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'''Family therapy''', also referred to as '''couple and family therapy''' and '''family systems therapy''', is a branch of [[psychotherapy]] related to [[relationship counseling]] that works with [[family|families]] and couples in [[intimate relationship]]s to nurture change and development. It tends to view these in terms of the [[system]]s of interaction between family members. It emphasizes family relationships as an important factor in psychological health. As such, family problems have been seen to arise as an [[emergence|emergent]] property of systemic interactions, rather than to be blamed on individual members. Marriage and Family Therapists (MFTs) are the most specifically trained in this type of psychotherapy.
[[Family therapy]] has been used as a [[psychotherapy]] [[treatment]] for people with [[eating disorders]]
Family therapists may focus more on how patterns of interaction maintain the problem rather than trying to identify the cause, as this can be experienced as blaming by some families. It assumes that the family as a whole is larger than the sum of its parts. Family therapy may also be used to draw upon the strengths of a social network to help address a problem that may be completely externally caused rather than created or maintained by the family.
Family therapy practitioners come from a range of professional backgrounds, and some are specifically qualified or [[licensure|licensed/registered]] in family therapy (licensing is not required in some jurisdictions and requirements vary from place to place). In the UK and the US, family therapists are usually [[psychologist]]s, [[nurse]]s, [[psychotherapist]]s, [[social work]]ers, or [[counselor]]s who have done further training in family therapy, either a [[diploma]] or an [[M.Sc.]]; however, in the U.S., there is a specific degree and license as a Marriage and Family therapist.
Family therapy has been used effectively where families, and or individuals in those families experience or suffer:
*interactional and transitional crises in a family’s life cycle (e.g. conflict, estrangement, [[divorce]], child and adolescent issues);
*serious [[mental disorder|psychological disorders]] (e.g. [[schizophrenia]], [[anxiety disorder|anxiety]], [[clinical depression|depression]], [[personality disorder]]s, [[conduct disorder]]s, [[ADHD]], [[addiction]]s and [[eating disorder]]s);
*as a support of other psychotherapies and medication.
Family therapy journals include: ''Family Process'', ''Journal of Systemic Therapies'', ''Journal of Marital and Family Therapy''.
[[Category:Eating disorders treatment]]
It uses a range of [[counseling]] and other techniques including:
[[Category:Family therapy]]
*[[communication theory]]
*[[systemic coaching]]
*[[systems theory]]
The basic theory of classical ''systemic'' family therapy was derived mainly from [[systems theory]] and [[cybernetics]], and secondarily from [[behavioral therapy]] and [[Cognitive therapy|cognitive psychotherapy]], although most of the founders of the field had [[psychoanalysis|psychoanalytic]] backgrounds.<ref>Dattilio, F.R. (Ed.) (1998). [ ''Case Studies in Couple and Family Therapy: Systemic and Cognitive Perspectives.''] Guildford Press: New York.</ref> More recent developments have come from [[Feminism|feminist]], [[postmodernist]], [[Narrative therapy|narrative]], [[psychodynamic]] and [[attachment theory|attachment]] theories.<ref>Sprenkle, D.H., & Bischof, G.P. (1994). [ Contemporary family therapy in the United States.] ''Journal of Family Therapy'', 16(1): 5-23(19)</ref><ref>Gurman, A.S. & Fraenkel, P. (2002). [ The history of couple therapy: a millennial review.] ''Family Process'', 41(2): 199-260(62)</ref><ref>[ Couple therapy] ''Harvard Mental Health Letter'' 03/01/2007.</ref><ref>[,M1 Attachment and Family Systems.] ''Family Process.'' Special Issue: Fall 2002 41(3)</ref><ref>Sholevar, G.P. & Schwoeri, L.D. (2003). [,M1 ''Textbook of Family and Couples Therapy: Clinical Applications.''] Washington, DC: American Psychiatric Publishing Inc.</ref>
Important schools of family therapy include [[Salvador Minuchin|structural family therapy]], [[strategic therapy|strategic family therapy]], a range of [[Cognitive behavioral therapy|cognitive and behavioral]] approaches, [[Constructivist epistemology|constructivist]] (eg, ''Milan systems'', ''post-systems/collaborative/conversational'', ''reflective''), [[Solution focused brief therapy|solution-focused therapy]], [[psychodynamic]], [[object relations]], ''intergenerational'' ([[Murray Bowen|Bowen systems theory]], [[Contextual therapy]]), [[EFT]] (emotionally focused therapy), and ''experiential therapy''. [[Multicultural]], [[Intercultural competence|intercultural]], and [[Integrative Psychotherapy|integrative]] approaches are being developed.<ref>McGoldrick, M. (Ed.) (1998). [,M1 ''Re-Visioning Family Therapy: Race, Culture, and Gender in Clinical Practice.'']Guilford Press: New York.</ref><ref>Dean, R.G. (2001). [ The Myth of Cross-Cultural Competence.] ''Families in Society: The Journal of Contemporary Human Services.'' 82(6): 623-30.</ref><ref>Ng, K.S. (2003). [,M1 ''Global Perspectives in Family Therapy: Development, Practice, and Trends.''] New York: Brunner-Routledge.</ref><ref>McGoldrick, M., Giordano, J. & Garcia-Preto, N. (2005). [,M1 ''Ethnicity & Family Therapy''], 3rd Ed.: Guilford Press.</ref><ref>Nichols, M.P. & Schwartz, R.C. (2006). Recent Developments in Family Therapy: Integrative Models; in [ ''Family therapy: concepts and methods.''] 7th ed. Boston: Pearson/Allyn & Bacon.</ref> Most practitioners claim to be "[[Eclecticism|eclectic]]", using techniques from several areas, depending upon their own inclinations and/or the needs of the client(s).<ref>Booth, T.J. & Cottone, R.R. (2000). [;jsessionid=2nu8vt826omdf.alice?format=print Measurement, Classification, and Prediction of Paradigm Adherence of Marriage and Family Therapists.] ''American Journal of Family Therapy.'' 28(4): 329-346.</ref>
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; (''conjoint family therapy'' is used in the approach of [[Virginia Satir]] and others.) 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]] or [[early childhood]] [[Psychological trauma|trauma]] of individuals as a [[Freud]]ian therapist would do - although some schools of family therapy, for example [[psychodynamic]] and ''intergenerational'', do consider such individual and historical factors, and they may use instruments such as the [[genogram]] to help to elucidate the patterns of relationship across generations.
Family therapy is really a way of thinking, an [[epistemology]] rather than about how many people sit in the room with the therapist. Family therapists are relational therapists; they are generally more interested in what goes ''between'' people rather than ''in'' people. Depending on circumstances, a therapist may point out to the family interaction patterns that the family might have not noticed; or suggest different ways of responding to other family members. These changes in the way of responding may then trigger repercussions in the whole system, leading to a more satisfactory systemic state; it should be noted though, that some family therapists - in particular those that identify as [[psychodynamic]], [[object relations]], ''intergenerational'', [[EFT]], or ''experiential'' family therapists - tend to be as interested in ''individuals'' as in ''systems''.
A novel development in the field of ''[[couples therapy]]'' in particular, has involved the introduction of insights gained from [[affective neuroscience]] and [[psychopharmacology]] into clinical practice.<ref>Atkinson, B., Atkinson, L., Kutz, P., ''et al.'' (2005). [ Rewiring Neural States in Couples Therapy: Advances from Affective Neuroscience.]''Journal of Systemic Therapies.'' 24 (3): 3-16.</ref> There has been interest in use of the so-called ''love hormone'' – [[oxytocin]] – during therapy sessions, although this is still largely experimental and somewhat controversial.<ref> Resnikoff, R. (2002). [ Couples Therapy and Psychopharmacology.] ''Psychiatric Times.'' 19 (7).</ref><ref> Smith, D. [ Clashing couples to get a spray of love.] ''Sydney Morning Herald'' May 26, 2007.</ref>
==Popularized Methodologies==
{{main|Relationship counseling}}
==In the United States==
===Licensing issues===
Prior to 1999 in California, counselors who specialized in this area were called Marriage, Family and Child Counselors. Today, they are known as Marriage and Family Therapists, (MFTs) and work variously in private practice, in clinical settings such as hospitals, institutions, or counseling organizations.
A master's degree is required to work as an MFT in some states. Most commonly, MFTs will first earn a B.S. or B.A. degree in [[psychology]], [[family studies]], or [[social work]] and then spend 2 to 3 years completing a program in specific areas of psychology relevant to marriage and family therapy. After graduation, prospective MFTs work as interns.
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 they call themselves MFTs and work unsupervised.
License restrictions can vary considerably from state to state. In Ohio, for example, Marriage and Family Therapists are not allowed to diagnose and treat mental and emotional disorders, practice independently, or bill insurance.
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 [[American Association of Marriage and Family Therapy|AAMFT]].<ref>Doherty, W. (2002). [ Bad Couples Therapy and How to Avoid It: Getting past the myth of therapist neutrality.] ''Psychotherapy Networker'', 26 (Nov/Dec), 26-33.</ref>
===Values and ethics in family therapy===
Since issues of interpersonal conflict, 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.<ref>Doherty, W., & Boss, P. (1991). Values and ethics in family therapy. In A. S. Gurman & D. P. Kniskern (Eds.), [ ''Handbook of family therapy. Vol. 2.''] NY: Brunner/Mazel</ref><ref>Dueck, A. (1992). [ Metaphors, models, paradigms and stories in family therapy.] In H. Vande Kemp (Ed.) ''Family therapy: Christian perspectives.'' 175-207. Grand Rapids, MI: Baker</ref><ref>Wall, J., Needham, T., Browning, D.S., & James, S. (1999). [ The Ethics of Relationality: The Moral Views of Therapists Engaged in Marital and Family Therapy.] ''Family Relations'', Vol. 48, No. 2 (Apr.), 139-149.</ref> Specific issues that have emerged have included an increasing questioning of the longstanding notion of ''therapeutic neutrality''<ref>Grosser, G.H. & Paul, N.L. (1964). [ Ethical issues in family group therapy.] ''American Journal of Orthopsychiatry.'' 34 (Oct): 875-884.</ref><ref>Hare-Mustin, R.T. (1978). [ A Feminist Approach to Family Therapy.] ''Family Process.'' 17 (2), 181–194.</ref><ref>Gottlieb, M.C. (1995). [ Developing Your Ethical Position in Family Therapy: Special Issues.] Paper presented at the Annual Meeting of the American Psychological Association (103rd, New York, NY, August 11-15, 1995).</ref>, a concern with questions of justice and self-determination<ref>Melito, R. (2003). [ Values in the role of the family therapist: Self determination and justice.] ''Journal of Marital and Family Therapy''. 29(1):3-11.</ref>, connectedness and independence<ref>Fowers, B.J. & Richardson, F.C. (1996). [ Individualism, Family Ideology and Family Therapy.] ''Theory & Psychology'', 6 (1): 121-151.</ref>, "functioning" versus "authenticity"<ref>Nichols, M.P. & Schwartz, R.C. (2006). The Evaluation of Family Therapy: Comparative Analysis; in [ ''Family therapy: concepts and methods.''] 7th ed. Boston: Pearson/Allyn & Bacon.</ref>, and questions about the degree of the therapist’s "pro-marriage/family" versus "pro-individual" commitment.<ref>''USA Today'' 6/21/2005 [ Hearts divide over marital therapy].</ref>
==Founders and key influences ==
Some key developers of family therapy are:
*[[Nathan Ackerman]] ([[psychoanalysis|psychoanalytic]])
*[[Tom Andersen]] (Reflecting practices and dialogues about dialogues)
*[[Harlene Anderson]] ([[Postmodern Collaborative Therapy]] and Collaborative Language Systems)
*[[Gregory Bateson]] ([[1904]] – [[1980]]) ([[cybernetics]], [[systems theory]])
*[[Iván Böszörményi-Nagy]] ([[Contextual therapy]], intergenerational, relational ethics)
*[[Murray Bowen]] ([[Systems theory]], intergenerational)
*[[John Bradshaw (author)]] ([[systems theory]])
*[[Steve de Shazer]] ([[Solution focused brief therapy|solution focused therapy]])
*[[Milton H. Erickson]] ([[hypnotherapy]], [[strategic therapy]], [[brief therapy]])
*[[Richard Fisch]] ([[brief therapy]], strategic therapy)
*[[James Framo]] ([[object relations theory]], intergenerational)
*[[Harry Goolishian]] ([[Postmodern Collaborative Therapy]] and Collaborataive Language Systems)
*[[John Gottman]] (marriage)
*[[Robert-Jay Green]] ([[LGBT]], [[cross-cultural]] issues)
*[[Jay Haley]] ([[strategic therapy]], communications)
*[[Lynn Hoffman (family therapist)|Lynn Hoffman]] ([[strategic therapy|strategic]], post-systems, collaborative)
*[[Don D. Jackson]] ([[systems theory]])
*[[Susan Johnson]] ([[Emotionally Focused Therapy|Emotionally focused therapy]], [[attachment theory]])
*[[Walter Kempler]] ([[Gestalt psychology]])
*[[Salvador Minuchin]] (structural)
*[[Braulio Montalvo]] (structural){{Fact|date=September 2007}}
*[[Virginia Satir]] (communications, experiential, conjoint and co-therapy)
*[[Mara Selvini Palazzoli]] (''Milan systems'')
*[[Robin Skynner]] ([[Group Analysis]])
*[[Paul Watzlawick]] ([[Brief therapy]], systems theory)
*[[John Weakland]] ([[Brief therapy]], strategic therapy, systems theory)
*[[Carl Whitaker (family therapist)|Carl Whitaker]] ([[Systems theory|Family systems]], experiential, co-therapy)
*[[Michael White (psychotherapist)|Michael White]] ([[narrative therapy]])
*[[Lyman Wynne]] (Schizophrenia, pseudomutuality)
==See also==
*[[Child abuse]]
*[[Conflict resolution]]
*[[Domestic violence]]
*[[Family Life Space]]
*[[Group therapy]]
*[[Internal Family Systems Model]]
*[[Interpersonal psychotherapy]]
*[[Interpersonal relationship]]
*[[Intimate relationship]]
*[[Mental health professional]]
*[[Neuro-linguistic programming]]
*[[Positive psychology]] (in development)
*[[Relationship counseling]]
*[[Relationships Australia]]
*[[Systemic therapy]]
*[[Systems psychology]]
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==External links==
Included in this list are the main professional associations in the [[United States|US]] and internationally; they reflect to some degree the different theoretical, ideological, and cross-cultural views of ''family therapy'' theory and practice.
*[ American Association for Marriage and Family Therapy]: main professional association in [[United States|US]]
*[ American Family Therapy Academy]: main research-oriented professional association in [[United States|US]]
*[ Association for Family Therapy and Systemic Practice in the UK]
*[ Australian and New Zealand Journal of Family Therapy]: the de facto professional association for [[Australia]] and [[New Zealand|NZ]]
*[ Bowen Theory] from the Bowen Center for the Study of the Family.
*[ California Association of Marriage and Family Therapists]
*[ European Family Therapy Association]
*[ International Family Therapy Association]
*[ Historical overview of the field; Therapist profiles; Timeline] from Allyn and Bacon/Longman publishing.
*[ Family Support Partnership - An Overview of Family Therapy and Mediation]
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Latest revision as of 20:36, March 5, 2010

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Family therapy has been used as a psychotherapy treatment for people with eating disorders

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