Frameworks For Practice in The Systemic Field: Part 1
Frameworks For Practice in The Systemic Field: Part 1
This is the first of two articles to map the landscape of practice theory in systemic
family therapy. In this first article, the representation of knowledge for practice is
explored, and an argument is made that while frameworks remain important, the
relationship to them is now more conditional and pragmatic. A particular chronol-
ogy is offered of the development of family therapy practice theory frameworks,
beginning with the frameworks that emerged in the 1960s to the 1970s. An analy-
sis is given of the important transitions in the 1980s and three sets of influences in
this decade — ecosystemic epistemology, the feminist challenge and postmod-
ernism — are identified. This reading emphasises hidden continuities in the transi-
tion, despite the seemingly discontinuous shifts in practice theor y from the
beginning of the 1980s to the beginning of the 1990s. Context and relationship are
identified as the enduring parameters of systemic family therapy knowledge,
though understandings of context and relationship have been recast in the
contemporary (post-1990s) practice theory. The second article will explore the
four contemporary influential approaches in Australian family therapy — the Milan-
systemic, narrative and solution-focused frameworks, and the dialogical perspective
— and point to intersections in practice ideas and integrative movements.
A foundational territory in teaching family therapy lies in how you choose to repre-
sent the parameters of the systemic field, how you choose to represent continuities
and commonalities in the development of practice theory frameworks across time,
Address for correspondence: Carmel Flaskas, School of Social Sciences and International Studies,
University of New South Wales, UNSW Sydney 2052. E-mail: [email protected]
and how you choose to represent the contemporary practice theory frameworks.
This is the first of two papers that together map this territory. I am offering the
papers for discussion to others teaching family therapy, and to those who are learn-
ing family therapy and wanting to ‘place’ practice theories within the systemic field.
How you represent theory for practice is not as straightforward as it might first
appear. The field of systemic family therapy has for various reasons been vulnerable
to telling its own history in a way that privileges the discontinuity of frameworks
across time and the difference between frameworks. This inward-looking perspec-
tive has generated rather grandiose announcements of paradigm shifts in the history
of the development of our knowledge. It has also at times fuelled divisive competi-
tion between frameworks. Yet, in the activities of learning and teaching family
therapy, the value of an appreciation of the continuity of the parameters of the
systemic field across time becomes crystal clear, as does the value of appreciating the
commonalities across frameworks alongside the differences in the options they offer.
As well, how you might represent practice knowledge in family therapy in 2010
is different to how it might have been represented in 1995, which in turn is differ-
ent to its representation in 1980 or 1965. I am not referring just to the content of
the (then) contemporary frameworks at any particular point of time. Rather, I am
referring to how the whole idea of practice theory frameworks comes to be repre-
sented and the changes in how we locate the knowledge of frameworks in relation
to practice and to family therapy as a whole.
The discussion for this first article comes in four parts. The first part is more of a
preamble, addressing the current context of the representation of practice knowledge,
in light of the by now taken-for-granted postmodernist sensibilities and the common
factors discussions. I will then chart the way in which family therapy practice theory
across time is represented in chronologies and groupings, introducing my own
choices about this. The third part considers knowledge generated in the period from
the 1960s to the 1970s, while the fourth part identifies the 1980s as a decade of
transition, locating the convergences of three different sets of influences that shaped
the transition to the contemporary frameworks. The conclusion of this first paper
will sketch the contemporary landscape and the way in which the enduring parame-
ters of context and relationship have been recast in our current practice theory.
The second paper — Part 2: Contemporary Practice Theory Frameworks — will
map the Milan-systemic, narrative and solution-focused frameworks, as well as the
dialogical influence, which has increasing coherence as an alternative theory
perspective in family therapy. I will be interested in similarities as well as differences
and the parallel genealogies of each framework, with the focus primarily on theory
rather than techniques. I will also gesture to the points of intersections in some
current integrative perspectives. While the first and second papers together form the
whole exploration of my project, they can each be read separately, offering readers
flexibility in terms of their own interests in family therapy knowledge.
It perhaps goes without saying that any commentary on the history of ideas
involves choices and emphases shaped by the context of the enquiry. I am a family
therapy educator and practitioner and academic, and my ‘home’ is Australian family
therapy. The commentary I am offering both reflects and speaks to this particular
context and different contexts of enquiry would generate different choices and
emphases. There is also necessarily a juggle of breadth and depth, and so I would
like to invite readers to follow up their own particular interests, using the references
in these two articles as a base for further exploration of family therapy knowledge.
There have been a number of commentaries that point to the growing maturity
of family therapy — that the more established family therapy becomes as a modal-
ity and field, the less there is a need for negative comparisons with outside frame-
works or intense competitiveness internally (see, for example, Nichols, 2008, p.
299). However, sitting alongside this change within family therapy is the change in
the wider social and intellectual environment with respect to the location of the
nature of knowledge. The shift to postmodernism no longer needs to be proclaimed
— and the decade of the 1990s, in which so much of our practice theory literature
began with denunciations of the ‘what-is-modernism-and-why-we-don’t-do-it-
anymore’ kind, has passed. For a short while it seemed as if postmodernism itself
would paradoxically be treated as an alternate ‘model’ (see, for example, Anderson,
1997; Weingarten, 1998), but this trend turned out to be transitional to a period in
which postmodernist sensibilities became embedded in different practice frame-
works in a more taken-for-granted way. In terms of the positioning of knowledge,
the postmodernist move away from the (modernist) search for single and (poten-
tially) ‘complete’ knowledge led to a tolerance of the possibility of multiple descrip-
tions of practice and multiple knowledges for and about practice. Glenn Larner
advocates this greater openness to the use of multiple knowledges in meeting the
needs of complex practice, calling especially on the work of Levinas and the ‘ethics
of hospitality’ (Larner, 2009a, 2009b).
The increasing influence of the common factors research has strengthened this
openness. Studies across nearly four decades have researched the generic factors
involved in successful therapy outcome, regardless of therapeutic modality or
model. A common factors perspective has been articulated in a number of impor-
tant publications across the last ten years (Duncan et al., 2009; Hubble et al., 1999;
Sprenkle & Blow, 2004; Sprenkle et al., 2009). Many family therapists are by now
familiar with the main findings from this research — that there would seem to be
four groups of factors related to positive therapy outcomes: the strengths and
resources that clients bring with them to the therapy, including all the fortunate
factors in their lives promoting change; the placebo effect, or clients’ capacity for
hopefulness about the therapy; the therapeutic alliance and relationship-mediated
variables in the therapeutic process; and, finally, the specific techniques and models
used in the therapy (Hubble, Duncan & Miller, 1999). The research ‘guesstimate’ is
that the first two groups of factors, which lie outside the influence of the therapy
itself, would together seem to account for 55% of the outcome variance. Of the
remaining 45% of the outcome variance, the therapeutic relationship variables
would seem to account for around 30% while the specific model variables account
for 15% (Hubble et al., 1999).
While this research very effectively challenges competitiveness between
models, it would be a serious mistake to read it as ‘anti’ the idea of practice
frameworks. Indeed, Sprenkle and Blow (2004) make it very clear in their review
that these findings about positive therapy outcomes relate to the range of estab-
lished and effective therapies, and not to any kind of practice that might be
calling itself counselling or psychotherapy. Far from arguing that the whole idea
of frameworks no longer matters, Sprenkle and Blow suggest instead that the
effectiveness of particular therapies relates to the way in which their specific
theory and practices utilise and promote common factors, and that there are
various ways in which common factors can be expressed and promoted within
psychotherapy practice knowledge.
Yet while the increasing confidence within family therapy, the influence of
postmodernist sensibilities and the influence of the common factors perspective may
all have played a part in the move toward a greater openness about practice knowl-
edge, I am inclined to think that ‘privately’ family therapy practitioners have always
moved between and across models, regardless of the formal public strictures of model
adherence. I have argued before (Flaskas, 2002b, 2005) that in ‘real life’ practice,
experienced practitioners build a repertoire of practice knowledges across time. Very
good practice often displays a finely tuned capacity to draw on a range of ideas in the
interests of the needs of the particular work with a particular family in a particular
context. Lynn Hoffman, arguably the finest commentator on twentieth century
family therapy knowledge (see, for example, Hoffman 1981, Hoffman 2002), offers
herself as a case example of the ‘setting aside models’ practitioner (Hoffman, 1998).
In her 1998 article, she writes of her own choice of ‘greatest hits’ of family therapy
practice knowledge across time, and her own constantly developing integration of a
range of ideas which fit with her use of self and guide her practice.
In her response to Hoffman’s article, Celia Falicov (1998) balances the plea for
setting aside models with the reminder that the fine bricolage represented in
Hoffman’s account is the province of the very experienced practitioner. Falicov
makes the point that it is easier to learn and to teach family therapy via the bound-
aries of specific frameworks — that one’s confidence builds through learning the
detail and coherence of frameworks and, with it, the capacity to integrate theory
ideas and practices. I would agree here, for there is a discipline in the process of
learning frameworks ‘from the inside out’. Practice frameworks provide practition-
ers with building blocks for their own practice and they offer systematic and coher-
ent ways of thinking about and ‘doing’ family therapy. Moreover, our own creativity
can be inspired by the creativity of different ideas and techniques within different
frameworks, as we develop a repertoire of practice theory that is finely tuned to our
own contexts of practice and our own use of self.
In short, the kind of knowledge that is represented by practice frameworks is
located differently now to the earlier period of models and model adherence. A
range of factors could account for family therapy’s move ‘beyond models’, including
the integration of postmodernist sensibilities and the common factors research.
What has changed, though, is not so much the value of practice frameworks and
the discipline and borders of their theory and practices, but rather the way we relate
to practice frameworks and their borders. Frameworks still matter, but we currently
relate to them more pragmatically, with less competitiveness and a greater openness
about the value of a plurality of knowledges in meeting the complexity of practice.
There is also a commitment to a process of learning that factors in the integration
process for each practitioner and the potential use of multiple frameworks. The
reading I am about to give of the development of practice theory in family therapy
and its important transitions sits within this understanding of our current relation-
ship to our own knowledge.
They are well documented in all accounts of the history of family therapy knowl-
edge (see, for example, Carr, 2000; Dallos & Draper, 2000; Goldenberg &
Goldenberg, 2004; Doherty & McDaniel, 2010; Nichols, 2008; Rivett & Street,
2009). These models do indeed stand as the first generation of systemic therapy
practice theory. Two other frameworks bear mentioning here, both using a systems
lens and both focusing on transgenerational patterns and relationships. Murray
Bowen’s ideas (Bowen, 1978) about patterns around differentiation in intimate
relationship remain influential in current practice in North America and in
Australia (see, for example, Brown, 2008; Papero, 2000; Titelman, 1998;
Chambers, 2009; Wright, 2009). The framework developed by Ivan Boszormenyi-
Nagy and colleagues (Boszormenyi-Nagy & Krasner, 1986; Boszormenyi-Nagy &
Spark, 1973) focused on intergenerational patterns of invisible loyalties. Though
Boszormenyi-Nagy’s ideas are less visible than Bowen’s ideas in current practice
theory in the North American and Australian contexts, their legacy continues to
show in some Australian writing (for example, Crago, 2006; Kozlowska, 2010; Le
Goff, 2001). I will note here, however, that one only very rarely sees the influence
of either of these frameworks in the current UK context of family therapy. This
might in part be explained by the ease of access in Britain to attachment theory,
which was developing in the United Kingdom just before and right alongside family
therapy, providing what was at the time a ‘local’ transgenerational perspective that
could be readily borrowed, even if it could not be so readily acknowledged.
With respect to the two major models of structural and strategic family therapy,
though, there are many enduring ideas that continue to inform contemporary
systemic practice. Structural therapy continues to be taught and written about (see,
for example, Colapinto, 2000; Minuchin et al., 2006; Vetere, 2001). The flexibility
and usefulness of its ideas can be seen in the contemporary integrative practice
frames of multisystemic family therapy (Henggeler, 1998; Henggeler & Sheidow,
2002), and the Maudsley model (Lock et al, 2001; Rhodes et al., 2009), which has
been specifically crafted for practice in relation to anorexia. Structural therapy in its
own time also fed directly into the development of Jay Haley’s strategic ideas.
Strategic therapy itself, particularly its MRI/Palo Alto version, is the precursor of
brief therapy, which in turn becomes the precursor of solution-focused therapy.
Ideas from strategic therapy also directly informed the early work of Michael White
(see, for example, White, 1984, 1986) and the early Milan model (see the commen-
tary by MacKinnon & James, 1987).
Rudi Dallos and Ros Draper (2000, p. 23) comment that the early use of
systems theory offered ‘both a compassionate view of individual experience but also
a reductionist and possibly mechanistic one’. Yet, despite the reductionist concepts
of this period of systemic therapy, the space was opened for therapeutic practices
that challenged the highly individualised and medicalised practices of the time. The
influence of assessment and therapeutic expertise remained untouched, but individ-
ual mental health symptoms were powerfully de-medicalised, and to a certain extent
de-patholigised. And while the language of the early theory may have been rather
de-humanised, the practices of engaging with families in the room, across ages and
generations, around the intimate patterns of everyday life, tended to be of necessity
more accessible and less mystifying as a form of psychotherapy (Flaskas, 2007).
In later times, the family therapy knowledge produced in this period would
sometimes be painted as unremittingly conservative. I would suggest that such a
perspective is ahistoric. For its time, early family therapy theory and practice
challenged the orthodoxies of understandings and practices of mainstream
psychotherapy. It is true that the models lacked attention to gender inequality
within families, that they lacked a theory of diversity and wider social context, and
that interpersonal abuse and violence remained largely unaddressed in the formal
venues of early family therapy. Yet in terms of practice commitments, early family
therapy, especially structural family therapy in the US, engaged actively with race
and poverty and difference.
Elsa Jones (1993) writes of the ‘great white male psychiatrist’ creationist myth of
family therapy, underscoring the significant contribution of social work, a largely
female profession, to family practice in the first half of the twentieth century. I
would also underscore here that not all the creators of early family therapy practice
theory were men and psychiatrists and, of those who were, many were not white
Anglo/American examples of their own profession. Salvador Minuchin, Braulio
Montalvo, Harry Aponte, Chloe Madanes, Ivan Boszormenyi-Nagy — their names
speak to their histories of immigration from non-English-speaking countries.
Minuchin, the towering figure in this period, spent much of his life working with
very poor African–American female-headed families and he had (and has) a strong
and clear left-wing politics around class, privilege and poverty. He brought to his
work his experience of political imprisonment in Argentina, and an intergenera-
tional family history of refugee migration. Minuchin’s own lived experience of social
marginality and difference was deeply embedded in his relationship to psychother-
apy and to his clients, expressed directly and movingly in this interview comment
about his relationship to working with African-American people: ‘I adopted the
marginalised poor population as my brothers and sisters … they became my Jews,
or I became their Black’ (Stagoll, 2002, p. 126). I make this detour here, at the end
of the account of the practice theory produced in the 1960s and 1970s, because
many of the nuances and political complexities of family therapy theory and
practice in its early stage came to be ‘ironed-out’ in the critiques that were to come
from the 1980s.
1986; Anderson & Goolishian, 1988). Around the same time, and with noticeable
resonances, the Norwegian family therapist Tom Andersen was publishing the first
Family Process article on the reflecting team (Andersen, 1987), leading to his 1990
edited collection The Reflecting Team.
By the early 1990s, just one decade later, the Milan-systemic framework was
somehow already in danger of being identified as the ‘post-Milan framework’, brief
therapy had metamorphosed into solution-focused therapy, narrative therapy had
been launched and named as such, and what I am calling ‘the dialogical perspective’
had started to take shape. There were, of course, many twists and turns along the
way, as the biological metaphors of systems theory gave way to postmodernist
theory ideas expressed mainly through social constructionist and narrative theory,
and as the emphasis on behaviour gave way to the emphasis on meaning.
Three sets of influences came to both intertwine and diverge during the decade.
The first involved ripples within the foundational use of systems theory that came
in the wake of second-order cybernetics and Bateson’s later ecosystemic ideas. There
was a move away from the modernist ‘observer free’ epistemology, with its language
of the therapist ‘acting on’ or ‘intervening in’ a (separate and autonomous) family
system. The shift was to an epistemology in which the unit of change was under-
stood to be the therapist–family system. This shift was accompanied by an accept-
ance (at least in theory, if not in practice) that the conditions of the context of
therapy itself and our relationship to the family construct in part how we are able to
‘see’ the family. There was a brief flurry of publications heralding the ‘new episte-
mology’ (see, e.g., Keeney, 1982; Keeney & Sprenkle, 1982). This was followed by a
good deal of fanfare around an engagement with the constructivist ideas of the
Chilean biologists Humberto Maturana and Francisco Varela, whose work was
positioned as directly continuing Bateson’s ecosystemic legacy (see, e.g., Dell, 1985;
Efran & Lukens, 1985).
The second set of influences toward the mid-1980s came belatedly from
feminism and its political challenge. Feminist family therapists provided a strong
critique of the tendency of family therapy to ignore abuse and negate responsibility
(see, for example, Goldner, 1985; Hare-Mustin, 1986; Luepnitz, 1988; MacKinnon
& Miller, 1987), a tendency that one could argue is an inherent vulnerability of the
theory of circular causality. Feminist therapy had emerged in the 1970s and was
shaped around a number of principles, including the principle that the personal is
the political. The practices developed there had already tackled the patriarchal social
context of gender inequality within families and moved toward collaborative and
demystifying practices in the therapeutic relationship. These practices began to cross
over to family therapy, because a number of (especially women) family therapists
were influenced by feminist politics and practices. The feminist critique also
challenged the de-humanised language of the early systems metaphor and it was one
part of the momentum to put topics like the therapeutic relationship, emotionality
and intimacy back on the family therapy agenda.
Postmodernism, which appeared in family therapy in the later part of the
1980s, provided the third set of influences. Like the feminist influence, this was
belated, reflecting the ‘time lag’ tendency in practice disciplines in responding to
changes in the wider cultural, intellectual and political milieu. The parameters of
All this might help to explain what otherwise looks like a wholesale change of
foundational knowledge metaphors in systemic family therapy in the late 1980s which,
depending on your point of view, could be cast as ‘onward-every-upward’ progress or
an embarrassing fickleness in attachment to our own knowledge. I was in the genera-
tion training in family therapy in the second half of the 1980s and a joke went around
some of us: ‘blink and you’ll miss a paradigm shift’. Earnest study groups reading
Bateson and Maturana in the first half of the 1980s seemed anachronistic scarcely a
few years later. The vanguard North American magazine The Family Therapy Networker
devoted a special feature in 1985 to constructivism, showcasing articles with primary
references to biology and ecosystemic theory (see, e.g., Efran & Lukens, 1985; Simon,
1985). Six years later, in 1991, the same magazine ran another feature, again on
‘constructivism’ but this time with the focus on postmodernism, and with primary
references to social psychology and sociology (see, for example, Doherty, 1991; O’Hara
& Anderson, 1991). One could only survive this particular confusion by referring to
Lynn Hoffman’s commentary article ‘Constructing Realities: An Art of Lenses’,
published in Family Process in 1990, in which she delineated the difference between the
(biological/ecosystemic) theories of constructivism and the (sociological/social psychol-
ogy) theories of social constructionism.
Thus, the announcements of major shifts plus the initial occlusion of the
theories of constructivism and social construction made for a very confusing transi-
tion decade. Yet an examination of the convergences across the three sets of influ-
ences at play in the 1980s makes the resulting transition appear less anarchic. It also
allows a clearer appreciation of the continuities in the transition from earlier to
contemporary frameworks, as well as a clearer appreciation of the common shape of
the recasting of practice theory post-1990.
that there were significant convergences in the ecosystemic, feminist and postmod-
ernist influences. These convergences created the conditions for theory reshaping
across all the different framework ‘fronts’ of our practice knowledge and this reshap-
ing ‘shows’ very clearly from the early 1990s.
The contemporary frameworks now primarily address meaning. They all show,
in different ways, the influence of theories that have emerged under the postmod-
ernist umbrella, with the single most important sets of ideas being social construc-
tionist and narrative ideas. Language moves to the centre in these sets of ideas and
becomes the medium of meaning within the therapeutic process. Context and
relationship remain the enduring parameters of the systemic field, but one sees a
significant recasting. In the early family therapy models, the practice boundary of
context was more strictly confined to interactional patterns in family relationships,
which is not to say that some first-generation family therapy practitioners were not
keenly aware of the force of social contexts. However, the exploration within
therapy itself of multiple contexts affecting family life is now much more clearly on
the agenda. We see a stronger consciousness about the multiplicity of family forms,
the different cultural expressions of intimacy and connectedness, and the many and
varied ways of ‘doing’ family and relationships. The role of the therapist is more
facilitative and less directive. In short, family therapy practice theory stays within
the enduring parameters of context and relationship but, recast in the contemporary
landscape, both context and relationship are interpreted and explored in broader
and multiple ways (Flaskas, 2007).
But how does this all ‘show’ in the practice theory frameworks consolidated
from the 1990s that are currently the most influential in the Australian family
therapy context? These next explorations will be the subject of the second paper,
which will track in more detail the Milan-systemic, narrative and solution-focused
frameworks, and the dialogical perspective, as well as point to the current integra-
tions. So, for the moment, we can close the door on the particular reading of the
history of family therapy practice theory that I have offered in this first paper, a
reading that has emphasised continuities and the conditions of transitions. Yet, as is
the nature of any attempt to map current disciplinary knowledge, there will be
some returning to the earlier ideas laid out in this first paper and the broader condi-
tions in our own genealogy of knowledge. As the saying goes, stay tuned …
Endnotes
1 For example, the UK family therapy association is named ‘The Association for Family
Therapy and Systemic Practice’ and a number of family therapy training programs have
‘systemic psychotherapy’ in their titles, including programs offered by the Institute of
Family Therapy and the Tavistock Clinic.
2 Some points in this paragraph, and in this section as a whole, have been developed previ-
ously in Flaskas (2007).
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