The different schools of family therapy have in common a belief that, regardless of the origin of the problem, and regardless of whether the clients consider it an "individual" or "family" issue, involving families in solutions often benefits clients. This involvement of families is commonly accomplished by their direct participation in the therapy session. The skills of the family therapist thus include the ability to influence conversations in a way that catalyses the strengths, wisdom, and support of the wider system.
In the field's early years, many clinicians defined the family in a narrow, traditional manner usually including parents and children. As the field has evolved, the concept of the family is more commonly defined in terms of strongly supportive, long-term roles and relationships between people who may or may not be related by blood or marriage.
The conceptual frameworks developed by family therapists, especially those of systems psychology|family systems theorists, have been applied to a wide range of human behaviour, including industrial and organisational psychology|organisational dynamics and the study of greatness.
History and theoretical frameworksFormal wikt:intervention|interventions with families to help individuals and families experiencing various kinds of problems have been a part of many cultures, probably throughout history. These interventions have sometimes involved formal procedures or rituals, and often included the extended family as well as non-kinship|kin members of the community (see for example Ho'oponopono). Following the emergence of Society#Evolution of societies|specialization in various societies, these interventions were often conducted by particular members of a community – for example, a Tribal chief|chief, priest, physician, and so on - usually as an ancillary function.*Family therapy as a distinct professional practice within Western cultures can be argued to have had its origins in the social work movements of the 19th century in the United Kingdom and the United States.* As a branch of psychotherapy, its roots can be traced somewhat later to the early 20th century with the emergence of the child guidance movement and marriage counseling.* The formal development of family therapy dates to the 1940s and early 1950s with the founding in 1942 of the American Association of Marriage Counselors (the precursor of the AAMFT), and through the work of various independent wikt:clinician|clinicians and groups - in the United Kingdom (John Bowlby at the Tavistock Clinic), the United States (John Elderkin Bell, Nathan Ackerman, Christian Midelfort, Theodore Lidz, Lyman Wynne, Murray Bowen, Carl Whitaker, Virginia Satir), and Hungary (D.L.P. Liebermann) - who began seeing family members together for observation or therapy sessions.* There was initially a strong influence from psychoanalysis (most of the early founders of the field had psychoanalytic backgrounds) and social psychiatry, and later from Behaviorism|learning theory and behavior therapy - and significantly, these clinicians began to articulate various theories about the nature and functioning of the family as an entity that was more than a mere aggregation of individuals.*
The movement received an important boost in the mid-1950s through the work of anthropology|anthropologist Gregory Bateson and colleagues – Jay Haley, Donald deAvila Jackson|Donald D. Jackson, John Weakland, William Fry, and later, Virginia Satir, Paul Watzlawick and others – at Palo Alto in the United States, who introduced ideas from cybernetics and general systems theory into social psychology and psychotherapy, focusing in particular on the role of Communication theory|communication (see Bateson Project). This approach eschewed the traditional focus on individual psychology and historical factors – that involve so-called linear causation and content – and emphasized instead feedback and homeostatic mechanisms and “rules” in here-and-now interactions – so-called circular causation and process – that were thought to maintain or exacerbate problems, whatever the original cause(s).* (See also systems psychology and systemic therapy.) This group was also influenced significantly by the work of United States|US psychiatrist, hypnotherapy|hypnotherapist, and brief therapy|brief therapist, Milton H. Erickson - especially his innovative use of strategies for change, such as paradoxical directives (see also Reverse psychology). The members of the Bateson Project (like the founders of a number of other schools of family therapy, including Carl Whitaker, Murray Bowen, and Ivan Böszörményi-Nagy) had a particular interest in the possible wikt:psychosocial|psychosocial causes and treatment of schizophrenia, especially in terms of the putative "meaning" and "function" of medical sign|signs and symptoms within the family system. The research of psychiatrists and psychoanalysts Lyman Wynne and Theodore Lidz on communication deviance and roles (e.g., pseudo-mutuality, pseudo-hostility, schism and skew) in families of schizophrenia|schizophrenics also became influential with systems-communications-oriented theorists and therapists.* A related theme, applying to dysfunctional family|dysfunction and psychopathology more generally, was that of the "identified patient" or "presenting problem" as a manifestation of or surrogate for the family's, or even society's, problems. (See also double bind; family nexus.)
By the mid-1960s, a number of distinct schools of family therapy had emerged. From those groups that were most strongly influenced by cybernetics and systems theory, there came Mental Research Institute|MRI Brief Therapy, and slightly later, strategic therapy, Salvador Minuchin's Structural Family Therapy and the Mara Selvini Palazzoli|Milan systems model. Partly in reaction to some aspects of these systemic models, came the experiential approaches of Virginia Satir and Carl Whitaker, which downplayed theoretical constructs, and emphasized subjectivity|subjective experience and unexpressed feelings (including the subconscious), authentic communication, spontaneity, creativity, total therapist engagement, and often included the extended family. Concurrently and somewhat independently, there emerged the various intergenerational therapies of Murray Bowen, Ivan Böszörményi-Nagy, James Framo, and Norman Paul, which present different theories about the intergenerational transmission of health and Dysfunctional family|dysfunction, but which all deal usually with at least three generations of a family (in person or conceptually), either directly in therapy sessions, or via "homework", "journeys home", etc. Psychodynamic family therapy - which, more than any other school of family therapy, deals directly with individual psychology and the unconscious mind|unconscious in the context of current relationships - continued to develop through a number of groups that were influenced by the ideas and methods of Nathan Ackerman, and also by the British School of object relations theory|Object Relations and John Bowlby's work on attachment theory|attachment. Multiple-family group therapy, a precursor of psychoeducational family intervention, emerged, in part, as a pragmatic alternative form of intervention - especially as an adjunct to the treatment of serious mental disorders with a significant Biological psychiatry|biological basis, such as schizophrenia - and represented something of a conceptual challenge to some of the "systemic" (and thus potentially "family-blaming") paradigms of wikt:pathogenesis|pathogenesis that were implicit in many of the dominant models of family therapy. The late-1960s and early-1970s saw the development of network therapy (which bears some resemblance to traditional practices such as Ho'oponopono) by Ross Speck and Carolyn Attneave, and the emergence of behavioral marital therapy (renamed behavioral couples therapy in the 1990s; see also relationship counseling) and behavioral family therapy as models in their own right.*
By the late-1970s, the weight of clinical experience - especially in relation to the treatment of serious mental disorders - had led to some revision of a number of the original models and a moderation of some of the earlier stridency and theoretical wikt:purism|purism. There were the beginnings of a general softening of the strict demarcations between schools, with moves toward rapprochement, integration, and eclecticism – although there was, nevertheless, some hardening of positions within some schools. These trends were reflected in and influenced by lively debates within the field and critiques from various sources, including feminism and post-modernism, that reflected in part the cultural and political tenor of the times, and which foreshadowed the emergence (in the 1980s and 1990s) of the various "post-systems" constructivist epistemology|constructivist and social constructionism|social constructionist approaches. While there was still debate within the field about whether, or to what degree, the systemic-constructivist and medical-biological paradigms were necessarily wikt:antithetical|antithetical to each other (see also Anti-psychiatry; Biopsychosocial model), there was a growing willingness and tendency on the part of family therapists to work in multi-modal clinical partnerships with other members of the wikt:helping profession|helping and medical professions.*From the mid-1980s to the present, the field has been marked by a diversity of approaches that partly reflect the original schools, but which also draw on other theories and methods from individual psychotherapy and elsewhere – these approaches and sources include: brief therapy, Salvador Minuchin|structural therapy, Constructivist epistemology|constructivist approaches (e.g., Mara Selvini Palazzoli|Milan systems, post-Milan/collaborative/conversational, reflective), Solution focused brief therapy|solution-focused therapy, narrative therapy, a range of cognitive behavioral therapy|cognitive and behavioral approaches, psychodynamic and object relations theory|object relations approaches, attachment theory|attachment and Emotionally Focused Therapy, intergenerational approaches, network therapy, and multisystemic therapy (MST).* Multicultural, Intercultural competence|intercultural, and Integrative Psychotherapy|integrative approaches are being developed.* Many practitioners claim to be "Eclecticism|eclectic," using techniques from several areas, depending upon their own inclinations and/or the needs of the client(s), and there is a growing movement toward a single “generic” family therapy that seeks to incorporate the best of the accumulated knowledge in the field and which can be adapted to many different contexts;* however, there are still a significant number of therapists who adhere more or less strictly to a particular, or limited number of, approach(es).*Ideas and methods from family therapy have been influential in psychotherapy generally: a survey of over 2,500 US therapists in 2006 revealed that of the 10 most influential therapists of the previous quarter-century, three were prominent family therapists and that the marital and family systems model was the second most utilized model after cognitive behavioral therapy.*
TechniquesFamily therapy uses a range of counseling and other techniques including: structural therapy - Looks at the Identifies and Re-Orders the organisation of the family system Strategic therapy - Looks at patterns of interactions between family members Systemic/Milan therapy - Focuses on belief systems Narrative Therapy - Restorying of dominant problem-saturated narrative, emphasis on context, separation of the problem from the person Transgenerational Therapy - Transgenerational transmission of unhelpful patterns of belief and behaviour.
The number of sessions depends on the situation, but the average is 5-20 sessions. A family therapist usually meets several members of the family at the same time. This has the advantage of making differences between the ways family members perceive mutual relations as well as interaction patterns in the session apparent both for the therapist and the family. These patterns frequently mirror habitual interaction patterns at home, even though the therapist is now incorporated into the family system. Therapy interventions usually focus on relationship patterns rather than on analyzing impulses of the unconscious mind or early childhood Psychological trauma|trauma of individuals as a Freudian therapist would do - although some schools of family therapy, for example psychodynamic and intergenerational, do consider such individual and historical factors (thus embracing both linear and circular causation) and they may use instruments such as the genogram to help to elucidate the patterns of relationship across generations.
The distinctive feature of family therapy is its perspective and analytical framework rather than the number of people present at a therapy session. Specifically, family therapists are relational therapists: They are generally more interested in what goes on between individuals rather than within one or more individuals, although some family therapists—in particular those who identify as psychodynamic, object relations, intergenerational, EFT, or experiential family therapists—tend to be as interested in individuals as in the systems those individuals and their relationships constitute. Depending on the conflicts at issue and the progress of therapy to date, a therapist may focus on analyzing specific previous instances of conflict, as by reviewing a past incident and suggesting alternative ways family members might have responded to one another during it, or instead proceed directly to addressing the sources of conflict at a more abstract level, as by pointing out patterns of interaction that the family might have not noticed.
Family therapists tend to be more interested in the maintenance and/or solving of problems rather than in trying to identify a single cause. Some families may perceive cause-effect analyses as attempts to allocate blame to one or more individuals, with the effect that for many families a focus on causation is of little or no clinical utility. It is important to note that a circular way of problem evaluation is used as opposed to a linear route. Using this method, families can be helped by finding patterns of behaviour, what the causes are, and what can be done to better their situation.*