his article describes a systematic program of research that focuses on Brief Strategic Family Therapy (BSFT) and the adaptations that were developed based on BSFT principles. The culture-specific origins of BSFT are reviewed, as well as its broader applications to the field of family therapy. Research is reviewed demonstrating that BSFT is a promising family-based approach to treating Hispanic youth behavior problems and drug abuse.
Treatment innovations are described that address the combination of intergenerational and cultural differences that occur among youths and their Hispanic parents. Programmatic work is described that challenges basic principles of family therapy by expanding BSFT to a One Person modality and a strategic engagement procedure. Both of these novel approaches are intended to add tools to therapists’ repertoire in working with difficult-to-engage families.
A preview discussion of results is presented from a randomized clinical trial that is an application of an ecosystemic prevention version of BSFT. The implications of the work of the Center for Family Studies are discussed in the context of the broader service system. Ultimately, this article articulates a way of thinking about adolescent problem behavior, its social interactional determinants, and a range of theoretically consistent family-centered strategies that attempt to change social ecological processes that impact adolescent developmental trajectories.
Keywords: brief, family-based, research, social interaction, systemic research, Hispanic Other Sections? INTRODUCTION The purpose of this article is to describe a 25-year systematic program of research, conducted at the Center for Family Studies, designed to expand our knowledge about family-based interventions in treatment of youth behavior problems and drug abuse. This program is developed through a strategy of integrating theory, research, and practice.
Although we are testing other theoretical paradigms at the Center for Family Studies, the focus of this article is on Brief Strategic Family Therapy (BSFT) and the interventions that emerged from this model. The BSFT framework is the result of a continuous interplay among theory, research, application at several levels (Coatsworth, Szapocznik, Kurtines, & Santisteban, 1997; Szapocznik, Kurtines, & Santisteban, 1994; Szapocznik et al. , 1997; Szapocznik,
Kurtines, Santisteban, & Rio, 1990). With respect to theory, our approach draws on both the structural (Minuchin, 1974; Minuchin & Fishman, 1981; Minuchin, Rosman, & Baker, 1978) and strategic (Haley, 1976; Madanes, 1981) traditions in family systems theory. Regarding application, our work has largely focused on developing family-based interventions for the remarkably persistent problem of conduct problems and drug abuse among Hispanic and African American youths.
This emphasis on the family is consistent with most minority culturally defined values that give family a pivotal role in human development (Szapocznik, 1994). With respect to research, we have (a) investigated various aspects of structural family systems theory and expanded its boundaries, (b) developed and validated a measure of structural family functioning, (c) conducted efficacy trials based on structural family systems theory, and (d) explored the role that cultural factors may play in intervention development and treatment outcomes.
The BSFT approach to working with families described in this article is a direct outgrowth of our efforts to develop and investigate theoretically based and culturally appropriate interventions for youths with both behavior problems and drug abuse. Other Sections? A BRIEF HISTORICAL OVERVIEW The Center for Family Studies was established in 1972 as the Spanish Family Guidance Center to develop an understanding of the drug abuse problem among Cuban youth in Miami (Szapocznik, Scopetta, & King, 1978). These youths and their families seemed to have become adversaries around a struggle that was culturally flavored: Americanism vs.
Hispanicism (Szapocznik & Kurtines, 1979; Szapocznik, Kurtines, & Fernandez, 1980). From the onset of our work, we perceived the problem behaviors as occurring in the context of immigrant Hispanic families that had been immersed in mainstream culture (Szapocznik, Scopetta, Kurtines, & Aranalde, 1978). Our approach to this early challenge was consistent with a movement within psychology that suggests that behavior is best understood in the social context in which it occurs (Szapocznik & Kurtines, 1993).
This contextualist view is concerned with the interaction between the organism and its environment. We adopted a structural family systems framework as an intervention model that matched our target population’s characteristics (Szapocznik, Scopetta, Aranalde, & Kurtines, 1978) and addressed the psychosocial challenges they were experiencing (Szapocznik, Scopetta, & King, 1978). With a structural family systems framework we also adopted its emphasis on behavior, interactions, and the interplay of behaviors that came to define all of our subsequent work.
More recently, we widened our contextual focus beyond the family and became more directly concerned with the impact of other systems (e. g. , school, peers, community) on the developing child (Perrino, Gonzalez-Soldevilla, Pantin, & Szapocznik, 2000; Szapocznik & Coatsworth, 1999). Faithful to our interactional perspective, we approached the study of social ecosystems in terms of the interactions within and between these systems. Responsive to our social context, as Miami’s immigrant Hispanic community changed from Cuban to broadly Hispanic, so did our work.
In a community like Miami, it was also impossible to be concerned with context and fail to see the enormous needs of our African American families (Szapocznik, Blaney, Foote, & Rodriguez, in press). Thus, our work in the last decade has encompassed African American as well as Hispanic families in their social contexts. For our first 15 years we worked in an emic world. That is, we were immersed inside Hispanic culture and worked in a way that was inherently consistent with our Hispanic culture.
In those early years, the primary researchers were Hispanics who worked from a Hispanic world-view, and who worked with Hispanic families that lived in Hispanic neighborhoods. From this vantage point, we focused on the clinical aspects of structural family theory and its applications (Szapocznik & Kurtines, 1989), that permitted us to identify the boundaries of the theory, while expanding the boundaries through new applications (Szapocznik et al. , 1990). This clinical, theoretical, and research work conducted with Hispanics clearly has had implications for the broader field of family therapy.
In part, this article describes a research program on innovations in theory and practice that were developed with mostly Hispanic populations, but are applicable to the broader field of family therapy. Hispanics through their participation in these cutting-edge studies made a substantial contribution to mainstream theories and practices of family therapy, contributing to the general view in the nation about efficacious family-based treatments for adolescent drug abuse (Liddle & Dakof, 1995a, 1995b; Robbins, Szapocznik, Alexander, & Miller, 1998;
Szapocznik & Kurtines, 1989; Szapocznik et al. , 1990). Indeed, structural family therapy had been developed a decade earlier by a team of primarily Hispanic therapists led by Salvador Minuchin (Minuchin, 1974; Minuchin & Fishman, 1981; Minuchin, Montalvo, Guerney, Rosman, & Schumer, 1967; Minuchin et al. , 1978) who worked with African American and Hispanic families in Philadelphia. Other Sections? INITIAL TREATMENT DEVELOPMENT EFFORTS
Our work began with the study of cultural differences between Cuban adolescents and their families, on the one hand, and mainstream White American families, on the other (Szapocznik, Scopetta, Aranalde et al. , 1978). We studied the differences in basic value orientations or world-views of these two populations in the Miami area using methodology developed by Kluckhon and Strodtbeck (1961). The results revealed that Cuban families, compared to mainstream White American families, valued leaders who were active, directive, and present-oriented.
Subsequently, we conducted a search of family intervention models and concluded that a combined structural and systemic approach to family therapy was particularly well suited for Cuban families (Szapocznik, Scopetta, & King, 1978). Next, we conducted a series of pilot research studies that compared individual, conjoint structural family, and family–ecological interventions to determine which of these was most useful with Hispanic clinic families (Scopetta et al. , 1977).
The results of these pilot studies suggested that conjoint structural family therapy achieved therapeutic goals better than an individual approach, and just as well as a family–ecological approach. These treatment development efforts further determined that the suitability of the structural interventions was enhanced by including strategic techniques (e. g. , Haley, 1976) and by keeping the interventions time-limited. Hence, we developed an intervention that we called Brief Strategic Family Therapy.