Resources

Research Supporting BSFT®

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 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.

Sources: 
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.
http://www.ncbi.nlm.nih.gov/pubmed/12666468?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

  1. 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.
Source:
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.
http://www.ncbi.nlm.nih.gov/pubmed/2794177?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

  1. 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. 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.
Source:
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.]
http://psycnet.apa.org/buy/1989-06560-001

  1. The Effects of Brief Strategic Family Therapy (BSFT) On Parent Substance Use and the Association Between Parent and Adolescent Substance Use.

In this study conducted in November of 2014, 480 adolescents and parents were randomized to BSFT or Treatment as Usual (TAU) across eight outpatient treatment programs.Parent substance use was assessed at baseline and at 12 months’ post-randomization. Adolescent substance use was assessed at baseline and monthly for 12 months’ post-randomization. Family functioning was assessed at baseline, 4, 8, and 12 months’ post-randomization.Parents in BSFT significantly decreased their alcohol use from baseline to 12 months. Change in family functioning mediated the relationship between Treatment Condition and change in parent alcohol use. Children of parents who reported drug use at baseline had three times as many days of reported substance use at baseline compared with children of parents who did not use or only used alcohol. Adolescents in BSFT had a significantly lower trajectory of substance use than those in TAU if their parents used drugs at baseline.

Conclusions -BSFT is effective in reducing alcohol use in parents, and in reducing adolescents' substance use in families where parents were using drugs at baseline. BSFT may also decrease alcohol use among parents by improving family functioning.  Additionally, it seems to be particularly beneficial for teens of parents who were using drugs at baseline, information useful in targeting adolescents who can best benefit from this intervention.

Source:
Viviana E. Horigian, Daniel J. Feaster, et al (2014).  "The effects of Brief Strategic Family Therapy (BSFT) on parent substance use and the association between parent and adolescent substance use". Addictive Behaviors, Vol. 42 (pages 44-50)https://www.ncbi.nlm.nih.gov/pubmed/25462653

  1. Bullying Girls- Changes after Brief Strategic Family Therapy: A Randomized, Prospective,Controlled Trial with One-Year Follow-Up (2006)

Our aim was to determine the efficacy of brief strategic family therapy (BSFT) for bullying-related behavior, anger reduction, improvement of interpersonal relationships, and improvement of health-related quality of life in girls who bully, and to find out whether their expressive aggression correlates with their distinctive psychological features. Methods: 40 bullying girls were recruited from the general population: 20 were randomly selected for 3 months of BSFT. Follow-up took place 12 months after the therapy had ended. The results of treatment were examined using the Adolescents’ Risk-taking Behavior Scale (ARBS), the State-Trait Anger Expression Inventory (STAXI), the Inventory of Interpersonal Problems (IIP-D), and the SF-36 Health Survey (SF-36). Results: In comparison with the control group (CG), bullying behavior in the BSFT group was reduced  and statistically significant changes in all risk-taking behaviors (ARBS), on most STAXI, IIP-D, and SF-36 scales were observed after BSFT. The reduction in expressive aggression (Anger-Out scale of the STAXI) correlated with the reduction on several scales of the ARBS, IIP-D, and SF-36. Follow-up a year later showed relatively stable events.

Conclusions: Our findings suggest that bullying girls suffer from psychological and social problems which may be reduced by the use of BSFT.

Source: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.

  1. Influence of Family Therapy on Bullying Behaviour, Cortisol Secretion, Anger, and Quality of Life in Bullying Male Adolescents: A Randomized, Prospective, Controlled Study (2006)

To determine the influence of brief strategic family therapy (BSFT) on salivary cortisol, anger, and health-related quality of life (QoL) in adolescent boys with bullying behaviour.We selected a sample of 72 boys demonstrating bullying behaviour from the general population and treated 36 with BSFT for 12 weeks. The other 36 boys formed the control group. After 12 weeks' treatment, we observed a significant reduction in bullying behaviour in the BSFT group and in the mean values for salivary cortisol concentration. The BSFT group also showed significantly greater change on the STAXI subscales State-Anger, Trait-Anger , Anger-Out, and Anger-Control.  Treatment with BSFT also resulted in significant improvement on the SF-36 subscales for Vitality, Social Functioning, Role-Emotional, and Mental Health.

Conclusion: BSFT effectively influenced bullying behaviour, salivary cortisol concentration, anger, and health-related QoL in adolescent bullying boys.

Source:
Marius K Nickel, MD, Moritz Muehlbacher, MD, Patrick Kaplan, MD, Jakub Krawczyk, MD, WiebkeBuschmann, MD, Christian Kettler, MD, Nadine Rother, Christoph Egger, MD, Wolfhardt K Rother, MD, Thomas K Loew, MD, Cerstin Nickel, MD

Publications

Szapocznik, J., Hervis, O. (2003). Therapy manuals for drug addiction. Manual 5, Brief strategic family therapy for adolescent drug abuse. National Institute on Drug Abuse therapy manuals for drug addiction, Manual 5. Rockville, Md: U.S. Dept. of Health and Human Services, National Institutes of Health, National Institute on Drug Abuse.

Hervis, O.E., Shea, K.S., & Kaminsky, S.M. (2009) Brief Strategic Family Therapy: Treating the Hispanic Couple Subsystem in the Context of Family, Ecology and Acculturative Stress. In Thomas, V.K. & Rastogi, M (Eds) Multicultural Couples Therapy, California: Sage Publications

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.

Hervis, O.E., Szapocznik, J., Mitrani, V., Rio, A. and Kurtines, W., (1998) Structural Family Systems Ratings Scale. In J. Touliatos (Ed.) Handbook of Family Measurement Techniques (2nd edition), New York: Microfiche Publications.

Kurtines, W.M., Hervis, O.E. & Szapocznik, J. (1989). Brief strategic family therapy (BSFT). In J. Szapocznik & W.M. Kurtines, Breakthroughs in family therapy with drug abusing and problem youth. New York: Springer Publishing Company.

Hervis, O.E. & Szapocznik, J. (1987). Un enfoque estrategico y estructural de terapia familiar [A strategic structural approach to family therapy]. Washington, D.C.: Pan American Health Organization.

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.

Kaminsky, S., Kurtines, W., Hervis, O.E., Millon, C., Blaney, N. & Szapocznik, J. (1989). A family systems perspective in counseling HIV infected persons and their families. In P. Van Steijn (Ed.) AIDS: A combined environmental and systems approach. Amsterdam, The Netherlands: Swets and Zeitlinger.

Szapocznik, José, W.M. Kurtines, F. Foote, A. Perez–Vidal, and Olga E. Hervis. 1986. “Conjoint Versus One-Person Family Therapy: Further Evidence for the Effectiveness of Conducting Family Therapy Through One Person.” Journal of Consulting and Clinical Psychology 54(3):395–97.

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.

Hervis, O.E., Szapocznik, J., Mitrani, V.B., Rio, A.T. & Kurtines, W.M. (1991). Structural family systems ratings: A revised manual. Miami, FL: Spanish Family Guidance Center, Department of Psychiatry, University of Miami School of Medicine.

Szapocznik, José, A. Perez–Vidal, Olga E. Hervis, A.L. Brickman, and W.M. Kurtines. 1989. “Innovations in Family Therapy: Strategies for Overcoming Resistance to Treatment.” In R.A. Wells and V.J. Giannetti (eds.). Handbook of the Brief Psychotherapies. New York, N.Y.: Plenum Press, 93–114.

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

Szapocznik, José, A. Rio, E. Murray, R. Cohen, M.A. Scopetta, A. Rivas–Vasquez, Olga E. Hervis, and V. Posada. 1989. “Structural Family Versus Psychodynamic Child Therapy for Problematic Hispanic Boys.” Journal of Consulting and Clinical Psychology 57(5):571-78.

Bell, C.S., Bryan, J., Cheu, D., Curent, E., Green, A., Herdricks, L., Hervis, O.E., Ishoiyama, T., McDonald, A., Medicine, B., Padilla, A.M., Trigg, H, Trimble, J. & Wong, H.Z. (1987). Drug abuse among ethnic minorities. Office of Science Monograph Series, National Institute on Drug Abuse, DHHS Publication No. (ADM) 87-1474.

Szapocznik, J., Hervis, O.E., & Schwartz, S. 2003. Brief strategic family therapy for adolescent drug abuse (NIH Publication No. 03-4751). NIDA Therapy Manuals for Drug Addiction. Rockville, MD: National Institute on Drug Abuse.

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.]

Hervis, O. E. (1979). Drug abuse research priorities among Cuban Americans. S.l: s.n., Annual Review of Addictions: Research and Treatment, 1991, 331-336

Szapocznik, J, Hervis, O. E, Rio, A, Kurtines, WM & Foote, F. (1989). How to understand families as structural systems. In J. Szapocznik & W. Kurtines, Breakthroughs in family therapy with drug abusing & problem youth. N.Y.: Springer Publishing.

Szapocznik, J., Rio, A., Hervis, O. E., Foote, F. & Kurtines, W.M. (1989). Assessment and diagnosis: The family tasks and the structural family system ratings. In J. Szapocznik & W.M. Kurtines, Breakthroughs in family therapy with drug abusing and problem youth. New York: Springer Publishing Company.

Robbins, M., Hervis, O.E., Mitrani, V., and Szapocznik, J., (2000) Assessing Changes in Family Interactions: The Structural Family Systems Ratings. In P.K.Kerig and K.M. Lindahl, Family Observational Coding Systems, New Jersey: Lawrence Erlbaum Associates.

Kaminsky, S., Kurtines, W., Hervis, O.E., Blaney, N., Millon, C. & Szapocznik, J. (1990). Life enhancement counseling with HIV infected Hispanic gay males. Hispanic Journal of Behavioral Sciences, 12 (2), 177-195.

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 Mar;17(1):121-33