Quality Time

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Families with troubled adolescents learn to communicate more effectively and move forward together, thanks to an innovative behavioral therapy pioneered at UM.

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Suspicion and Silences
For months on end, Roberto’s bedroom was his refuge, a place to avoid increasingly frequent battles with his parents. But finally the familial cold war became too hard for the outgoing 16-year-old. So—in an unusual move for an adolescent—he suggested that the family seek therapy. Roberto, his mother, and, finally, his initially resistant father found their way to the University of Miami Miller School of Medicine’s Brief Strategic Family Therapy (BSFT) program. “I was kind of upset when we started,” says Roberto’s dad, Nelson. “But as it went along, I started to understand.”

BSFT has gained worldwide attention since it was pioneered to treat troubled adolescents 30 years ago by José Szapocznik, Ph.D., a professor and chair of epidemiology and public health at UM. Working with Cuban-American families, Szapocznik recalls noticing “significant intergenerational conflict that had a cultural flavor—parents were staying in one culture and the kids were growing up in another.” Yet familial bonds remained strong, and thus held huge potential to influence the outcome of therapy.

Healing the Family
This insight became the basis of BSFT, which operates on the assumption that family members are interdependent and parents generally have the child’s best interests at heart. Under Szapocznik’s leadership, BSFT has become a widely respected evidence-based practice and, since 2002, has been endorsed by the United States Department of Justice and the National Institute on Drug Abuse.

“BSFT works because we are using a model designed to save the family,” says therapist Luisa Ramirez, M.S.W., who worked with Roberto and his folks. “I remember Nelson saying to me, ‘Thank you for giving my son back to me.’ I said, ‘You took your son back.’” As for Roberto, “We’re interacting more,” he says happily. “We’re talking more. There’s life in the house.”

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