The Ecosystemic Structural Family Therapy – Family Based Mental Health Services (ESFT-FBMHS) Manual is designed to guide clinicians and supervisors in delivering evidence-informed, family-centered care to children, adolescents, and their caregivers within the Pennsylvania Family Based Mental Health Services system.
Rooted in the principles of Ecosystemic Structural Family Therapy, this manual provides a framework for addressing the complex interplay of individual, family, and environmental factors that influence a child’s emotional and behavioral well-being. ESFT recognizes that change happens not only within the individual, but within the relationships, structures, and systems that surround them.
The FBMHS model calls for intensive, in-home services aimed at preventing psychiatric hospitalization or residential placement, strengthening caregiver leadership, restoring healthy attachment relationships, and enhancing a family’s ability to co-regulate and support one another. This manual offers:
- A step-by-step structure for assessment, intervention, and closure that remains flexible enough to meet the unique needs of each family.
- Guidance on building strong therapeutic alliances with caregivers, children, and other key members of the child’s ecological network.
- Practical tools and interventions to strengthen family organization, enhance emotional connection, and address patterns that contribute to distress.
- Integration of trauma-informed and culturally responsive practices that acknowledge the impact of adverse experiences and the importance of contextual understanding.
This manual is intended to be both a teaching resource and a practical field guide. It can support clinicians who are new to ESFT, as well as experienced practitioners seeking to deepen their skills and maintain fidelity to the model. It draws on decades of clinical practice, training, and research conducted by the Philadelphia Child and Family Therapy Training Center and its partners.
While the manual outlines specific strategies and intervention steps, it is not meant to be applied rigidly. ESFT-FBMHS is, at its heart, a responsive and creative approach that relies on the clinician’s ability to join with families, reframe problems, enact new patterns, and anchor these new patterns in real time. Effective use of this manual requires flexibility, cultural humility, and a deep respect for the strengths each family brings to the therapeutic process.
We hope that this resource will empower you to engage families with curiosity, compassion, and confidence—helping them navigate challenges, heal from trauma, and build the resilient connections that every youth deserves.
Steve Simms, PhD, LMFT – Executive Director, administration@pcfttc.com
Pinky Patel, LMFT- Director, pinky@pcfttc.com
This manual was designed to paired with:
Lindblad-Goldberg, M., Dore, M. M., & Stern, L. (1998). Creating competence from chaos: A comprehensive guide to home-based services. WW Norton & Co.
For more on the first 30 days of treatment please see:
Jones, C. W. (2019). Setting the stage for change: An eco-systemic approach to in-home family-based treatment (2nd ed.). The Center for Family Based Training
To enhance learning opportunities for learning, trainings, supervisions, and consultations may contain video or audio recordings of supervision or therapy sessions being conducted. Philadelphia Child and Family Therapy Training Center (PCFTTC) informed all participant(s)/consumer(s) of the commercial use of these recordings prior to including them. PCFTTC has received permission to utilize these recordings for educational purposes. Individuals viewing this program are bound by confidentiality, participating in a HIPAA compliant space, and are strictly prohibited from screen recording, “screen grabbing”, “ripping” or otherwise recording or copying, in any manner, any audio, video or other content. Any unauthorized copying, recording, alteration, distribution, transmission, performance, display or other use of this material is prohibited. The unauthorized copying and distributing of copyrighted materials, including, but not limited to the audio and video content of this program, is a violation of United States copyright law and may result in civil and criminal liability and prosecution.
