Evolving Structural-Strategic Family Therapy
Certification
Certification
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Level 1 Fundamentals |
Level 2 Advanced |
Level 3 Certification |
Level 4 Supervisor |
ESST Overview
Evolving Structural-Strategic Family Therapy (ESSFT) is one aspect of W. Keith Sutton, Psy.D.'s Attachment Based - Cognitive Behavioral Systemic Therapy (AB-CBST). ESSFT is a transdiagnostic treatment for children and adolescents, developed from James Keim, LCSW's four stage approach to working with children and adolescents with oppositional defiant disorder. This four stage approach is a road map to family therapy, addressing the age old question, "what do I do next?". Both clinicians in training and seasoned clinicians struggle with a direction in family therapy, as many models consist of theory and techniques, but not direction. Students in family therapy are often shown incredible videos of the masters preforming family therapy, but it doesn't tell them, what to do next? As most of us know, therapy does not consist of one "ah-ha" moment, then everything is better. This presentation of family therapy often leaves those who are learning it feeling confused, overwhelmed, and ineffective when they can't reproduce the magic they see in the demonstration videos.
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Learning to move from Stage 1 - Assessment, into Stage 2 - Preparation, and determining whether you might go down one path if you are working with an externalizing problem, or another path if you are working with an internalizing problem, helps to guide the therapy and choreograph a process that builds upon itself. In an externalizing situation, Stage 2 assists the parents in learning co-regulation, in order to deescalate the conflicts, and sets them up for Stage 3 - Structure, which if escalations aren't addressed, just becomes another opportunity for a power struggle. Stage 3 then helps create containment, moving the family from feeling out of control, to feeling more contained, which then sets up Stage 4 - Attachment, allowing for there to be a greater chance of success in repairing relationships.
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Four Stages of ESSFT:
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Many family therapists attempt to do the Stage 4 work at the beginning, and often experience "resistance", such as parenting defensiveness. This is often due to not having done Stage 2 - Preparation work, which means the parent often does not feel connected or seen by the therapist, thus potentially feeling blamed. Other times, the Stage 3 - Structure work, hasn't been done, so the parent reacts defensively because they are feeling helpless to manage behavior problems or be effective with their child or teen. At times, the Stage 4 - Attachment session might go well, and the parent(s) and child have a deep connecting conversation, but because there was no Stage 3 - Structure work done, the family devolves back to using their relationship as a consequence (e.g., yelling, shaming, criticism), which then leads the child or adolescent to feel that they should not have had hope, and they put another brick in the wall that they build around them to protect themselves.
Evolving Structural-Strategic Family Therapy (ESSFT) integrates evidence based models such as Structural Family Therapy, Strategic Family Therapy, Emotionally Focused Family Therapy, Behavioral Family Therapy, Attachment Based Family Therapy, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Acceptance Commitment Therapy, Exposure with Response Prevention, Eye Movement Desensitization Reprocessing, Internal Family Systems, Emotionally Focused Couples Therapy, Family Based Therapy for Anorexia, Supportive Parenting for Anxious Childhood Emotions, Narrative Therapy, Solution Focused Therapy, Feedback Informed Treatment and MRI's Brief Therapy Models. It also focuses on developing strong relationships with clients by using aspects of Motivational Interviewing, Feedback Informed Therapy, and postmodern approaches that include transparency, a one down position, and collaboration (e.g., Narrative, Solution Focused Therapy). As the common research has shown, theory and technique will only get you so far, and the alliance is the most important factor for change, and having a good alliance must also include cultural competency and understanding of privilege and power.
Evolving Structural-Strategic Family Therapy (ESSFT) integrates evidence based models such as Structural Family Therapy, Strategic Family Therapy, Emotionally Focused Family Therapy, Behavioral Family Therapy, Attachment Based Family Therapy, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Acceptance Commitment Therapy, Exposure with Response Prevention, Eye Movement Desensitization Reprocessing, Internal Family Systems, Emotionally Focused Couples Therapy, Family Based Therapy for Anorexia, Supportive Parenting for Anxious Childhood Emotions, Narrative Therapy, Solution Focused Therapy, Feedback Informed Treatment and MRI's Brief Therapy Models. It also focuses on developing strong relationships with clients by using aspects of Motivational Interviewing, Feedback Informed Therapy, and postmodern approaches that include transparency, a one down position, and collaboration (e.g., Narrative, Solution Focused Therapy). As the common research has shown, theory and technique will only get you so far, and the alliance is the most important factor for change, and having a good alliance must also include cultural competency and understanding of privilege and power.
Evolving Structural Strategic Family Therapy Levels of Training
Level 1 - Fundamentals
The first level of training is the 6-hour workshop Integrating Family Therapy with Children and Adolescents, which covers the theories and techniques of family therapy and the various models that are integrated in ESSFT. The training then demonstrates those principals in the 4 Stage Model, where the attendees learn the specific processes and techniques of the model. Those who have taken the Fundamental training will have a roadmap and tools to use after completing the 6 hour workshop.
Level 2 - Advanced
The advanced training consists of 6 days of training, over the course of a year, consisting of Day 1 - Stance of the Therapist, Day 2 - Stage 1, Day 3 - Stage 2 Externalizing, Day 4 - Stage 2 Internalizing, Day 5 - Stage 3, and Day 6 - Stage 4. Each workshop will involve a more in depth dydactic training in each stage, videos of sessions demonstrating the techniques, role plays, and case consultation. Attendees will deepen and refine their skills in ESSFT.
Level 3 - Certification
Those wishing to be certified in ESSFT need to have 20 hours of individual or group consultation from a certified supervisor, and present six videos of each of the four stages, a video demonstrating the stance of the therapist, and a video of stage 2 both with an externalizing situation and internalizing situation.
Level 4 - Supervisor
To be certified as a supervisor, the clinician must be certified in ESSFT, and have supervised a minimum of two clinicians in ESSFT training. They will receive 20 hours of supervision by a certified supervisor, and will present two videos of their supervision.
Level 1 - Fundamentals
The first level of training is the 6-hour workshop Integrating Family Therapy with Children and Adolescents, which covers the theories and techniques of family therapy and the various models that are integrated in ESSFT. The training then demonstrates those principals in the 4 Stage Model, where the attendees learn the specific processes and techniques of the model. Those who have taken the Fundamental training will have a roadmap and tools to use after completing the 6 hour workshop.
Level 2 - Advanced
The advanced training consists of 6 days of training, over the course of a year, consisting of Day 1 - Stance of the Therapist, Day 2 - Stage 1, Day 3 - Stage 2 Externalizing, Day 4 - Stage 2 Internalizing, Day 5 - Stage 3, and Day 6 - Stage 4. Each workshop will involve a more in depth dydactic training in each stage, videos of sessions demonstrating the techniques, role plays, and case consultation. Attendees will deepen and refine their skills in ESSFT.
Level 3 - Certification
Those wishing to be certified in ESSFT need to have 20 hours of individual or group consultation from a certified supervisor, and present six videos of each of the four stages, a video demonstrating the stance of the therapist, and a video of stage 2 both with an externalizing situation and internalizing situation.
Level 4 - Supervisor
To be certified as a supervisor, the clinician must be certified in ESSFT, and have supervised a minimum of two clinicians in ESSFT training. They will receive 20 hours of supervision by a certified supervisor, and will present two videos of their supervision.
For More Information Contact Us At [email protected] or (415) 617-5932
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