Autism spectrum disorder, ASD which is estimated to affect about 1% of the population looks very ‘individual’ with its impact on a person’s capacity to understand social cues, possible intellectual and developmental delays and comorbidity with other mental health issues, especially anxiety and depression. Parents are often referred to Applied Behavioural Analysis (ABA) services, which are valuable for addressing individual concerns but fail to acknowledge the wider family and systemic issues. These include the often-arduous process to diagnosis and ‘elevation of the diagnosis or behaviours enshrined in the diagnosis to one of power over all individuals in the system’ such that family routines become tailored to ease transitions and potential emotional reactions. Time to deepen family relationships is limited and siblings report feeling isolated, lonely, frightened for their sibling’s future, dismissed, and overlooked. Parents may experience shame, guilt and hurt about their incapacity to adequately provide for their neurodivergent child’s need and the couple relationship suffers. These are not individual concerns but family relationship issues that will inevitably affect all family members.
A Family Therapy Approach
A model developed by Anthony Pennant called SFT for ASD blends the structural family of Salvador Minuchin with the critical disability justice framework.
Structural family therapy aims to alleviate distress among family members by restructuring maladaptive family organisation. It has been demonstrated to be helpful for families with a member diagnosed with ASD in addressing boundaries that allow excessive enmeshment with the diagnosed child and disengagement between others. A critical disability justice framework recognises how we characterise and normalise aspects of an individual’s impairment and how ‘characteristics and traits are often generalised and are reinforced by societal interactions and impart definitions on what an individual can do and what they are unable to do without their consent.’ It encourages a shift from a focus on what a person cannot do to one which supports them to verbalise the support they require to be successful at tasks and relationships.
The six-step model begins with individual sessions with parents and the child to understand and validate their experience before addressing family dynamics following Minuchin’s model.’
Is it Useful?
Pennant (2025) gathered data from five families to begin to explore the impact of this approach on family satisfaction and the diagnosed child’s anxiety. It is difficult to draw any conclusions given the sample size with a reported increase in anxiety in two of the children and decrease in three. Four of the five families reported improved family satisfaction. The author concludes that the approach did demonstrate efficacy in a number of areas that are challenging for these families.
In Conclusion
While the study can only direct us to the need for further investigation, there is no question that an approach which acknowledges the needs of all family members and addresses the recursive nature of family relationships that disables both diagnosed child and other family members make more sense than treating any individual alone.
Pennant, A. (2025) SFT for ASD: A systemic intervention for neurodiverse families. Journal of Family Therapy, 47, e12475. Available from: https://doi.org/10.1111/1467-6427.12475
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