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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 and couples in intimate relationships to nurture change and development. It tends to view change in terms of the
system A system is a group of interacting or interrelated elements that act according to a set of rules to form a unified whole. A system, surrounded and influenced by its environment, is described by its boundaries, structure and purpose and express ...
s 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 expressi ...
.


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 as well as non- kin 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, t ...
(see for example Ho'oponopono). Following the emergence of specialization in various societies, these interventions were often conducted by particular members of a community – for example, a
chief Chief may refer to: Title or rank Military and law enforcement * Chief master sergeant, the ninth, and highest, enlisted rank in the U.S. Air Force and U.S. Space Force * Chief of police, the head of a police department * Chief of the bo ...
,
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 continental mainland. It comprises England, Scotland, Wales and ...
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 Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
. As a branch of
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
, 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 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 Kin ...
), the United States ( Donald deAvila Jackson, John Elderkin Bell, Nathan Ackerman, Christian Midelfort, Theodore Lidz, Lyman Wynne, Murray Bowen, Carl Whitaker, Virginia Satir, Ivan Boszormenyi-Nagy), and in
Hungary Hungary ( hu, Magyarország ) is a landlocked country in Central Europe. Spanning of the Carpathian Basin, it is bordered by Slovakia to the north, Ukraine to the northeast, Romania to the east and southeast, Serbia to the south, Cr ...
, 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 ...
(most of the early founders of the field had psychoanalytic backgrounds) and social psychiatry, 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 Gregory Bateson (9 May 1904 – 4 July 1980) was an English anthropologist, social scientist, linguist, visual anthropologist, semiotician, and cyberneticist whose work intersected that of many other fields. His writings include ''Steps to ...
and colleagues – Jay Haley, Donald D. Jackson, John Weakland, William Fry, and later, Virginia Satir, Ivan Boszormenyi-Nagy,
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 in the United States, who introduced ideas from
cybernetics Cybernetics is a wide-ranging field concerned with circular causality, such as feedback, in regulatory and purposive systems. Cybernetics is named after an example of circular causal feedback, that of steering a ship, where the helmsperson ma ...
and general systems theory 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 Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
, 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 The Bateson Project (1953-1963) was the name given to a ground-breaking collaboration organized by Gregory Bateson which was responsible for some of the most important papers and innovations in communication and psychotherapy in the 1950s and earl ...
). This approach eschewed the traditional focus on individual psychology and historical factors – that involve so-called ''linear causation'' and ''content'' – and emphasized instead ''
feedback Feedback occurs when outputs of a system are routed back as inputs as part of a chain of cause-and-effect that forms a circuit or loop. The system can then be said to ''feed back'' into itself. The notion of cause-and-effect has to be handled ...
'' 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 an ...
'' 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 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 A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
,
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 - especially his innovative use of strategies for change, such as ''paradoxical directives'' ''(see also Reverse psychology)''. The members of the
Bateson Project The Bateson Project (1953-1963) was the name given to a ground-breaking collaboration organized by Gregory Bateson which was responsible for some of the most important papers and innovations in communication and psychotherapy in the 1950s and earl ...
(like the founders of a number of other schools of family therapy, including Carl Whitaker, Murray Bowen, and Ivan Boszormenyi-Nagy) 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 w ...
, especially in terms of the putative "meaning" and "function" of
sign A sign is an object, quality, event, or entity whose presence or occurrence indicates the probable presence or occurrence of something else. A natural sign bears a causal relation to its object—for instance, thunder is a sign of storm, or ...
s and
symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showi ...
s within the family system. The research of
psychiatrist A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
s and
psychoanalyst 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 ...
s Lyman Wynne and Theodore Lidz on communication deviance 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 w ...
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 Psychopathology is the study of abnormal cognition, behaviour, and experiences which differs according to social norms and rests upon a number of constructs that are deemed to be the social norm at any particular era. Biological psychopathol ...
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, creati ...
;
family nexus In psychology, a family nexus is a common viewpoint held and reinforced by the majority of family members regarding events in the family and relationships with the world. The term was coined by R. D. Laing, who believed that this nexus "exists o ...
.)'' By the mid-1960s, a number of distinct schools of family therapy had emerged. From those groups that were most strongly influenced by
cybernetics Cybernetics is a wide-ranging field concerned with circular causality, such as feedback, in regulatory and purposive systems. Cybernetics is named after an example of circular causal feedback, that of steering a ship, where the helmsperson ma ...
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'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 and Carl Whitaker, 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
feeling Feelings are subjective self-contained phenomenal experiences. According to the ''APA Dictionary of Psychology'', a feeling is "a self-contained phenomenal experience"; and feelings are "subjective, evaluative, and independent of the sensation ...
s (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 Boszormenyi-Nagy, James Framo, 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 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 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’s work on attachment. ''Multiple-family
group therapy Group psychotherapy or group therapy is a form of psychotherapy in which one or more therapists treat a small group of clients together as a group. The term can legitimately refer to any form of psychotherapy when delivered in a group format, i ...
'', 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 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 remitti ...
s with a significant
biological Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditary in ...
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 w ...
- and represented something of a conceptual challenge to some of the ''"systemic"'' (and thus potentially "family-blaming")
paradigm In science and philosophy, a paradigm () is a distinct set of concepts or thought patterns, including theories, research methods, postulates, and standards for what constitute legitimate contributions to a field. Etymology ''Paradigm'' comes f ...
s 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'') 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 remitti ...
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. 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 moder ...
, 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 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 Biopsychosocial models are a class of trans-disciplinary models which look at the interconnection between biology, psychology, and socio-environmental factors. These models specifically examine how these aspects play a role in topics ranging from ...
)'', 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 Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
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 Solution-focused (brief) therapy (SFBT) is a goal-directed collaborative approach to psychotherapeutic change that is conducted through direct observation of clients' responses to a series of precisely constructed questions. Based upon social con ...
, narrative therapy, 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, ''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 communi ...
, 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 Critical race theory (CRT) is a cross-disciplinary examination, by social and civil-rights scholars and activists, of how laws, social and political movements, and media shape, and are shaped by, social conceptions of race and ethnicity. Goa ...
, and Decolonizing Theory. This framework necessitates an understanding of the ways Colonization, Cis-Heteronormativity,
Patriarchy Patriarchy is a social system in which positions of dominance and privilege are primarily held by men. It is used, both as a technical anthropological term for families or clans controlled by the father or eldest male or group of males ...
,
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 ...
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 Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
.


Techniques

Family therapy uses a range of
counseling Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes. This is a list of co ...
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 Communication theory is a proposed description of communication phenomena, the relationships among them, a storyline describing these relationships, and an argument for these three elements. Communication theory provides a way of talking about a ...
* psychoeducation *
psychotherapy Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome pro ...
*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 Coaching is a form of development in which an experienced person, called a '' coach'', supports a learner or client in achieving a specific personal or professional goal by providing training and guidance. The learner is sometimes called a ''co ...
*
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 inju ...
of individuals as a
Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating pathologies explained as originating in conflicts i ...
ian 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 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 Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
. 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 m ...
of over a hundred
secondary studies Secondary may refer to: Science and nature * Secondary emission, of particles ** Secondary electrons, electrons generated as ionization products * The secondary winding, or the electrical or electronic circuit connected to the secondary winding ...
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 w ...
,
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of Depression (mood), depression and periods of abnormally elevated Mood (psychology), mood that last from days to weeks each. If the elevat ...
,
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.


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 continental mainland. It comprises England, Scotland, Wales and ...
, family therapists will have a prior relevant professional training in one of the helping professions usually
psychologist A psychologist is a professional who practices psychology and studies mental states, perceptual Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the pre ...
s,
psychotherapist Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome prob ...
s, or counselors who have done further training in family therapy, either a
diploma A diploma is a document awarded by an educational institution (such as a college or university) testifying the recipient has graduated by successfully completing their courses of studies. Historically, it has also referred to a charter or offici ...
or an M.Sc. 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 Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
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,
psychologist A psychologist is a professional who practices psychology and studies mental states, perceptual Perception () is the organization, identification, and interpretation of sensory information in order to represent and understand the pre ...
s,
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 ...
s,
psychotherapist Psychotherapy (also psychological therapy, talk therapy, or talking therapy) is the use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome prob ...
s,
social work Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social wo ...
ers, 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 Counseling is the professional guidance of the individual by utilizing psychological methods especially in collecting case history data, using various techniques of the personal interview, and testing interests and aptitudes. This is a list of co ...
,
psychology Psychology is the science, scientific study of mind and behavior. Psychology includes the study of consciousness, conscious and Unconscious mind, unconscious phenomena, including feelings and thoughts. It is an academic discipline of immens ...
, family studies, or
social work Social work is an academic discipline and practice-based profession concerned with meeting the basic needs of individuals, families, groups, communities, and society as a whole to enhance their individual and collective well-being. Social wo ...
. 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 Continental United States, primarily located in North America. It consists of 50 U.S. state, states, a Washington, D.C., ...
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 to ...
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. 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 Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a ...
'' * ''
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 journal ...
'' * ''
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 The ''Journal of Marital and Family Therapy'' is a quarterly peer-reviewed academic journal published by Wiley-Blackwell on behalf of the American Association for Marriage and Family Therapy. The journal was established in 1975. The current editor ...
'' * '' Families, Systems and Health''


See also

*
Alternative dispute resolution Alternative dispute resolution (ADR), or external dispute resolution (EDR), typically denotes a wide range of dispute resolution processes and techniques that parties can use to settle disputes with the help of a third party. They are used for ...
*
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 mind ...
* CAMFT *
Child abuse Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...
*
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 Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...
*
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 Domestic violence (also known as domestic abuse or family violence) is violence or other abuse that occurs in a domestic setting, such as in a marriage or cohabitation. ''Domestic violence'' is often used as a synonym for '' intimate partn ...
*
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 * ENRICH * Family Environment Scale * Family Life Education * 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 * Interpersonal psychotherapy *
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 Mediation is a structured, interactive process where an impartial third party neutral assists disputing parties in resolving conflict through the use of specialized communication and negotiation techniques. All participants in mediation are ...
*
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 Positive psychology is the scientific study of what makes life most worth living, focusing on both individual and societal well-being. It studies "positive subjective experience, positive individual traits, and positive institutions...it aims t ...
*
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 Relationships Australia (RA) is an Australian not-for profit organisation providing professional services to support relationships across Australia that began in 1948 under the name of Marriage Guidance Council. Initially providing counselling ...
* 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