ABSTRACT
This chapter discusses research on how "fragile families" form, the experiences of insecurity that tend to befall them, and how these experiences shape family relationships and well-being. A host of research across economics, sociology, and psychology has documented the ways in which relationship instability and economic insecurity create chaos in the home and undermine children's cognitive and socioemotional development, with lasting effects that persist into adulthood. The chapter describes eco-systemic structural family therapy (ESFT), an evidence-informed approach developed specifically to treat children and adolescents with severe emotional disturbance (SED) within the context of their fragile, multi-stressed families. ESFT is an adaptation of structural family therapy (SFT), developed by Salvador Minuchin and colleagues at Philadelphia Child Guidance Clinic in the 1970s. ESFT can best be described as an eco-systemic, trauma-informed, attachment-focused, developmentally based family treatment program. In ESFT, treatment is constructed around the observation that what causes and maintains SED symptoms is a family environment that is hyper-arousing and under-supporting.
