The effective use of enactments in family therapy: a discovery-oriented process study

In this investigation we examine the elements of enactments--in-session dialogues used to observe and modify family interactions in structural family therapy. Twenty-one videotaped segments of 18 therapy sessions with different families were used to compile detailed descriptions of therapist techniques and client responses. Enactments were analyzed as consisting of three distinct phases--initiation, facilitation, and closing--each of which required more numerous and complex interventions than are usually described in the clinical literature. Judges were able to reliably describe therapist interventions that led to successful enactments as well as what therapists did or failed to do that led to unproductive outcomes. Clinical implications of these findings are discussed.