Family and Systemic Therapies 347at least once would easily lead to erroneous conclusions being drawn,
or to a lack of appreciation of important influences. Nowadays most
family therapists will work with whoever can come, while recognising
the importance of the family system. It is therefore possible to work in a
systemic way with only one person.
Drawing a family genogram (family tree). This rapidly enables all the family
members to be recognised for their influence, including grandparents,
aunts and uncles, and deceased relatives. Intergenerational patterns may
be revealed, and family stories (often called narratives) and expectations
brought to light: ‘He’s the black sheep of the family’; ‘I’m a Daddy’s girl’,
‘All the men in our family die early or drink heavily.’
Use of colleagues to observe the therapy process. This may be through a one-
way mirror. The therapist then receives feedback on what is happening
in the family and suggestions for interventions, which may be given
through an ear bug, by a telephone, or by taking a break to talk to them.Varieties of family therapy
There have been many varieties of family therapy, which have evolved
over time within themselves and which have influenced each other.
Whereas in the last century these were fairly clearly demarcated and dis-
tinct, nowadays many therapists draw on several approaches. Nonetheless
it is helpful to know the varieties.Structuralmakes explicit the structure of
a family in terms of who holds the power and what the communication
patterns are. Therapy attempts to correct any distortions in this structure
through practical manoeuvres.Strategicmakes use of novel practical strate-
gies to help families find a fresh way to break out of ingrained negative
cycles of behaviour, without prescribing a ‘correct’ structure.Milanuses
questioning to reveal to family members the forces and beliefs which
constrain their behaviour towards each other, enabling them to change
these if they are uncomfortable with what is revealed.Solution focused
therapyconcentrates on identifying the external events and contexts that
are operating when the problem isnotpresent or being expressed, and
tries to work with the family to change the predominant circumstances to
these.Social constructionist systemic therapyandnarrative therapybuild on the
wider general currency of notions that there is no objective reality, rather,
it is all construed. This conceptualisation then offers the opportunity to
acknowledge the impact of social values, for example, relating to power
inequalities due to gender, race or social class, and to reconstruct events, or
retell a person’s story, in a way that leads to helpful changes in their family
and personal functioning. For example, a girl’s predominant narrative that
she has suffered as a victim of parental hostility could be ‘rewritten’ as the
heroic survival of hard times, weaving in that despite this she achieved a
number of notable specific successes, and is now ready to spread her wings
and move on to be a successful young adult.
Irrespective of the particular type of family and systemic therapy, it
offers a different way to think about personal difficulties. Prior to systems
thinking, the dominant medical or psychodynamic models tended to locate