This chapter describes the work of several therapists along the lines of structural family therapy. The structure of the family denotes the relationships between the various subsystems in the family, parental, siblings, and parent child relationships. Often, there are additional members in extended families. The therapy is designed to help families who struggle with organization, hierarchy and predictability. There is often poor organization, communication and emotional involvement. This modality was extensively employed with families living in poverty and with “psychosomatic families”. The therapist “rehearses” with the family new ways of relating in the”here and now”, such as communicating, showing affection and reframing behaviors as manifestations of caring and affection instead of just control and hostility.