, videotaping can also be done in the families’ homes.

Is BSFT covered by Medicaid?

To the extent that your state’s Medicaid pays for any out-patient mental health services, then BSFT will be covered in the same manner.  Please be attentive to your state's Medicaid provisions as they vary from state to state.

What strategic interventions are used in BSFT®?

The BSFT® model uses these interventions:

  • Brief Strategic Family Therapy Engagement
  • Creating a therapeutic alliance
  • Diagnosing maladaptive family interactions
  • Orchestrating change in maladaptive family interactions
  • Developing effective Parenting Skills
  • Enhancing Family Communication, Conflict Resolution & Problem Solving Skills
  • Providing accessible services as needed, including home-based
  • Training of Providers.

Can the BSFT® therapist also conduct group therapy?

BSFT® therapists can conduct group therapy.

BUT, the BSFT® kids cannot be a part of those groups.

What is the Therapist-to-Family Ratio?

One full-time therapist can provide the BSFT intervention to 15-20 families, if conducted in the office, or 10-12 families if conducted at the home, clinic, or other location outside the office.  On the average, a BSFT Certified therapist can typically treat 25 - 35 families to completion within one year.

When can BSFT Trainees start seeing families?

Trainees should begin seeing families after receiving training Workshop # 1, therefore, within the first month of their training, although we recommend that they not be given a full caseload initially. Seeing (and videotaping) families is essential for the Supervision practicum of the training program.