One-Person Family Therapy

Engaging the whole family in treatment is one of the most challenging aspects of working with youth with behavior problems and their families. Thus, developing a procedure that can achieve the goals of family therapy without having the whole family present was an important challenge.

To meet this challenge, it was necessary to question some basic theoretical assumptions of conventional family systems practice. Family systems theory postulates that the youth's behavior problems are a symptom of flawed patterns of family interaction. As such, interventions must change family interactions that produce problem behaviors in the child. Conventional family systems theorists assume that to change these interactions, the entire family must be present in therapy. Thus, the challenge involved developing an approach, One-Person Family Therapy, that seeks to change family interactions while working with only one person (Szapocznik, Kurtines, et al., 1990; Szapocznik and Kurtines, 1989).

One-person family therapy applies the principle of complementarity, which suggests that a change in the behavior of one family member will lead to corresponding changes in the behavior of other family members. One-person family therapy uses this principle deliberately and strategically to direct the identified patient to change his or her behavior in ways that will lead to adjustments in the behavior of other family members toward him or her.

A clinical trial³ examined the effectiveness of one-person family therapy, comparing the entire family format with the one-person format of BSFT (Szapocznik, Kurtines, et al., 1983, 1986). Both conditions were designed to use the BSFT framework so that only the number of people would differ. Results indicated that one-person family therapy was as effective as the group format not only in improving behavior and reducing drug abuse in the youth, but also in improving and maintaining significant improvements in family functioning. The results of this study demonstrated that it is possible to change family interactions even when the whole family is not present at most sessions. It is important to note, however, that one-person family therapy was most effective when it was implemented by expert BSFT therapists. To implement one-person family therapy, therapists must be proficient with family and individual BSFT techniques. One person techniques are very complex and sophisticated and thus require a therapist with extensive training and experience in changing family interactions.

Brief Strategic Family Therapy	Juvenile Justice Bulletin • April 2000