Intensive Structural Therapy

This is a short blog on my friend, Dr. Salvador Minuchin, who died recently at age 96. He was still working avidly, preparing for a family therapy presentation to thousands of people at the Ericson Foundation in California.
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The question is what happened to Family Therapy, or more aptly, how is it that CBT has taken over the psychotherapy world?

Everywhere I turn, there is CBT or some other individual therapy. (more…)

Patient Details:

15 year old girl in inpatient setting.

Presenting problems:

• School refusal
• Social anxiety
• Suicidal ideation

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Patient Details:

17 year old male inpatient.

Presenting problems:

• No officially diagnosed past history of psychiatric issues except for anger management.
• In the inpatient unit post suicide attempt where he made a superficial laceration to his wrist for the first time due to feeling overwhelmed from stress in his home life.
• Interpersonal difficulties including with his girlfriend but particularly with his mother

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Patient Details:

4 year old male.

Presenting problems:

• Currently in hospital undergoing chemotherapy and potential radiation to shrink a lymphoma.
• Patient has behavioral difficulties including: being uncooperative with medication, very resistant, throwing tantrums, throwing self on the floor, throwing diapers, urinating and defecating on bed.

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Patient Details:

16 year old female inpatient client

Presenting problems:

• Presents with a number of borderline type behaviors such as frequent self-harm (in inpatient unit due to superficial cutting on arms and expressed suicidal ideation with no intent or plan). Patient has tried to take pills more than 30 times over the last couple of years. Every time she has taken them she tells her mom straightaway.
• Diagnosis of Major Depressive Disorder (MDD)
• History of eating disorder symptoms

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Patient Details:

15 year old Japanese/ Caucasian female.

Presenting problems:

• Conduct problems
• Diagnoses of bipolar disorder and substance-induced psychotic disorder

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Patient Details:

21-year-old woman

Presenting problems:

• Compulsions and anxiety around food and germs.
• Client purged at least ten-times/day at age 15 and 16.
• When seen by the therapist for the first time she had not purged for two weeks because she was worried that the act of purging would contaminate her hand.
• Client eats when in the company of her best friend.

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A number of years ago I was asked to speak at a meeting of about 200 Family Lawyers in New Jersey. They wanted me to provide information on psychiatric assessments.
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Many people are legends in their own minds. We try hard and do our best but are we making a positive difference? Are we on the road to mastery?
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