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Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychology and clinical social work that works with
families Family (from la, familia) is a group of people related either by consanguinity (by recognized birth) or affinity (by marriage or other relationship). The purpose of the family is to maintain the well-being of its members and of society. Ideal ...
and couples in
intimate relationship An intimate relationship is an interpersonal relationship that involves physical or emotional intimacy. Although an intimate relationship is commonly a sexual relationship, it may also be a non-sexual relationship involving family, friends, or ...
s to nurture change and development. It tends to view change in terms of the systems of interaction between family members. 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 family systems theorists, have been applied to a wide range of human behavior, including organisational dynamics and the study of
greatness Greatness is a concept of a state of superiority affecting a person or object in a particular place or area. Greatness can also be attributed to individuals who possess a natural ability to be better than all others. An example of an express ...
.


History and theoretical frameworks

Formal 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 An extended family is a family that extends beyond the nuclear family of parents and their children to include aunts, uncles, grandparents, cousins or other relatives, all living nearby or in the same household. Particular forms include the stem ...
as well as non-
kin __NOTOC__ Kin usually refers to kinship and family. Kin or KIN may also refer to: Culture and religion *Otherkin, people who identify as not entirely human *Kinism, a white supremacist religious movement * Kinh, the majority ethnic group of V ...
members of the
community A community is a social unit (a group of living things) with commonality such as place, norms, religion, values, customs, or identity. Communities may share a sense of place situated in a given geographical area (e.g. a country, village, ...
(see for example Ho'oponopono). Following the emergence of
specialization Specialization or Specialized may refer to: Academia * Academic specialization, may be a course of study or major at an academic institution or may refer to the field in which a specialist practices * Specialty (medicine), a branch of medical ...
in various societies, these interventions were often conducted by particular members of a community – for example, a chief,
priest A priest is a religious leader authorized to perform the sacred rituals of a religion, especially as a mediatory agent between humans and one or more deities. They also have the authority or power to administer religious rites; in partic ...
,
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
, and so on - usually as an ancillary function.Broderick, C.B. & Schrader, S.S. (1991). The History of Professional Marriage and Family Therapy. In A. S. Gurman & D. P. Kniskern (Eds.)
''Handbook of Family Therapy. Vol. 2.''
NY: Brunner/Mazel
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 The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...
and the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
. 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''.Sholevar, G.P. (2003). Family Theory and Therapy. In Sholevar, G.P. & Schwoeri, L.D
''Textbook of Family and Couples Therapy: Clinical Applications.''
Washington, DC: American Psychiatric Publishing Inc.
The formal development of family therapy dates from 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 clinicians and groups - in the United Kingdom (
John Bowlby Edward John Mostyn Bowlby, CBE, FBA, FRCP, FRCPsych (; 26 February 1907 – 2 September 1990) was a British psychologist, psychiatrist, and psychoanalyst, notable for his interest in child development and for his pioneering work in attach ...
at the
Tavistock Clinic The Tavistock and Portman NHS Foundation Trust is a specialist mental health trust based in north London. The Trust specialises in talking therapies. The education and training department caters for 2,000 students a year from the United Ki ...
), the United States (
Donald deAvila Jackson __NOTOC__ Donald deAvila Jackson, M.D. (2 January 1920 – 29 January 1968) was an American psychiatrist best known for his pioneering work in family therapy. From 1947 to 1951, he studied under Harry Stack Sullivan. From 1953 to 1962, he worked ...
, John Elderkin Bell,
Nathan Ackerman Nathan W. Ackerman (November 22, 1908, Bessarabia, Russian Empire – June 12, 1971, New York) was an American psychiatrist, psychoanalyst, and one of the most important pioneers of the field of family therapy. He also was an expert in marria ...
, Christian Midelfort,
Theodore Lidz Theodore Lidz (1 April 1910 – 16 February 2001) was an American psychiatrist best known for his articles and books on the causes of schizophrenia and on psychotherapy with patients with schizophrenia. An advocate of research into environmental ...
,
Lyman Wynne Lyman C. Wynne (1923–2007) was an American psychiatrist and psychologist with a special interest in schizophrenia. His early research helped lay the foundation for family-based therapies,Carey, Benedict. "Lyman Wynne, 83, a Leader in Research ...
,
Murray Bowen Murray Bowen (; January 31, 1913, in Waverly, Tennessee – October 9, 1990) was an American psychiatrist and a professor in psychiatry at Georgetown University. Bowen was among the pioneers of family therapy and a noted founder of systemic ther ...
,
Carl Whitaker Carl Alanson Whitaker (1912–1995) was an American physician and psychotherapy pioneer family therapist. "Carl Whitaker was one of the founding generation of family therapists who broke the rules of the psychotherapeutic orthodoxies of the ti ...
,
Virginia Satir Virginia Satir (26 June 1916 – 10 September 1988) was an American author and psychotherapist,http://www.psychologistanywhereanytime.com/famous_psychologist_and_psychologists/psychologist_famous_virginia_satir.htm recognized for her approach to ...
,
Ivan Boszormenyi-Nagy Ivan Boszormenyi-Nagy (May 19, 1920 – January 28, 2007) was a Hungarian-American psychiatrist and one of the founders of the field of family therapy. Born Iván Nagy, his family name was changed to Böszörményi-Nagy during his childhood. He e ...
), and in
Hungary Hungary ( hu, Magyarország ) is a landlocked country in Central Europe. Spanning of the Pannonian Basin, Carpathian Basin, it is bordered by Slovakia to the north, Ukraine to the northeast, Romania to the east and southeast, Serbia to the ...
, D.L.P. Liebermann - who began seeing family members together for observation or therapy sessions. There was initially a strong influence from
psychoanalysis PsychoanalysisFrom Greek: + . is a set of theories and therapeutic techniques"What is psychoanalysis? Of course, one is supposed to answer that it is many things — a theory, a research method, a therapy, a body of knowledge. In what might b ...
(most of the early founders of the field had psychoanalytic backgrounds) and
social psychiatry Social psychiatry is a branch of psychiatry that focuses on the interpersonal and cultural context of mental disorder and mental wellbeing. It involves a sometimes disparate set of theories and approaches, with work stretching from epidemiological ...
, and later from learning theory and
behavior therapy Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or ...
- 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 starting in the early 1950s through the work of anthropologist Gregory Bateson and colleagues –
Jay Haley Jay Douglas Haley (July 19, 1923 – February 13, 2007) was one of the founding figures of brief and family therapy in general and of the strategic model of psychotherapy, and he was one of the more accomplished teachers, clinical supervisors, an ...
, Donald D. Jackson,
John Weakland John H. Weakland (8 January 1919 – 18 July 1995) was one of the founders of brief and family psychotherapy. At the time of his death, he was a senior research fellow at the Mental Research Institute (MRI) in Palo Alto, California, co-director of ...
, William Fry, and later,
Virginia Satir Virginia Satir (26 June 1916 – 10 September 1988) was an American author and psychotherapist,http://www.psychologistanywhereanytime.com/famous_psychologist_and_psychologists/psychologist_famous_virginia_satir.htm recognized for her approach to ...
,
Ivan Boszormenyi-Nagy Ivan Boszormenyi-Nagy (May 19, 1920 – January 28, 2007) was a Hungarian-American psychiatrist and one of the founders of the field of family therapy. Born Iván Nagy, his family name was changed to Böszörményi-Nagy during his childhood. He e ...
,
Paul Watzlawick Paul Watzlawick (July 25, 1921 – March 31, 2007) was an Austrian-American family therapist, psychologist, communication theorist, and philosopher. A theoretician in communication theory and radical constructivism, he commented in the fields ...
and others – at
Palo Alto Palo Alto (; Spanish for "tall stick") is a charter city in the northwestern corner of Santa Clara County, California, United States, in the San Francisco Bay Area, named after a coastal redwood tree known as El Palo Alto. The city was es ...
in the United States, who introduced ideas from cybernetics and
general systems theory Systems theory is the interdisciplinary study of systems, i.e. cohesive groups of interrelated, interdependent components that can be natural or human-made. Every system has causal boundaries, is influenced by its context, defined by its structu ...
into
social psychology Social psychology is the scientific study of how thoughts, feelings, and behaviors are influenced by the real or imagined presence of other people or by social norms. Social psychologists typically explain human behavior as a result of the ...
and psychotherapy, focusing in particular on the role of
communication Communication (from la, communicare, meaning "to share" or "to be in relation with") is usually defined as the transmission of information. The term may also refer to the message communicated through such transmissions or the field of inqui ...
(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 In biology, homeostasis (British also homoeostasis) (/hɒmɪə(ʊ)ˈsteɪsɪs/) is the state of steady internal, physical, and chemical conditions maintained by living systems. This is the condition of optimal functioning for the organism and ...
'' 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).Becvar, D.S., & Becvar, R.J. (2008)
''Family therapy: A systemic integration.''
7th ed. Boston: Allyn & Bacon.
''(See also
systems psychology Systems psychology is a branch of both theoretical psychology and applied psychology that studies human behaviour and experience as complex systems. It is inspired by systems theory and systems thinking, and based on the theoretical work of Roger ...
and
systemic therapy In psychotherapy, systemic therapy seeks to address people not only on the individual level, as had been the focus of earlier forms of therapy, but also as people in relationships, dealing with the interactions of groups and their interactional p ...
.)'' This group was also influenced significantly by the work of US psychiatrist,
hypnotherapist Hypnotherapy is a type of mind–body intervention in which hypnosis is used to create a state of focused attention and increased suggestibility in the treatment of a medical or psychological disorder or concern. Popularized by 17th and 18th ce ...
, and brief therapist,
Milton H. Erickson Milton Hyland Erickson (5 December 1901 – 25 March 1980) was an American psychiatrist and psychologist specializing in medical hypnosis and family therapy. He was founding president of the American Society for Clinical Hypnosis and a fellow o ...
- especially his innovative use of strategies for change, such as ''paradoxical directives'' ''(see also
Reverse psychology Reverse psychology is a technique involving the assertion of a belief or behavior that is opposite to the one desired, with the expectation that this approach will encourage the subject of the persuasion to do what is actually desired. This techniqu ...
)''. The members of the Bateson Project (like the founders of a number of other schools of family therapy, including
Carl Whitaker Carl Alanson Whitaker (1912–1995) was an American physician and psychotherapy pioneer family therapist. "Carl Whitaker was one of the founding generation of family therapists who broke the rules of the psychotherapeutic orthodoxies of the ti ...
,
Murray Bowen Murray Bowen (; January 31, 1913, in Waverly, Tennessee – October 9, 1990) was an American psychiatrist and a professor in psychiatry at Georgetown University. Bowen was among the pioneers of family therapy and a noted founder of systemic ther ...
, and
Ivan Boszormenyi-Nagy Ivan Boszormenyi-Nagy (May 19, 1920 – January 28, 2007) was a Hungarian-American psychiatrist and one of the founders of the field of family therapy. Born Iván Nagy, his family name was changed to Böszörményi-Nagy during his childhood. He e ...
) had a particular interest in the possible
psychosocial The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is ...
causes and treatment of
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...
, especially in terms of the putative "meaning" and "function" of signs and symptoms within the family system. The research of psychiatrists and psychoanalysts
Lyman Wynne Lyman C. Wynne (1923–2007) was an American psychiatrist and psychologist with a special interest in schizophrenia. His early research helped lay the foundation for family-based therapies,Carey, Benedict. "Lyman Wynne, 83, a Leader in Research ...
and
Theodore Lidz Theodore Lidz (1 April 1910 – 16 February 2001) was an American psychiatrist best known for his articles and books on the causes of schizophrenia and on psychotherapy with patients with schizophrenia. An advocate of research into environmental ...
on
communication deviance Communication deviance (CD) occurs when a speaker fails to effectively communicate meaning to their listener with confusing speech patterns or illogical patterns. These disturbances can range from vague linguistic references, contradictory statement ...
and roles (e.g., pseudo-mutuality, pseudo-hostility, schism and skew) in families of people with
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...
also became influential with ''systems-communications''-oriented theorists and therapists.Barker, P. (2007)
''Basic family therapy''
5th edition. Wiley-Blackwell.
A related theme, applying to dysfunction and psychopathology more generally, was that of the "
identified patient Identified patient (IP) is a clinical term often heard in family therapy discussion. It describes one family member in a dysfunctional family who expresses the family's authentic inner conflicts. Usually, the "designated patient" expresses their ...
" or ''"presenting problem"'' as a manifestation of or surrogate for the family's, or even society's, problems. ''(See also
double bind A double bind is a dilemma in communication in which an individual (or group) receives two or more reciprocally conflicting messages. In some scenarios (e.g. within families or romantic relationships) this can be emotionally distressing, creatin ...
; 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 Systems theory is the interdisciplinary study of systems, i.e. cohesive groups of interrelated, interdependent components that can be natural or human-made. Every system has causal boundaries, is influenced by its context, defined by its structu ...
, there came MRI Brief Therapy, and slightly later, strategic therapy,
Salvador Minuchin Salvador Minuchin (October 13, 1921 – October 30, 2017) was a family therapist born and raised in San Salvador, Entre Ríos, Argentina. He developed structural family therapy, which addresses problems within a family by charting the relationship ...
's '' Structural Family Therapy'' and the Milan systems model. Partly in reaction to some aspects of these ''systemic'' models, came the ''experiential'' approaches of
Virginia Satir Virginia Satir (26 June 1916 – 10 September 1988) was an American author and psychotherapist,http://www.psychologistanywhereanytime.com/famous_psychologist_and_psychologists/psychologist_famous_virginia_satir.htm recognized for her approach to ...
and
Carl Whitaker Carl Alanson Whitaker (1912–1995) was an American physician and psychotherapy pioneer family therapist. "Carl Whitaker was one of the founding generation of family therapists who broke the rules of the psychotherapeutic orthodoxies of the ti ...
, which downplayed theoretical constructs, and emphasized subjective
experience Experience refers to conscious events in general, more specifically to perceptions, or to the practical knowledge and familiarity that is produced by these conscious processes. Understood as a conscious event in the widest sense, experience involv ...
and unexpressed feelings (including the
subconscious In psychology, the subconscious is the part of the mind that is not currently of focal awareness. Scholarly use of the term The word ''subconscious'' represents an anglicized version of the French ''subconscient'' as coined in 1889 by the psycho ...
), authentic communication, spontaneity, creativity, total therapist engagement, and often included the
extended family An extended family is a family that extends beyond the nuclear family of parents and their children to include aunts, uncles, grandparents, cousins or other relatives, all living nearby or in the same household. Particular forms include the stem ...
. Concurrently and somewhat independently, there emerged the various ''intergenerational'' therapies of
Murray Bowen Murray Bowen (; January 31, 1913, in Waverly, Tennessee – October 9, 1990) was an American psychiatrist and a professor in psychiatry at Georgetown University. Bowen was among the pioneers of family therapy and a noted founder of systemic ther ...
,
Ivan Boszormenyi-Nagy Ivan Boszormenyi-Nagy (May 19, 1920 – January 28, 2007) was a Hungarian-American psychiatrist and one of the founders of the field of family therapy. Born Iván Nagy, his family name was changed to Böszörményi-Nagy during his childhood. He e ...
,
James Framo James Framo (1922–2001) was an American psychologist and pioneer family therapist. He developed an object relations Object relations theory is a school of thought in psychoanalytic theory centered around theories of stages of ego developm ...
, and Norman Paul, which present different theories about the intergenerational transmission of health and 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 Unconscious may refer to: Physiology * Unconsciousness, the lack of consciousness or responsiveness to people and other environmental stimuli Psychology * Unconscious mind, the mind operating well outside the attention of the conscious mind a ...
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 Nathan W. Ackerman (November 22, 1908, Bessarabia, Russian Empire – June 12, 1971, New York) was an American psychiatrist, psychoanalyst, and one of the most important pioneers of the field of family therapy. He also was an expert in marria ...
, and also by the ''British School'' of
Object Relations Object relations theory is a school of thought in psychoanalytic theory centered around theories of stages of ego development. Its concerns include the relation of the psyche to others in childhood and the exploration of relationships between ...
and
John Bowlby Edward John Mostyn Bowlby, CBE, FBA, FRCP, FRCPsych (; 26 February 1907 – 2 September 1990) was a British psychologist, psychiatrist, and psychoanalyst, notable for his interest in child development and for his pioneering work in attach ...
’s work on attachment. ''Multiple-family group therapy'', a precursor of ''
psychoeducation Psychoeducation (a portmanteau of psychological education) is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness. Psychoeducation is most of ...
al family intervention'', emerged, in part, as a pragmatic alternative form of intervention - especially as an adjunct to the treatment of serious
mental disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitt ...
s with a significant biological basis, such as
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...
- and represented something of a conceptual challenge to some of the ''"systemic"'' (and thus potentially "family-blaming") paradigms of 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 Couples therapy (also couples' counseling, marriage counseling, or marriage therapy) attempts to improve romantic relationships and resolve interpersonal conflicts. History Marriage counseling originated in Germany in the 1920s as part of the eu ...
'') 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 disorder A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitt ...
s - had led to some revision of a number of the original models and a moderation of some of the earlier stridency and theoretical
purism Purism, referring to the arts, was a movement that took place between 1918 and 1925 that influenced French painting and architecture. Purism was led by Amédée Ozenfant and Charles Edouard Jeanneret (Le Corbusier). Ozenfant and Le Corbusier f ...
. There were the beginnings of a general softening of the strict demarcations between schools, with moves toward
rapprochement In international relations, a rapprochement, which comes from the French word ''rapprocher'' ("to bring together"), is a re-establishment of cordial relations between two countries. This may be done due to a mutual enemy, as was the case with Germ ...
, integration, and
eclecticism Eclecticism is a conceptual approach that does not hold rigidly to a single paradigm or set of assumptions, but instead draws upon multiple theories, styles, or ideas to gain complementary insights into a subject, or applies different theories i ...
– 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 Feminism is a range of socio-political movements and ideologies that aim to define and establish the political, economic, personal, and social equality of the sexes. Feminism incorporates the position that society prioritizes the male po ...
and
post-modernism Postmodernism is an intellectual stance or mode of discourseNuyen, A.T., 1992. The Role of Rhetorical Devices in Postmodernist Discourse. Philosophy & Rhetoric, pp.183–194. characterized by skepticism toward the " grand narratives" of modern ...
, 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 and
social constructionist Social constructionism is a theory in sociology, social ontology, and communication theory which proposes that certain ideas about physical reality arise from collaborative consensus, instead of pure observation of said reality. The theor ...
approaches. While there was still debate within the field about whether, or to what degree, the ''systemic-constructivist'' and ''medical-biological'' paradigms were necessarily antithetical to each other ''(see also
Anti-psychiatry Anti-psychiatry is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionabl ...
; 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
helping Helping behavior refers to voluntary actions intended to help the others, with reward regarded or disregarded. It is a type of prosocial behavior (voluntary action intended to help or benefit another individual or group of individuals, such as shar ...
and
medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
professions.Nichols, M.P. & Schwartz, R.C. (2006)
''Family therapy: concepts and methods.''
7th ed. Boston: Pearson/Allyn & Bacon.
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 Brief psychotherapy (also brief therapy, planned short-term therapy) is an umbrella term for a variety of approaches to short-term, solution-oriented psychotherapy. Overview Brief therapy differs from other schools of therapy in that it emphas ...
, structural therapy, constructivist approaches (e.g., Milan systems, ''post-Milan/collaborative/conversational'', ''reflective''), Bring forthism approach (e.g. Dr. Karl Tomm's IPscope model and Interventive interviewing), solution-focused therapy,
narrative therapy Narrative therapy (or Narrative Practice) is a form of psychotherapy that seeks to help patients identify their values and the skills associated with them. It provides the patient with knowledge of their ability to live these values so they can ...
, a range of cognitive and behavioral approaches,
psychodynamic Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
and
object relations Object relations theory is a school of thought in psychoanalytic theory centered around theories of stages of ego development. Its concerns include the relation of the psyche to others in childhood and the exploration of relationships between ...
approaches, attachment and
emotionally focused therapy Emotionally focused therapy and emotion-focused therapy (EFT) are a family of related approaches to psychotherapy with individuals, couples, or families. EFT approaches include elements of experiential therapy (such as person-centered therapy and ...
, ''intergenerational'' approaches, ''network therapy'', and multisystemic therapy (MST).
Multicultural The term multiculturalism has a range of meanings within the contexts of sociology, political philosophy, and colloquial use. In sociology and in everyday usage, it is a synonym for " ethnic pluralism", with the two terms often used interchang ...
,
intercultural Cross-cultural communication is a field of study that looks at how people from differing cultural backgrounds communicate, in similar and different ways among themselves, and how they endeavor to communicate across cultures. Intercultural commu ...
, and integrative approaches are being developed, with
Vincenzo Di Nicola Vincenzo Di Nicola is an Italian-Canadian psychologist, psychiatrist and family therapist, and philosopher of mind. Di Nicola is a tenured Full Professor in the Dept. of Psychiatry & Addiction Medicine at the University of Montreal, where he fo ...
weaving a synthesis of family therapy and transcultural psychiatry in his model of cultural family therapy, '' A Stranger in the Family: Culture, Families, and Therapy''. Many practitioners claim to be "
eclectic Eclectic may refer to: Music * ''Eclectic'' (Eric Johnson and Mike Stern album), 2014 * ''Eclectic'' (Big Country album), 1996 * Eclectic Method, name of an audio-visual remix act * Eclecticism in music, the conscious use of styles alien to th ...
", 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). The Liberation Based Healing framework for family therapy offers a complete paradigm shift for working with families while addressing the intersections of race, class, gender identity, sexual orientation and other socio-political identity markers. This theoretical approach and praxis is informed by
Critical Pedagogy Critical pedagogy is a philosophy of education and social movement that developed and applied concepts from critical theory and related traditions to the field of education and the study of culture. It insists that issues of social justice and de ...
,
Feminism Feminism is a range of socio-political movements and ideologies that aim to define and establish the political, economic, personal, and social equality of the sexes. Feminism incorporates the position that society prioritizes the male po ...
, Critical Race Theory, and Decolonizing Theory. This framework necessitates an understanding of the ways Colonization, Cis-Heteronormativity, Patriarchy,
White Supremacy White supremacy or white supremacism is the belief that white people are superior to those of other races and thus should dominate them. The belief favors the maintenance and defense of any power and privilege held by white people. White s ...
and other systems of domination impact individuals, families and communities and centers the need to disrupt the status quo in how power operates. Traditional Western models of family therapy have historically ignored these dimensions and when white, male privilege has been critiqued, largely by feminist theory practitioners, it has often been to the benefit of middle class, white women's experiences. While an understanding of
intersectionality Intersectionality is an analytical framework for understanding how aspects of a person's social and political identities combine to create different modes of discrimination and privilege. Intersectionality identifies multiple factors of adva ...
is of particular significance in working with families with violence, a liberatory framework examines how power, privilege and oppression operate within and across all relationships. Liberatory practices are based on the principles of Critical-Consciousness, Accountability and Empowerment. These principles guide not only the content of the therapeutic work with clients but also the supervisory and training process of therapists. Dr. Rhea Almeida, developed the Cultural Context Model as a way to operationalize these concepts into practice through the integration of culture circles, sponsors, and a socio-educational process within the therapeutic work. 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.


Techniques

Family therapy uses a range of counseling and other techniques including: * Structural therapy - 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 *IPscope model and Interventive Interviewing * communication theory *
psychoeducation Psychoeducation (a portmanteau of psychological education) is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness. Psychoeducation is most of ...
* psychotherapy *relationship counseling *
relationship education Relationship education and premarital counseling promote practices and principles of premarital education, relationship resources, relationship restoration, relationship maintenance, and evidence-based marriage education. History The formal orga ...
* systemic coaching *
systems theory Systems theory is the interdisciplinary study of systems, i.e. cohesive groups of interrelated, interdependent components that can be natural or human-made. Every system has causal boundaries, is influenced by its context, defined by its structu ...
* reality therapy * the genogram 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 The unconscious mind (or the unconscious) consists of the processes in the mind which occur automatically and are not available to introspection and include thought processes, memories, interests, and motivations. Even though these processes exi ...
or
early childhood Early childhood is a stage in human development following infancy and preceding middle childhood. It generally includes toddlerhood and some time afterward. Play age is an unspecific designation approximately within the scope of early childhood. ...
trauma Trauma most often refers to: * Major trauma, in physical medicine, severe physical injury caused by an external source * Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event *Traumatic i ...
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 A genogram (also known as a McGoldrick–Gerson study, a Lapidus schematic or a family diagram) is a pictorial display of a person's family relationships and medical history. It goes beyond a traditional family tree by allowing the user to visual ...
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 Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
,
object relations Object relations theory is a school of thought in psychoanalytic theory centered around theories of stages of ego development. Its concerns include the relation of the psyche to others in childhood and the exploration of relationships between ...
, ''intergenerational'', or ''experiential'' family therapists (EFTs)—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.


Evidence base

Family therapy has an evolving evidence base. A summary of current evidence is available via the UK's Association of Family Therapy. Evaluation and outcome studies can also be found on the Family Therapy and Systemic Research Centre website. The website also includes quantitative and qualitative research studies of many aspects of family therapy. According to a 2004 French government study conducted by French Institute of Health and Medical Research, family and couples therapy was the second most effective therapy after Cognitive behavioral therapy. The study used
meta-analysis A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
of over a hundred secondary studies to find some level of effectiveness that was either "proven" or "presumed" to exist. Of the treatments studied, family therapy was presumed or proven effective at treating
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...
,
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
,
anorexia Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gre ...
and
alcohol dependency Alcohol dependence is a previous (DSM-IV and ICD-10) psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol (also chemically known as ethanol). In 2013, it was reclassified as alcohol use disorder ...
.


Concerns and criticism

In a 1999 address to the Coalition of Marriage, Family and Couples Education conference in Washington, D.C.,
University of Minnesota The University of Minnesota, formally the University of Minnesota, Twin Cities, (UMN Twin Cities, the U of M, or Minnesota) is a public land-grant research university in the Twin Cities of Minneapolis and Saint Paul, Minnesota, United States. ...
Professor William Doherty said: Doherty suggested questions prospective clients should ask a therapist before beginning treatment: # "Can you describe your background and training in marital therapy?" # "What is your attitude toward salvaging a troubled marriage versus helping couples break up?" # "What is your approach when one partner is seriously considering ending the marriage and the other wants to save it?" # "What percentage of your practice is marital therapy?" # "Of the couples you treat, what percentage would you say work out enough of their problems to stay married with a reasonable amount of satisfaction with the relationship." "What percentage break up while they are seeing you?" "What percentage do not improve?" "What do you think makes the differences in these results?"


Licensing and degrees

Family therapy practitioners come from a range of professional backgrounds, and some are specifically qualified or licensed/registered in family therapy (licensing is not required in some jurisdictions and requirements vary from place to place). In the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the European mainland, continental mainland. It comprises England, Scotlan ...
, family therapists will have a prior relevant professional training in one of the helping professions usually psychologists, psychotherapists, or counselors who have done further training in family therapy, either a diploma or an
M.Sc. A Master of Science ( la, Magisterii Scientiae; abbreviated MS, M.S., MSc, M.Sc., SM, S.M., ScM or Sc.M.) is a master's degree in the field of science awarded by universities in many countries or a person holding such a degree. In contrast to ...
In the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
there is a specific degree and license as a
marriage Marriage, also called matrimony or wedlock, is a culturally and often legally recognized union between people called spouses. It establishes rights and obligations between them, as well as between them and their children, and between ...
and family therapist; however, psychologists,
nurse Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health c ...
s, psychotherapists, social workers, or counselors, and other licensed mental health professionals may practice family therapy. In the UK, family therapists who have completed a four-year qualifying programme of study (MSc) are eligible to register with the professional body the Association of Family Therapy (AFT), and with the UK Council for Psychotherapy (UKCP). A master's degree is required to work as a Marriage and Family Therapist (MFT) in some American states. Most commonly, MFTs will first earn a M.S. or M.A. degree in marriage and family therapy, counseling,
psychology Psychology is the scientific study of mind and behavior. Psychology includes the study of conscious and unconscious phenomena, including feelings and thoughts. It is an academic discipline of immense scope, crossing the boundaries between ...
, family studies, or social work. After graduation, prospective MFTs work as
interns An internship is a period of work experience offered by an organization for a limited period of time. Once confined to medical graduates, internship is used practice for a wide range of placements in businesses, non-profit organizations and gover ...
under the supervision of a licensed professional and are referred to as an MFTi. Prior to 1999 in
California California is a state in the Western United States, located along the Pacific Coast. With nearly 39.2million residents across a total area of approximately , it is the most populous U.S. state and the 3rd largest by area. It is also the m ...
, counselors who specialized in this area were called Marriage, Family and Child Counselors. Today, they are known as Marriage and Family Therapists (MFT), and work variously in private practice, in clinical settings such as hospitals, institutions, or counseling organizations. Marriage and family therapists in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
and
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
often seek degrees from accredited Masters or Doctoral programs recognized by the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE), a division of the
American Association of Marriage and Family Therapy The American Association for Marriage and Family Therapy (AAMFT) is a professional association in the field of marriage and family therapy representing more than 50,000 marriage and family therapists throughout the United States, Canada, and abroad. ...
. Requirements vary, but in most states about 3000 hours of supervised work as an intern are needed to sit for a licensing exam. MFTs must be licensed by the state to practice. Only after completing their education and internship and passing the state licensing exam can a person call themselves a Marital and Family Therapist and work unsupervised. License restrictions can vary considerably from state to state. Contact information about licensing boards in the United States are provided by the Association of Marital and Family Regulatory Boards. There have been concerns raised within the profession about the fact that specialist training in ''couples therapy'' – as distinct from ''family therapy'' in general - is not required to gain a license as an MFT or membership of the main professional body, the AAMFT.


Values and ethics

Since issues of interpersonal conflict, power, control, values, and ethics are often more pronounced in relationship therapy than in individual therapy, there has been debate within the profession about the different values that are implicit in the various theoretical models of therapy and the role of the therapist's own values in the therapeutic process, and how prospective clients should best go about finding a therapist whose values and objectives are most consistent with their own. An early paper on ethics in family therapy written by
Vincenzo Di Nicola Vincenzo Di Nicola is an Italian-Canadian psychologist, psychiatrist and family therapist, and philosopher of mind. Di Nicola is a tenured Full Professor in the Dept. of Psychiatry & Addiction Medicine at the University of Montreal, where he fo ...
in consultation with a bioethicist asked basic questions about whether strategic interventions "mean what they say" and if it is ethical to invent opinions offered to families about the treatment process, such as statements saying that half of the treatment team believes one thing and half believes another. Specific issues that have emerged have included an increasing questioning of the longstanding notion of ''therapeutic neutrality'', a concern with questions of justice and self-determination, connectedness and independence, "functioning" versus "authenticity", and questions about the degree of the therapist's "pro-marriage/family" versus "pro-individual" commitment. The
American Association for Marriage and Family Therapy The American Association for Marriage and Family Therapy (AAMFT) is a professional association in the field of marriage and family therapy representing more than 50,000 marriage and family therapists throughout the United States, Canada, and abroad. ...
requires members to adhere to a "Code of Ethics", including a commitment to "continue therapeutic relationships only so long as it is reasonably clear that clients are benefiting from the relationship."


Founders and key influences

Some key developers of family therapy are:


Summary of theories and techniques

(''references:''Gurman, A. S. (2008). ''Clinical handbook of couple therapy.'' New York: Guilford Press.Sexton, T. L., Weeks, G. R., & Robbins, M. S. (2003). ''Handbook of family therapy: The science and practice of working with families and couples.'' New York: Brunner-Routledge.)


Journals

* '' Australian and New Zealand Journal of Family Therapy'' * ''
Contemporary Family Therapy ''Contemporary Family Therapy'' is a peer-reviewed academic journal covering research on family therapy, focusing on recent applied practice and developments in theory and research that is published quarterly by Springer Science+Business Media. ...
'' * ''
Family Process ''Family Process'' is a quarterly peer-reviewed academic journal covering research on family system issues, including policy and applied practice. It is published by Wiley-Blackwell on behalf of the Family Process Institute. Since 2007, the journa ...
'' * ''
Family Relations ''Family Relations'' (russian: Родня, Rodnya) is a 1981 Soviet drama film directed by Nikita Mikhalkov. Plot A rural woman Mariya Konovalova (Nonna Mordyukova) goes to the regional center to visit her daughter Nina (Svetlana Kryuchkova), a ...
'' * ''
Family Relations ''Family Relations'' (russian: Родня, Rodnya) is a 1981 Soviet drama film directed by Nikita Mikhalkov. Plot A rural woman Mariya Konovalova (Nonna Mordyukova) goes to the regional center to visit her daughter Nina (Svetlana Kryuchkova), a ...
'', Interdisciplinary Journal of Applied Family Studies * '' Journal of Family Therapy'' * ''Marriage Fitness'' * ''Murmurations: Journal of Transformative Systemic Practice'' * '' Journal of Marital & Family Therapy'' * ''
Families, Systems and Health ''Families, Systems and Health'' is a peer-reviewed academic journal published by the American Psychological Association on behalf of the Collaborative Family Healthcare Association. It was established in 1983 and covers research in the areas of ...
''


See also

* Alternative dispute resolution *
Acceptance and commitment therapy Acceptance and commitment therapy (ACT, typically pronounced as the word "act") is a form of psychotherapy, as well as a branch of clinical behavior analysis. It is an empirically based psychological intervention that uses acceptance and m ...
* CAMFT * Child abuse *
Conflict resolution Conflict resolution is conceptualized as the methods and processes involved in facilitating the peaceful ending of conflict and retribution. Committed group members attempt to resolve group conflicts by actively communicating information abo ...
* Cognitive behavioral therapy *
Deinstitutionalisation Deinstitutionalisation (or deinstitutionalization) is the process of replacing long-stay psychiatric hospitals with less isolated community mental health services for those diagnosed with a mental disorder or developmental disability. In the lat ...
* Domestic violence *
Dysfunctional family A dysfunctional family is a family in which conflict, misbehavior, and often child neglect or abuse and sometimes even all of the above on the part of individual parents occur continuously and regularly, leading other members to accommodate such ...
*
Emotionally focused therapy Emotionally focused therapy and emotion-focused therapy (EFT) are a family of related approaches to psychotherapy with individuals, couples, or families. EFT approaches include elements of experiential therapy (such as person-centered therapy and ...
* ENRICH * Family Environment Scale *
Family Life Education Family life education is defined by the National Council on Family Relations (NCFR) as "the educational effort to strengthen individual and family life through a family perspective. The objective of Family Life Education is to enrich and improve t ...
* Family Life Space *
Identified patient Identified patient (IP) is a clinical term often heard in family therapy discussion. It describes one family member in a dysfunctional family who expresses the family's authentic inner conflicts. Usually, the "designated patient" expresses their ...
* Impact Therapy *
Internal Family Systems Model The Internal Family Systems Model (IFS) is an integrative approach to individual psychotherapy developed by Richard C. Schwartz in the 1980s. It combines systems thinking with the view that the mind is made up of relatively discrete subperson ...
*
Interpersonal psychotherapy Interpersonal psychotherapy (IPT) is a brief, attachment-focused psychotherapy that centers on resolving interpersonal problems and symptomatic recovery. It is an empirically supported treatment (EST) that follows a highly structured and time-limite ...
*
Interpersonal relationship The concept of interpersonal relationship involves social associations, connections, or affiliations between two or more people. Interpersonal relationships vary in their degree of intimacy or self-disclosure, but also in their duration, in t ...
* Mediation *
Mindfulness-based cognitive therapy Mindfulness-based cognitive therapy (MBCT) is an approach to psychotherapy that uses cognitive behavioral therapy (CBT) methods in collaboration with mindfulness meditative practices and similar psychological strategies. The origins to its concept ...
* Multisystemic Therapy (MST) * Positive psychology *
Relationship education Relationship education and premarital counseling promote practices and principles of premarital education, relationship resources, relationship restoration, relationship maintenance, and evidence-based marriage education. History The formal orga ...
* Relationships Australia * Strategic Family Therapy *
Abnormal Psychology Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psyc ...


Footnotes


Further reading

* Deborah Weinstein, ''The Pathological Family: Postwar America and the Rise of Family Therapy.'' Ithaca, NY: Cornell University Press, 2013. * Satir, V., Banmen, J., Gerber, J., & Gomori, M. (1991). The Satir Model: Family Therapy and Beyond. Palo Alto, CA: Science and Behavior Books. * The Systemic Thinking and Practice Series. Routledge {{DEFAULTSORT:Family Therapy Family Psychotherapies Relationship counseling Cybernetics sr:Породична терапија