Family therapy: A 70s thing?
Margaret McKenzie
An earlier version of this paper was presented at a Memorial Symposium, held to
recognise and commemorate the work of Dr Roy Muir at the Ashburn Clinic, Dunedin,
19th March 2003.
Margaret McKenzie is a Senior Lecturer in the School of Family and Community Studies
at the University of Otago.
Introduction
As a brief introduction, in order to explain both the subject matter and the title of this article, I
want to acknowledge the contributions Roy Muir made to the field of Family Therapy in New
Zealand. I consider Roy to have been a major influence in bringing systemic family therapy to
New Zealand in the late 1970s. Additionally, he has been a major influence in the life and
development of the professional therapeutic community. This was both in Dunedin and more
widely in New Zealand, and additionally in those overseas localities where he worked, especially
Montreal and Toronto, Canada. This article pays tribute to Roy’s work, his role in introducing,
consolidating and legitimising therapeutic practice with families and to his focus on family, as
being worthy of and indeed a key to change and to problem-solving.
I have chosen to do this by responding to the often repeated phrase: ‘Family Therapy: it’s a
70s thing’.
This comment arose from one of those conversations we have all been part of: the questioning
of the usefulness and relevance of a particular approach in this day and age and this was an
approach which we have held dear! The comment was recalling the time when family therapy
got a bad name: for class, gender and race bias, for manipulation and for disregarding the views
of users. Such a comment suggests these views are the received knowledge of family therapy; the
way family therapy is viewed. Specifically, the challenge was being made that Family Therapy, as
an approach is passé. That it is an outdated and outmoded approach that has been
comprehensively critiqued and consequently has no place in the approaches of the new
millennium: a 70s thing. It suggests, as in the TV programme ‘That 70s Show’, a set of
stereotypical images: a caricature of the clinical approach with an institutional power base, a rigid
unbending system, a team of white middle-class therapists, a one-way screen and video
technology.
This article is a response to this challenge. It argues that choosing the family as the focus of
interventive work in the helping and caring professions continues to have a significant place in
the range of effective therapeutic practice approaches. It first reviews what these challenges to
family therapy said, and then considers whether and how they have been answered by the styles
and approaches of contemp-orary family therapy practice. Additionally, the article suggests that
there are a number of core concepts and practices which remain as useful now as they were in the
70s ‘ideas that keep knocking on the door’ (Dallos and Draper, 2000) and thus that Family
Therapy is more than a 70s thing, it is a vibrant, useful and effective therapeutic method for
today.
Critiquing family therapy
The argument that is being made when describing (or is it dismissing) family therapy as a 70s
approach, fails to understand and recognise the continuum of growth and development in the
field. Such an argument rather sees the practice as one frozen in time, as a stereotypical version of
Family Therapy. This view equates all Family Therapy with a particular clinical model of a
particular time. Carpenter and Treacher put this succinctly when they wrote:
…the family has replaced the individual as the locus of pathology. Its social context has been ignored
and it has been assumed that all its problems can be easily revealed to the gaze of a group of
therapists who cluster behind a one-way screen (Carpenter and Treacher, 1993: 3).
This view restricts the vision and potential of Family Therapy to a particular time: a time of
purely clinical technological practice where the technology came to construct the therapy. In this
view the more recent developments in family therapeutic approaches are not seen as part of the
overall field of Family Therapy but as new and separate entities. Some examples to which I’ll
return later are Narrative Therapy, Strengths and Resilience Approaches, and the Just Therapy
Model. Indeed, the ‘bad’ or negative reputation that family therapy gained in the late 80s-90s led
to a certain reluctance by the proponents of these newer approa-ches to see and name themselves
as family therapists. Thus, the theo-retical background to the development of these practice
innovations was not always well acknowledged. These newer approaches are not separate
theories but part of a developmental conti-nuum in family intervention. These approaches both
stem from and graft onto, core conceptual ideas. They are theoretical and practice innovations,
responding to and addressing the critical challenges, discussed below, and thus bring family
therapy firmly into the 2000s.
Additionally, I draw attention to the close connection and influence the core concepts of
family therapy have with internationally significant developments in social care policy and
legislation. Specifically, the foregrounding of family voice and experience in decision-making
processes in care and protection, in the normalisation pushes in education and the de-institutionalisation of mental health services. Within the developing field of a Sociology of Childhood
(James and Prout, 1997) the attention to hearing the voice of the child, and understanding
children’s needs as socially constituted connects to the consideration that family therapy has
given to empowering children within their family setting, the hearing of each family member’s
voice, regardless of status and position.
What are the detailed critiques behind the throw away comment?
The challenges to Family Therapy
Family Therapy became unpopular and was dismissed as a ‘70s thing’ from the late 80s onward
and was critiqued on the following fronts.
Normalising
It was critiqued as a normalising approach. It failed to challenge the accepted ‘wisdom’ of
sociologists of the time such as Talcott Parsons who described the post-WW2 role segregation
and nuclear arrange-ments of family life as natural and unproblematic. For example, it failed to
recognise single parents, non-traditional family arrangements and ‘working’ mothers.
Additionally, it considered separation, divorces and reconstitution arrangements as problematic
rather than as possible solutions to untenable situations.
Gender biased
Feminists critiqued family therapy for a failure to recognise gender and power differentials in the
family. This included failing to understand and address the complexities of women's role within
the family and not attending to structural inequalities in family life. Feminists were particu-larly
concerned that if little attention was paid to how gender power differentials operated, issues of
violence and abuse for women and children remained hidden in families.
Cultural and class biased
It was thought that a narrow view of the cultural diversities of family life prevailed. Middle class,
white theorists (most often male) and practitioners dominated and their cultural models of family
life prevailed. Thus a hegemonic, western cultural bias prevailed, despite often working with
‘other’.
Resource hungry
It was increasingly critiqued as too costly. The new right manageralism era required efficient and
economic use of time and space. Family therapists, working at least in conjoint pairs, required
large family- sized rooms and facilities, often with an assisting team present, and taking extensive
consultation and debriefing time. This was seen to be time and resource hungry and ultimately
wasteful of a now limited public purse.
The mechanistic and technocratic gaze
The approach was seen as too mechanistic, and the technology came to construct and dominate
the approach. One-way screens, video cameras, ear bugs that linked the therapist to an invisible
back-up team were intended as adjuncts to collaborative safe practice. Instead, these were seen as
alienating, as tools of surveillance; unsettling, provo-king suspicion and fear in families that
‘their’ therapist was being controlled by an unknown, but all seeing team, in an adjacent room.
Other professionals, too, felt this gaze. Exposure and indignity, rather than collaboration was the
felt response.
Elitist and expert
Power relations between worker and client family were problematic. The power to define
problems and prescribe solutions according to the theoretical interests and the disposition of the
therapist dominated. In this view therapists were cast as authoritarian, elitist experts typically
defining problems as family or maritally based. The more radical critics saw this as evidence of
further hegemony. It was considered that the powerful and ruling sections of society (the white
and male middle class) were emphasising the responsibilities of families to care for and control
their members rather than call on state help, or more radically, call for system change. Thus, there
was a perceived failure to acknowledge and recognise the meso and macro system, socioeconomic, cultural and political dimensions to micro-level problem situations.
Access and service provisions were considered unduly restrictive. User rights movements
considered that power was further exercised by Family Therapy orthodoxy. This included such
rules as: you can only come if you all come, we always work as a team, the screen is part of the
service and access issues, you come to us we don’t come to you, we offer a 9-5 service only, clinic
locations that needed a car to access. Small rooms gave messages that big, multigenerational
families didn't fit, while well-appointed surroundings emphasised difference.
Each of these challenges were valid and grounded critiques of the practices of the time,
however, accepting this does not constitute an agreement with the statement that, therefore,
Family Therapy is passé, as consequent and subsequent develop-ments since the mid 80s have
addressed each of these critiques.
Overall, these critiques can be summed up as being about power relations.
An understanding of the operation and influence of power was absent from these earlier
methods of practice. Increasingly, the challenges coalesced around the social constructionist view
of the centrality of power relations. This view suggests that a variety of societal influences shape
people’s experiences. Institutionalised struc-tures and practices and dominant shared beliefs and
ideologies define family life: roles, obligations and expectations as much as the earlier therapeutic
emphasis on pattern and process did. (Dallos and Draper. 2000:93). Practitioners and theorists
such as Anderson and Goolishian (1988), Gergen (1985), Lynne Hoffman (1993) in the USA, and
Michael White and David Epston (1990) in Australia and New Zealand increasingly began to
draw on the work of Michael Foucault in both analysing the exercise of power and applying his
ideas to improve family therapy practices. These included but were not limited to, bringing
issues of power to visibility within the therapeutic task. Knowledge and power began to be
understood as inextricably intertwined, enabling the creation of not only dominant discourses on
how families and family life should be, but also the creation of technologies of profes-sional
practice to which many of the challenges outlined above refer.
Foucault in his later works introduced the idea of resistance as an integral and constituent part
of power: where there is power there is also resistance (White, 1997; White and Epston, 1990;
Freedman and Combs, 1996). It is the resistance that allows and opens up space for change to
occur. This mechanism fosters an ongoing conceptual development within a practice of family
therapy. Thus, each challenge discussed earlier can be seen as a resistance to aspects of power
relations, and as opening the space for theorists and practitioners to construct responsive
improvements in theory and practice.
Each critical challenge has been answered in a subsequent and consequent theoretical
development. The approaches of Narrative Therapy, Strengths and Resilience Approaches and
the Just Therapy Model, while not always directly acknowledged as part of the continuum of
Family Therapy, have arisen at least in part to meet these challenges.
Unpacking these theoretical building blocks, while perhaps akin to tracing a map through the
swamp, helps identify how these challenges have been met, and can allow clarification and
acknowledgement of what is useful and enduring in thinking and practice. This view is based on
an understanding of the theorising about, and practice of, family therapy as a developmental
continuum.
Dallos and Draper (2000) have devised an overview of the development of Family Therapy
theory, models and systematic ideas as comprising three chronological stages, or phases, a
classification system, which has conceptualised 50 plus years of development. This provides a
useful three-phase map, identifying the dominant conceptual ideas of each phase. It can be used
to trace how the responses developed in the spaces opened up by various critical challenges or
resistances discussed earlier. A brief overview of Dallos and Draper’s (2000) model follows.
A developmental frame
Phase one: Modernism: 1950s to
mid 70s
This comprises the early formu-lations of Family Therapy based predominantly in systems
theory, the directive first order approaches. These drew therapeutic attention to patterns and
regularities in families’ lives and experiences. Realities of actions and processes were
acknowledged. There was an emphasis on communication as complex and multifaceted to help
the therapist be attentive to the emotional and behavioural aspects of family life.
Phase two: Early post-modern and constructivist: mid-70s to late 80s
This phase maps the move to constructivist approaches, the second order cybernetic approaches
that gave rise to a proliferation of models. These cautioned us to consider the uniqueness of what
emotional and behavioural actions may mean to a particular family, and to be sensitive to
differences between and within families who superficially appear to display similar patterns and
problems.
Phase three: Post- modernism and social constructionism: the 90s on
Contemporary social constructionist thinking became influential in this phase. Power and power
relation-ships were recognised at micro, meso and macro operations. Indigenous models,
strengths and narrative approaches that take account of the influence of the social context, of
culture and politics, are emphasised. While to some extent this turns the clock back to concepts
within the first phase, alerting us that family life can be predictable and rule bound, there is a key
shift. This is the recognition that these tendencies are not simply constructed by families in
isolation but are shaped by context – the social context, the cultural context – economic realities
and importantly held societal ideas or dominant discourses about family life (Dallos and Draper,
2000).
Overall, it is visible that the phases differ and have shifted developmentally or evolved along
continuums of whether difficulties are seen to result from:
• predominately family dynamics as opposed to social factors,
• whether there is an assumption of normality as opposed to an emphasis on diversity and
difference,
• whether family members are seen as self-determined or constrained by their experiences.
And for a practitioner’s orientation:
• from blame to neutral compas-sion,
• from a knower to a questioner,
• from an expert to a collaborative co-author.
I suggest that these shifts along the continuums link to answering the critical challenges or
resistances that have been made of family therapy, moving from phase one, through phase two to
current phase three practices.
Dallos and Draper (2000: 183) sum this up well when they write:
…in the world of family therapy and systemic practice ‘same behaviour, different meaning’ might be
the slogan for clients and therapists alike.
In other words, family behaviour that has reached the point of attracting professional helping
services may well be the same across time, but new theoretical approaches understand and
explain this differently and thus devise interventions in new ways. Family Therapy is not a static
notion of the 70s but has grown and responded to challenge.
If we consider current, contemp-orary forms of practice informed by social construction and
located in this third phase (Dallos and Draper, 2000) we can identify how this has occurred. In
narrative approaches, which are incidentally strongly Australasian in origin, strengths
approaches, indigenous empower-ment practices and specific models such as ‘Just Therapy’
from the Lower Hutt Family Centre, these continuum shifts are epitomised (Healy, 2000; Parton
and O’Byrne, 2000). All address and respond to the various challenges, entailing not only an
acknowledgement of power and power relations, but also the necessity of using power in the best
interests of clients, as defined by clients.
Narrative, embedded in language and conversation, its use of metaphors, the focus on
separating (externalising) the problem from the person and its recognition of the negative effects
of dominant stories, uses collaborative work to co-create or re-author new and preferred stories
of success to replace stories of failure and problem domination (White and Epston, 1990.
Freedman and Combs, 1996). Normalising, expertness and class, gender, culture and class bias
are all addressed.
The strengths and resilience approaches move away from a deficit focus, to one where the
heart of collaborative work is to use the building blocks of what works and has worked for
families, finding and celebrating strength, resilience and resources (Elliot, et al. 2000; Saleeby,
2002). Expertness, restrictive access, resource-hungry mechanistic practice is turned on its head.
Just Therapy emphasises the necessity for therapy to be ethically and politically defensible
within a complex culturally-diverse society, to attend to hegemonic and colonising histories
(Waldegrave and Tamasese, 1994). Again, socio-cultural hege-monic practice(s) with its attendant
technocracies is challenged.
In each approach, context and social factors are foregrounded. Diversity and difference is celebrated, family members’ experiences are seen as constraints that can be overcome, collaboration
and partner-ship are emphasised. Power relations are deconstructed (White, 1997; Saleeby, 2002).
In addition to identifying these developmental responses as points of difference it is also
possible to trace the core conceptual frame, the bones or threads of the systemic approach that
have remained throughout the three phases. The developmental approach allows us to trace how
the core concepts connect and extend the phases of theory development. These include the
ongoing recognition of feedback mechanisms, boundaries, context, holding more than one story,
listening to more than one voice, not preferring one version over another, the complexity of social
situations and systems, considering values and belief systems, decreasing distance between the
client and the worker.
Enduring technologies can also be traced as well as team approaches, live and peer
supervision, group not individual foci, collaborative consultations, people as persons not
patients, strong convictions about efficacy and ethics of approaches. Strands of the earlier phases
and approaches can be seen to coexist alongside and sometimes within the current approaches.
For example, solution-focused approaches, while aligned to strategic models, depend upon
curiosity and collaboration. Structural suggestions such as strengthening the parental sub-system
are still used, but offered in a collaborative and not prescriptive manner.
The central task of Family Therapy, while shifting methodo-logically as it has through the
three phases of development, retains the central requirement of the recognition of a person in a
situation, an under-standing of clients as connected relational beings, negotiating the micro, meso
and macro systems.
Interestingly, paralleling this foregrounding of family and attuned to similar conceptual shifts
have been changes and developments in social care legislation in health, welfare and education
where New Zealand has been at the forefront. The Children, Young Persons and their Families Act
1989, with its centrality of family decision-making processes via the family group conference
emphasises a collaborative partnership approach between families and professionals on
continuing parental responsibility and family involvement while safeguarding the rights of
children, can be seen as over-lapping quite substantially with the core conceptual theories and
the practice of Family Therapy. In work with children and families generally, the emphasis is on
‘empowering families’, and professionals are required to share information, goals and decisionmaking to foreground family network and context as never before. Similarly, movements to deinstitutionalisation in Mental Health services and normalisation in education and disability
services are congruent with the principles that have underpinned and been implicit in family
therapy across its history. Individuals must be understood as embedded within a context.
Conclusion
Family therapy is still about beginning by looking for patterns in families we work with. But now
it moves to consider collaboratively with the family how what we are seeing within our
theoretical models is also partly our own personal view or prejudice, and how our families and
our views are shaped by the wider socio-cultural context. Thus, in the 2000s we have moved to a
more neutral and compassionate view. This is in contrast to the earlier models where we could
either implicitly or explicitly blame families for their difficulties. We are now more alert to the
notion that both family members, ourselves as workers and societal discourse are implicated and
need to take responsibility. We have conver-sations with families where we explore not only their
private history, but also the history and context of their problem as well as their social and
cultural context.
Thus, the core focus of family therapy, on not seeing an individual in isolation but within their
contexts, remains the centre stage throughout the development of various approaches. What has
changed has been the way we understand and view the context. The development of narrative,
strengths, and indigenous models of Family Therapy practice, as approaches which build on the
core conceptual framework yet take firm account of power relations, ensure that family therapy is
not a 70s thing.
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