Family Therapy is Not Out of Date

I remember when undertaking my social work training in the early 1980s that family therapy was very much seen as a technique whose time had arrived. As part of my training we watched part of Eugene O’Neill’s play Long Day’s Journey into Night to illustrate family difficulties. I can still remember the stunning performance of Katherine Hepburn in the lead role in the film version. This small vignette powerfully illustrated family difficulties and how these difficulties can become entrenched.

At the time of my training I remember being particularly impressed by the work of Salvatore Minuchin[i], a charismatic practitioner who adopted a very interactive approach in that he used to direct families where to sit and how to communicate with each other, very much like a director in a play. Although when writing about it now it seems a slightly patronising approach, at the time, however, it seemed honest, open and direct.

Family therapy lost some of its credibility in the 1990s when people began to argue that working with families as a whole may not be appropriate in all circumstances, in particular when there are issues of abuse. Family therapy, it was argued, allowed the abuser to escape their responsibility, shift responsibility away from the individual to other members of the family. In my view, this was a valid criticism, because we must always remember at the root of abuse is the issue of power or more specifically the abuse of power. However, this should not preclude undertaking work with the whole family.

The key when working with families is the need for clarity, having a clear plan and working with all members of the family, individually and where appropriate as a unit. In my work with abusers I used a cognitive behavioural approach to explore the perpetrator’s distorted thinking. The crucial aspect of this work was to see the offender first individually and to focus on the actual offences. The latter approach ensured that the offender could not shift responsibility and play the blame game. A detailed assessment provides the practitioner with key information to help future work with other family members.

The information gleaned through the assessment will then be a base to work with the family ultimately if appropriate. The assessment provides the worker and other family members with an insight into the thinking of the abuser. This information could be used in future family work, ensuring that the abuser does not shirk his responsibility and that the distorted thinking and entrenched views are appropriately challenged. It breaks down the ‘wall’ of secrecy.

[i] Minuchin, S. (1974) Families and Family Therapy. Cambridge: Harvard University Press.

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