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Conjoint family therapy : ウィキペディア英語版
Family therapy

Family therapy, also referred to as couple and family therapy, marriage and family therapy, family systems therapy, and family counseling, is a branch of psychotherapy that works with families and couples in intimate relationships to nurture change and development. It tends to view change in terms of the systems of interaction between family members. It emphasizes family relationships as an important factor in psychological health.
The different schools of family therapy have in common a belief that, regardless of the origin of the problem, and regardless of whether the clients consider it an "individual" or "family" issue, involving families in solutions often benefits clients. This involvement of families is commonly accomplished by their direct participation in the therapy session. The skills of the family therapist thus include the ability to influence conversations in a way that catalyses the strengths, wisdom, and support of the wider system.
In the field's early years, many clinicians defined the family in a narrow, traditional manner usually including parents and children. As the field has evolved, the concept of the family is more commonly defined in terms of strongly supportive, long-term roles and relationships between people who may or may not be related by blood or marriage.
The conceptual frameworks developed by family therapists, especially those of
family systems theorists, have been applied to a wide range of human behaviour, including organisational dynamics and the study of greatness.
==History and theoretical frameworks==

Formal interventions with families to help individuals and families experiencing various kinds of problems have been a part of many cultures, probably throughout history. These interventions have sometimes involved formal procedures or rituals, and often included the extended family as well as non-kin members of the community (see for example Ho'oponopono). Following the emergence of specialization in various societies, these interventions were often conducted by particular members of a community – for example, a chief, priest, physician, and so on - usually as an ancillary function.〔Broderick, C.B. & Schrader, S.S. (1991). The History of Professional Marriage and Family Therapy. In A. S. Gurman & D. P. Kniskern (Eds.), (''Handbook of Family Therapy. Vol. 2.'' ) NY: Brunner/Mazel〕
Family therapy as a distinct professional practice within Western cultures can be argued to have had its origins in the social work movements of the 19th century in the United Kingdom and the United States.〔 As a branch of psychotherapy, its roots can be traced somewhat later to the early 20th century with the emergence of the ''child guidance'' movement and ''marriage counseling''.〔Sholevar, G.P. (2003). Family Theory and Therapy. In Sholevar, G.P. & Schwoeri, L.D. (''Textbook of Family and Couples Therapy: Clinical Applications.'' ) Washington, DC: American Psychiatric Publishing Inc.〕 The formal development of family therapy dates to the 1940s and early 1950s with the founding in 1942 of the ''American Association of Marriage Counselors'' (the precursor of the AAMFT), and through the work of various independent clinicians and groups - in the United Kingdom (John Bowlby at the Tavistock Clinic), the United States (Donald deAvila Jackson, John Elderkin Bell, Nathan Ackerman, Christian Midelfort, Theodore Lidz, Lyman Wynne, Murray Bowen, Carl Whitaker, Virginia Satir), and Hungary (D.L.P. Liebermann) - who began seeing family members together for observation or therapy sessions.〔〔Silverman, M. & Silverman, M. Psychiatry Inside the Family Circle. ''Saturday Evening Post'', 46-51. 28 July 1962.〕 There was initially a strong influence from psychoanalysis (most of the early founders of the field had psychoanalytic backgrounds) and social psychiatry, and later from learning theory and behavior therapy - and significantly, these clinicians began to articulate various theories about the nature and functioning of the family as an entity that was more than a mere aggregation of individuals.〔
The movement received an important boost starting in the early 1950s through the work of anthropologist Gregory Bateson and colleagues – Jay Haley, Donald D. Jackson, John Weakland, William Fry, and later, Virginia Satir, Paul Watzlawick and others – at Palo Alto in the United States, who introduced ideas from cybernetics and general systems theory into social psychology and psychotherapy, focusing in particular on the role of communication (see Bateson Project). This approach eschewed the traditional focus on individual psychology and historical factors – that involve so-called ''linear causation'' and ''content'' – and emphasized instead ''feedback'' and ''homeostatic'' mechanisms and ''“rules”'' in ''here-and-now interactions'' – so-called ''circular causation'' and ''process'' – that were thought to maintain or exacerbate problems, whatever the original cause(s).〔Guttman, H.A. (1991). Systems Theory, Cybernetics, and Epistemology. In A. S. Gurman & D. P. Kniskern (Eds.), (''Handbook of Family Therapy. Vol. 2.'' ) NY: Brunner/Mazel〕〔Becvar, D.S., & Becvar, R.J. (2008). (''Family therapy: A systemic integration.'' ) 7th ed. Boston: Allyn & Bacon.〕 ''(See also systems psychology and systemic therapy.)'' This group was also influenced significantly by the work of US psychiatrist, hypnotherapist, and brief therapist, Milton H. Erickson - especially his innovative use of strategies for change, such as ''paradoxical directives'' ''(see also Reverse psychology)''. The members of the Bateson Project (like the founders of a number of other schools of family therapy, including Carl Whitaker, Murray Bowen, and Ivan Böszörményi-Nagy) had a particular interest in the possible psychosocial causes and treatment of schizophrenia, especially in terms of the putative "meaning" and "function" of signs and symptoms within the family system. The research of psychiatrists and psychoanalysts Lyman Wynne and Theodore Lidz on communication deviance and roles (e.g., pseudo-mutuality, pseudo-hostility, schism and skew) in families of schizophrenics also became influential with ''systems-communications''-oriented theorists and therapists.〔〔Barker, P. (2007). (''Basic family therapy'' ); 5th edition. Wiley-Blackwell.〕 A related theme, applying to dysfunction and psychopathology more generally, was that of the "identified patient" or ''"presenting problem"'' as a manifestation of or surrogate for the family's, or even society's, problems. ''(See also double bind; family nexus.)''
By the mid-1960s, a number of distinct schools of family therapy had emerged. From those groups that were most strongly influenced by cybernetics and systems theory, there came MRI Brief Therapy, and slightly later, strategic therapy, Salvador Minuchin's ''Structural Family Therapy'' and the Milan systems model. Partly in reaction to some aspects of these ''systemic'' models, came the ''experiential'' approaches of Virginia Satir and Carl Whitaker, which downplayed theoretical constructs, and emphasized subjective experience and unexpressed feelings (including the subconscious), authentic communication, spontaneity, creativity, total therapist engagement, and often included the extended family. Concurrently and somewhat independently, there emerged the various ''intergenerational'' therapies of Murray Bowen, Ivan Böszörményi-Nagy, James Framo, and Norman Paul, which present different theories about the intergenerational transmission of health and dysfunction, but which all deal usually with at least three generations of a family (in person or conceptually), either directly in therapy sessions, or via ''"homework"'', ''"journeys home"'', etc. ''Psychodynamic'' family therapy - which, more than any other school of family therapy, deals directly with individual psychology and the unconscious in the context of current relationships - continued to develop through a number of groups that were influenced by the ideas and methods of Nathan Ackerman, and also by the ''British School'' of Object Relations and John Bowlby’s work on attachment. ''Multiple-family group therapy'', a precursor of ''psychoeducational family intervention'', emerged, in part, as a pragmatic alternative form of intervention - especially as an adjunct to the treatment of serious mental disorders with a significant biological basis, such as schizophrenia - and represented something of a conceptual challenge to some of the ''"systemic"'' (and thus potentially "family-blaming") paradigms of pathogenesis that were implicit in many of the dominant models of family therapy. The late-1960s and early-1970s saw the development of ''network therapy'' (which bears some resemblance to traditional practices such as Ho'oponopono) by Ross Speck and Carolyn Attneave, and the emergence of ''behavioral marital therapy'' (renamed ''behavioral couples therapy'' in the 1990s; see also ''relationship counseling'') and ''behavioral family therapy'' as models in their own right.〔
By the late-1970s, the weight of clinical experience - especially in relation to the treatment of serious mental disorders - had led to some revision of a number of the original models and a moderation of some of the earlier stridency and theoretical purism. There were the beginnings of a general softening of the strict demarcations between schools, with moves toward rapprochement, integration, and eclecticism – although there was, nevertheless, some hardening of positions within some schools. These trends were reflected in and influenced by lively debates within the field and critiques from various sources, including feminism and post-modernism, that reflected in part the cultural and political tenor of the times, and which foreshadowed the emergence (in the 1980s and 1990s) of the various ''"post-systems"'' constructivist and social constructionist approaches. While there was still debate within the field about whether, or to what degree, the ''systemic-constructivist'' and ''medical-biological'' paradigms were necessarily antithetical to each other ''(see also Anti-psychiatry; Biopsychosocial model)'', there was a growing willingness and tendency on the part of family therapists to work in multi-modal clinical partnerships with other members of the helping and medical professions.〔〔〔Nichols, M.P. & Schwartz, R.C. (2006). (''Family therapy: concepts and methods.'' ) 7th ed. Boston: Pearson/Allyn & Bacon.〕
From the mid-1980s to the present, the field has been marked by a diversity of approaches that partly reflect the original schools, but which also draw on other theories and methods from individual psychotherapy and elsewhere – these approaches and sources include: brief therapy, structural therapy, constructivist approaches (e.g., Milan systems, ''post-Milan/collaborative/conversational'', ''reflective''), solution-focused therapy, narrative therapy, a range of cognitive and behavioral approaches, psychodynamic and object relations approaches, attachment and Emotionally Focused Therapy, ''intergenerational'' approaches, ''network therapy'', and multisystemic therapy (MST).〔Dattilio, F.R. (Ed.) (1998). (''Case Studies in Couple and Family Therapy: Systemic and Cognitive Perspectives.'' ) Guildford Press: New York.〕〔(Couple therapy ) ''Harvard Mental Health Letter'' 03/01/2007.〕〔(Attachment and Family Systems. ) ''Family Process.'' Special Issue: Fall 2002 41(3)〕〔Denborough, D. (2001). (''Family Therapy: Exploring the Field's Past, Present and Possible Futures''. ) Adelaide, South Australia: Dulwich Centre Publications.〕〔Crago, H. (2006). (''Couple, Family and Group Work: First Steps in Interpersonal Intervention.'' ) Maidenhead, Berkshire; New York: Open University Press.〕〔Van Buren, J. (Multisystemic therapy. ) ''Encyclopedia of Mental Disorders.'' retrieved 29 October 2009〕 Multicultural, intercultural, and integrative approaches are being developed.〔McGoldrick, M. (Ed.) (1998). (''Re-Visioning Family Therapy: Race, Culture, and Gender in Clinical Practice.'' ) Guilford Press: New York.〕〔Krause, I-B. (2002). (''Culture and System in Family Therapy.'' ) London; New York: Karnac.〕〔Ng, K.S. (2003). (''Global Perspectives in Family Therapy: Development, Practice, and Trends.'' ) New York: Brunner-Routledge.〕〔McGoldrick, M., Giordano, J. & Garcia-Preto, N. (2005). (''Ethnicity & Family Therapy'' ), 3rd Ed.: Guilford Press.〕〔Nichols, M.P. & Schwartz, R.C. (2006). Recent Developments in Family Therapy: Integrative Models; in (''Family therapy: concepts and methods.'' ) 7th ed. Boston: Pearson/Allyn & Bacon.〕 Many practitioners claim to be "eclectic," using techniques from several areas, depending upon their own inclinations and/or the needs of the client(s), and there is a growing movement toward a single “generic” family therapy that seeks to incorporate the best of the accumulated knowledge in the field and which can be adapted to many different contexts;〔Lebow, J. (2005). (Handbook of clinical family therapy. ) Hoboken, NJ: John Wiley and Sons.〕 however, there are still a significant number of therapists who adhere more or less strictly to a particular, or limited number of, approach(es).
Ideas and methods from family therapy have been influential in psychotherapy generally: a survey of over 2,500 US therapists in 2006 revealed that of the 10 most influential therapists of the previous quarter-century, three were prominent family therapists and that the marital and family systems model was the second most utilized model after cognitive behavioral therapy.

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