How Is Teaching Family Therapy Different From 35 Years Ago?

Family therapy has changed as the social context has changed.

Posted Jun 04, 2018

I have had the privilege of teaching family therapy every year since 1982, the last 35 years at the University of Maryland School of Social Work.  I was trained at the Philadelphia Child Guidance Clinic in the 1970s when Salvador Minuchin, Marianne Walters, and Harry Aponte ran the Clinic.  And, like many of us trained in those days, I have attended workshops by or met other icons of family therapy - Carl Whitaker, Virginia Satir, Jay Haley, Cloe Madanes, Olga Silverstein, Peggy Papp, Froma Walsh, Betty Carter, Nancy Boyd-Franklin, Marion Lindblad-Goldberg, Monica McGoldrick, Bill O'Hanlon, and Ken Hardy.  What has changed over the years in what needs to be taught?

1. Race/culture/ethnicity - Always important and considered crucial in family therapy training, race has become increasingly important to social work students who feel ill-prepared to work across race/culture/ethnicity.  The social rifts apparent in society and reflected in the news, particularly in relation to men of color, are felt by students and they are seeking relevant training to rectify the damage wreaked by a racist society;

2. Gender - The Feminist Family Therapy Collective, formed in the 1980s, highlighted many of the shortcomings of the traditional models of family therapy.  The #MeToo movement has brought a new focus on gender inequality not only in the workplace but in the home.  Couples are still struggling with how family life is shared or divided and who initiates intimacy.  The #MeToo movement and the political landscape have added a new and needed urgency for family therapists to understand how news events affect the family they are treating.  People may struggle anew with what to report about their own pasts as victims (and perpetrators - note the May/June 2018 of the Psychotherapy Networker that focuses on men). Students need to get the topic on their radar as they think through their own experiences.  They also need to be aware of binary assumptions;

3. Getting the whole family in for a session - More women are in the workforce than before and, with an unemployment rate under 4%, seeing the whole family system in action is harder to arrange.  But family therapy models still have a place in helping social workers treating an individual client to understand that client's family history (Bowen), boundaries (Minuchin), and communication patterns (Satir).  Just because the family as a whole is not being seen does not mean the family as a whole is not "present" in the room:

4. Political divides within families and working with clients of a different political persuasion -  The more family members there are, the more likely political differences will emerge within the family that the therapist has to be sensitive to.  But in addition, in a time of political extremism, another issue is afoot with students needing to help clients whose political affiliations may be fundamentally anathema to them.  It is one thing to work with a person expressing abhorrent views and believe that person is isolated in a small community or is part of a small minority of people holding those views; it is another to work with that same person and connect that person to a larger political movement.  For years we helped students work through their own implicit or unconscious bias.  We have to make sure political affiliation is included in that training so that all people can be served.

5. Easy answers - We never really could fix things to the extent that we thought we could but family therapy models spoke to our need for concrete solutions. Now we need to be comfortable with the ambiguity of life and the ambivalence we feel towards others and towards ourselves.  When we have comfort with ambiguity and ambivalence we can join others in their struggles.