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 (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
tribal chief,
priest,
physician, and so on—usually as an ancillary function. 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 and the
United States. 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 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, D.L.P. Liebermann—who began seeing family members together for observation or therapy sessions. There was initially a strong influence from
psychoanalysis (most of the early founders of the field had psychoanalytic backgrounds) and
social psychiatry, and later from
behaviorism and
behavior therapy—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. This group was also influenced significantly by the work of US
psychiatrist,
hypnotherapist, and
brief therapist Milton H. Erickson—especially his innovative use of strategies for change, such as
paradoxical directives. The members of the
Bateson Project (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 causes and
treatment of
schizophrenia, especially in terms of the putative "meaning" and "function" of
signs and symptoms within the family system. The research of psychiatrists and psychoanalysts
Lyman Wynne and
Theodore Lidz on
communication deviance and roles (e.g., pseudo-mutuality, pseudo-hostility, schism, and skew) in families of people with schizophrenia also became influential with systems-communications-oriented theorists and therapists. A related theme—applying to
dysfunction and
psychopathology more generally—was that of the "
identified patient" or "presenting problem" as a manifestation of or surrogate for the
family's (or even society's) problems. By the mid-1960s, a number of distinct schools of family therapy had emerged. From the groups that were most strongly influenced by
cybernetics and
systems theory there came
Mental Research Institute brief therapy,
strategic therapy,
Salvador Minuchin's
structural family therapy and the model proposed by
Mara Selvini Palazzoli (i.e., 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 and unexpressed
feelings (including the
subconscious), authentic communication, spontaneity, creativity, total therapist engagement, and often included the
extended family. Concurrently, intergenerational therapies by
Murray Bowen,
Ivan Boszormenyi-Nagy,
James Framo, and Norman Paul emerged. They proposed different theories on the intergenerational transmission of health and dysfunction, usually involving three generations in therapy or through "homework" and "journeys home."
Psychodynamic family therapy—which, more than any other school of family therapy, deals directly with individual psychology and the
unconscious mind 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, the British school of
object relations theory, and
John Bowlby's work on
attachment theory. Multiple-family
group therapy, 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 illnesses with significant
biological underpinnings, such as schizophrenia—and represented something of a conceptual challenge to some of the systemic (and thus potentially "family-blaming")
paradigms of pathogenesis that were implicit in many of the dominant models of family therapy. The late 1960s and early 1970s saw the development of network therapy (which bears some resemblance to traditional practices such as Ho'oponopono) by
Ross Speck and
Carolyn Attneave, and the emergence of
behavioral marital therapy (renamed behavioral couples therapy in the 1990s) and behavioral family therapy as models in their own right. From the mid-1980s to the present, the field has been marked by a diversity of approaches that partly reflect the original schools, but which also draw on other theories and methods from
individual psychotherapy and elsewhere—these approaches and sources include:
brief therapy,
structural therapy, constructivist approaches (e.g., Milan systems, post-Milan/collaborative/conversational, and reflective), bringforthist approach (e.g., Karl Tomm's IPscope model and Interventive interviewing),
solution focused brief therapy,
narrative therapy, a range of
cognitive behavioral therapy approaches,
psychodynamic and object relations approaches,
attachment and
emotionally focused therapy, intergenerational approaches, network therapy, and
multisystemic therapy (MST).
Multicultural,
intercultural, and
integrative approaches are being developed, with
Vincenzo Di Nicola 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, 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. Nonetheless, 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, feminism,
critical race theory, and decolonizing theory. It necessitates an understanding of the ways colonization,
cisheteronormativity,
patriarchy,
white supremacy 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 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 therapeutic work with clients but also the supervisory and training processes for therapists. Ideas and methods from family therapy have been influential in psychotherapy generally: a survey of over 2,500 US therapists in 2006 revealed that of the 10 most influential therapists of the previous quarter-century, three were prominent family therapists and that the marital and family systems model was the second-most-utilized model after
cognitive behavioral therapy. ==Techniques==