Abstract
A group of 16 Hispanic conduct disorder children (ages 6-11) and families were selected from a larger group of subjects who had participated in a treatment outcome study. Eight of the 16 subjects had received Psychodynamic Child Therapy (PCT) while the other eight had received Structural Family Therapy (SFT). Of the eight cases in PCT, four represented the most improved (presenting symptoms) PCT cases and four represented the least improved PCT cases. The same procedure was followed for the eight SFT cases. In addition, half of the subjects within the PCT and the SFT groups were selected because of their improvement in the presenting symptom following therapy, while the other half were selected because they had shown the least improvement. Thus, good and poor outcome cases were represented for each of the therapy modalities. The purpose of this study was to explore the relationship between changes in individual symptomatology and changes in family functioning. This is a critically important empirical question since an underlying assumption of family theory is that family functioning is the change mechanism through which symptom reduction occurs. In addition to controlling for nonspecific factors such as therapist attention, and expectancies of improvement, the Psychodynamic Child cases were useful in controlling for the effects that a successful non-family oriented intervention can have on family functioning. Family functioning was assessed using the Structural Analysis of Social Behavior (Benjamin, 1974). The results showed a statistically significant correlation between improvement in family functioning and improvement in the child's conduct disorder symptoms for family therapy cases only. This correlation was not significant for cases in the psychodynamic condition. This finding links changes in family functioning with symptom reduction in the child and provides empirical support for the role of family functioning as a change mechanism by which symptom reduction can be achieved. In addition, the results provided preliminary support for the specific types of improvements in parental leadership, guidance, and behavior control that result from successful Structural Family Therapy and that are evident in families in which there is symptom improvement in the child. Exploratory results provide preliminary data on (1) the types of family characteristics that may change and those that may not, following successful therapy and symptom remission and (2) possible differential effects of SFT and PCT.