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The Many Faces & Uses of Family Therapy

Dr Leonie White

Clinical Family Therapist, Psychologist & Co-Director Queensland Institute of Family Therapy



Years ago, I stumbled across an article titled “Family Therapy Saves the Planet: Messianic Tendencies in the Family Systems Literature”. This article inspired some interesting responses in the field and landed on the train of thought that family therapy can really make a difference.


The first part of the title caught my attention and imagination.  Why?  There’s a part of me that dreams of endless potential and believes anything is possible on any scale.  I’ve also always been passionate about effecting change on as large a scale as possible – it’s one of the reasons I chose to complete my PhD in Organisational Psychology – I wanted to work with groups, systems, organisations, and even nations. 


But can Family Therapy really be so powerful as to “save the planet”?  The idea of saving the world seems a bit farfetched.  Isn’t Family Therapy just for helping families?


Actually no, Family Therapy is not just for helping families – it is so much more and has the potential for positive impact at many levels.  When I first started to study Family Therapy many years ago, I had the great fortune to have teachers and mentors who were grounded in Systems Theory, and promoted the importance of being a systemic thinker regardless of how many people are “in the room” or what your role is.  And so, from the very beginning I always thought of Family Therapy as something bigger and more encompassing than simply a therapeutic framework for helping families.

 

This idea was reinforced when I extended my counselling and family therapy practice into supervising and teaching.  Across all my teaching in the Master of Mental Health (Family Therapy), Master of Counselling, and the QIFT Advanced Certificate in Systemic Family Therapy I found that even with a huge diversity of students, thinking systemically always had some help to offer.  To give you an idea of how diversely family therapy was helpful, some of the professional fields of students and trainees included: Child and Youth Mental Health, School settings, Infant Mental Health, Forensic Mental Health, Youth Detention, Gender Diversity, Couples Therapy, Private Practice, Adult Mental Health, Hospital based Allied Health, Medical positions, Childhood Abuse and Neglect (trauma), Child Protection, Domestic and Family Violence, Human Services, Indigenous Health, Drug and Alcohol, and Dietetics.  And Professions included: Social Work, Psychology, Occupational Therapy, Speech Pathology, Nursing, Psychiatry, Counselling, Human Services, Teaching, Guidance Counselling, Youth Work, Support Work, Dietetics, General Practitioner, Indigenous Health Work, Maternity Services, and Management.


So, what is systemic thinking? Why does being a systems thinker matter so much and how does it relate to “saving the planet”? 


Family Therapy has its roots in systems theory, and I believe the future of family therapy and its capacity to effect positive change on so many levels are because of this.   Systems theory evolved from around 1940 to 1980 and is an umbrella term for an amazing, exciting combination of epistemologies including engineering, physical and biological sciences, and larger social systems.  Yes, that’s right, something seemingly as unrelated to the helping profession as engineering has positively impacted the world of counselling.  Systems theory provides a way to organise the way we think to be helpful to people, families, interagency stakeholder groups, organisations and so much more broadly in other larger systems. 

 

“Systems thinking is not so much directly translatable into specific counselling techniques, but rather provides the counsellor with a way of organising his or her thinking about people” (Goldenberg & Goldenberg, 2002: 24).  Essentially, it’s “a way of thinking about a system and a set of concepts” (Robinson, 1980: 184), that understands “the individual as part of a significant social context” (Robinson, 1980: 183) and helps with analysing complex systems and interconnected and interdependent entities.  It involves consideration of relationships, interactions, patterns and meaning making within a system rather than focusing solely on individual components in isolation.  Instead of viewing issues or events in isolation systems thinking emphasizes the interconnections, feedback loops, the dynamic nature of systems, and broader context and systemic influences that shape behaviour, outcomes, and relationships, and not just for family systems, for any social, ecological, organisational system or psychological system. 

 

It makes sense, then, that systemic thinking would be incredibly useful in working therapeutically with families, and also with any system.  Thinking even bigger than families there are systems in systems e.g., schools are systems and exist in communities that exist in states that exist in countries.



 Systems thinking provides a valuable framework for understanding complex problems, identifying leverage points for intervention, and promoting holistic solutions that address the underlying systemic dynamics, no matter what type of system.

 

There’s a helpful idea in family therapy that a system is more than just the sum of its parts and this is very true statement for families, and all systems.  Families are made up of individuals, but the family as a whole is much more than just an adding up of the individuals; there are subsystems (e.g., parental subsystem), and the system as a whole is more than all the individuals added up in much the same way that a rain forest is more than just a number of plants, animals and trees added up.  If you’ve ever been for a rain forest walk, you’ll have a felt sense of this.  In the same way an organisation or community is made up of individuals, there is a leadership system in management and the organisation or community is more than the sum of its parts.



There are some key principles of systemic thinking.  These include:

Holistic Perspective.  Systemic thinking takes a holistic view, considering the entire system rather than isolating individual elements.  It considers the system’s organisation, structure (including hierarchy, roles, and rules), dynamics, and the many multiple layers of context to understand behaviour and functioning.  We call this the “helicopter view” and it’s not just a key feature of systemic thinking, it’s a key benefit because taking a big picture view provides more opportunities to find some area of manoeuvrability e.g., if working with one part of the system isn’t working, then we can land the helicopter in another part e.g., a shift from child to parent sessions, or in stakeholder work adding in “subsystem meetings” as well as whole group meetings to build up key relationships.  This is possible because of the shift in thinking about problems being individual and having separate elements to understanding the complex organisation and coordination of the system’s parts.


Circular Causality.  Systemic thinking challenges linear cause-and-effect thinking by recognising that causality in systems is often circular.  Behaviours and events influence each other in complex, non-linear, recursive ways.    Or, in the words of Carmel Flaskas, “Causality in living systems is not a chain of ‘linear’ determining cause-and-effect dyadic interactions, but rather a constellation of multi-determining interactions involving many parts of the system, occurring in a specific set of environmental conditions” (2010: 238).  Circular causality helps conceptualise a family’s/system’s collective behaviour in interactional terms.  This means that each person affects everyone else and is in turn affected by everyone else.  Understanding these connective patterns helps show a family’s/system’s implicit rules, rituals, and roles.  And if you’ve ever worked in a team or stakeholder group, you’ll know that rules, rituals, and roles are as important in your team as it is in a family.


Multiple Perspectives: Systemic thinking encourages consideration of multiple perspectives and parts/stakeholders within a system. It recognises that different individuals or groups may have different experiences and understandings of the system.  This is based on understanding Social Constructionism which highlights language as a creative social process (Goolishian and Anderson, 1987) and points out that “As we move through the world we build up our ideas about it in conversation” (Hoffman, 1990: 3).  What’s the benefit of this? “When individuals grasp that meanings are not carved in stone, they are freed to investigate, experiment with, and invent meanings of their own” (Efran et al in Sexton & Stanton, 2016).  This type of thinking benefits not just families, but teams, organisation, and communities, by creating opportunity and manoeuvrability, through privileging multiple perspectives, deconstruction of unhelpful meanings, and creation of coherent, strengths-based/resilience-based narratives and understandings. 


Let’s look at some specific examples of family therapy in bigger systems. 

Systems thinking can be a valuable approach in supporting communities to:

  • Address Complex Issues: Communities often face complex challenges that involve multiple factors and stakeholders. Systems thinking helps in analyzing these challenges by considering the underlying systemic causes, patterns, and dynamics. It enables a broader perspective, allowing for a more effective and sustainable approach to problem-solving.

  • Promoting Collaboration and Participation: Systems thinking encourages collaboration and participation among community members and stakeholders. It recognizes the value of diverse perspectives and encourages inclusive decision-making processes. This approach fosters collective ownership and empowers community members to actively contribute to the well-being and development of their community.

  • Building Resilience: Systems thinking promotes the development of resilient communities by focusing on the adaptive capacity and ability to respond to change and challenges. By understanding the interdependencies and dynamics within the community, interventions can be designed to strengthen community resilience and enhance its ability to navigate challenges and uncertainties.

  • Advocating for Systemic Change: Systems thinking encourages a systemic approach to community development and social change. It highlights the need for addressing root causes and systemic issues rather than solely focusing on symptoms. This approach supports advocacy efforts for policy changes, systemic reforms, and interventions that create lasting positive impact.

 

 Systems thinking and family therapy principles can be beneficial in helping organizations and stakeholder groups by promoting a deeper understanding of the organization as a complex system of relationships, dynamics, and interdependencies.


Here's how these approaches can support organizations:

  • Holistic Perspective: Systems thinking and family therapy encourage a holistic perspective, with this broader view helping to identify and understand the interconnections, patterns, and feedback loops within the organization, leading to a more comprehensive understanding of its functioning.

  • Communication and Collaboration: Family therapy emphasizes effective communication and collaboration among family members, and similarly, organizations can benefit from improved communication and collaboration among their employees and departments.

  • Addressing Dynamics: Family therapy theory and practice can be adapted to organizational settings to explore organizational anxiety, dynamics, power structures, roles, relationships, decision making, conflict resolution and patterns of interaction. This understanding can help to identify and address dysfunctional or counterproductive dynamics within the organization, leading to improved teamwork, cooperation, and overall organizational health.

  • Change Management: Both systems thinking and family therapy acknowledge that change is a natural part of systems and organizations. These approaches provide frameworks for understanding the complexities of change and the potential resistance or reactions that may arise within the organization. By considering the organization as a system and addressing the underlying dynamics, systems thinking and family therapy principles can guide effective change management strategies.

  • Organizational Resilience: Systems thinking and family therapy recognize the importance of resilience in organizations. By understanding the organization as a dynamic system, interventions can be designed to enhance adaptability, problem-solving, and the ability to navigate challenges. This focus on resilience can help organizations thrive in the face of uncertainties and changes in the external environment.

 

And of course, family therapy has a wide range of applications in the counselling and mental health field. 

  • Individual Therapy: Family therapy can assist individuals with multigenerational issues, mental health, and substance misuse. Family therapy can address intergenerational issues and patterns of behaviour that are passed down through generations. It explores the family's history, dynamics, narratives and beliefs, helping members understand and modify unhealthy patterns and create healthier ways of relating.  Family therapy is also helpful in working with individuals with mental health disorders or substance abuse issues. It helps develop understanding and coping strategies, deconstruct problems, externalize problems, seek exceptions to problems, and focuses on strengths, and meaning making to create conditions that facilitate growth, healing and recovery. 

  • Couples and Family Therapy: Family therapy is often used to work with couples and families who are experiencing relationship difficulties or seeking to improve their communication, problem solving, relationship dynamics, bonds, and overall relationship satisfaction.  Family Therapy can also help with the changes and challenges that are involved in the family life cycle. Therapists help to explore their patterns of interaction, address conflicts, and develop healthier ways of relating to each other.

 

Some specific applications of systemic family therapy in individual, couple and family work include:

  • Family Cohesiveness and Conflict Resolution: Family therapy can assist families in developing a sense of connection and belonging, and also in resolving conflicts and improving their ability to communicate effectively. It helps family members understand each other's perspectives, address underlying issues, enjoy each other, and develop strategies for resolving conflicts in a constructive and respectful manner.

  • Parent-Child Relationships: Family therapy can support parents in developing their parenting approach and strengthening their relationships with their children. It may address issues such as behavioural problems, discipline, parent-child communication, and improving the emotional bond between parents and children.  In families with adult children family therapy can also help with renegotiating the nature of the relationship to be adult to adult relationships, and support changes in roles as adult children become parents and their parents become grandparents.

  • Blended Family Issues: Blended families, which consist of parents and children from previous relationships, often face unique challenges in integrating different family systems. Family therapy can assist blended families in navigating these challenges, improving relationships, and creating a sense of cohesion and harmony.

  • Divorce or Separation Support: Family therapy can assist families in navigating the challenges and emotional impact of divorce or separation. It can help parents develop co-parenting strategies, support children in adjusting to the changes, and minimize the negative effects of the separation on family members.

 

Family therapy is also helpful for services that support the safety, wellbeing, and mental health of people, and for interagency work, e.g.,

  • Residential Care and Inpatient settings: A systemic family therapy approach helps with understanding and working with the “anxiety in the system”, which can be amplified with young people who have experienced trauma and multiple placements.  The approach can provide a framework to support the young person and the care system through considerations such as the structure of the residential care system “family” including leadership and roles, the need for felt safety in relationships, relationship dynamics, communication and problem solving, and the meaning young people make of their situation as well as the meaning residential care/inpatient staff make of the care situation.

  • Stakeholder Groups:  Systemic family therapy can support collaborative practice through the understanding of emotional relational processes in groups such as triangling or the over-functioning/under-functioning dynamic, as well as structural considerations including contracting shared goals and roles, and developing effective working relationships with sound communication and problem solving.  Systemic thinking can also support with developing shared meaning making providing a consistent approach.



And speaking of the counselling and mental health field, family therapy also provides a framework for clinical and professional supervision. 


Systemic family therapy supervision promotes a collaborative and reflective approach, encouraging therapists to explore alternative perspectives and innovative solutions using systems thinking.  The supervisor supports therapists in managing challenging situations, ethical dilemmas, and complex issues and dynamics that may arise in therapy.  Systemic supervision can be in the format of individual or group supervision.



What are some of the specific applications of systems thinking in supervision?  Here’s a few ideas to get you thinking.  Family therapy theory and practice is helpful in supervision, e.g.,

  • Solution Focused Ideas in Supervision:  Solution focused ideas can be very helpful in supervision e.g., paying attention to what is going well in the supervisee’s work in order to punctuate and amplify this is a very helpful supervisory process.  In an isomorphic process this approach might also support a supervisee to then pay attention to what is working well for the client, amplifying the client’s strengths, resources and capacities.

  • Narrative Ideas in Supervision:  Narrative practices can be very helpful in supervision e.g., deconstructing problems to situate the problem in context, and to discover, acknowledge, and “take apart” beliefs, ideas and practices of broader culture that assist the Problem and the Problem Story.  This might be a problem the supervisee is experiencing or helping the supervisee deconstruct a problem the client is experiencing.  Externalization is also often helpful in supervision e.g., if there is a “not good enough monster” inviting a supervisee to double themselves or if a supervisee is noticing invitations from “Anxiety” or “Perfectionism”.

  • Systemic Ideas in Supervision:  Often a genogram and ecomap are used to map the system to support the helicopter view and engage in reflexivity to fine manoeuvrability.  That is, where to “land the helicopter: to do some work that could make a difference.  Regardless of the process used, systemic supervision will always consider context, relationships and meaning making. In a systems approach to supervision, conceptualizing the case and creating ideas for effecting therapeutic change will involve systems thinking on the part of the supervisor and the supervisee (Montgomery, Hendricks, Bradley, 2001: 305).

 

These are just a few examples of the many applications of family therapy to help your thinking, and remember to keep in mind that each system, be that a family system, organisation or community is unique and the application of systems thinking will need to be tailored to the specific context and needs of the system in question. 


And so, I hope this blog helps you see the versatility of the systemic approach within and beyond “family therapy with families” and how applicable and helpful it is in a wide range of situations and systems.  I hope it also inspires you to bring systemic thinking into other aspects of your work that haven’t been named here, that you’ve been inspired to think systemically whatever type of system you work in or with.


And please reach out and let us know how you are finding systemic thinking and practice helpful.  Who knows, with enough systemic thinkers we might just contribute to “saving the planet.”

 

Leonie

 

 

References:

Anderson, H. & Goolisian, H. (1991).  Thinking about multi-agency work with substance abusers and their families: A language systems approach.  Journal of Systemic Therapies, 10(1), 20 – 35.

Flaskas, C. (2010). Frameworks for Practice in the Systemic Field: Part 1 – Continuities and Transitions in Family Therapy Knowledge. The Australian and New Zealand Journal of Family Therapy, 31(3), pp. 232-247.

Goldenberg, H. & Goldenberg, I.  (2002).  Counseling Today’s Famlies (4th Edition).  Brooks/Cole: Pacific Grove CA.

Goolishian, H. & Anderson, H. (1987).  Language systems and therapy: An evolving idea.  Psychotherapy, 24, 529 – 538.

Hardy, K. (2001).  Healing the world in fifty-minute intervals: A response to “Family therapy saves the planet”.  Journal of Marital and Family Therapy, 27(1), 19 – 22.

Hoffman, L. (1990).  Constructing realities: An art of lenses. Family Process, 29(1), 1 – 12.

Johnson, S.  (2001).  Family therapy saves the planet: Messianic tendencies in the family systems literature.  Journal of Marital and Family Therapy, 27 (1), 3 – 11.

Johnson, S. (2001).  Saving the planet – or ourselves?  Journal of Marital and Family Therapy, 27(1), 23 – 25.

McGoldrick, M. (2001).  Response to “Family therapy saves the planet”.  Journal of Marital and Family Therapy, 27(1), 17 – 18.

Miller, J.  (2008).  The Anxious Organisation: Why Smart Companies Do Dumb Things.  Facts on Demand Press.

Montgomery, M. J., Hendricks, C. B., Bradley L. J. (2001).  Using systems perspectives in supervision.  The Family Journal: Counselling and Therapy for Couples and Families, 9 (3), 305 – 313. 

Robinson, M. (1980).  Systems theory for the beginning therapist.  Australian Journal of Family Therapy, 4,(1), 183 – 194.Stagoll, B. & Lang, M. (1980).  Climbing the family tree: Working with genograms.  Australian Journal of Family Therapy, 1(4), 161 - 170.

Sexton, T. & Stanton, M. (2016).  Systems Theory (Chapter 8).  In Norcross, G., VandenBos, G., Freedheim, D., & Olatunji, B. (Eds.). APA Handbook of Clinical Psychology, Vol 2, Theory and Research.  American Psychological Association.

Sherbersky, H., Vetere, A., & Smithson, J. (2023).  “Treating this place like home”: An exploration of the notions of home within an adolescent inpatient unit with subsequent implications for staff training.  Journal of Family Therapy, 45, 392 – 413.

Sluzki, C. E. (2001).  All those in favour of saving the planet, please raise your hand: A comment about “Family therapy saves the planet”.  Journal of Marital and Family Therapy, 27(1), 13 – 15.

Sng, R. (2012).  Family therapy for kids without families: Working systemically with children and young people in residential care.  Australian and New Zealand Journal of Family Therapy, 30 (4), 247 – 259.



Please note that this article is educational in nature and does not constitute professional advice.


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