THE HISTORY OF FAMILY THERAPY Conceptual and Clinical Influences

1. SYSTEMIC COMPARATIVE
Lecture 1
Introduction to Systemic therapy:
THE HISTORY OF FAMILY
THERAPY
Conceptual and Clinical Influences
Kevin Standish
Newham College University
Centre

2. Learning Objectives
 Understand the Shift From Linear to
Systemic Epistemology
 Understand and define key concepts
used in systemic therapy
 Describe the historical and clinical
developments of systemic therapy

3. WHAT IS SYSTEMIC
FAMILY THERAPY?

4. What is Systemic family
therapy?
 Systemic family therapy is an approach
to helping people with psychological
difficulties which is radically different
from other therapies.
 It does not see its work as being to cure
mental illnesses that reside within
individuals, but to help people to mobilise
the strengths of their relationships so as
to make disturbing symptoms
unnecessary or less problematic
(Stratton 2010).

5. The Systemic Family Therapy
Perspective on problems
 We live our lives through our relationships.
Research into what matters most to people
consistently finds that close
relationships, especially family
relationships, rank higher than anything
else.
 Our sense of who we are is intimately
associated with our relationships – both to
other people and the contexts in which we
live. When relationships do not give us what
we need, we lose our sense of comfort and
confidence about the person that we are.

6. The Systemic Family Therapy
Perspective on problems
 When relationships go seriously
wrong, powerful psychological process
come to operate.
 Often not in full awareness, and often
with unwanted consequences.
 Much psychological distress is a result
of these processes.

7. The Systemic Family Therapy
Perspective on problems
 Conditions that get given labels such
as depression, anxiety, and conduct
disorder, are very often effects of
relationship problems.
 Conversely, when systemic family
therapists see someone in
psychological distress they look first
for relationships that have gone awry.
(Stratton 2010)

8. Advantages of Systemic
interactional based therapies
 Relationship problems are usually
best treated within those
relationships.
 Problems are being treated in the
context in which they arose
 The other people in the family or
group with close relationships are
a powerful (and nearly always
willing) resource for change.

9. Advantages of Systemic
interactional based therapies
 Therapeutic gains that have been
achieved in collaboration with the
family and other relational systems are
most likely to continue as the person
moves forward in their context of
everyday living.
 therapy carried out within relational
systems is so effective that it is often
not necessary to understand where a
problem such as depression came
from.

10. How Systemic Family Therapy
Works (Simple version)
 Systemic family therapy has developed a
varied repertoire of highly effective methods
that a family therapist can call on to meet
the needs of clients and families. These
include:
1. An awareness of how family processes
operate and ability to make these apparent
to the family.
2. An ability to work with children in relation to
their parents and vice-versa.
3. Working with families to understand and
productively use the influence of their

11. How Systemic Family Therapy
Works (Simple version)
4. Through both conversation and
action, helping family members to recognise
options they have not been making use of.
5. Collaborative exploration of strengths and
resources of family members that they can
bring to bear to support each other.
6. It always takes account of the full range of
systems that can be seen as nesting inside
each other.
7. It place a high priority on working with all
aspects of diversity and to be concerned with
issues of power , gender, race and economic
contexts

12. Who gets systemic therapy?
 It is most often offered to couples or families
 Group specific behaviors like classroom or
organisational issues.
 But always with the larger and smaller systems
in mind, and with an awareness that change at
any level of the systems is likely to impact on
the other systems.
 A counterbalance is provided by an increasing
willingness in systemic therapy to incorporate
understandings of internal processes as they
have been understood by psychodynamic and
cognitive therapies. Systemic therapy with
individuals

13. Who gets systemic therapy?
 A typical family therapy clinic helps
families deal with a great variety of
physical and psychological difficulties.
 The families will vary widely in terms
of family structure, ethnicity and
culture.
 Treatment most often consists of
about seven sessions, spread over six
months. Long short therapy

14. THE HISTORY OF FAMILY
THERAPY
CONCEPTUAL AND
CLINICAL INFLUENCES

15. THE HISTORY OF FAMILY THERAPY
Conceptual and Clinical Influences
 Family therapy as a distinct method of did not
actually emerge until the early1960s.
 Conceptual and clinical influences that
informed the development of family therapy
are traced to a much earlier period.
 Beginning with the development of
professional social work in late19th and
early20th centuries, along with the early
group-work, marriage counseling, and child
guidance movements in the early 20th century
 family therapy research on the etiology of
schizophrenia in the1950s play an influential
role

16. THE HISTORY OF FAMILY THERAPY
Conceptual and Clinical Influences
 1940s and 1950s the development of
cybernetics, systems, and communication
theory.
 These theories, informed by concepts from
sociology, anthropology, and biology,
 provided powerful theoretical frameworks for
a more in-depth under-standing of the
complexities of family interaction.
 challenged the dominant psychoanalytic
understanding that emotional disorders were
of intrapsychic origin
 Postulated the rather innovative and then
novel hypothesis that these disorders were
symptomatic of troubled family relationships

17. THE HISTORY OF FAMILY THERAPY
Conceptual and Clinical Influences
 The history of family therapy reveals
profound paradigm shifts in under-standing
the causative factors that contribute to
emotional disorders.
 These paradigm shifts will become evident as
we examine the theoretical and clinical
influences on the formation of the varied
family therapy models.
 It is vital you understand the shift in
epistemology and paradigms
 Epistemology: How we explain how we know
what we know. A system of beliefs on how
we view and explain the world.

18. First challenge: Relational self
 Initially a challenge to the notion of the
autonomous self with the systems-based
concepts of the relational self
 Based on the paradigm of the
autonomous self, emotional disorders
were viewed as symptomatic of a
disordered inner self. Even though the
family unit has always been valued in
society, the family was seen as a
collection of individuals that could either
support or impede the development of
the autonomous self.

19. First challenge: Relational self
 Symbolic interactionism and structural
functional theories challenged the notion of
the autonomous self with the understanding
that the human self was embedded in a
system of human relationships.
 the emergence of systems and
communication theories, and those
theorists and researchers in early
schizophrenia confirmed that the human
self was indeed a relational and
communicating being.

20. First challenge: Relational self
 This self is embedded in a system of
relational networks, the primary one
being the family.
 This concept of the Self as embedded or
as the relational self was the guiding
paradigm for early family therapy.
 The source of human emotional
suffering was seen as symptomatic of
disordered family relationships and/or
disordered family communication
patterns.

21. Second challenge: Post Modern
Narrative approaches
 a more contemporary and postmodern
perspective of the self, is the narrative
self.
 This postmodern understanding of the
self provides a unique insight into
understanding families by giving
attention to how family members
construct their intrafamilial
experiences through language.
 Language is the means of
organizing and structuring life
experiences.

22. Second challenge: Post Modern
Narrative approaches
 It is the narrative that individuals
construct about their lives that provides
them with a sense of personal identity.
 Narratives reveal the significance of
individuals‟ lived experience within the
context of their social worlds
(Gergen, 1999; Polkinghorne, 1988).
 The focus shifts from examining
relational interactions and
communication patterns to examining
the meaning embedded in narrative
forms of expression.

23. Second challenge: Post Modern
Narrative approaches
 Human actions and relationships as
expressed through narratives or
stories are seen as efforts to create
meaning out of personal experiences.
 These efforts at meaning construction
are reflected in narratives or stories
that give organization and structure to
a person or family (Kilpatrick &
Holland, 2009).

24. Second challenge: Post Modern
Narrative approaches
 Thus family problems are located
within narrative constructions of
meaning.
 The narrative emphasis on “meaning”
is further supplemented by a focus on
ways in which broader sociopolitical
influences impact family and individual
narratives

25. MODERN/POST
MODERN?
What do these terms mean?
How do they influence the
approach in therapy?

26. Postmodernism in Context: A
Brief History of Thought
 The three historical epochs of
premodern, modern, and postmodern
as paradigms or schemas that coexist
within specific historical context
 Western societies currently are
transitioning the modern to the
postmodern paradigm.
 Certain approaches to epistemology
prevailed in each of these developmental
periods. Themes typically relate back to
this central question of how we know
what we know

27. Historical time periods
Premodern
ism
Modernism Post-
modernism
Time Period Up to
1650‟s
1650 –
1950‟s
1950‟s
onwards
Epistemolog
y
Religion &
Revelation
Reason,
Empiricism
and Science
Pluralism &
constructed
reality

28. Premodernism: Truth
Revealed The premodern period dates from the
beginning of recorded thought until the mid
1600s.
 During this time, truth was revealed by God
or more specifically,
a special revelation from God.
 Later developments in the premodern period
focused on authoritative texts or books
written by authoritative sources.
 The ultimate source of Truth was still
God, but most people could only access this
Truth through religious leaders. The role of
religious leaders was not to
discover, control, or construct Truth, but to

29. Modernist: the truth can be
known
 major modernist thinkers had to
first deconstruct pre-modern thought and
call into question pre-modern
assumptions and demonstrated their
insufficiency,
 Major blow in the 1500s with the
Protestant Reformation challenged the
authority of the church
 scientists such as Copernicus and
Galileo promoted scientific theories that
countered long-accepted truth.

30. Modernist: the truth can be
known
 Proven wrong the church was unable to
defend its claim as the source of Truth.
In this context, two new epistemological
approaches emerged: reason and
empiricism(or positivism).
 A key process in the establishment of the
modern period was the construction or
development of methodology. This
replaced the role of systematic theology
and the sacred texts of the premodern
period.

31. Modernism to post
modernism
 Failures of inventions and
philosophies (e.g. League of Nations) to
end war and promote peace left many
disgruntled with the tenets
of modernism.
 In this context, numerous thinkers
proposed alternatives to
modernism, many of which have been
identified as postmodern
 Postmodern approaches to epistemology
emphasize the need for multiple
epistemologies and question over-

32. Post-Modernism
 Postmodernism is difficult to define
because it is still a relatively new
paradigm in the process of defining
itself.
 the focus has shifted toward
developing a new approach to
epistemology, what we call a pluralistic
approach
 The characteristic epistemology of this
phase was constructivism, a belief

33. Post-Modernism
 While epistemology focuses on how we know
what we know an important underlying question
pertains to the nature of truth.
 Premodernism and modernism function with the
assumption that people are able to attain ultimate
truth (“T” truth).
 In the premodern era, God revealed Truth to
people; in the modern era, humans aimed to discover
and control Truth through reason and science.
 However postmodernism takes a different stand on
the nature of truth. What is consistent among
postmodern thinkers is the belief that humans are
unable to attain ultimate truth.
 What is not agreed upon is whether ultimate truth

34. Concepts associated with
modernism and post-modernism
Modernism
 Belief in societal
progress
 Optimism
 Rationality
 Belief in absolute
knowledge through
science, technology
and politics
 Belief in the true self
 Belief in universal
structures, usually
containing binary
opposites
Post-modernism
 Multiple versions of
post-modernism: no
single definition
 Distrust in promises
made in the name of
progress
 Looking for what is
between binary
opposites and what has
been excluded by the
particular distinctions
 Importance of variation
over coherence Belief
in a socially constructed

35. FAMILY THERAPY AND THE
PATH
TOWARDS POST-
MODERNISM
Boston, P. (2000) Systemic family therapy
and the influence of post-modernism Advances in
Psychiatric Treatment vol. 6, pp. 450-457

36. Family therapy and the
path
towards post-modernism Family therapy became a distinct form of
practice with the adaptation of general
systems theory (von Bertalanffy, 1950).
 The major points of development were based
on Minuchin‟s structural family therapy model
(1968). Primarily concerned with the issue of
the optimal organisation of the family and
clarity of boundaries
 Bateson‟s cybernetic model (1972)
 The cybernetic model was adapted by
clinicians to consider the family as a
homoeostatic mechanism with
communication pat-terns analogous to those
in mechanical information- processing
systems.

37. Family therapy and the path
towards post-modernism
 The Milan method (Selvini Palazzoli et
al, 1978) and brief therapy (De
Shazer, 1985) are based on Bateson‟s
cybernetic model (1972)
 These were the major paradigms until
the mid 1980s.
 This was first-order family therapy,
characterised by the therapist‟s
observation of the system from the
outside.

38. Family therapy and the path
towards post-modernism
 Second-order family therapy was marked
by the inclusion of the
concept of constructivism.
 Inherent in this body of thought is the notion
that what is „known‟ in the external world is
determined by our innate mental and sensory
structures (Maturana & Varela, 1984).
 This was a change from the former position
that external reality was „knowable‟.
 In terms of family therapy, this now meant
that therapists were called upon to include
their own personal or theoretical bias as part
of the observation.

39. Family therapy and the path
towards post-modernism
 Another profoundly different way of considering
reality comes from social constructionism.
 This suggests that reality is created through
language in an ongoing interactional and
relational process.
 Discourse about the world is not a reflection or
map of reality, but an artefact of com-munal
interchange (Gergen, 1985).
 Family therapists now became interested in the
active process of meaning-making and the
greater variation of possibilities – the inherent
assumptions in partic-ular discourses and
ideas that had been excluded

40. constructivism to social
constructionism
 For systemic thinking, the movement
from constructivism to social
constructionism initially appeared to
have been a small step, but it proved
to be a huge leap (Gergen, 1991).
 Social constructionism introduced us
to post-modernism.

41. The post-modern model
 Social constructionism and the philosophical culture of
hermeneutics, the science of interpretation and
explanation play a vital role in the development of the
model.
 The structure of therapy is less about beginning, middle
and end points, and more about creating space for a
specific kind of conversation between participants.
 The process of therapy is characterised by a quiet,
reflective stance on the part of the therapist. Questions
would gently be aimed at the expansion and uncovering
of meanings for the individuals in the system.
 the therapist avoids the “expert” role.
 The therapist‟s primary contribution to the process of
change is in the construction of a particular style of
conversation.
 „Reflecting-team conversations‟ are ones in which team
members speak to one another in front of the family
(Andersen, 1987).

42. The principal components of
post-modern therapy
 The therapist is the participant–manager of
the conversation, not the „expert‟
 Language, rather than interactional pattern, is
the system
 Meaning and understanding are achievable
through continued efforts
 Difficulties are constructed in the language
system and can be „dissolved‟ through
language
 Change occurs through development of new
language
 Reflecting teams are used to comment on
and participate in the co-construction of
alternative meanings

44. The narrative model
 The narrative model is also based on social
constructionism,
 Draws directly from the French post-
structuralists.
 Derrida‟s (1976) concept of deconstruction
 Foucault„s (1975) ideas about dominant and
subjugated discourses are central notions.
 Using Bruner and Luciarello‟s research (1989)
on the importance of narrative structure in
meaning-making for humans,
 White has linked societal discourses to
individual narratives (White & Epston, 1990;
Epston & White, 1992).

45. The principal components of
narrative therapy
 An individual‟s identity is embodied in a
personal narrative that includes different
versions of the self
 Clients come to therapy with a ‘problem-
saturated narrative’ that has become
internalised as their primary self-
description
 Problem stories/identities are created,
lived and kept alive by their connection
to important others.
 The technique of externalisation
disconnects the problem from the client‟s
self-descriptions

46. The principal components of
narrative therapy
 The influence of the problem is
„mapped‟, thus connecting the problem
narrative to relevant others
 Narratives are created at a societal level,
so problem ideas held by family
members require „deconstruction‟
 The therapist looks for ‘unique
outcomes‟ – positive exceptions to the
problematic story – and amplifies change
using letter-writing, specific audiences
(others who have successfully
conquered the same issue) and personal
enthusiasm

47. “Religion
without science
becomes superstition;
science without religion
becomes a monster”
Garrit tenZythoff

48. Readings
 Dallos & Draper (2010) intro & Chap 1
 Metcalff (2011) chap 1
 Boston, P. (2000) Systemic family therapy
and the influence of post-modernism
Advances in Psychiatric Treatment vol. 6, pp.
450-457
 THE HISTORY OF FAMILY THERAPY
Conceptual and Clinical Influences
 Hoffman et al (no date) Modern and
Postmodern Ways of Knowing: Implications
for Therapy and Integration
 Stratton (2011) Evidence Base of Systemic
Family and CouplesTherapies