Frameworks For Practice in The Systemic Field: Part 2

Articles
Frameworks for Practice

in the Systemic Field:
Part 2 — Contemporary
Frameworks in Family Therapy
Carmel Flaskas
School of Social Sciences and International Studies, University of New South Wales, Australia
This is the second of two articles to map the landscape of practice theory in
systemic family therapy. The first article gave a particular chronology of the devel-
opment of family therapy practice theory, beginning with the frameworks that
emerged in the 1960s-1970s and then tracing the transitional decade of the 1980s.
The convergences of three sets of influences — ecosystemic epistemology, the
feminist challenge and postmodernist ideas — led to the changed landscape of
post-1990 practice theory. This second article picks up at this point, mapping four
contemporary influential approaches in Australian family therapy — the Milan-
systemic, narrative and solution-focused frameworks, and the dialogical perspective.
Social constructionist and narrative ideas together constitute the dominant
common theory influence in the post-1990 practice frameworks, although inter-
sected and used in different ways in the different frameworks. Throughout the
history of the development of practice theory, context and relationship remain the
enduring parameters of the systemic family therapy field.
Keywords: family therapy knowledge, practice theory, practice frameworks, models
Understanding the array of current practice frameworks on offer in systemic family

therapy, placing them in relation to each other, and getting a sense of the history
and theory landscape in which the frameworks are located — all this can be a
daunting challenge when first learning family therapy. How one invites this learning
as a teacher is also a challenge.
This is the second of two articles devoted to an analysis of practice theory in the
systemic field, written primarily for those learning and teaching family therapy. The
Address for correspondence: Carmel Flaskas, School of Social Sciences and International Studies,
University of New South Wales, Sydney NSW 2052. E-mail: [email protected]
THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY 87

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Carmel Flaskas
articles together form one project, although they can also stand alone. The first
article (Flaskas, 2010) explored continuities and transitions in family therapy
practice theory, giving a particular chronology through to 1990. Contemporary
practice theory becomes the subject of this second article, which brings into view
four main approaches — the Milan-systemic, narrative and solution-focused frame-
works, and the still-emerging dialogical approach. There will be a three-part struc-
ture in this article. The beginning part summarises some groundwork developed in
the first article. The second part outlines the landscape of social constructionist and
narrative theory, which is the dominant theory landscape of the mainstream contem-
porary approaches, although used in different ways in the different approaches. The
third part plots the theory shape of the Milan, dialogical, narrative and solution-
focused approaches. The concluding discussion gestures to influential integrative
frameworks and returns full circle to the question of how we relate to practice theory
frameworks, which was the original setting-off point in my first article.
Orienting to Practice Theory and Earlier Family Therapy Knowledge

The groundwork of the first article will be retraced in five relatively short
paragraphs, addressing changing orientations to practice theory as well as a geneal-
ogy of the continuities and transitions of family therapy practice theory through to
the early 1990s. This summary will be redundant for those who have read the first
article, which of course provides a lot more detail.
Any discussion about practice frameworks is embedded in a set of assumptions
about how the idea of knowledge and practice theory is understood. These assump-
tions in turn influence how we relate to practice theory. Earlier family therapy
knowledge emerged within the wider social context of a modernist theory of knowl-
edge and so, in this first period, practice theory was constructed as models. The aim
of a good model is to offer a coherent view of the nature of practice itself and to
prescribe a well-developed and complete set of practices and techniques for under-
taking the work of therapy. Models are related to as potentially whole and complete
within themselves, which generates a momentum to mark out differences,
sometimes at the expense of commonalities.
In 2011, the language of ‘models’ is not used so often — we are more likely to
talk about frameworks, or approaches, or even just (e.g., Milan) ideas or (e.g., a
narrative) way of working. This languaging both reflects and constructs another way
of relating to practice theory, one that tends to be more pragmatic and pluralist.
Our practice theory is now set within the sensibilities of postmodernist understand-
ings of knowledge and, for all the messiness postmodernism may bring, it opens the
door for approaching knowledge as partial, conditional and diverse. The common
factors research (Duncan, Miller, Wampold, & Hubble, 2009; Hubble, Duncan, &
Miller, 1999; Sprenkle & Blow, 2004; Sprenkle, Davis, & Lebow, 2009) has also
exerted some clout, reminding us again and again of the important generic ingredi-
ents of positive therapy outcomes that lie beyond the specifics of any framework,
even though how different frameworks mobilise and express those important ingre-
dients remains important.
88 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY
Frameworks for Systemic Practice: Part 2
‘Frameworks’ (my chosen description for specific practice theories) remain

important for other reasons as well. First, it is easier to learn and to teach through the
discipline of frameworks, which provide building blocks for practice. Our own
creativity can be inspired by the creativity of different ideas and techniques within
different frameworks. From this angle, learning becomes a process of developing a
repertoire of practice theory and techniques that over time becomes finely tuned to
specific contexts of practice and to the therapeutic capacities of one’s own use of self.
The second reason is that it is easier to research via the boundaries of frameworks, as
the complexity of the most difficult and sophisticated psychotherapy practice is still
hard to capture within the current limits of empirical research methods.
The genealogy of practice theory within systemic family therapy begins with the
models that emerged in the 1960s and 1970s. The dominant structural and strate-
gic models, through to the secondary strand of transgenerational models, borrowed
ideas from early systems theory in casting their particular conceptualisations of
context and relationship within family relationships. These models primarily
targeted behaviour, although how behaviour was framed and understood in terms of
family relationships differed. The 1980s proved an interesting if confusing decade
that significantly reshaped the landscape of family therapy practice theory. The
strong influences of the (later) ecosystemic theory, feminism and postmodernism all
jostled together. For all the differences in these three sets of influences, there were
also significant convergences, and I argued that it was the convergences that created
the conditions for such a definitive theory reshaping across the different framework
‘fronts’ of our practice knowledge.
Through the transitional decade of the 1980s, Milan therapy became popularised
in the English-speaking world, brief therapy was developed within the strategic tradi-
tion, the Dulwich Centre was formed in Adelaide, and the ‘collaborative language
systems therapy’ of Harlene Anderson and Harry Goolishian paralleled the first
English-speaking publications by Tom Andersen on the reflecting team. By the early
1990s, Milan therapy was already in danger of being called ‘post-Milan’, the theory
and practices of brief therapy had led into solution-focused therapy, ‘narrative
therapy’ (named as such) had begun to influence family therapy internationally, and
the dialogical perspective was emerging more clearly as an important fourth frame of
reference for practice theory.
The re-telling of ideas from the first article stops here and the exploration of the
contemporary frameworks starts. In the genealogy I have been tracing, the approaches
to context and relationship are recast in the post-1990 practice theory. So rather than
beginning with the differences the main frameworks offer, I will begin instead with
the common shape they all share in the recasting of context and relationship.
The Shape of Contemporary Practice Theory in Family Therapy

To a greater or lesser extent, all the main contemporary frameworks rest within
postmodernist sensibilities, all emphasise language and meaning, and all are
informed in one way or another by social constructionist and/or narrative ideas.
This is the shared theory territory, within which other shared ethical and practice
commitments are sometimes situated.

Carmel Flaskas
The embracing of postmodernism in family therapy from the late 1980s led to a
period of oppositionality to the earlier (modernist) forms of systemic practice
theory (Flaskas, 2002). This oppositionality should, by now, be well and truly
obsolete. The transition to current forms of practice theory occurred approximately
two decades ago, indeed just about as long ago as the first (1960s–1970s) period of
our practice theory, so it is far too far down the track to be heralding current frame-
works as ‘new’ and better than ‘old’. The theory and practices of the Milan,
solution-focused and narrative frameworks have all been consolidated, although the
dialogical approach still retains a ‘newness’ (at least in the English-speaking world)
and has considerable capacity for further elaboration at a practice level.
The early forms of family therapy practice theory focused on behaviour, using
the ideas from systems theory that had been generated in the 1940s and 1950s, and
in particular the ideas of systems and subsystems boundaries, positive and negative
feedback, homeostasis, plus Gregory Bateson’s (later) theory of circular causality
(Flaskas, 2007, 2010). Current frameworks emphasise meaning and language. This
emphasis is seen in the explicit and implicit explanatory formulations of individual
experience and relationships. It is also seen in approaches to the process of therapeu-
tic change, and through them to the aim and form of specific practice techniques.
In the same way that the early forms of family therapy were related to the broader
context of contemporaneous knowledge, the shift to meaning and language is
located in what is sometimes called ‘the linguistic turn’ within a postmodernist
environment in the humanities and social sciences.
Postmodernism is not a social theory. It is a multilayered social and intellectual
phenomenon, emerging in Western culture in the latter part of the 20th century,
itself a response to economic, social and political changes, and by now shaping (and
continually being reshaped within) the humanities and social sciences (Flaskas,
2002). Postmodernism is in part a frame for how we think about our relationship to
the world, what it is we are trying to ‘know’, and the extent and limits on how and
what we might come to ‘know’. In this sense, postmodernism is meta to any specific
social theory and it is an epistemology as much as it is a meta-theory frame.
Languaging, meaning and relationship are by no means solely the province of a
postmodernist attention, but many social theories generated within postmodernist
times share this central focus. And there are potentially infinite ways in which social
theories located within a postmodernist frame might address understandings of
language, meaning and relationship.
While there have been a number of specific intersections made with a range of
postmodernist theories within contemporary family therapy, social constructionist
and narrative ideas have been the dominant influences in family therapy theory. In
different ways and to different degrees, versions of either or both these theories
inform and shape all the main frameworks post 1990.
Before considering exactly where and how social constructionist and /or narra-
tive ideas shape the contemporary frameworks, I would like to address shared
ethical and practice commitments, which are sometimes situated within the
commitment to these postmodernist ideas and sometimes not. First, all current
practice theory is embedded to a greater or lesser extent in a commitment to collab-
orative practice, and to an orientation to cultural and other diversities in the ‘doing’
of family and intimate relationships. I would also argue that current practices across
the different frameworks orient fairly reliably to individual and family strengths and
resilience, although the extent to which this is explicitly part of the language of the
practice framework differs. Finally, delineations of context extend beyond the
boundaries of the family to social and cultural contexts, although how widely this
net is thrown, and how allied it might be to a broader social justice or other
progressive politics, varies from framework to framework.
In short, in terms of the commonalities, contemporary family therapy practice
theory is informed by postmodernist sensibilities; it centres on language and
meaning, it is shaped by social constructionist and/or narrative ideas, and both
context and relationship have been recast in comparison to earlier theory. This then
is the shared theory landscape.
Four Contemporary Frameworks

The task now is to consider each of the four contemporary approaches one by one,
noting their specific theory shapes and genealogies. The choice of the Milan, dialog-
ical, narrative and solution-focused approaches reflects the Australian context. The
Milan, narrative and solution-focused frameworks are influential across a range of
health and welfare services, and come with well-developed practices. The dialogical
approach offers a perspective on theory and practice and embraces a range of
practices. While not mainstream in Australian practice, dialogical ideas have been
consistently influential across the last two decades, intersecting particularly with the
Milan framework, while at the same time offering significant differences in theory
and practice.
It is worth noting at this point that a North American or British choice of
frameworks would be different, and these nuances of context make for confusing
reading in the initial study of family therapy theory. While Milan therapy was
popularised in North America in the 1980s, its later developments have not been so
influential there: commentaries written in North America have tended to continue
to address the 1980s form of Milan therapy (see, e.g., Goldenberg & Goldenberg,
2004), and there has been a notable absence of the inclusion of Milan therapy in
some of the most recent US texts (see, e.g., Doherty & McDaniel, 2010; Nichols,
2008). US commentaries also tend to include narrative therapy and the dialogical
approach under a much broader umbrella of constructionist and constructivist
therapies (see, e.g., Doherty & McDaniel, 2010), while solution-focused therapy
(largely a US ‘product’) continues to be very influential in North America. By
contrast, in the United Kingdom, solution-focused therapy does not have a strong
influence, while Milan therapy has been heavily influential, to the point that ‘family
therapy’ in the United Kingdom is increasingly being identified as ‘systemic
psychotherapy’, built solidly on Milan-systemic ideas with some integrations of
dialogical and narrative ideas.
Milan Therapy
The story of the beginning of Milan therapy has been told again and again (see,
e.g., Campbell, Draper, & Crutchley, 1991; Goldenberg & Goldenberg, 2004;
MacKinnon & James, 1987). Four psychoanalytically trained psychiatrists in Milan

Carmel Flaskas
in the early 1970s committed to the development of family therapy practices based
on a rigorous use of Bateson’s ideas and generating these practices in the context of
work with families with one member (usually a young person) experiencing
psychosis or anorexia. Their book, Paradox and Counter-Paradox, was published in
English in the United States in 1978 (Selvini Palazzoli, Boscolo, Cecchin & Prata,
1978), and the foundational Family Process article ‘Hypothesising, circularity and
neutrality’ in 1980 (Selvini Palazzoli, Boscolo, Cecchin, & Prata, 1980). In this first
period, the Milan group had strong links with the Palo Alto Mental Research
Institute (MRI). The MRI was one of the key creative centres of strategic therapy in
the United States, and Bateson had worked with MRI associates including Jay
Haley in a long-term research project on communication. This very first stage of
Milan therapy saw the focus on communication, family games, the use of the team,
the 5-part session, the importance of the referring context, rituals as interventions,
and the enduring practice and theory principles of hypothesising, circularity and
neutrality.
In 1980, there was a parting of company. Mara Selvini Pallazoli and Guiliana
Prata continued the initial project, working specifically with the same client popula-
tion, focusing on communication and the family game, and hence developing the
more strategic practices. Luigi Boscolo and Gianfranco Cecchin moved into train-
ing and consultation and broader practice contexts. They shifted away from the
earlier strategic family games focus, while extending and reshaping the principles of
hypothesising, neutrality and circularity. This practice shift was intertwined with
the influence of Bateson’s later ecosystemic ideas and a commitment to second-
order cybernetic ideas, and one sees the effect of these ideas in two ways. First,
ecosystemic ideas led to an important reshaping of the principle of neutrality,
throwing the emphasis on neutrality-as-curiosity and the therapist’s position of
curiosity about the meanings, and the effects of the meanings, within the family
and the therapeutic system (Cecchin, 1987). Secondly, second-order cybernetic
ideas led to the boundary of the significant therapeutic system being redrawn in
both theory and practice, including now the therapist, the context of the therapy
and the therapist-family relationship, not just the family system itself.
It was this second Boscolo-Cecchin phase that came to be popularised as Milan
therapy in the English-speaking family therapy world by a number of writers from
Canada, the United States and the United Kingdom, who in turn themselves
extended and elaborated the theory and practices (Boscolo, Cecchin, Hoffman, &
Penn, 1987; Campbell & Draper, 1985; Campbell, Draper, & Crutchley, 1991;
Jones, 1993; Tomm, 1984a, 1984b). Karl Tomm’s work should be singled out here
for his development of circularity, reflexivity and the use of questions within the
Milan framework (Tomm, 1987a, 1987b, 1988).
David Campbell (2003), in an excellent retrospective, names the importance of
feminist ideas in the late 1980s. This critique challenged the limits of the Milan
framework even while its influence was still gathering momentum, simultaneously
modifying it in the process (see, e.g., the critiques by MacKinnon & Miller, 1987;
Luepnitz, 1988). Attention was drawn to abuse and power within families, as well
as the effects of the therapist’s beliefs and positions in addressing or ignoring these
issues (Campbell, 2003, p. 18). In this way, ‘context’ came to be extended beyond
the therapeutic system and the immediate relational context of the therapy, while
political and ethical commitments demanded a more complex negotiation of the
theory and practices of neutrality/curiosity. I would add that the demystified and
collaborative therapeutic style embedded in feminist therapy practices also
challenged and ameliorated the very hierarchical positioning of the therapist in
earlier Milan therapy.
The shift from a focus on behaviour to meaning in Milan therapy came about in
the wake of the application of Bateson’s earlier systemic ideas and then the later
ecosystemic ideas — it was not fuelled by postmodernism. However, in the same
way that the simultaneous timing of the feminist critique in the 1980s mediated
aspects of the Milan development, so too did the influence of postmodernist and
social constructionist ideas. In the United Kingdom, the first intersection with
social constructionist theory was via the work of American communication theorists
W. Barnett Pearce and Vernon Cronen, and their Coordinated Management of
Meaning model still holds some sway there (see the discussion in Campbell, 2003).
The more widespread influence was Kenneth Gergen’s social constructionist theory,
which came via the work of Anderson and Goolishian (Anderson & Goolishian,
1988; Anderson & Goolishian, 1992). In this way, the early stages of the dialogical
approach brought a different set of postmodernist and constructionist ideas to bear
on the Milan framework. As both Jones (1993) and Campbell (2003) note, the
emphasis on language in Milan therapy comes through this route.
In tracing the genealogy of Milan practice theory, one sees the initial heritage of
strategic therapy combined with a rigorous allegiance to Bateson’s earlier ideas, as
well as the later ecosystemic and second-order ideas. The Milan framework was
chronologically the first of the contemporary family therapy frameworks to shift the
focus from behaviour to meaning, and the first to broaden ‘context’ beyond the
boundaries of the family’s dynamics to include explicitly the referring system, the
therapist and the immediate therapy context. These moves predated the feminist,
postmodernist and social constructionist influences, and in many ways Milan
therapy stands in its early 1980s form as the transitional framework from the earlier
to the contemporary family therapy frameworks. The simultaneous influences of
feminist and social constructionist ideas in the late 1980s demanded attention to
broader contexts of the family’s experience and the location of the therapy itself,
and also to language as the medium of meaning. Thus the three influences of the
transitional decade of the 1980s — ecosystemic, feminist and postmodernist ideas
— all shaped the contemporary Milan framework.
Yet, of these three sets of ideas, ecosystemic theory exerted the foundational
influence and, in this way, the Milan framework remains the most ‘systemic’ of all
the contemporary approaches. This makes sense of the UK tendency to speak of the
‘Milan-systemic’ (rather than simply the ‘Milan’) framework and then, in the past
decade, to drop the ‘Milan’ part of it, and simply use ‘systemic psychotherapy’.
Indeed, much of the contemporary UK writing about ‘systemic psychotherapy’ is
set within the strong tradition of Milan practice theory,1 while the work of (Italian)
Paolo Bertrando and colleagues (see, e.g., Bertrando, 2002, 2007; Bertrando &
Arcelloni, 2006) provides another reading source showing current developments of
the Milan framework.

Carmel Flaskas
The Dialogical Perspective

Although the dialogical perspective is the least visible of the four practice
approaches in the landscape of Australian family therapy, I will nonetheless place it
second on my list, because it links more closely to the Milan-systemic framework
than to either the narrative or solution-focused approaches. Indeed, having just
named Bertrando’s work in terms of current Milan developments, it can be noted
that his recent book The Dialogical Therapist (Bertrando, 2007) blends both Milan-
systemic and dialogical ideas. So let me draw the main points of reference for the
dialogical perspective, including some historical and current links.
The dialogical metaphor in family therapy can be traced back to two parallel
strands in the second half of the 1980s, happening in quite different parts of the
world. From Texas in the United States, Harlene Anderson and Harry Goolishian
began outlining a series of ideas about the languaged nature of social reality and
‘problems’ in human systems, and the implications for therapy practice. Their first
important Family Process publication in 1988 and other joint publications set the
groundwork (Anderson & Goolishian, 1988, and see also, e.g., Anderson &
Goolishian, 1992). The theory premises, that human systems are linguistic systems
and that problems are constructed then ‘dis-solved’ in language, generated their
practice orientation to therapy as a linguistic event. This orientation led in turn to
their idea of therapy as a collaborative conversation, in which the therapist needs to
listen from a non-expert ‘not-knowing’ position.
Following the death of Harry Goolishian in 1991, Anderson continued to
develop these ideas, moving Gergen’s theory of social constructionism (Gergen,
1991, 1994) more centre stage and, via Gergen’s theory, also moving the processes
of dialogue and narrative centre stage in her elaboration of ‘collaborative language
systems therapy’ (see Anderson, 1997). While the name of this approach never
really became commonplace, aspects of its theory and practice were quickly
popularised within the systemic field. The ideas that spread to other systemic thera-
pies, incorporated by many alongside the Milan-systemic framework, included the
understanding of therapy as a collaborative event in language (which fitted the
focus on meaning within Milan), and the idea that the therapist should adopt a
not-knowing position (which sat very easily alongside Milan practices of curiosity).
The reinstatement of the importance of listening and witnessing in the collaborative
construction of new stories also provided a balance to the hierarchical and at times
quite ‘high-handed’ style of Milan opinions in the 1980s.
Meanwhile, a long way from Texas, in Tromsø in the north of Norway, Tom
Andersen and colleagues were simultaneously developing innovative reflecting
practices, including the reflecting team. Tom Andersen’s paper ‘The reflecting team:
Dialogue and meta-dialogue in clinical work’ was published in Family Process in
1987 (Andersen, 1987), followed by an edited collection on the reflecting team in
1991 (Andersen, 1991), and then a number of other publications (see, e.g.,
Andersen, 1992, 1995, 1996). These ideas were sparked in the midst of practice,
generated by an ethics and politics about practice rather than being theory led (see
Andersen in conversation with Jensen, 2007). Indeed, there is comparatively little
‘outside’ theory discussion in Tom Andersen’s work, no foundational commitments
to social constructionism, and he did not especially think of himself as postmod-
ernist (personal communication, 2003). Instead, he was guided by an unswerving

ethic of creating respectful, just and helpful therapeutic practices, entwined with
particular ideas about the importance of language and its expression, which very
much included the language of the body (see especially the discussion in Andersen,
1995).
Thus, Tom Andersen’s version of ‘dialogue’ moved well beyond dialogue-in-
(worded)-language. His emphasis on the language of the body led to emotionally
attuned practices that Lynn Hoffman (2007) later calls ‘practising “withness”’, and
which fall under the umbrella of the current ‘being-with’ dialogical practices.
Andersen also generated ideas about relational and bodily knowing (in contrast to
the commitment to not-knowing), and the importance of the therapist’s use of self
and her/his own inner conversation, including curiosity and inner dialogue about
her/his own bodily reactions.
The current contributions to the dialogical approach by Finnish therapist Jaako
Seikkula and colleagues, and Belgian therapist Peter Rober, follow more the path of
Tom Andersen, overlapping in time as Andersen continued his work through to his
death in 2007. Seikkula (like Andersen, a psychiatrist, working in adult mental
health) has developed the open dialogue approach to work with psychotic crises,
including convening social network meetings and developing finely tuned practices
for allowing the space for dialogue, and for many voices to be heard in the midst of
the intensity of crisis (see Seikkula, 2002, 2008; Seikkula, Arnkil & Eriksson, 2003;
Seikkula & Trimble, 2003; Seikkula & Arnkil, 2006). Rober, working from broader
child and family and adult relational contexts, has given the most thorough
mapping of the contemporary theory of the dialogical approach and by doing this
has extended its theory field.
Rober identifies the resonance of his ideas with Harlene Anderson’s collabora-
tive language systems therapy, while also noting significant points of departure
(Rober, 2005b). Perhaps most importantly, he argues that the idea of ‘not-knowing’
within the earlier theory is oriented more toward the receptive aspect of the thera-
pist’s listening (i.e., the not-knowing position from which we hear the client’s
experience), while he emphasises the importance of thinking more about the reflec-
tive aspect of the therapist’s listening (i.e., the position from which we try to under-
stand what it is that we are hearing; Rober, 2005b). In particular, he is interested in
the engagement and reciprocity of the therapist’s meanings with the clients’
meanings in the collaborative dialogue of therapy. This change in emphasis is about
how language is located — rather than situating human relationships within
language (the earlier Anderson/Goolishian premise), language is situated within
human relationships. This counterbalancing of language within ‘the dialogue of
living persons’ potentially embraces greater complexities of worded and unworded
human relating.
Rober is also clear that the dialogical project is about an approach to thinking
about therapy, rather than the construction of any unified model of practice. Like
Seikkula (see 1993), he draws especially on the heritage of selected ideas of the
Russian theorist Mikhail Bakhtin, whose theory from the earlier part of the 20th
century on dialogue informs the current work of social constructionist John Shotter.
Shotter’s ideas have become more familiar within the systemic field, largely through

Carmel Flaskas
his direct involvement in the development of the theory of dialogical therapy.

Shotter’s version of social constructionism allows for a dynamic and reciprocal
relationship in our experience of social realities (see Shotter, 1993, p. 34). He writes
of ‘knowing of a third kind’, beyond knowing-that or knowing-how to, to ‘a practi-
cal knowledge: knowing how to go on’ (Rober 2005a, p. 388; see also Shotter,
2010, p. 28). Consistent again with the emphases of Tom Andersen’s ideas, there is
an elaboration of the fullness of Bakhtin’s understanding of relating: ‘In this
dialogue, a person participates wholly and throughout his whole life; with his eyes,
lips, hands soul, spirit, with his whole body and deeds…’ (Bakhtin, as cited in
Rober, 2005a, p. 387). Rober is interested in the possibility of space opening up in
the moment-by-moment dialogical meeting of human beings, including using these
ideas to inform how we think about our own involvement and use of self as thera-
pists in therapeutic processes and the therapeutic relationship (Rober, 2002,
2005b).
From even the brief overview I have just given, one can see quite different shapes
in dialogical ideas across the past 25 years, and in this sense it is a still-emerging
approach. In terms of its relationship to the influences of the 1980s, the dialogical
approach strongly reflects the shift to postmodernism, with the influence of
feminism and the later ecosystemic ideas being less evident. In terms of postmod-
ernism, the emphasis on Gergen’s social constructionist ideas of dialogue and narra-
tive in the (earlier North American) collaborative language systems therapy has
moved to the much fuller use of Shotter’s social constructionist ideas in the current
(European) dialogical approach. The genealogy of systems thinking is strongly in
the background, and Judith Brown (2010) has recently traced the Milan-systemic
principles of hypothesising, circularity and neutrality in dialogical practices,
especially noting the strength of circularity in the contemporary European ideas.
Alongside the earlier crossing of dialogical ideas into Milan theory and practice,
the current crossing shows very clearly in Paolo Bertrando’s recent integration, and
in the work of the UK therapist, Jim Wilson, whose current dialogical thinking is
grafted onto a strong systemic base (see Wilson, 2007). The reflective team and
other reflective processes of the dialogical approach continue to enrich Milan
therapy, and also resonate with the witnessing practices of narrative therapy.
Narrative Therapy
Milan and narrative are the strongest frameworks in Australian family therapy,
although they have different theory trajectories and quite different practices. While
at a practice level many of us would use ideas and in-the-room practices from both
frameworks (sometimes with equal familiarity and ease), the theory of narrative and
Milan would be hard to integrate, and there have been no signs in Australia or
elsewhere of any attempt to do this.
Like Milan, the story of narrative therapy has also been told again and again.2 It
happens slightly later in a different part of the world, with different politics, and
initially in different practice contexts. It is impossible to write a first paragraph
about narrative therapy without naming the centrality of Michael White’s creativity
although, like Milan therapy, narrative therapy has been the product of collective
ongoing development. In 1979, White became the first editor of the Australian
Journal of Family Therapy (later to become The Australian and New Zealand Journal
of Family Therapy). In 1983, he and Cheryl White established the Dulwich Centre
in Adelaide, home to the development of the narrative approach to therapy and
community work. The first two main international publications were White’s
‘sneaky poo’ article, which appeared in the journal Family Systems Medicine in 1984,
and then his article on negative explanation, restraint and double description,
published in Family Process in 1986. During this first period, externalisation was
established as the main practice frame, within a family-inclusive, non-blaming and
strengths-based orientation. The ‘sneaky poo’ protocol for encopresis showed the
influence of strategic therapy within the genealogy of what was to become narrative
therapy, while Bateson’s ideas were foundational in the practices built around
negative explanation, restraint and double description.
Since Michael White’s untimely death in 2008, a number of tributes have
addressed the history of narrative ideas (see, e.g., Denborough, 2009; Epston, 2009;
C. White, 2009). The richness and closeness of the collaboration between David
Epston and Michael White (especially during the 1980s) has been well documented
(C. White, 2009), and it was this partnership that produced the first narrative text,
Narrative Means to Therapeutic Ends (White & Epston, 1990). Published initially
just one year earlier by Dulwich Centre Publications under the title Literary Means
to Therapeutic Ends (White & Epston, 1989), the book marks the transition point
to what then became known as ‘narrative therapy’. This transition was also embed-
ded in the creative collaboration of Michael White and Cheryl White. David
Denborough quotes Michael’s clear acknowledgement of Cheryl’s encouragement
to centre the metaphor of narrative and that her interest in narrative came through
feminist theory (Denborough, 2009). Thus ‘narrative’ came to narrative therapy
through feminist theory and not via social constructionism.
In Narrative Means to Therapeutic Ends, White and Epston (1990) expand on
the use of externalisation, relative influence questioning and unique outcomes.
They also give a detailed discussion of ways of using letters, other documents and
rites-of-passage in the storying of change, and so the first layer of the narrative
witnessing practices is set out. The framing of letters-as-narrative bridged the liter-
ary and narrative metaphors, and the work of the cultural anthropologists Clifford
Geertz and Barbara Myerhoff is referenced in this book. Geertz’s text analogy was
used very immediately, and his work was also the source of White’s later practice
orientation to ‘thickening’ the new story. Myerhoff’s work inspired the theory frame
for the development of the practices of re-authoring, re-membering and definitional
ceremonies.
An extended discussion is also given of selected ideas of the poststructuralist
French philosopher, Michel Foucault, and the book lays out some of Foucault’s
thinking about the relationship of power and knowledge, about the practices of
power, and about dominant and marginalised (/subjugated) discourses (see Flaskas,
2002, p. 44). It should be noted that Foucault’s theory offers a very different
account of social context and relationship to that offered by social constructionism.
White used Foucault’s ideas to elaborate a position on power and the practices of
power, to mark the distinction of dominant and marginalised discourses in the
deconstruction of the old (problem-saturated) story and search for the new

Carmel Flaskas
(preferred) story, and in the consistent attention to the social and relational context
of individuals’ stories and identities. In this way, his particular use of Foucault’s
ideas became woven into the fabric of narrative practices, with the theory being
explicitly addressed primarily in the decade through to the late 1990s (see, e.g.,
White 1991, 1997).
Following the publication of Narrative Means to Therapeutic Ends, the influence
of narrative ideas spread first to North America, and then to other English-speak-
ing, South American and European environments. From the mid-1990s, a number
of North Americans developed narrative ideas in their own contexts. Here I would
include the work of Canadian Stephen Madigan (e.g., 1993, 2010) and, from the
United States, Jill Freedman and Gene Combs (e.g., 1996), and Jeffrey Zimmerman
and Victoria Dickerson (e.g., 1994). Meanwhile, Epston has continued to write
extensively about narrative ideas, by himself and with other colleagues (see, e.g.,
Epston, 2008; Freeman, Epston, & Lebovits, 1997; Maisel, Epston, & Borden,
2004; Monk, Winslade, & Epston, 1997), and the faculty at the Dulwich Centre in
Adelaide are continuously developing and expanding and writing about narrative
practices.
The last decade has seen the consolidation of narrative therapy practices and the
continuing development of the narrative approach to community work. Witnessing
and taking-it-back practices continue to be elaborated, and White’s last major
publication, Maps of Narrative Practice, was published in 2007. Here the metaphor
of maps of practice is used to lay out the main points of the narrative approach,
focusing explicitly on ways of ‘scaffolding’ therapeutic conversations. There is no
abandoning of previous ideas in this last book, but instead a cohering integration of
the many layers in the development of narrative ideas.
In the same way that it is hard to begin a discussion of narrative therapy without
immediately locating Michael White, it is also impossible to end it without clearly
naming the politics of liberation and social justice that is entwined with the frame-
work and its practices. Feminist and radical therapies of the 1970s could be consid-
ered just as much a part of the genealogy of narrative therapy as the heritage of the
systemic therapies. Mark Furlong (2008), in an ‘outside’/social work commentary
of White’s contribution, also notes the resonances of White’s politics with
mainstream social work social justice politics and with the more radical politics of
some social workers and sections of the (Australian) social work profession. Cheryl
White (2009) notes that she and Michael were social workers, and I follow just
behind their generation of Australian social workers myself. In the period of their
social work degrees, they would have studied feminist, Marxist and radical critiques
within social work education, and they were also part of the student generation that
had the opportunity to be politicised and involved in broader liberationist and left-
wing political movements.
The critique of the practices of psychotherapy itself, of the institutional practices
that can so profoundly affect people’s lives, and of the oppressive power of social
practices and discourse around gender and race identity — these are all part of the
canvas of narrative therapy. That narrative is seen as a cohering metaphor for
practices in therapy and community work is one part of this politics (and also
strongly echoes mainstream social work practice commitments). The strong and
explicit political commitments of narrative can lend a social movement-type form

to this framework of therapy that has a different flavour to the politics and ethical
commitments of other frameworks.
Narrative therapy emerged from, and continues to be part of, the tradition of
family therapy, while also being broader than a family therapy/psychotherapy
framework. White’s ideas through to the late 1980s are built directly on ideas from
the earlier strategic therapies and informed and inspired by Bateson’s theory. The
influences within family therapy practice theory of the later ecosystemic theory,
feminism and postmodernism shaped and reshaped different frameworks in family
therapy different ways. Narrative therapy emerged in 1990 showing very little
engagement with the ecosystemic theory, but of all the frameworks it showed the
strongest engagement with feminism and postmodernism. The ideas of the cultural
anthropologists Geertz and Myerhoff provided early inspiration for emerging narra-
tive practices, alongside selected ideas from the poststructuralist philosopher
Foucault. The metaphor of narrative was crafted from the theories and ideas drawn
from feminist writing and selected ideas from cultural anthropology, not from social
constructionism, while Foucault’s ideas provided an alternate springboard for the
orientations to power which inform narrative practices.
Solution-Focused Therapy
Despite the differences in the practice theories of the Milan, dialogical and narrative
approaches, they are in many ways more similar to each other than they are to
solution-focused therapy. These first three approaches are all oriented squarely to
meaning, they all range across the time domains of past, present and future
meaning in their therapeutic conversations, and they have all departed markedly
from the early family therapy models. Also, while there has been a significant US
family therapy presence at points in all the Milan, dialogical and narrative
approaches, nonetheless the creative momentum of each of these three approaches
has largely come from other parts of the family therapy world (Italy and the United
Kingdom, Northern Europe, and Australia and New Zealand).
Solution-focused therapy (sometimes also called ‘solution-focused brief therapy’)
is influential in Australian family therapy as well as wider counselling contexts. It
has had the most seamless evolution from early systemic family therapy, emerging
from the centre of strategic therapy while developing beyond it. Solution-focused
therapy successfully balances an even-handed attention to behaviour and meaning
and so offers a hybrid modernist/postmodernist therapy approach. Inspired and
developed in the United States, it has been cast explicitly as a strengths-based
approach to therapy (see Saleeby, 1996), and it has a pragmatism that is in line with
its central remit to develop accessible, helpful and effective therapy practices.
Brian Cade (2001) tells the early part of the story of the development of the
Brief Therapy Centre in 1966 within the Palo Alto Mental Research Centre in
California, the strategic ‘home base’ for the development of what was to eventually
become solution-focused therapy. The work of the MRI Brief Therapy Centre drew
on the creativity of Milton Erickson’s interventions; it was organised by the deter-
mination to stick strictly to what people came about, and it called on the MRI
strategic ideas that approached problems by focusing on the effects of the family’s

Carmel Flaskas
(failed) attempted solutions. The Tactics of Change: Doing Therapy Briefly was
published in 1982 and written by Richard Fisch, John Weakland and Lynn Segal.
Meanwhile, running parallel with the aims of the MRI Centre, the Brief Family
Therapy Centre was established in Milwaukee in 1978 by Steve de Shazer, Insoo
Kim Berg and colleagues. Cade quotes de Shazer:
Insoo and I and a group of colleagues — who had been working together (secretly)
for many years — decided to set up an independent ‘MRI of the Midwest’ where we
could both study therapeutic effectiveness, train therapists to do things as efficiently
as possible, and, of course, practice therapy. (de Shazer, as cited in Cade, 2001, pp.
184–185)
Berg and de Shazer were partners in life as well as in work, and their first discipline
was social work. The practice of the Brief Therapy Family Centre included therapy
and consultations in child welfare settings, and work with many clients who were
poor and at the centre of complex multi-agency involvements. James Derks, Marvin
Weiner, Elam Nunnally, Eve Lipchick, Alex Molnar and Marilyn La Court were all
part of the original group of colleagues (Cade, 2001, pp. 184). Other important
contributors to the solution-focused approach include Bill O’Hanlon, Michelle
Weiner-Davis, Peter DeJong, Bob Bertolino. Scott Miller and, closer to home,
Brian Cade. The groundbreaking Family Process article, ‘Brief therapy: Focused
solution development’, was published in 1986 as a collective effort of the Brief
Family Therapy Centre colleagues (de Shazer et al., 1986). This was followed over
the next eight years by three books written by de Shazer — Clues: Investigating
Solutions in Brief Therapy (1988), Putting Difference to Work (1991), and Words Were
Originally Magic (1994). The theory and practices of solution-focused therapy were
well elaborated by the mid-1990s, and the textbook Interviewing for Solutions by
DeJong and Berg was published in its first edition in 1997, with the third edition
being published in 2008.
A major shift marked the change from the earlier forms of strategic and brief
therapy to solution-focused therapy developing in the 1980s. Instead of orienting to
the presenting problem via the family’s (past and current) failed attempted
solutions, solution-focused therapy orients, from the very first moment of contact,
to the family’s present (successful) solutions and their capacities to imagine and
move toward their own future solutions. This shift strongly invokes the domain of
an imagined (hopeful) future time. Like the earlier strategic therapies (and indeed
the early systemic therapies in general), there is little engagement with past time in
solution-focused therapy, nor is there very much attention to using people’s experi-
ence and re-imagining of past time to facilitate present and future change (in
contrast, e.g., to the Milan use of ritual or explanatory hypotheses, or the narrative
practices of re-membering the past).
The hybrid modernist–postmodernist nature of solution-focused therapy is also
interesting. Consistent with the emphasis on meaning within postmodernism, there
is considerable discussion within solution-focused practice theory of the importance
of language and the elasticity of meanings (see, e.g., de Shazer, 1991). Social
constructionism is present, with a light touch in the base of the solution-focused
approach to meaning. Nonetheless, although de Shazer’s writing covers a wide intel-
lectual territory, including his engagement with poststructuralist and other

postmodernist ideas (see, e.g., de Shazer, 1991), in general there is a minimalist
approach to theory in solution-focused therapy. Instead, this framework shows an
intense pragmatism about useful therapeutic techniques and, like Andersen’s devel-
opment of the reflecting team practices, solution-focused techniques emerged
directly from practice rather than being theory led. At the same time, postmodernist
sensibilities show in the commitment to clients’ expertise in relation to their own
imagining of difference and solutions, and the practices of staying strictly with the
clients’ language and the ‘holding back’ of the therapist’s influence on the content
of the clients’ choice of solutions.
However, while the problem focus of strategic therapy was replaced with the
disciplined orientation to solutions, the strategic heritage of creating well-defined
behavioural goals was retained in solution-focused therapy. Also, although the
strengths-based solution-focused therapy is pitched toward establishing a collabora-
tive and positive therapeutic relationship, there is no special practice theory interest
in the reflexivity of the therapist’s use of self, or in reflective practices within the
therapy or within understandings of the therapeutic relationship. Thus, solution-
focused therapy retains modernist elements alongside more postmodernist elements.
The interview techniques of solution-focused therapy include drawing out and
reinforcing competency and strengths, staying with the clients’ use of language, and
‘leading from one step behind’ in the process of the interview. The building of
solutions starts with tasks set before the first meeting, and is embedded in the inter-
view process through the identification and exploration of exceptions, the long and
detailed use of the miracle question, and the extended use of scaling questions. All
these techniques, but particularly the use of the miracle question and scaling
questions, are pitched at eliciting clients’ imagination of difference, their own
calibrations of change, and marking out with clients the behavioural steps that lead
to their own preferred solutions.
Of all the contemporary approaches in the systemic field, solution-focused
therapy retains the strongest relationship to early systems thinking via strategic
therapy. The transitional influences in the 1980s of feminism and the later ecosys-
temic ideas did not show too much in its development. However, some postmod-
ernist elements have shaped the way in which language and meaning are located in
solution-focused therapy, the ‘light’ touch of social constructionism, and the politics
of honouring clients’ expertise and relationships. At the same time, the continuing
emphasis on behavioural goals, and the lack of interest in reflexivity and reflective
processes has allowed a pragmatic hybrid of modernist and postmodernist
emphases. The ideas and techniques that have been generated from practice rather
than theory have an easy transfer-ability to other ways of working, perhaps precisely
because of this pragmatism.
Integrations and Concluding Comments

The map I have just drawn of the four contemporary approaches plots differences as
well as similarities. Their genealogies reach back to the earlier family therapy
practice theories in different ways; they each show different patterns of responses to

Carmel Flaskas
the 1980s influences of the later ecosystemic theory, feminism and postmodernism;
and the way in which (and extent to which) they are informed by more ‘local’
contexts of knowledge, culture and politics also differs. Yet that these practice
theories have all emerged from, and been shaped by, the conditions of earlier family
therapy knowledge and its influences is unmistakable. The patterning of their
relation to social constructionist and/or narrative ideas is also unmistakable. And,
perhaps most importantly in terms of the continuing evolution of family therapy
ideas, all four approaches show an unmistakable, enduring and creative commit-
ment to generating psychotherapy theory and practices oriented to context and
relationship.
Doherty and McDaniel (2010), from a US perspective, write of the advent of a
third generation of integrative family therapy practice models. I do not think we
have as yet entered a third generation of practice theory in family therapy. Yet in the
course of writing this article, I have ‘computed’ that the contemporary models have
by now all served the same time as the first generation models (two decades). I have
also found myself silently mourning the recent losses of so many inspirational
pioneers of this second generation of family therapy practice theory. All died
relatively early while still engaged in their life’s work — Gianfranco Cecchin (in
2004), Tom Andersen (in 2007), Michael White (in 2008), Steve de Shazer (in
2005) and Insoo Kim Berg (in 2007).
Yet while I would argue that there is not as yet a third generation of family
therapy practice theory, it is significant that we are seeing the development of
practice approaches that use either specific integrations of different therapy frame-
works, and/or use specific inclusions of other psychotherapy and relevant empiri-
cally based knowledges. Both multisystemic family therapy and the Maudsley
model are examples of well-developed integrative approaches that have been
constructed quite specifically for particular contexts of practice. Multisystemic
family therapy has been developed in the United States specifically for work with
young people who are in the juvenile justice system, involving intensive work with
families and wider systems in the community, and calling on a range of structural
and other therapy and community network approaches (see, e.g., Henggeler, 1998;
Henggeler & Sheidow, 2002). The Maudsley model, initially developed in the
Maudsley Hospital London, provides a therapeutic treatment approach to work
with young people with serious eating disorders and their families, again integrating
a range of therapeutic modalities and approaches, including structural and narrative
therapy (see, e.g., Lock et al., 2001; Rhodes et al., 2009).
There has also been a body of theory and practice developing within systemic
therapy, more in the United Kingdom and Australia, using a range of intersections
with psychoanalysis (see, e.g., the contributions in Flaskas & Pocock, 2009).
Engaging with knowledge from attachment theory and research shows in this wider
body of work, although Rudi Dallos and Arlene Vetere from the United Kingdom
have also been building a coherent set of theory and practices that integrate attach-
ment, systemic therapy and narrative ideas (Dallos, 2006; Dallos & Vetere, 2009).
In gesturing to this range of integrative developments, one could possibly even
include the development within the United Kingdom of ‘systemic psychotherapy’,
constructed as a form of psychotherapy that is in itself integrative while being built
around Milan-systemic ideas. And, last but not least, as in the entire field of
psychotherapy, the implications of current knowledge about neurobiology is filter-
ing through to our practice theory. With the benefit of this knowledge, I think we
will come to revisit in a different way the recursivity of the biology of systems and
the relational contexts of biology.
It may seem tantalising to leave this paper wondering about a third generation
of practice theory and gesturing to other integrations and intersections. However, I
have reached the end of this two-part project on family therapy knowledge, where I
have allowed myself the freedom to speak from the context of my own ‘home’ in
Australian family therapy as an educator and practitioner and academic. It goes
without saying to a systemic audience that my own context has of course provided
the conditions of the map I have given, and some nuances of my choices and
emphases will not be visible to me. Still, I offer the map for those teaching and
learning family therapy, in the hope of inspiring further interest in the history and
continuing development of our practice theory.
A Postscript
After I had written the first article of this project, the Editor invited me to think
about including myself more — to say what kind of family therapy I am attached to
and what kind of family therapist I see myself as. There is a simple enough identifi-
cation of this — I am most at home within the Milan-systemic tradition, but learnt
family therapy while in intensive psychoanalytic psychotherapy, so psychoanalytic
thinking has been always a ‘second base’ for me as a therapist, providing something
like a constant double description. But I am an intense pragmatist in the therapy
and supervision room, and can play fast and loose with a range of practices and
ideas from earlier and contemporary family therapy frameworks and other practice
ideas from outside family therapy.
Yet if I am to take up the invitation to comment more reflexively about my own
positioning, it is perhaps my commitments as a teacher rather than my commit-
ments as a practitioner that have more profoundly shaped this project, which from
the first was conceived in terms of the processes of learning and teaching family
therapy. It seems to me that, as a teacher, if you genuinely take on the ideas that
there are many pathways to change, that there are many kinds of clients, that there
are many kinds of human struggles and dilemmas, that there are many kinds of
therapeutic practice contexts, that there are many kinds of good therapy, and that
there are many kinds of good therapists — this kind of thinking about difference
and pluralities changes how you imagine your position as a teacher. It doesn’t
neutralise your own passions and allegiances, it doesn’t need to water down the focus
of the training program, but it does change something about structuring different
venues of learning, and using yourself and your own passions and allegiances in
different ways during the program, especially in longer training programs.
Specifically with respect to teaching an overview of practice theory, or locating
particular practice theory in its wider context, I find it helps to take three steps to
one side as a teacher, in much the same way as I have tried to take three steps to one
side in writing these two articles. Taking three steps to one side allows the space for

Carmel Flaskas
a freer invitation to independent thinking — an activity of mutually looking at

practice theory from a bit of a distance, and then us all leaning in closer to track the
different kinds of relationships we have to this particular kind of theory, followed by
a curiosity about the context of the resonances and differences. The tracking and
curiosity about different relationships to knowledge is something that can happen
easily in the interactive space of learning and teaching — although even in the ‘one-
sided’ activity of writing, it is still possible to imagine(/hope/wish) something kind
of similar might potentially happen. There is a lot more that could be said about
this, but I suspect it belongs to a different article.
Endnotes
1 Titles in the Systemic Thinking and Practice Series published by Karnac Books, London
over the past 20 years give a good cross-section of UK systemic family therapy interests.
2 The metaphor of narrative has been used more broadly in psychotherapy, including in
psychoanalysis — ‘narrative therapy’ is being addressed here as it has been generated
within the systemic family therapy tradition.
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Frameworks For Practice in The Systemic Field: Part 2

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Frameworks for Practice

Keywords: family therapy knowledge, practice theory, practice frameworks, models

Understanding the array of current practice frameworks on offer in systemic family

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Orienting to Practice Theory and Earlier Family Therapy Knowledge

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‘Frameworks’ (my chosen description for specific practice theories) remain

The Shape of Contemporary Practice Theory in Family Therapy

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90 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

Four Contemporary Frameworks

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92 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

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The Dialogical Perspective

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ernist (personal communication, 2003). Instead, he was guided by an unswerving

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his direct involvement in the development of the theory of dialogical therapy.

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98 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

explicit political commitments of narrative can lend a social movement-type form

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100 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

lectual territory, including his engagement with poststructuralist and other

Integrations and Concluding Comments

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102 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

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a freer invitation to independent thinking — an activity of mutually looking at

104 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

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106 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

Madigan, S. (2010) Narrative therapy. Washington: American Psychological Association.

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108 THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY

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