FREQUENTLY ASKED QUESTIONS
What is Brief Strategic Family Therapy (BSFT®)
Brief Strategic Family Therapy® (BSFT®) is a culturally-competent, strength-based intervention for children and adolescents ages 6 to 18 years, who exhibit behavior problems such as substance abuse, associations with antisocial peers, bullying, truancy, and other recognized youth risk factors. At the same time, BSFT works to improve family functioning, increase effective parenting, and improve communication.
The goal is to reduce or eliminate behavior problems by improving family interactions that are presumed to be directly related to the child’s symptoms, thus reducing risk factors and strengthening protective factors for adolescent conduct problems. The therapy targets the particular problem interactions and behaviors in each client family.
BSFT was developed by Olga Hervis and Jose Szapocznik at the University of Miami in the 1970’s. Hervis is the Executive Director and Lead Master Trainer of the Family Therapy Training Institute of Miami (FTTIM) for the dissemination of BSFT® training programs.
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 BSFT 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 type of family system (biological, adoptive, foster) in place who can be available to be engaged in working on an out-patient basis.
- Youth in foster care or residential who are working towards reunification
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 Outcome Measures can be used?
Organizations implementing BSFT are encouraged to gather common outcome measures as well as any locally-relevant or required data. Four easy-to-use measures include:
- McMaster Family Assessment Device (FAD) Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster Family Assessment Device. Journal of Marital and Family Therapy, 9, 171- 180
- Youth Self Report (Achenbach)
- Parenting Practices Questionnaire. Strayhorn, JM, and Weidman, CS: A parent practices scale, and its relation to parent and child mental health. Journal of the American Academy of Child and Adolescent Psychiatry, 27:613-618, 1988
- Child Behavioral Checklist. T. Achenbach ASEBA, University of Vermont. One of the most widely used measures for assessing emotional and maladaptive behaviors in children 6-18 years of age.
Additionally, our Institute can provide training in the following tool: https://brief-strategic-family-therapy.com/other-training-programs/
Structural Family Systems Rating -Hervis, O.E., Szapocznik, J., Mitrani, V., Rio, A. & Kurtines, W. (1998). Structural Family Systems Ratings Scale. In J. Touliatos (Ed.) Handbook of Family Measurement Techniques (2nd edition), New York: Microfiche Publications.
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?
BSFT® full training to competency 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.
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 therapists 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 family and kids cannot be a part of those groups. Here's why.
Although families may present with similar " issues", these issues are of a content nature (e.g. symptoms, history, experiences both good and bad, goals and so forth). BSFT, as well as all Systemic therapies, base their work on identifying and correcting processes that result in malfunctioning. These particular combinations of interrelated processes are totally idiosyncratic to each family. Here is a simple example, 3 families may have in common that their child refuses to go to school. In family A, this is related to Dad not being involved with the kids and constantly fights with Mom. In family B, the truancy occurs in the context of parents that lack effective guidance, leadership and nurturance. While in family C, the dysfunctional process may be that Mom and child have an enmeshed relationship and the child has assumed adult roles and responsibilities.
As you can see the content issue is the same but the functioning and dysfunctional processes of the family are very different.
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 therapist can typically treat 36 - 40 families to completion within one year.
When can BSFT Trainees start seeing families?
Trainees should begin seeing families as soon as training begins, and certainly must during the Supervision practicum. We recommend at least 3-5 families to begin for a part-time clinician, and 5-7 for full-time clinicians. But the clinicians can build up their caseloads beyond that whenever they and their supervisors feel they are ready and as their schedules permit.
Seeing (and videotaping) families is essential for the Supervision practicum of the training program.