Family therapy is a form of psychotherapy. It involves members of a family and is usually conducted by a pair or team of therapists. In many situations, the pair of therapists will be one male and one female to treat gender related issues and act as a role model to family members.   We will discuss more on family therapy in later lessons, but in this lesson we will consider how and why family therapy developed. 

After World War II, doctors treating schizophrenic patients noticed that patients’ families tended to communicated in disturbed ways.  They also found that the patients’ symptoms increased or decreased according to the level of tension between their parents. This led to the observation that a family is an organism or system with its own rules, patterns of functioning and the tendency to resist change.  As a result of this observation, the therapists began to treat the families of the schizophrenic patients as a whole unit, rather than just focusing on the person with schizophrenia. They found that in many situations the condition of the person with schizophrenia improved when the whole family was treated as the patient.  They are not saying that schizophrenia is caused by family problems, but that family problems may worsen the condition. Therefore, this approach focuses on involving the entire family in the treatment plan and therapy.

In America, family therapy is becoming increasingly common. It has led to other developments such as couples’ therapy – which treats relationship problems in marriages or gay couples, and an extension of family therapy into religious communities or other groups that resemble families.

Actually treating psychological problems in the context of the family did not actually start until the mid-1950s. However, the roots of family therapy were found in earlier social and theoretical changes and developments in psychology. Family therapy developed out of psychoanalysis and the medical psychiatric model.  Today due to the cultural changes of managed health care, the idea of treating the entire family as opposed to individual member is favoured due to the fact that it is quicker than treating individual members.  In the early 20th century psychotherapy focused on individual therapy and the relationship between the patient and therapist is the best way to solve psychological problems.  

Therapists such as Freud and Rogers believed that the whole family shapes a person’s personality but that the most influential and dominant forces that control behaviour were actually the internal and subjective belief that a person had about their family. That is, it was what the patient believed about their family rather than the interrelationships between the families. Freud and Rogers believed that any psychological problems arose as the result of destructive interactions in that person’s family and the treatment will be most effective if it was conducted in isolation away from the harmful influence of relatives. Therefore, patients were often segregated from their families for treatment and therapy which focused on the individual’s symptoms and behaviour.

Family therapy, therefore, brought in a whole new way of looking at human behaviour and trying to understand it. Family therapists argued that psychological problems developed and were maintained in the context of the family. This new context of placing responsibility for problems within the family and focusing treatment on the entire family led to the growth of family therapy.  This was a shift in considering human events in terms of the interaction and patterns of behaviour to explain any emotional distress. The these psychoanalytic and biological models argued that there was a causal and linear model to understand human illness, focusing on internal dysfunction are not taking into account the reciprocal nature of interpersonal relationships.

Family therapists, therefore, argued that psychological problems were best explained as circular events that were mutually influenced and should be considered in the context of the family. Therefore, these changes in psychology influence the evolution of family therapy, and move the focus from the individual to a systemic approach. Influential factors were –

  • 1-Social work practices
  • 2-Research of family dynamics
  • 3-Studies of schizophrenia
  • 4-Marriage counselling
  • 5-Child guidance
  • 6-Studies of small group dynamics