This chapter introduces the reader to the field of family therapy. It explores how family therapy was born in the 1950s in work with schizophrenics and their families. The chapter introduces the reader to the primary figures in the field and explains how they began to establish the foundational models of family therapy. It ends by exploring the similarities and differences between family therapy and other helping fields.
This chapter presents the core competencies that family therapists, regardless of model, utilize in their practice. Family therapists are expected to be competent, having knowledge and skills in a variety of areas. The self-of-the-therapist is an important competency, as the person of the therapist impacts how they understand and influence the therapeutic process. Joining is the process of making a connection with clients, which is extremely important as it is the medium in which client change happens. Family therapists understand that not all clients come to therapy with the same motivation to change and work with each client differently based on their readiness for change. The basic therapy skills of empathic understanding, distinguishing between content and process, and handling emotionality are some of the most useful family therapy skills. The chapter ends by describing how family therapists use basic skills such as door openers, minimal encouragers, paraphrases, reflections of feeling, reflections of meaning, and questions to help expand the conversation.
This chapter describes how family therapists have integrated notions of diversity into their theory and practice. Family therapy was initially developed primarily by White Western males based on a patriarchal society. Family therapists have since attempted to explore diversity aspects, which include therapist, client, and wider social systems. Family therapists explore people's intersectionality and how issues of privilege and oppression impact individuals. Culturally responsive therapy prompts the therapist to work with clients in a way that is responsive to the local community's knowledge. This shifts the expertise from the therapist to the client. The chapter ends by describing how the notion of diversity in therapy has been continuously changing, leading therapists to have a better appreciation of the unique contexts and struggles of clients from a multitude of backgrounds and situations.
This chapter establishes the understanding that family therapists must follow both ethical principles and local laws. The core ethical principles are designed to ensure therapists help people, not harm them. These principles include the notion that family therapists should ensure clients are willingly choosing to engage in therapy; should hold almost everything they say in confidence; and should do whatever they can to ensure clients do not harm themselves or others. The chapter ends by asserting that therapists from any orientation follow ethical principles, and family therapists also have several additional ethical issues that they must deal with.
This chapter presents the two most significant systemic family therapies: Milan systemic family therapy and structural family therapy. Milan systemic family therapy takes the view that problems happen in families because the family has adopted a family myth that preserves problematic patterns (family games). The Milan Team developed a five-stage format for sessions, including a presession, session, intersession, intervention, and postsession. The Milan Team developed three guidelines for therapists: hypothesizing, circularity, and neutrality. These guidelines inform their interactions with families and the design of their interventions. The chapter goes on to provide an overview of structural family therapy, which explores the family's current organization, looking for areas in which they have not adapted to their current life stage. The chapter ends by exploring how structural family therapists attempt to change who is in what subsystem, as well as the boundaries between subsystems, so that a more functional hierarchy is in place.
This chapter introduces the reader to the two foundational strategic family therapies: the Mental Research Institute's (MRI) brief therapy and strategic therapy. The MRI developed brief therapy, which lasts for 10 sessions at most. MRI brief therapy takes the view that problems arise from people trying to solve normal life difficulties in ways that make those problems worse. Thus, it is the failed solution attempts that are the problem. MRI brief therapy attempts to interrupt the failed solution attempts by getting clients to do something 180 degrees different. The chapter then provides an overview of strategic therapy, which is based on the strategic interventions of Milton Erickson, the cybernetic ideas of Gregory Bateson, and the hierarchical ideas of Salvador Minuchin. Strategic therapy takes the view that problems arise from people maintaining patterns of interaction that may have worked for a previous family life stage, but not the current one. The chapter ends by exploring how strategic therapy uses directives to get people to move incrementally toward their desired goals.
This chapter describes the possible directions in which family therapy could move in the future. Family therapists primarily work in private practice settings. They also work in agencies, residential settings, hospitals, schools, and business organizations. Over the last few years, most family therapists have begun meeting clients both in person and online via telehealth (videoconferencing). The various models of family therapy are also being researched to demonstrate that they are empirically validated treatment methods—thus proving their effectiveness. In empirically validated treatment studies, clients are randomly assigned to receive therapy or remain on a waiting list (or receive a different type of therapy), to determine which condition is more effective. Single-session therapy (SST) attempts to help clients, in one session, to move forward in their lives, focusing on outcomes. SST is predicated on the notion that people can change quickly. The chapter ends by describing international family therapy, which recognizes that Western ideas and practices may not be in line with non-Western cultures. International family therapy attempts to promote both universal and essential aspects of personhood based on the culture in which one is practicing.
This chapter presents two of the most prominent intergenerational family therapies: Bowen therapy and contextual therapy. Bowen therapy is based on natural systems theory, which holds that eight interlocking concepts are present in all natural systems. Bowenians explore a person's emotional system, in which there is a struggle between being an individual and staying connected to others. Bowenian therapists encourage people to understand the historical relational dynamics in their families so they can be thoughtful in the choices of their interactions rather than being reactive. The chapter goes on to provide an overview of contextual therapy, which is best known for introducing the concept of relational ethics into the family therapy field—that there should be a balancing of what one has earned and what one owes to someone else. Contextual therapy rests on five dimensions: facts, psychology, family systems, relational ethics, and ontic. Contextual therapists take a position of multidirected partiality, considering the position of all parties who are impacted by the actions of those in the therapy room. The chapter ends by explaining that contextual therapy attempts to help people through the rejunction process, where they are better able to relate ethically to one another.
The theme of this chapter is the life of children living in state foster homes of the so-called family type. The theoretical scope of the research on the quality of life is based on the chosen capabilities according to the theory by Martha Nussbaum. The qualitative strategy has been chosen as a base for the methodology of the research. Predominantly, the deductive method has been used for collecting and processing the research data by openly coding the transcripts of clinic interviews with children living in foster homes. The research has been searching for answers to these four questions: How can children, living in foster homes, develop cognitively? How can children build relationships and emotions in foster homes? What does the term "home" mean for children living in foster homes? How do children living in foster homes perceive their own identity? Among the most important research findings belongs the information on an excessive burden of adoption on the children, on a weak engagement in creation and improvement of children's home, on wrong conditions for the self-development, self-evaluation and self-reflection of a child and other.
Meta-analysis research supports the notion that common factors are at work across theoretically different therapies. However, some advocates of empirically supported treatments (ESTs) criticize that there is no common factor chronological map to guide clinicians across different stages of therapy (initial, intermediate, termination). In this chapter, supported by recent research, we propose a preliminary chronological map which has the potential to guide clinicians as they use common factors across all three stages of couple and family therapy. The common factors approach is an overarching therapeutic model within which the therapist can determine and use well-timed common mechanisms of change to support therapy's success. This is consistent with the AAMFT Core Competencies to provide safe and effective therapy.
