Family Therapy: Concepts and Methods
Twelfth Edition
Chapter 1
The Evolution of Family
Therapy
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The Early Years: Shift in Perspective (1 of 2)
• The evolution of family therapy is really about
– 1) personalities and 2) ideas
• Treating patients with schizophrenia in hospitals
• Noticed that when one family member got better,
someone else would get worse
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The Early Years: Shift in Perspective (2 of 2)
• Hypothesized that the family needed a symptomatic
family member
– Case study of the depressed woman and her
husband
– His stability was predicated on having a sick wife
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Influence of Group Therapy (1 of 2)
• Group therapy: a complex blend of individual personalities
• Group concepts borrowed for family therapy:
– Kurt Lewin theorized that groups are psychologically
coherent wholes
▪ Not collections of individuals
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Influence of Group Therapy (2 of 2)
– Lewin’s ideas about “unfreezing” (shaking up a group’s
beliefs) foreshadowed:
▪ Family therapists’ concerns with disrupting family
homeostasis
– Focus on “process” (how people talk), rather than
“content” (what they talk about)
– Role theory
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Child Guidance Movement (1 of 3)
• Real source of children’s problems were not from
themselves,
– But from tensions in the family that created symptoms
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Child Guidance Movement (2 of 3)
• Frieda Fromm-Reichmann (1948) – schizophrenogenic
mother
– Domineering, aggressive, insecure woman;
▪ Married to a passive, inadequate, indifferent man
– Provided pathological parenting that produced
schizophrenia
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Child Guidance Movement (3 of 3)
• Eventually emphasis in child guidance shifted to viewing
parents solely as:
– The problem, to viewing the interaction that was the
problem – Bowlby, Ackerman
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Influence of Social Work
• Social workers among the leaders of family therapy
• Social workers considered families as whole units and
viewed the family as:
– A system functioning within larger systems
• Social work students were taught to interview both
parents at the same time
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Etiology of Schizophrenia (1 of 2)
• Gregory Bateson
– One of the first family researchers; developed
communications theory
– Homeostasis
▪ Feedback which regulates the behavior of the
family and preserves the family equilibrium
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Etiology of Schizophrenia (2 of 2)
– Double-bind
▪ Craziness stemmed from an extension of the
family environment
– Receiving two related but contradictory
messages
▪ Difficult to detect and comment on the
inconsistency
• Lidz, Wynne, and role theorists
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Marriage Counseling
• Began as informal procedure
• Currently practiced outside of traditional mental health
settings
– Ministers, family doctors, lawyers
• Couples therapy was absorbed into the theory and
practice of family therapy
• Empirically supported and expanding field
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Pioneers of Family Therapy (1 of 6)
• John Bell
– Family group therapy
• Palo Alto group
– Communications Theory
▪ Gregory Bateson – cybernetics
▪ Don Jackson – family homeostasis
▪ Jay Haley – strategic family therapy
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Pioneers of Family Therapy (2 of 6)
• Murray Bowen
– Believed people who are helped resolve emotional
problems by working with family
– Pathological mechanisms in schizophrenic families
were present in all families
– Help partners achieve a reasonable level of
differentiation of self in family relationships
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Pioneers of Family Therapy (3 of 6)
• Nathan Ackerman
– Moved away from psychoanalysis
– Wanted to see everyone together
– Interested in family secrets, conflicts
– Agent Provocateur
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Pioneers of Family Therapy (4 of 6)
• Carl Whitaker & Virginia Satir
– Experiential Family Therapy
▪ Believed people were alienated from their
emotions
▪ Favored spontaneity v s theoryersu
▪ Used co-therapy
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Pioneers of Family Therapy (5 of 6)
• Ivan Boszormenyi-Nagy
– Ethical accountability
– Relationships based on trust and loyalty
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Pioneers of Family Therapy (6 of 6)
• Salvador Minuchin
– Structural Family Therapy
▪ Begins with observation that family transactions
– When they are repeated, develop a pattern of
regularity or structure
▪ Family structure is determined by emotional
boundaries: Enmeshed; Disengaged
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The Golden Age of Family Therapy
• In their first decade, family therapists had all the bravado
of new kids on the block
• 1970 to 1985 saw the flowering of the classic schools of
family therapy
– Structural theory
– Erickson
– The Milan group
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The Postmodern Revolution
• Challenged family therapist’s ability to define a healthy family,
instead claiming that an ideal family was socially constructed,
often to the advantage of some and disadvantage of others.
• Focused on understanding the family’s definition of health and
dismantling social constructs and power structures
• Gained momentum in late 80’s through 90’s
• Main approaches:
– Solution-focused
– Narrative
– Feminist
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Therapy Today v s Early Years ersu
• Early years were focused on creativity (e.g., Haley,
1962).
• Focus is now on effective interventions.
• Therapy is a lot more sensitive towards gender, culture, S
ES, etc.
• Methods used now are built on a set of common factors
and evidence based.
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