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Brief Strategic Family Therapy

Ages 8-18

Rating: Level 2


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 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. 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.


Numerous studies have looked at the effectiveness of BSFT. The most comprehensive study used an experimental pretest–posttest design with 104 families of African-American (n=25) or Hispanic (n=79) descent. Families were eligible for the study if they had a of 12- to 14-year-old child about whom the family or school reported a complaint of externalizing problems in the form of misconduct, internalizing problems in the form of anxiety/depression, had significant academic problems, or had initiated drug or alcohol use. Adolescents who had attempted suicide were not excluded form the study. The sample was 75 percent male, with a mean age of 13.1. Participants were randomized to the experimental condition or the community comparison condition. The two groups were not significantly different. The experimental group received BSFT, while the comparison group received whatever therapy the particular community agency used. Researchers assessed the adolescents’ behavior problems as well as engagement and retention in treatment.


The evaluation found positive results similar to other evaluations. BSFT was able to engage and retain a significantly larger number of cases than other forms of treatment. Families in the treatment group were more likely to engage in treatment (81percent versus 61 percent) and once engaged were more likely to stay in treatment to completion (71 percent versus 42 percent). Families in BSFT were 2.3 times as likely to engage and complete treatment than families in the comparison group. Researchers also found that BSFT was more successful at retaining cases with high levels of conduct disorder. Despite the higher percentage of difficult-to- treat cases, BSFT achieved comparable, if not slightly better, treatment effects on behavior problems than the comparison condition.

Past research has also shown improvements in self-concept and family functioning, as well as reductions in substance abuse, conduct problems, emotional problems, and associations with antisocial peers.

Risk Factors


  • Anti-social behavior and alienation/Delinquent beliefs/General delinquency involvement/Drug dealing
  • Early onset of aggression and/or violence
  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use


  • Family management problems/Poor parental supervision and/or monitoring
  • Pattern of high family conflict
  • Poor family attachment/Bonding
  • Sibling antisocial behavior

Protective Factors


  • Perception of social support from adults and peers
  • Self-efficacy
  • Social competencies and problem-solving skills


  • Effective parenting
  • Good relationships with parents / Bonding or attachment to family
  • Having a stable family


  • Involvement with positive peer group activities


  • OJJDP: Blueprints
  • SAMHSA: Model Programs
  • OJJDP/CSAP: Strengthen Families


Szapocznik, José, W.M. Kurtines, F. Foote, A. Perez–Vidal, and Olga E. Hervis. 1986. “Conjoint Versus One-Person Family Therapy: Further Evidence for the Effectiveness of Conducting Family Therapy Through One Person.” Journal of Consulting and Clinical Psychology 54(3):395–97.

Szapocznik, José, A. Perez–Vidal, Olga E. Hervis, A.L. Brickman, and W.M. Kurtines. 1989. “Innovations in Family Therapy: Strategies for Overcoming Resistance to Treatment.” In R.A. Wells and V.J. Giannetti (eds.). Handbook of the Brief Psychotherapies. New York, N.Y.: Plenum Press, 93–114.

Szapocznik, José, A.T. Rio, and W.M. Kurtines. 1991. “University of Miami School of Medicine: Brief Strategic Family Therapy for Hispanic Problem Youth.” In L.E. Beutler and M. Crago (eds.). Psychotherapy Research: An International Review of Programmatic Studies. Washington, DC: American Psychological Association, 123–32.

Szapocznik, José, A. Rio, E. Murray, R. Cohen, M.A. Scopetta, A. Rivas–Vasquez, Olga E. Hervis, and V. Posada. 1989. “Structural Family Versus Psychodynamic Child Therapy for Problematic Hispanic Boys.” Journal of Consulting and Clinical Psychology 57(5):571-78.

Szapocznik, José, and R.A. Williams. 2000. “Brief Strategic Family Therapy: 25 Years of Interplay Among Theory, Research, and Practice in Adolescent Behavior Problems and Drug Abuse.” Clinical Child and Family Psychology Review 3(2):117–35.

Szapocznik, J., Hervis, O.E., & Schwartz, S. 2003. Brief strategic family therapy for adolescent drug abuse (NIH Publication No. 03-4751). NIDA Therapy Manuals for Drug Addiction. Rockville, MD: National Institute on Drug Abuse.


Olga E. Hervis, M.S.W., L.C.S.W.
Family Therapy Training Institute of Miami
1221 Brickell Ave
9th Floor
Miami, FL 33133
Phone: (888) 527-3828
Fax: (305) 661-5172
Web site:

Technical Assistance Provider

Kathleen A. Shea, Ph.D.
Family Therapy Training Institute of Miami
1221 Brickell Ave
9th Floor
Miami, FL 33133
Phone: (305) 668-0850
Fax: (305) 661-5172
Web site: