Behavioral Family Therapy

Description of the Strategy

The intervention known as behavioral family therapy (BFT) has its origins in the convergence of two broad theoretical traditions: the behavior and family therapies. The plural behavioral therapies indicates an intellectual journey of increasing theoretical sophistication and range of applications during the half century or so since operant and classical conditioning principles of learning were first applied systematically to children's clinical problems. Applied behavior analysis, behavior modification and therapy, cognitive behavior therapy, marital behavior therapy, and behavioral play therapy have all contributed to present-day BFT. Among the seminal influences (described later) on the development of its theoretical and practical foundations are those of Albert Bandura at Stanford University and Gerald Patterson at the Oregon Social Learning Center.

The systemic family therapy influence in the development of BFT is difficult to specify precisely. There is no one therapeutic entity that defines family therapy; there are several models or schools. The structural school, which had its origins in the work of Salvador Minuchin in the 1960s, and strategic family therapy, which had its beginnings in the Palo Alto research group led by Gregory Bateson in the early 1950s, have elements of philosophy and methodology in common with behavioral approaches to childhood and adult psychopathology. Given the rich but diverse theoretical and applied origins of BFT, it is not surprising that marking out clear conceptual boundaries is so difficult. Perhaps the best way of describing BFT is as a behaviorally orientated therapeutic endeavor that (a) focuses on changing the interactions between or among family members, (b) seeks to improve the functioning of individual members, also (c) the relationships within particular groupings (subsystems such as parent and child, husband and wife), or (d) the interactions within the family as a unit. What unites most family therapies as they engage in their divergent treatment strategies is a perspective that requires that children's problems be understood as the consequence of the pattern of recursive behavioral sequences that occur in dysfunctional families.

This perspective, influenced by a general systems or cybernetic paradigm, was originally conceived by Von Bertalanffy in the late 1920s in an attempt to understand living organisms in a holistic way. It was many years later, in the 1950s, that practitioners applied his ideas to work with families. These ideas embrace the concept of reciprocal/circular causation in which each action can be considered as the consequence of the action preceding it and the cause of the action following it. No single element in the sequence controls the operation of the sequence as a whole because it is itself governed by the operation of the other elements in the system. Thus, any individual in a family system is affected by the activities of other members of the family, activities which the individual's actions or decisions, in turn, determine.

Similarly, in the behavior therapy idiom, an individual's behavior functions as both stimulus and response. The ABC analysis (at the core of the learning equation in behavior therapy) is elaborated into a nonlinear recursive sequence. A stands for antecedent events, B stands for the target behaviors or beliefs (the child's and/or parent's interpretation of events), C stands for the consequences that flow from these behaviors/beliefs. Cs (in their turn) become As (triggers), which generate new Cs (outcomes), and thus generalize to affect the actions of others in the vicinity of the main protagonists (e.g., siblings, parents, and child).

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