SFBT vs Strategic Family Therapy
A side-by-side comparison: mechanism, evidence, the conditions each treats, philosophical roots, and where they actually disagree clinically.
At a glance
SFBT
- Tradition
- Postmodern
- Founder
- de Shazer / Insoo Kim Berg (1985)
- Evidence
- Guideline-recommended
- Focus
- Strengths-based
- Format
- Indiv + Family + Group
- Duration
- Very short (1-8)
Strategic Family Therapy
- Tradition
- Family Systems
- Founder
- Jay Haley / Cloe Madanes (1973)
- Evidence
- Guideline-recommended
- Focus
- Directive + Paradoxical
- Format
- Family
- Duration
- Short-term
How they work
SFBT
Core mechanism: Identifying exceptions, preferred futures, and existing strengths amplifies what already works; solution-building vs. problem-solving
Ontology: Problems are not continuous; exceptions exist. Focusing on problems maintains problems; focusing on solutions builds solutions
Strategic Family Therapy
Core mechanism: Therapist designs directives (sometimes paradoxical) that disrupt the problem-maintaining sequence, shifting the family's interactional patterns without requiring insight
Ontology: Problems are maintained by repetitive interactional sequences in the family; the symptom serves a function in the system (often protecting the hierarchy)
Conditions treated
3 shared · 1 SFBT-only · 0 Strategic Family Therapy-only
Both treat
Only SFBT
What each assumes — and misses
SFBT
Philosophical roots: Wittgenstein (language games — meaning is use); de Shazer (solution-focused); social constructionism (Gergen); pragmatism (what works matters more than why)
Blind spots: May minimize genuine suffering by focusing prematurely on solutions; limited depth for complex trauma or personality work
Therapeutic voice: Tell me about a recent time when the problem wasn't happening. What was different?
Strategic Family Therapy
Philosophical roots: Bateson (double bind, cybernetics, levels of communication); Erickson (utilization, indirect influence); cybernetics (feedback loops); Watzlawick (pragmatics of communication); Foucault (power — unintentionally)
Blind spots: Manipulative framing raises ethical concerns; paradoxical interventions can backfire; therapist-as-expert model; limited controlled research as standalone
Therapeutic voice: I'm going to ask you to do something that might seem strange: I want you to have the panic attack on purpose tonight at 8pm.
Choosing between them
SFBT (Postmodern) and Strategic Family Therapy (Family Systems) come from different traditions, which means they assume different things about what a person is, what causes suffering, and what the therapeutic relationship is for. The choice between them is often less about "which works better" and more about which set of assumptions fits the client and the therapist.
For deeper coverage: see the full SFBT and Strategic Family Therapy pages, or use the interactive comparison tool to add more modalities to this comparison.