A personal retrospective of the family therapy field: Then and now

Journal of Marital and Family Therapy, Jul 1996 by Framo, James L

One important book that came out in the 1970s attempted to develop a classification of different kinds of families, based on the families' psychological health (Lewis, Beavers, Gossett, & Phillips, 1976). Nagy and Spark published Invisible Loyalties (BoszormenyiNagy & Spark, 1973), a text which led to the development of contextual therapy, focusing on the intergenerational ledger of debts, legacies, and entitlements. It took a while for this elegant theory to be understood well enough to apply to clinical problems in families. Structural family therapy became widely used, partly because it offered a set of family therapy procedures that were more teachable (Minuchin, 1974). Braulio Montalvo's contributions to structural family therapy were acknowledged by Minuchin, but you don't hear much about Montalvo because he was so unassuming. Although Haley had published widely for years, his 1976 book Problem Solving Therapy clearly presented his strategic approach (Haley,1976). Neil Jacobson was the foremost proponent of the behavioral approach to the treatment of relationships (Jacobson & Margolin, 1979). The field had to wait until 1978 for Bowen's book of his collected papers, Family Therapy in Clinical Practice (Bowen, 1978). Among all the theories presented by the pioneers, I believe Bowen's was, and still is, the most comprehensive, far-ranging, and influential in the field. Clinically, Bowen spent decades studying the fundamental question of how one can deal with one's family's craziness without giving the family up.

Family systems therapy began to be practiced in many different settings-in clinics, hospitals (both medical and psychiatric), social service agencies, children's residential settings, institutions for the aged, courts, the home, private practice, and so on. The early workers had put the broad strokes on the canvas, and the details were being filled in. Some family therapists focused on the family or marital contexts of specific symptoms like alcoholism, drug abuse, eating disorders, depression, medical problems, incest, adolescent problems, chronic illness, and areas such as women's issues, loss, the person of the therapist, ethnicity, effects of divorce, problems of remarriage, and so forth. Different varieties of systems therapy began to be practiced, such as multiple family therapy, conjoint marital therapy, couples groups, social networks, and intergenerational therapy, and a whole assortment of techniques were developed, such as paradoxical interventions, hypnosis, role playing, videotape playback, sculpting, behavioral tasks, imagery, relabeling-all of which were designed to bring about system change. Family therapists pioneered in opening up the treatment room with one-way mirrors, audio and videotape recorders, and live supervision.

A small group of eight of us got together in 1977 to found the American Family Therapy Association. It would never have happened without the prestige of Murray Bowen. He was the first president and I became the second. A long series of events preceded this step; a description of how AFTA got started is in the Winter 1989 issue of the AFTA newsletter. AFTA and AAMFT went through their domain struggle for a few years. That's how the relationship between me and Don Williamson started; I was president of AFTA and he was president of AAMFT, so we started as adversaries. Over the years our relationship has developed into a firm friendship. As is now known, the relationship between AAMFT and AFTA has become a model of interorganizational cooperation.