Family Therapy Theory
Doherty, W. J., and Baptiste, D. A.,
Jr. (1993). Theories emerging from
family therapy. In P.G. Boss, W. J.
Doherty, R. LaRossa, W. R. Schumm, &
S. K. Steinmetz (Eds.), Sourcebook of
family theories and methods: A
contextual approach (pp. 505-524).
New York: Plenum.
Historical Development
 Gregory Bateson suggested two forms of
communication:
 Verbal (a/k/a digital): what is said.
 Nonverbal (a/k/a analogic): provides the
context for the digital, providing interpretative
information. This is referred to as a
metamessage.
 The Palo Alto Team:
 Double bind hypothesis: a sequence of
interaction which featured a contradiction
between the contextual and verbal levels.
 Family homeostasis, influenced by
cybernetics: families were calibrated like a
furnace to maintain themselves within
tolerable limits.
Dr. Ronald J. Werner-Wilson
Historical Development (cont.)
 Murray Bowen
 Use a biological metaphor which linked
individual and family differentiation.
 Family process influenced an individual
differentiation of self, a balance between
intellectual and emotional functioning.
autonomy and togetherness in social
relationships.
 Families transmit level of differentiation.
 Salvador Minuchin: Structural Family
Therapy
 Families have functions which:
socialization of children
mutual support or married couples.
 Families are systems which operate through
subsystems which require adequate boundary
clarity and permeability.
 Family problems are the result of
boundaries which are too porous
(enmeshed)
boundaries which are too rigid
(disengaged).
Dr. Ronald J. Werner-Wilson
Historical Development (cont.)
 Recent Developments
 Milan approach
 Constructivism: infusion of epistemology
(theories of knowing) and other ideas.
Reality cannot be assessed objectively
because it is a subjective experience.
Reflexivity: the observer is part of the
system being observed.
Dr. Ronald J. Werner-Wilson
Working Assumptions of Family
Therapy Theories
 Family relationships are a principal
source of mental health and
psychopathology for individuals.
 Family interaction patterns tend to repeat
across generations.
 Family health requires a balance of
connection and individuation.
 Family flexibility is a core trait that
prevents family dysfunction.
 The triad is the minimum unit for a
complex understanding of family
interactions.
 Individuals' symptoms frequently have
meaning within the family's interaction
patterns or worldview.
Dr. Ronald J. Werner-Wilson
Major Questions Addressed by
Family Therapy Theories
 How do individuals develop psychosocial
symptoms within families?
 How do families maintain levels of
interpersonal connection that allow for
emotional bonding and individual
autonomy?
 How does family conflict become
unmanageable?
 How can families change dysfunctional
patterns?
Dr. Ronald J. Werner-Wilson
Major Contemporary Concepts
 Boundaries: family rules which determine
membership in systems and responsibilities.
 Triangles: triadic interactional configurations
which is the basic building block of any
emotional system. When a two-party system
becomes unstable because of anxiety, a third
person is involved to stabilize them.
 Coalitions: negative alliances between two or
more family members, a version of triangles.
 Family belief systems: problems are
maintained by the families construction of the
problem.
 Self Processes: The field is divided into two
groups
 One group emphasizes only family processes.
 A second group is influenced by one of two
theoretical orientations
Object relations concepts (e.g., Framo,
Scharff & Scharff).
Self-differentiation (Bowen).
Dr. Ronald J. Werner-Wilson
Family Therapy Theory and
Research on Psychosomatic Families
 Theory: enmeshed, overprotective, rigid,
and inadequate conflict resolution
transactional patterns are associated with
the following medial problems:
 anorexia nervosa
 poor control of diabetes
 asthma
 Results: general support for hypothesis.
 Children from psychosomatic families had
higher levels of FFA than control group when
they observed parental conflict.
 Parents in psychosomatic families relaxed
when children entered the room; the child’s
FFA level increased.
Dr. Ronald J. Werner-Wilson
Family Therapy Theory and
Research on Schizophrenia
 Major contributions to the understanding of
schizophrenia only occurred after researchers
accepted the notion that it is a biologically based
disease.
 Researchers began to study the influence of
family factors intensify problems and lead to
relapse.
 Expressed Emotion (EE):
 Refers to the level of criticalness and
emotional overinvolvement of a family
member to another family member with a
psychiatric impairment.
 Measured during a Camberwell Family
Interview, a 90-minute semi-structured
interview.
 People from high EE families are likely to
relapse three to four times more rapidly.
 Expressed emotion has also been used to
predict relapse in
depression,
manic-depressive disorder,
obesity.
Dr. Ronald J. Werner-Wilson
Limitations of Family Therapy
Theory
 Two Standard Criticisms:
 Individual psychological factors were
neglected.
 Lack of clear operationalization of the
constructs for research purposes.
 Three New Critiques:
 Feminist Critique
 Race/Ethnic Diversity
 Systems in Context: Need to Examine Larger
Social Systems
Dr. Ronald J. Werner-Wilson
Limitations of Family Therapy
Theory (cont.)
 Feminist Critique: Doherty and Baptiste
(1993) suggest that feminism has entered
the mainstream of theoretical work in
family therapy. Main points of the
feminist critique:
 Traditional theory ignored gender.
 Traditional theory ignored sociocultural and
political contexts of family life.
 Traditional theory reinforced traditional roles.
 Traditional theory ignored issues of power and
differential vulnerability of men and women to
exploitation (Doherty & Baptiste, 1993, p.
518).
Dr. Ronald J. Werner-Wilson
Limitations of Family Therapy
Theory (cont.)
 Critique Based on Race/Ethnicity. Two
problems:
 Theoretical myth of sameness.
 Use of stereotypes.
 Critique Based on Larger Social Systems:
 Families are influenced by their interactions
with major environmental systems (e.g., health
care system, schools, legal system, mental
health and social service systems).
 Emerging consensus, as a result of
collaboration with medical professionals:
adequate family theory must involve a
biopsychosocial perspective (e.g., mind, body,
and larger social systems).
Dr. Ronald J. Werner-Wilson
Future Directions
 Emergent Trends
 Greater link between theory and assessment.
 Greater emphasis on biopsychosocial models.
 Emphasis on constructivist approaches to
family theory. Analysis of the family as a group
that
observes itself and its environment
formulates hypotheses, and holds lasting
belief patterns (Doherty & Baptiste, 1993,
p. 521).
 Emphasize race/ethnicity and gender.
 Two Divergent Paths
 Theory that is tied directly to research
activities.
 Theory that is influenced by nontraditional
research paradigms which emphasize
epistemology (theory of knowing) and
properties of interacting therapeutic systems.
Dr. Ronald J. Werner-Wilson