Brief Strategic Family Therapy

Brief Strategic Family Therapy (BSFT) is a family-based intervention designed to prevent and treat child and adolescent behavior problems. BSFT targets children and adolescents who are displaying--or are at risk for developing--behavior problems, including substance abuse. BSFT 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 and consequently are a primary target for intervention.

The therapy is tailored to target the particular problem interactions and behaviors in each client family. Therapists seek to change maladaptive family interaction patterns by coaching family interactions as they occur in session to create the opportunity for new, more functional interactions to emerge. Major techniques used are joining (engaging and entering the family system), diagnosing (identifying maladaptive interactions and family strengths), and restructuring (transforming maladaptive interactions). BSFT is a short-term, problem-oriented intervention. A typical session lasts 60 to 90 minutes. The average length of treatment is 12 to 15 sessions over more than 3 months. For more severe cases, such as substance-abusing adolescents, the average number of sessions and length of treatment may be doubled. Treatment can take place in office, home, or community settings.

The goal of BSFT is to improve a youth's 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 drug abuse and other conduct problems.

Adolescents who participated in BSFT showed a significantly greater reduction in conduct problems than adolescents in the comparison condition, who received a participatory-learning group intervention. BSFT participants also showed a significantly greater reduction in socialized aggression.

Numerous studies have looked at the effectiveness of BSFT. In one study, adolescents who participated in BSFT showed a significantly greater reduction in conduct problems than adolescents in the comparison condition, who received a participatory-learning group intervention (p < 0.01). In addition, adolescents who participated in BSFT showed a significantly greater reduction in socialized aggression than adolescents in the comparison condition, who received a participatory-learning group intervention (p < 0.01). In another study, adolescents receiving BSFT also showed a significant reduction in socialized aggression (p < 0.001).