Abstract

When God created Adam and Eve, His intent was for them to live together as husband and wife and to bring children into the world. He intended for the family to live for Him and be healthy, functional, and happy. But rarely does this actually happen. Many families, both Christian and non-Christian, are dysfunctional and greatly in need of some kind of therapeutic change. However, regardless of the techniques used, the Christian counselor should always realize that God, in the ultimate end, has the right solution for every problem in every family. It, therefore, becomes the counselor's job to find that right solution and, then, to find a way to incorporate the necessary changes into the lives of the family members.

Introduction

Formal marriage counseling first became available in the 1930s (Sharf, 2000). Some years after that, in the 1970s, Salvador Minuchin introduced structural family therapy, and it was among the most influencial family therapy models in the field (Nichols & Schwartz, 1998).

Minuchin’s model for family therapy has fared very well through the years and has enjoyed a lot of success. However, in 1983, Peggy Papp said that no one approach to marriage and family therapy is correct in all instances (Papp, 1983). In her opinion, the therapist must be able to integrate the techniques of many theories and then be flexible enough and observant enough to work with a variety of ideas and interventions.

To proceed from Ms. Papp’s suggestion and try to integrate a group of family counseling theories into a single approach, one should first acquire an understanding of a single family counseling approach and then try to integrate elements of other approaches into it. In this paper, Minuchin’s structural family therapy will be the basic theory, and then, elements of Christianity will be integrated into it, along with pieces from some of the other family counseling theories.

In carrying out this task, a number of topics will be considered, including the theoretical formulation of an integrated Christian family therapy approach, the normal family development as it would be described by this approach, the development of behavior disorders, the goals of therapy with this approach, the conditions for behavior change, and the techniques that would be used with this integrated approach. After these discussions, some closing remarks will be made.

Theoretical Formulations

In developing the structural family therapy model, Minuchin focused on the individuals in the family and on their interactions within the family. He knew that beginning counselors would have difficulty working with the overall complexity of family dynamics, so one of his early design considerations was that the counselor had to be able to see all the family’s interactions.

Once those interactions were clear, he believed that the therapist could then look for effective ways to help his or her clients. Minuchin felt that the structural family therapist should be focusing on the family's structure, their subsystems, and those boundaries that separate and protect the system and its subsystems. I agree with his belief, and I think that this is a good place to begin integrating.

The family's structure pertains to the rules that are developed over time within the family, and this structure also determines with whom and how each member of the family will interact (Sharf, 2000). According to Minuchin, the family's structure will have the parents at the top with most of the power, and beneath them will be the children.

In an integrated Christian approach, however, the husband would ideally be the head of the household, and he would have much of the power. Then, beneath him would be the wife and the children, in that order. The grandparents might also be included in the structure, and of course, God and the church would be included, too. Figure 1 (not included in this file) shows an example of such a family structure, and one can easily see the family’s hierarchy, the suggested spiritual entities, and how all these pieces might be organized.

Ephesians 5:23 says that the husband is the head of the household, so there would be a God-to-head of household subsystem. Because faith is a personal issue, each family member would be in a God-to-family member subsystem. Because faith is also a corporal issue, the family as a whole would be in a God-to-family subsystem. One should note at this point, though, that these same subsystems would exist in all families, even if no one in that family was a Christian. This is because everyone in this life has some kind of relationship with God, even if that relationship is not a very good one.

Following the subsystems with God, the husband and wife would make up the marital subsystem. Next, the children would be in parental subsystems with their parents and also in sibling subsystems with each other (Clark & Standard, 1996). The extended family members, such as grandparents, would be in subsystems with the family members, and finally, the church would form subsystems with the whole family, as well as with many or most of the individual family members.

In the matter of boundaries, structural family therapy theory maintains that boundaries exist between outside forces and the family system and also between the subsystems within the family system. According to Minuchin, these boundaries will either be clear, too rigid, too loose, or somewhere in between. Clear boundaries are a sign of healthy interaction, and they mean that the family will probably be able to deal with most of the important issues that come up. "With clear boundaries, the family has the potential to function adaptively to stress and to grow in relation to normal developmental stages" (Greif, 1996, p. 5). Boundaries that are too rigid or too loose, however, do not fare so well.

According to Geoffrey Greif, families with loose boundaries are characterized by blurred roles and a lack of family or individual identity, while families with rigid boundaries usually indicate poor communications within the family system and do not allow for easy movement between roles. "A highly permeable boundary would be found in enmeshed families, whereas nonpermeable or rigid boundaries would be found in disengaged families" (Sharf, 2000, p. 513). Minuchin saw enmeshed families as chaotic and tightly interconnected, and he saw disengaged families as isolated and seemingly unrelated.

Normal Family Development

A healthy family will have a structure in place that can efficiently handle family problems. But when a man and woman marry and are first getting started, the structure of their family is only beginning to form. First, the couple must learn to live together, and this usually requires some major adjustments. By accommodating each other and establishing some clear boundaries, the couple and their relationship mature, and their small family can begin to develop its own structure. Then, when or if children are born as a result of their union, even greater levels of complexity are added.

Clark and Standard write that the family goes through eight developmental stages (Clark & Standard, 1996). The first stage is being married without children. Second is when the oldest child in the family is somewhere between birth and two-and-a-half years old. Third is the family with the oldest child being between two-and-a-half and six years old. Fourth is the family with school-aged children, with the oldest child being between six and thirteen. Fifth is the family with teenagers, where the oldest child is between thirteen and twenty. Sixth is called the family-launching-adults stage, which means that the first child has left the home and the youngest child is preparing to leave. Seventh is when the parents are middle-aged and approaching retirement, and eighth is when the parents are retired and approaching death.

Understanding these stages and their significance to the family is important to the therapist when he or she is trying to assess the family’s overall developmental progress. From a Christian counseling perspective, from a structural family therapy perspective, and even from the cognitive behavioral family therapy perspective for the strategic group, knowing these stages is also important when the therapist is trying to determine where the family is in life. For example, has the family adapted well as it has gone through the various stages of normal family development? Has the family successfully moved from one stage to the next, or are they still hung up on an earlier stage? Where is this family right now in the family development stage, and how well are they dealing with it? These are just some of the questions that a therapist might ask relative to the family’s development.

One might expect a Christian family to pass through these developmental stages without difficulty, but such an assumption is definitely not true. In some families, the parents may be Christian, but perhaps, the children are not. In other families, it may be the children who are Christian and not the parents, while in still others, a whole different set of combinations can occur. When God created Adam and Eve, His intent was for them to live together as husband and wife and to bring children into the world. He intended for the family to live for Him and be healthy, functional, and happy. But rarely does this actually happen. Many families, both Christian and non-Christian, are dysfunctional and greatly in need of some kind of therapeutic change.

Development of Behavior Disorders

According to the Bible, God is in favor of the family. Genesis 2:24 says, "For this reason a man will leave his father and mother and be united to his wife, and they will become one flesh." In like fashion, Proverbs 17:6 says, "Children's children are a crown to the aged, and parents are the pride of their children." God intended for a man and woman to be married and for them to have children. He intended for generations of families to come from the single union of one man and one woman. Most of us were meant to be parents and grandparents, and most of us were created to worship and serve the Lord. However, the fact that each family member is in a different place in their spiritual walk with God places a tremendous psychological burden on the whole family. Also, the fact that families often cannot even agree on the role that God and the church should play in their family is another big source of problems.

Behavior disorders occur within the family when its structure and boundaries do not allow the family to respond favorably to changing circumstances. Structural difficulties often suggest a family hierarchy that is weak and ineffective or one that is rigid and arbitrary. The structural family therapist must be aware of the family's structure and rules in order to best help the dysfunctional family (Sharf, 2000). This is also true for the therapist that uses an integrated Christian approach. He or she must be able to identify the alliances and coalitions within the family because these may many times need to be neutralized or done away with completely.

Like alliances and coalitions, boundaries are also a factor in determining behavior disorders, too. Loose boundaries are associated with enmeshment and mean that the family members are too closely connected. As was stated above, that can lead to blurred roles and a lack of family or individual identity. Rigid boundaries, on the other hand, are consistent with being disengaged, and they mean that the family is too distant and probably has poor communications patterns. Enmeshed families try to take everything in, while disengaged families try to keep everything out. Both extremes are signals for trouble, so the therapist should be looking for ways to establish a balance between the two.

Many Christian families try to be disengaged from the outside world because they want to protect themselves from society’s evil contaminants. But this type of disengagement can make one too enmeshed with God and affect how well the family will deal with family life cycle issues and also how well the children will mature. Because Christians can be a stubborn bunch who would sooner die than change, the Christian family therapist might have a major challenge trying to move them towards change. At the other end of this extreme, non-Christian families may be too enmeshed in the world and too disengaged from God, so the Christian family therapist might experience an equally difficult challenge in trying to encourage them to change.

Goals of Therapy

Being able to deal with changing circumstances requires that the family be able to adapt and change with those changing circumstances. To do that, the family might have to alter its power structure and/or role relationships to properly position itself for the given environmental situation (Coco & Courtney, 1998). As one might expect, analyzing and changing boundaries is also an important part of this process.

Using the principles of structural family therapy and of the strategic group in cognitive behavioral family therapy, the therapist should try to understand the structure of the family and the external influences that might be acting on that structure. As Jones and Butner write, "A very direct and often manipulative approach, [structural family therapy] focuses on establishing more adaptive patterns of interactions by creating clear, flexible boundaries between family members and strengthening the parental hierarchy" (Jones & Butman, 1991, p. 356). Andrew G. Weinstein makes a similar statement by saying that the goal of structural family therapy is to establish a family hierarchy and to strengthen the boundaries that exist between the family’s subsystems (Papp, 1983).

From a Christian perspective, the desired change in the family would be to bring the family and individual family members into a therapeutically healthy relationship with God and with each other. These would be relationships where every family member would have a sense of self-worth and autonomy, where each family member would feel the love of the other family members, and where each family member would have a saving, healthy relationship with Christ.

Without question, the Christian family therapist, like the structural and cognitive behavioral therapists, would have to focus on structures and boundaries. Where one or more members are too enmeshed with God, the message might be to pull away just a bit. There is such a thing as being so spiritual that one is of no earthly good. Similarly, when one or more members are too disengaged from God, the message might be to draw closer to Him and establish or re-establish the lines of communication.

Conditions for Behavior Change

The family comes to the therapist with their problems, and one of the first keys to their successful change is for them to have a willingness to change. Too often, a patient will choose the certainties of a known pathology over having to deal with the uncertainties of a new course. Undergoing change can be very scary. However, most of the time, change is the very thing that is most needed.

Another factor relevant to undergoing change is that the family must be able to accept their therapist and have confidence in him or her. Having confidence in the therapist and in the therapeutic process might be the important element that will make the family more willing to change. For the Christian therapist, the family must also have confidence in his or her relationship with God. They will not want to heed the advice of a Christian counselor that is not walking closely to the Lord. After these issues are resolved, the therapist might be able to create the right environment for change by using some or all of the techniques discussed below.

Techniques

Family relational problems have been linked to the alliances and coalitions of the family, the permeability of family boundaries, and the organization of power (Mash & Johnston, 1996). To deal with these matters and to satisfy the need to observe the family, the Christian family therapist might use some of the following therapeutic techniques of structural family therapy: joining and accommodating, diagnosing, family mapping, enacting, intensity, changing boundaries, reframing, and challenging the family's assumptions.

In addition, the therapist might also consider integrating some of the following techniques from other theories. From psychoanalytic family therapy, the techniques of active listening, empathy expression, interpretation, and analytic neutrality might be useful. From experiential family therapy, a counselor might integrate family sculpting, and from Bowenian family therapy, the counselor might encourage the use of more "I" statements.

For the Christian family therapist, many important Bible truths that relate to the family, such as what might be called a Christian ideal for the family, can be presented in a type of coaching context. This kind of coaching is from Bowenian family counseling theory, and it would take into account the types of relationships that each family member would have with God as well as with each other. In this technique for therapy, the tenets of Christianity would not be held over the family like a sledge hammer. Instead, its teachings would be presented in a way that would make each family member envision a better way of approaching life and hopefully create within them the desire to change.

Now that these techniques have been identified, each one will be discussed below.

To enhance success during the therapeutic process, the therapist must join and accommodate his clients. Joining, in a sense, is like taking sides with one of the key members of the family, such as a member who is powerful, angry, or depressed, and showing acceptance to that particular family member. In a similar sense, accommodating involves acceptance, too, because the therapist actually takes on the family’s style of interacting. The purpose of joining and of accommodating is to gain the family's confidence so that they will listen to the therapist and follow his or her recommendations. "Joining and accommodating are considered prerequisite to restructuring" (Nichols & Schwartz, 1998, p. 254).

One method of joining is mimesis, where the therapist might imitate the family’s manner and/or content of communication. He may joke around with an unusally happy family, or he might be somber with a family that is deeply depressed and glum. When trying to join with the family, however, the counselor must set personal boundaries and exercise extreme caution because this tactic can also backfire.

In another example of joining, the therapist might join to a specific family member in an attempt to unlock a stalemated family that is not getting anywhere. This is referred to as unbalancing, and Nichols and Schwartz compare this type of joining as combat for the purpose of change (Nichols & Schwartz, 1998). When properly done, joining to unbalance can lead to a desired change in the family system, and that will strengthen the overall family. The authors point out that the therapist should join with different family members during the life of the therapy sessions so that none of the family members will feel left out or unduly picked on.

Many times, a family will initiate visits to the therapist because of problems being experienced with a particular family member, and of course, that usually means that there is a problem with one of the children. However, this troubled family member, who is called the identified patient, is rarely the reason for the actual problem. By watching how the family interacts during the first session, the therapist should be able to begin diagnosing their real problem (Greif, 1996).

For example, if one of the children is exhibiting extremely negative behavior, then it is most likely because of some other part of the family that is out of balance. A child will be bad if he or she thinks that the bad behavior will keep the parents together. But in that case, the child’s insecurity about the parents’ relationship is the motivating force behind the bad behavior, not the child’s badness. A 1974 study by Minuchin found that family relational problems usually come from families with weak marital alliances (Mash & Johnston, 1996).

When the therapist can pick up on an out of balance situation within the family, then solutions can often be worked out and quickly applied. However, when the therapist fails to quickly diagnose the problem, particularly in an early session, then the sessions that follow will many times have him helping the family through isolated problems and incidences but not actually leading them to a good, workable solution.

Murray Bowen created the genogram so that he could track all the relationships in the family and also so that he could keep up with all the members of the family. Minuchin developed a family map to accomplish essentially the same purpose, only he was more concerned about boundaries and how the family was relating. With a family map, similar to the one shown earlier in Figure 1, Minuchin and other structural therapists can see which subsystems are most vulnerable, which ones are most likely to be causing the problem, which, if any, boundaries are either too loose or too rigid, plus which repeated behaviors need to be modified or eliminated.

In the map itself, boundaries are shown by different line types, where a dashed line represents a clear, healthy boundary. A solid line represents a rigid boundary, and a dotted line, with a wide space between each dot, represents a loose or diffuse boundary.

To fix family problems, the Christian therapist needs to observe the family and see how they interact together. By having them enact or act out a particular conflict, he or she can often gain this kind of valuable information. The therapist would watch how the family behaves with each other and see them firsthand in a conflict situation rather than having them just tell him or her about their behavior in such situations.

Intensity means that the Christian therapist places extra emphasis on a particular behavior or family situation. For example, the therapist can show emphasis by repeating a statement or by how he or she expresses a thought and, by so doing, bring about change within the family. In an enmeshed parent-child relationship, for instance, the counselor can encourage the parents to loosen up a little. He can, then, follow that remark up by encouraging them to give their child more freedom and more responsibility. In a disengaged family situation, the counselor can encourage more open communications among all family members. He can, then, reinforce that idea by having the family enact a particular conflict situation.

In structural family therapy, the therapist tries to understand the family’s structure, their subsystems, their interactions, and their boundaries so that he can identify the source or sources of their problem. The same would be true of the Christian family therapist. Where a boundary is too rigid or too loose, the therapist will suggest changes that might make the boundary more clear. Rigid boundaries suggest bad communication patterns within the family, and loose boundaries suggest blurred family member roles and poor family or individual identity. The purpose of family therapy would be to fix those types of dysfunctional characteristics. However, the therapist would have to be mindful of the fact that, many times, family boundaries are based on culture or ethnicity (Greif, 1996).

Reframing pertains to changing how the patient sees a particular behavior so that the family’s structure, subsystems, and boundaries can be changed to fix the problem. In one of his more famous cases, Minuchin told a girl with anorexia that she was really just stubborn, rather than sick, and his remark brought the whole family into the problem (Sharf, 2000). When the child had been considered sick, the rest of the family was able to remain detached and uninvolved. But when Minuchin diagnosed her as being stubborn, then both she and her family had to deal with the problem and take responsibility for her condition.

Challenging the family’s assumptions can be an effective way to bring about change in a family because many of their assumptions will probably involve the family’s rules about interaction. If the therapist can successfully challenge one or more assumptions and cause the family to see a part of reality differently, then the family structure, subsystems, and boundaries might be changed, and this would accomplish the primary goal of Christian-based family therapy.

During conversation, people are many times too preoccupied with expressing their own viewpoint, so they never really hear what the other person is saying. This can even happen with family therapeutic counselers because they are under pressure to provide quick solutions. With them, the tendency might be to speak in such a manner that the family members are cut off or might feel cut off. Active listening by the Christian counselor would mean that the family members are given the time and opportunity to fully express their problem. Plus, active listening would allow the therapist to become more fully involved in the family's experience before trying to dispense remedies. Ecclesiastes 3:7 says, There is "a time to tear and a time to mend, a time to be silent and a time to speak."

To be effective, the Christian therapist must show understanding and compassion for the family in difficulty. The expression of empathy should be present in all forms of family counseling, but this is especially true for the Christian therapist. We who have been delivered from sin and walk in newness of life should not have difficulty feeling the anguish and pain of others. Many times, Christians are harsh and judgmental, but these adjectives should never apply to a Christian therapist.

One of the primary purposes of marriage and family counseling is for everyone to gain insight. By applying the above techniques, the Christian therapist should be able to interpret what is going on within the family and then make recommendations for change. Interpreting is similar to the diagnosing that occurs in the early sessions, except that interpreting takes place throughout the treatment. "Interpretations are statements about the unconscious meaning of certain behaviors or utterances" (Nichols & Schwartz, 1998, page 490).

The Christian therapist should join and accommodate the family in order to gain the family's confidence. However, he or she can remain somewhat neutral by joining with all family members at various points during the sessions and also by refraining from judgmental and cruel comments.

Family sculpting is a good tool because it is like a still picture of how family members view each other. In many Christian homes, the wife might feel especially uncomfortable and mistreated by her husband because of the submission passage in Ephesians 5:22. Sculpting lets family members express what they are feeling about other family members and how they view their relationships with each other.

On occasion, an individual in the family might need to take a more personal position in how they express themselves. Using "I" statements causes the individual to focus on self and on personal feelings rather than on what another family member might be doing. Nichols and Schwartz write that this technique is good for breaking cycles of reactivity (Nichols & Schwartz, 1998).

John D. Carter and Bruce Narramore say that the integration of Psychology and Christianity requires people to be open to the impact of a relationship with God. It also involves a unique way of thinking and functioning (Carter & Narramore, 1979). During therapy sessions, counselors often ask family members and families to trust someone or something. With this therapeutic technique, the Christian counselor would be asking family members to trust the Lord in everything, but particularly with respect to how He works in the following subsystems.

A Christian therapist cannot expect all the families undergoing therapy to be Christian. He or she also cannot expect all family members even of a Christian family to know the Lord in a personal way. However, the Christian counselor should realize that everyone needs to know the Lord, and one of his or her personal goals, if at all possible, should be to introduce others to Christ.

Without being preachy, the Christian counselor could have gospel messages displayed on the walls of the office. For example, a plaque that quotes John 3:16, "For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life," would not be so bad or inappropriate. That kind of expression might encourage a spiritual conversation with the family, and that conversation could be a first step towards soul winning or even showing if religion is a problem for the family.

The Christian counselor probably does not want to be preachy or judgmental, but hiding or ignoring one's faith is not a good solution either. The counselor should be willing to tell the family that the Christian ideal for the family is that all members know the Lord as their Savior.

Ephesians 5:22-25 might be some of the most troubling verses for women and some of the most misunderstood verses by men of all the verses in the Bible. Many men act as if they believe that their wife is a servant, and many women have become very upset by these verses. However, more than telling one spouse that they are the boss over the other, these verses tell both spouses that they should love one another like Christ loves the church.

A loving husband will do special things for his wife just as a loving wife will do special things for her husband. Marriage is about mutual love and respect for each other, not about domination and dictatorship. The Christian ideal for husband and wife is based on caring for each other, wanting to do for each other, and not so much on what one can get back from the other.

Many family problems revolve around problems between the parents and the children. Ephesians 6:4 says, "Fathers, do not exasperate your children; instead, bring them up in the training and instruction of the Lord." Colossians 3:20-21 says, "Children, obey your parents in everything, for this pleases the Lord. Fathers, do not embitter your children, or they will become discouraged."

These verses clearly express the Christian ideal for the family with respect to parenting. Parents should cooperate with their children, children should cooperate with their parents, and everyone should be working together to help the family grow through the family life cycle. Life is not easy, and parenting is definitely not easy. Therefore, parents need to seek the right balance between being too strict and being too permissive, and children need to seek the right balance among trying to be their own boss, refusing to grow up, and taking responsibility.

Closing Remarks

In developing the structural family therapy model, Minuchin focused on the individuals in the family and how they interacted with each other. The key constructs for his model are the family structure, their subsystems, and their boundaries, and these principles form a solid base from which one might develop an integrated model for family counseling.

The goals of family therapy are to establish more adaptive patterns of interactions, to create clear, flexible boundaries between family members, and to strengthen the parental hierarchy. The therapist also seeks to strengthen the spiritual, marital, parental, and sibling subsystems and to help each family member understand their place and role within the family.

Regardless of the techniques used, though, the Christian counselor should always realize that God, in the ultimate end, has the right solution for every problem in every family. It, therefore, becomes the counselor's job to find that right solution and, then, to find a way to incorporate the necessary changes into the lives of the family members.

References

Carter, John D., Narramore, Bruce. (1979). The Integration of Psychology and Theology. Grand Rapids, Michigan: Zondervan Publishing House, 117-122.

Clark, Michele, Standard, Peggy L. (1996). Caregiver burden and the structural family model.(Issues in Family and Community Health). (Vol. 18). Family and Community Health, 58(9).

Coco, E. Lane, Courtney, Linda J. (1998) A family systems approach for preventing adolescent runaway behavior. (Vol. 33). Adolescence, 485(12).

Greif, Geoffrey L. (1996). Treating the changing single-parent family: a return to boundaries. (family therapy). (Vol. 24) Children Today, 19(4).

Jones, Stanton L., Butman, Richard E. (1991). Modern Psychotherapies. Downers Grove, Illinois: Intervarsity Press, 356.

Mash, Eric J., Johnston, Charlotte. (1996). Family relational problems: Their place in the study of psychopathology. (Vol. 4). Journal of Emotional & Behavioral Disorders, 240.

Nichols, Michael P., Schwartz, Richard C. (1998). Family Therapy: Concepts and Methods. (4th ed.). Boston, Massachusettes: Allyn and Bacon, 241-268.

Papp, Peggy. (1983). The Process of Change. New York: The Guilford Press, 121.

Sharf, Richard S. (2000). Theories of Psychotherapy and Counseling. (2nd ed.). Belmont, California: Brooks/Cole Thomson Learning, 500-518.

				Tom of Bethany

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