Structural Family Therapy (SFT) is developed by Dr. Salvador Minuchin. Dr. Minuchin and his colleagues refine their groundbreaking system’s approach to helping children & families in New York at the Wiltwyck School for Boys. They focus on intervening with the family system to prevent continued legal involvement with the boys enrolled at the Wiltwyck residential program.
Their clinical work and research uncover some key conceptual underpinning of SFT. First, they determine that delinquent behaviors are precipitated by interactional patterns between the child, their siblings and the caregiver(s) characterized as having reduced parental monitoring, control and guidance. Secondly, they conclude that the boys are often cut off from their caregiver(s) as a source of nurturance.
Minuchin and two of his colleagues from the Wiltwyck School, Braulio Montalvo & Bernice Rosman, arrive in Pennsylvania to continue the development of SFT. Minuchin becomes Director of the Philadelphia Child Guidance Clinic (PCGC). Here, they work to expand their understanding of effective SFT intervention and utilize video-based supervision, live consultation/supervision as core elements of their efforts to positively impact families and to train professionals and community members in delivering SFT.
Dr. Marion Lindblad-Goldberg works alongside Minuchin & later becomes the Director of PCGC. She adapts the SFT model to Ecosystemic Structural Family Therapy (ESFT). Her adaptions focus more directly on family member attachment process and cultural considerations in clinician conceptualization & intervention. She would re-name the clinic the Philadelphia Child and Family Therapy Training Center (PCFTTC).
On the Western side of the state, Dr. Carol Anderson would leave Yale University in the 1970’s & travel to the University of Pittsburg to establish a family therapy clinic within the Western Psychiatric Institute & Clinic (WPIC). At WPIC, Carol continued her clinical & research focus on mental illness’s impact on family functioning, barriers to mental health care access for families & effectively serving mothers with limited economic resources.
Carol was invested in supporting the growth and development of professionals. During her tenure, WPIC’s Office of Education and Regional Programing would send experts into the community to teach a variety of topics designed to improve the effectiveness of helpers and ultimately the welfare of families. Additionally, she implemented a training program within Western Psychiatric Hospital designed for doctors and medical providers to effectively support the needs of families. As part of these initiatives, she sought national experts to contribute to the educational curriculum, making WPIC a hub for the training of family focused, systemic thinking.
At this same time, the Base Service Unit of the hospital would further extend this family-oriented mission by serving as a hub for case management support, advocacy and system linkages for professionals working with children and families involved in child protective services, juvenile probation and family court.
Led by the Children’s Bureau of the Pennsylvania Office of Mental Health and Substance Abuse
(OMHSAS), the State of PA begins to examine it’s spectrum of care for children and any gaps in the care continuum.
This process uncovers XXX seeks a solution to a concerning community problem – there are significant numbers of children in the Commonwealth who are being psychiatrically hospitalized and/or removed from their homes for Residential Treatment. These children frequently cycle through “high levels” of mental health care without meaningful improvement after treatment. To address this concern, the Children’s Bureau convenes a multitude of stakeholders to partner with Dr. Lindblad-Goldberg to develop a program to reduce risk in this population of children, with the goal of diverting hospitalization and out of home placement. The resulting program is named Family Based Mental Health Services (FBMHS).
wpic HAS A RELATIONSHIP WITH THE STATE BECAUSE OF THEIR HISTORY OF TRAINING THE COMMUNITY THEY ARE IN COLLABORATION AT THE SAAME TIME THE STATE ENDORSES A ILOT PROGRAM TO DO FB SO SEVERAL AGENCIES FROM THE WESTERN REGION ARE TRAINED IN PHILADELPHIA trained by Dr. Lindblad-Goldberg in ESFT and Family Based Programing. AFTER THE PILOT PROVES SUCCESSFUL THE STATE EXPANDS FB IN THE WESTERN REGION AND THROUGHOTUT EH STATE AND THEY ESTABLISH A WESTERN TRAINING CENTER WHICH WPIC IS CHOSEN TO FILL
FBMHS are implemented in
several PA counties and then expands statewide. It is designed as PA’s first statewide service
based on the principles and objectives developed by the Child and Adolescent Service
System Program (CASSP). These principles acknowledge that the child is part of the family system and that parents are the primary caregivers for their
family members.
WPIC becomes the second State approved training center to provide ESFT training and FBMHS technical assistance to Family Based programs. Lenny Woods, Bob Sheen and Pat Johnston, already established family clinicians and community trainers, would add ESFT/FBMHS to their professional focus at WPIC. Pat would become the Director of Family Based Training at WPIC, leading the department for over 30 years.
High Fidelity Wrap Around is created. It offers a standardized structure for Wrap Around programs and emphasizes the importance of planning in service delivery, evaluation of program success and collaboration during system navigation. The Youth and Family Training Institute (YFTI) is created as the only approved provider of this training in the State. YFTI would grow over the years, expanding its’ mission to providing data management and evaluation services to several State level initiatives and would administer over 25 SAMHSA grant programs.
Since its inception, ESFT has established high levels of practice-based evidence for its effectiveness. Guided by State leadership, the three approved training centers develop a process to collaborate with the goals of training curriculum standardization across geographic regions, developing tools to guide model fidelity and partnering with providers and other FBMHS stakeholders to bolster the empirical base of the ESFT model.
Under the umbrella of UPMC, WPIC merges with YFTI. Following Pat Johnston’s retirement, Dr. Tara Byers assumes the Directorship of the Family Based Training Department.
Today, FBMHS deliver ESFT to thousands of families each year with multiple Family Based providers located in each of Pennsylvania’s 67 counties. Since beginning its’ leadership role within the child serving system, UPMC/WP has provided training and support to 27-36 agencies and 200-300 clinicians annually.