An Introduction to Marriage and Family Therapy

Joseph L. Wetchler, Lorna L. Hecker, Joseph L. Wetchler, Lorna L. Hecker

• Publisher: Routledge
• Year: 2014
• eBook ISBN: 9781317963394
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Now in its second edition, this text introduces readers to the rich history and practice of Marriage and Family Therapy, with 32 professionals from across the US presenting their knowledge in their areas of expertise. This blend of approaches and styles gives this text a unique voice and makes it a comprehensive resource for graduate students taking their first course in Marriage and Family Therapy.

The book is divided into three sections:

Part 1 focuses on the components on which 21st century family therapy is based and summarizes the most recent changes made to not only therapeutic interventions, but to the very concept of "family."

Part 2 presents an overview of the 7 major theoretical models of the field: structural, strategic, Milan, social constructionist, experiential, transgenerational, and cognitive-behavioral family therapy. Each chapter in this section • Focuses on the founder of the theory, its theoretical tenants, and its key techniques • Shows how the model focuses on diversity • Presents the research that supports the approach

Part 3 addresses specific treatment areas that are common to marriage and family therapists, such as sex therapy, pre-marital therapy, research, and ethics and legal issues.

As an introduction to the field of Marriage and Family Therapy, this volume stands above the rest. Not only will readers gain an understanding of the rich history of the field and its techniques, but they will also see a complete picture of the context in which families are embedded, such as gender, culture, spirituality, and sexual orientation. This knowledge is the key to understanding what differentiates Marriage and Family Therapy from individual psychotherapy. Glossaries, case studies, tables, figures, and appendices appear generously throughout the text to present this information and give students a thorough overview to prepare them for their professional lives.

PART IFoundations of Marriage and Family Therapy

1The History of Marriage and Family Therapy

Christi R. McGeorge, Thomas Stone Carlson and Joseph L. Wetchler

DOI: 10.4324/9781315867335-2

The whole is greater than the sum of its parts.

Gregory Bateson

Welcome to An Introduction to Marriage and Family Therapy. This book serves as an introduction to and overview of the fastest-growing arm of the mental health field: marriage and family therapy. Perhaps this would be a good time to present a preliminary definition. Marriage and family therapy is a model of mental health treatment that takes a family perspective on emotional problems and psychopathology It places individual pathology in a relational context and views treatment as encompassing the environment in which it is maintained—namely, the family. It is important to note that in more recent years, scholars have called for a more inclusive name for the field, “couple and family therapy,” in an effort to more accurately reflect the varying types of couple and family relationships that receive services from family therapists.

The marriage and family therapy movement was started by several charismatic leaders who became disenchanted with the traditional individual-oriented mental health models (Guerin, 1976; Kaslow, 1980). For many of these clinicians, the psychoanalytic approach that dominated the field did not fit the patients nor the problems they treated. Marriage counselors and family therapists began experimenting with their new ideas in isolated pockets around the United States. In fact, with some notable exceptions in England, the marriage and family therapy movement was initially an American phenomenon.

Although one might think that the mental health field would have embraced these new approaches to treating emotional problems, in fact, the opposite occurred. Marriage and family therapists found themselves shunned by the mental health establishment. Much of what they did was shared privately with trusted colleagues and students. Florence Kaslow (1980) reflects on the early family therapy movement:

From 1950 to 1954 much work in family therapy took place underground. The ideas of the leaders were considered heresy and no platform was readily available to them at major professional conferences. Their writings were not welcome in the standard journals.

(p. 93)

If anything, this initial rejection by the mental health field probably helped spark the revolutionary zeal of the original marriage and family therapists. John Elderkin Bell (1976), one of the founders of family therapy, beautifully summarizes his experience during this time:

I began to be confronted by experienced psychotherapists and theoreticians who disapproved of my practice and were uncomfortable with my concepts. I learned that these critics were not to be won over easily by simple endorsements of working with the whole family, and usually answered their arguments by saying I would take their comments into account, as I did; but I also learned I could not fit older theories to my new experiences. I realized that, fundamentally, I had to find the rationale for family therapy from my own experiences, in private reflections on the actions of which I was a part. As a result, more and more I found myself avoiding the ideas and language of individual therapy and traditional group therapy. I found, also, the formulations and terms mastered for my university teaching on personality and abnormal psychology had little pertinence to my new activities.

(p. 130)

Today, marriage and family therapy has gained acceptance by the mental health establishment and the laity in general. Family therapy is provided at most mental health centers and family service associations, and graduate degrees are available at universities across the United States and around the world. Marriage and family therapy was influenced by four major movements: early social work, the sexual reform movement, marriage counseling, and the family therapy movement. The following pages summarize their impact on the field.

Early Social Work

Although marriage and family therapy is a relatively new idea, working with families is not. The early social workers first pioneered interventions with marriages and families (Broderick & Schrader, 1991). The field of social work, a branch of the mental health field that focuses on the impact of societal issues on human problems, grew out of the charity movements in Great Britain and the United States in the late 19th century (Nichols & Schwartz, 1998). The initial focus of the movement was to minister to the needs of the underprivileged. The first social workers proposed that effective interventions must begin with the family. As early as 1890, Zilpha D. Smith wrote to the mental health establishment:

Most of you deal with poor persons or defective individuals, removed from family relationships. We deal with the family as a whole, usually working to keep it together, but sometimes helping to break it up into units and to place them in your care.

(p. 377)

Perhaps the greatest early champion of family intervention was Mary Richmond. In her influential book Social Diagnosis (1917), she wrote about the importance of treating the family as a whole unit if one hoped to alleviate the problems of the poor. She believed that meeting with the family at the beginning of treatment and specifically intervening in their process was the best way to achieve lasting results. She also foreshadowed the family therapy movement in her ability to see family systems as nested in larger societal systems (Nichols & Schwartz, 1998). This led to interventions in larger units, such as neighborhoods, and government policies to effect change for families. It also led to a greater appreciation of the role of culture in one's family life.

Unfortunately, while social workers were some of the most influential pioneers in family intervention, when they joined forces with psychiatry in the 1920s they returned to a focus on the individual (Broderick & Schrader, 1991). Although, with notable exceptions, they did not play a dominant role in the initial development of either marriage counseling or family therapy, they were influential members of both movements from the 1960s onward. Social workers who have made valuable contributions to marriage and family therapy include Insoo Kim Berg, Betty Carter, Lynn Hoffman, Monica McGoldrick, Braulio Montalvo, Peggy Papp, Virginia Satir, Steve de Shazer, Richard Stuart, Froma Walsh, and Michael White. Many of the contributions of these influential social workers will be discussed in later chapters.

The Sexual Reform Movement

Following World War I, several Europeans and Americans participated in a movement to establish human sexuality as a science and to provide sexual education to the general population (Broderick & Schrader, 1991). At the forefront of this movement were Havelock Ellis of Great Britain and Magnus Hirschfeld of Germany.

In the late 1800s and early 1900s, Havelock Ellis wrote extensively on human sexuality, including sexual orientation, and provided counseling to people with sexual problems. He is considered one of the first scholars to write about same-sex relationships as a normal expression of human sexuality and is also credited with early attempts to explore and define a transgender identity. Although his practice consisted primarily of listening and providing readings, he would sometimes initiate women into his own version of non-demand sexual pleasuring (Broderick & Schrader, 1991). He felt he could do this without being controversial, as he was impotent for most of his adult life (Ellis, 1939). It is interesting to note that he restricted his practice to individuals and did not meet with couples. Although his methods could be considered simplistic and ethically questionable, he probably was helpful to several individuals in that, considering the times, a good proportion of the problems suffered by his clientele may have been related to a lack of education and Victorian views of sexuality as much as anything else.

Magnus Hirschfeld founded the Institute of Sexual Science in Berlin in 1918 and, together with August Forel and Ellis, founded the World League for Sexual Reform. His institute was a destination for physicians from all over the world who wished to learn more about human sexuality. His definitive book, Geschlechtskunde (Sex Education) (1930), reported his findings based on 10,000 questionnaires completed by men and women (Broderick & Schrader, 1991). He also founded the German Marriage Consultation Bureau, to provide counseling to German families and couples (Hirschfeld, 1940). Sadly, when Hitler came to power in Germany, he closed Hirschfeld's centers and turned them into institutions meant to evaluate couples for fitness to marry and reproduce.

Four American pioneers were instrumental in continuing the work of Ellis and Hirschfeld: Robert Dickinson, Alfred Kinsey, William Masters, and Virginia Johnson.

Robert Dickinson, a gynecologist, was active as a scientist and counselor in the area of human sexuality. He systematically sketched the pelvic area of each of his patients, both women and men, and he included several of these sketches in his landmark book, Human Sex Anatomy (1933). He also published his findings from thousands of interviews with his patients about their sexual histories and current practices (Dickinson & Beam, 1931, 1934). Further, he was one of the founders of the marriage counseling movement.

Alfred Kinsey, a professor at Indiana University, is typically the first person who comes to mind when we think about the history of human sexuality in the United States. He and his colleagues authored two of the most important and controversial books of the mid-20th century: Sexual Behavior in the Human Male (Kinsey, Pomeroy, & Martin, 1948) and its companion, Sexual Behavior in the Human Female (Kinsey, Pomeroy, Martin, & Gebhard, 1953). These publications created a whirlwind of both praise and criticism for their frank presentations of the sexual practices of a wide range of Americans.

William Masters and Virginia Johnson worked out of the Washington University Medical School in Saint Louis, Missouri. They conducted a vast body of scientific research in both the areas of sexual problems and treatment. Although written for professionals, their book Human Sexual Response (1966) was a popular success, selling more than 300,000 copies (Broderick & Schrader, 1991). However, it was their second book, Human Sexual Inadequacy (1970), that promoted and popularized the field of sex therapy. In 1978 the Masters and Johnson Institute (formerly the Reproductive Biology Research Foundation) was founded in Saint Louis, and here the pair continued to conduct research, provide professional trainings, and treat couples until the center closed in 1994.

Marriage Counse...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Contents
• About the Editors
• List of Contributors
• Acknowledgements
• Introduction
• Part I Foundations of Marriage and Family Therapy
• Part II Theories in Marriage and Family Therapy
• Part III Special Issues and Topics in Marriage and Family Therapy
• Index