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Goldenberg
Goldenberg
N I N T H E D I T I O N
Stanton
NINTH EDITION
Family Therapy
Family Therapy A N
AN OVERVIEW
Irene Goldenberg Mark Stanton Herbert Goldenberg
OVERVIEW
Family Therapy
EDITION
AN OVERVIE W
NINTH
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N i n t h E D ITI O N
Family Therapy
AN OVERVIEW

Professor Emerita, University of Azusa Pacific University
California, Los Angeles
Australia • Brazil • Mexico • Singapore • United Kingdom • United States

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Printed in the Canada

Print Number: 01 Print Year: 2016
Dedication to Herb Goldenberg, 1926–2008
To Herb, whose compassion, integrity, intelligence, and unwavering support
nourished our relationship and made this book possible. Thank you for the life,
the love, and the family.
Irene Goldenberg
Contents
PART I Fundamentals of Family Psychology 1

1 Adopting a Family Relationship Framework 1
Family Systems: Fundamental Concepts 2
Today’s Families: A Pluralistic View 3
Family Structure 4
Basic Structural Characteristics 4
Family Interactive Patterns 5
Family Narratives and Assumptions 5
Family Resiliency 7
Gender, Race, and Ethnicity and Family Therapy 10
Gender Roles and Gender Ideology 10
Cultural Diversity and the Family 12
Impact of Gender and Cultural Influences on the Therapist and Therapy 14
Shifting Perspectives of Family Therapy 15
Shifting Paradigm: From Individual Psyche to Family System 15
The Origins of Family Therapy: A New Paradigm Begins to Take Shape 16
Cybernetics: The Paradigm Shift Continues 19
Reciprocal Determinism 20
Second-Order Cybernetics and Postmodernism 22
The Identified Patient as Seen from the
Different Family Therapy Perspectives 25
Summary 27
Recommended Readings 28
2 Family Development: Continuity and Change 29

Developing a Life Cycle Perspective 30
Identifying Developmental Tasks 30
Conceptualizing the Life Cycle: Some Preliminary Cautions 30
Family Diversity May Modify Life Cycle Stages 31
The Family Life Cycle Framework 32
Family Life Cycle Stages 32
Continuity and Change Throughout the Family Life Cycle 32
v
vi Contents
A Family Life Cycle Stage Model 35

The Developmental Stages 35
Family Transitions and Symptomatic Behavior 35
Family Life Cycles: A Multidimensional, Multicultural,
and Multigenerational Perspective 36
Critiques of the Stage Model 37
The Stages of Family Development 39
“Coupling” and Preparing for Parenthood 40
The Arrival of Children 41
Coping with Adolescence 43
Leaving Home 44
Reorganizing Generational Boundaries 44
Retirement, Illness, Widowhood 44
Other Developmental Sequences in Families 45
Single-Parent–Led Families 47
Remarried Families 49
Families with Gay or Lesbian Members 53
Summary 58
3 Diversity in Family Functioning 60

Multicultural and Culture-Specific Considerations 62
Culture-Sensitive Therapy 63
Developing a Multicultural Framework 64
Cultural Specificity and Family Systems 65
Gender Issues in Families and Family Therapy 69
Feminism and Family Therapy 71
Feminist Reexamination of Family Therapy Theory and Practice 72
Gender, Work, and Family Life 73
Men’s Studies and Gender-Role Awareness 74
Therapy from a Gender-Sensitive Perspective 79
Socioeconomic Status and Family Functioning 79
Therapy and Social Justice 81
Summary 82
4 Systems Theory and Systemic Thinking 84

Extending Beyond the Scientific Method 84
Seeing the System 85
Some Characteristics of a Family System 87
Organization and Wholeness 87
Family Rules and Patterns 89
Contents vii
Family Homeostasis or Adaptation? 92

Feedback, Information, and Control 92
Subsystems and Suprasystems 95
Boundaries 96
Open and Closed Systems 97
Families and Larger Systems 99
Family–School Interventions 99
Family–Healthcare Interventions 101
Family Interventions with Other Populations 101
Systemic Thinking in Family Therapy Practice 103
Critiques of Systems Theory 105
Summary 107
PART II The Development and Practice

of Family Therapy 108
5 Origins and Growth of Family Therapy 108
istorical Roots of Family Therapy 109
H
Studies of Schizophrenia and the Family 109
Fromm-Reichmann and the Schizophrenogenic Mother 109
Bateson and the Double Bind 110
Lidz: Marital Schism and Marital Skew 112
Bowen, Wynne, and NIMH Studies 113
Marriage and Premarriage Counseling 116
The Child Guidance Movement 118
Group Dynamics and Group Therapy 119
The Evolution of Family Therapy 121
From Family Research to Family Treatment (1950s) 121
The Rush to Practice (1960s) 123
Innovative Techniques and Self-Examination (1970s) 124
Professionalization, Multiculturalism, and a New
Epistemology (1980s) 126
Integration, Eclecticism, and the Impact of Constructionism
(1990s) 128
Ecological Context, Multisystemic Intervention,
and Evidence-Based Practice (2000s) 131
The Core Competency Movement (2000–present) 132
Summary 134
viii Contents
6 Professional Issues and Ethical Practices 136

Professional Issues 136
The License to Practice 137
Peer Review 138
Managed Care and Professional Practice 139
Legal Liability 141
Maintaining Ethical Standards 145
Professional Codes of Ethics 145
Ethical Issues in Couples and Family Therapy 146
Confidentiality 149
Informed Consent 152
Privileged Communication 153
Maintaining Professional Competence 154
Summary 156
PART III The Established Schools of

Family Therapy 157
7 Psychodynamic Models 157
The Place of Theory 159
Psychodynamic Models: Some Historical Considerations 160
Freud’s Impact on Family Therapy 161
Adler and Sullivan: Contributing Pioneers 162
The Psychodynamic Outlook 164
Classical Psychoanalytic Theory 164
Early Approaches to Integrating Psychodynamic Theory
with Family Systems Theory 166
Psychoanalysis and Family Dynamics: Ackerman’s
Foundational Approach 166
Object Relations Theory 170
Object Relations Therapy 174
Object Relations and Family-of-Origin Therapy (Framo) 174
Object Relations Family Therapy (Scharff and Scharff ) 176
Kohut and Self Psychology 180
Intersubjective Psychoanalysis 183
Relational Psychoanalysis 184
Postscript: Attachment Theory and Neuroscience 186
Summary 187
Contents ix
8 Transgenerational Models 190

Bowen’s Family Theory 191
Eight Interlocking Theoretical Concepts 193
According to Family Systems Theory, Eight
Forces Shape Family Functioning: 194
Differentiation of Self 194
Triangles 198
Nuclear Family Emotional System 200
Family Projection Process 201
Emotional Cutoff 202
Multigenerational Transmission Process 203
Sibling Position 204
Societal Regression 205
Empirical Support for Bowen’s Theories 205
Bowen Family Systems Therapy 207
The Evaluation Interview 207
The Genogram 209
Therapeutic Goals 211
Back Home Visits 214
Family Therapist as Coach 214
A Controlled, Cerebral Approach 216
Contemporary Bowenian Theorists 216
Contextual Therapy 217
Relational Ethics 217
Family Ledger, Legacies, Debts, and Entitlements 219
The Ethical Connection 221
Summary 223
9 Experiential Models 224

A Shared Philosophical Commitment 225
The Experiential Model 226
Carl Whitaker and Symbolic-Experiential Family Therapy 226
The Use of Co-Therapy with Schizophrenics 227
The Symbolic Aspects of Family Therapy 228
The Therapist’s Use of Self 229
Normalizing Human Behavior 229
Establishing Therapeutic Goals 230
x Contents
The Therapeutic Process 230

Toward Evidence for Symbolic-Experiential Family Therapy 233
Gestalt Family Therapy (Kempler) 235
Leading Figure: Walter Kempler 237
The Therapeutic Encounter 238
The Human Validation Process Model (Satir) 240
Leading Figure: Virginia Satir 240
Symptoms and Family Balance 241
Individual Growth and Development 242
Family Roles and Communication Styles 243
The “Threat and Reward” and “Seed” Models 244
Family Assessment and Intervention 244
Family Reconstruction 246
The Avanta Network 247
Satir’s Legacy 248
Emotionally Focused Therapy 248
Leading Figures: Johnson and Greenberg 249
A Brief, Integrative Approach 249
The Change Process 249
Attachment Theory and Adult Relatedness 250
Effectiveness Evidence for EFT 251
Summary 252
10 The Structural Model 254

The Structural Outlook 255
Leading Figure: Salvador Minuchin 255
Other Leading Figures in Structural Theory 257
Psychosomatic Families 257
Structural Family Theory 258
Family Structure 259
Family Subsystems 260
Family Dysfunction 261
Boundary Permeability 262
Alignments, Power, and Coalitions 264
Structural Family Therapy 266
Joining and Accommodating 267
Contents xi
Assessing Family Interactions 268

Monitoring Family Dysfunctional Sets 271
Restructuring Transactional Patterns 275
Research on the Effectiveness of Structural Family Therapy 280
Summary 282
11 Strategic Models 283

The Communications Outlook 284
The Strategic Outlook 284
Mri Interactional Family Therapy 285
Don Jackson 285
Developing a Communication Paradigm 285
Paradoxical Communication 287
Therapeutic Assumptions 288
First-Order and Second-Order Changes 289
The Therapeutic Double Bind 290
Mri Brief Family Therapy 292
Three Types of Misguided Solutions 292
MRI Brief Therapy in Action 292
Strategic Family Therapy (Haley and Madanes) 294
Jay Haley, John Weakland, Milton Erickson 296
The Meaning of Symptoms 297
Triangles, Sequences, and Hierarchies 298
Developing Therapeutic Strategies 299
The Initial Interview 300
The Use of Directives 301
The Milan Systemic Model 305
History and Leaders 305
Key Concepts: Paradoxes, Counterparadoxes, Positive Connotations,
and Rituals 306
Structured Family Sessions 307
An Evolving Model: Hypothesizing, Neutrality, and Circular
Questioning 307
A Post-Milan Systemic Epistemology 308
Reflexive Questioning 309
Effectiveness of Strategic Approaches 311
Summary 312
xii Contents
12 Behavioral and Cognitive-Behavioral

Models 314
Behavioral Therapy and Family Systems 315
Leading Figures 315
Adopting a Family Framework 315
The Rise of Cognitive-Behavioral Therapy With Families 316
Leading Figures: Ellis and Beck Applied to Families 317
The Cognitive-Behavioral Outlook 318
The Key Role of Assessment 318
A Behavioral Assessment 318
A Cognitive-Behavioral Assessment 319
Behaviorally Influenced Forms of Family Therapy 320
Behavioral Couples Therapy 321
Broadening the Outlook: The Cognitive Perspective 324
Integrative Couples Therapy 325
The Gottman Method 327
Behavioral Parent Training and Family Management Skills 329
Contingency Contracts and Other Techniques 331
Research in Behavioral Couple and Family Therapy 334
Functional Family Therapy 335
Conjoint Sex Therapy 338
A Constructivist Link 342
Summary 343
PART iv New Directions in Family Therapy 345

13 SOCIAL CONSTRUCTION MODELS I:
SOLUTION-FOCUSED THERAPY AND
COLLABORATIVE THERAPY 345
The Postmodern Revolution 346
Postmodernist Constructions 347
Postmodern Therapeutic Outlooks 349
Social Constructionist Therapies 351
Solution-Focused Brief Therapy (SFBT) 351
Solution-Oriented Possibility Therapy 360
A Collaborative Approach 362
The Reflecting Team 366
Summary 368
Contents xiii
14 Social Construction Models II: Narrative Therapy 370

Poststructuralism and Deconstruction 372
Thin and Thick Descriptions 373
Deconstruction 374
Leading Figures: Michael White, David Epston, and Colleagues 375
Self-Narratives and Cultural Narratives 375
A Therapeutic Philosophy 377
Therapeutic Conversations 378
Externalizing the Problem 378
Employing Therapeutic Questions 380
Seeking Unique Outcomes 381
Co-Constructing Alternative Stories 382
Therapeutic Ceremonies, Letters, and Leagues 383
Definitional Ceremonies 383
Therapeutic Letters 384
Forming Supportive Leagues 386
Summary 388
15 Population-Based Family Treatments 390

Families and Schools 391
Families and Mental Disorders 391
Families With Depression and Anxiety 391
Families and Substance Abuse 392
Families and Eating Disorders 393
Families and Serious Mental Illness 394
Expressed Emotion and Schizophrenia 395
The Therapeutic Process 396
Medical Family Therapy 398
Leading Figures 398
Collaborative Family Healthcare Association 399
Family Therapist–Physician Partnerships 400
Family Therapist–Family Partnerships 401
Gay and Lesbian Families 402
Psychoeducation: Teaching Skills to Specific Populations 403
Relationship Education Programs 404
Relationship Enhancement 405
PREPARE/ENRICH 407
The Prevention and Relationship Enhancement Program (PREP) 408
Other Couple and Marriage Programs 409
xiv Contents
Family Violence 410

Divorce and Remarriage 410
Divorce 410
Stepfamily Programs 411
Summary 414
PART v Clinical Research: The Synergy of

Science and Practice 416
16 Evidence-Based Family Therapy 416
Qualitative and Quantitative Research Methodologies 418
Couple and Family Assessment Research 421
Self-Report Measures 422
The Circumplex Model 422
Family Environment Scale 424
Observational Methods 426
The McMaster Model of Family Functioning 427
The Beavers Systems Model 428
Dyadic Assessment 433
Individual Assessment in Couple and Family Therapy 433
Family Therapy Process and Outcome Research 433
Process Research 435
Outcome Research 437
Evidence-Based Family Therapy: Some Closing Comments 440
Summary 442
PART vI Family Theories and Family Therapies:

A Comparative Assessment 443
17 Comparative View of Family Theories and
Therapies 443
Family Theories: A Comparative Overview 444
Units of Study: Monads, Dyads, and Triads 444
Time Frame: Past, Present, Future 445
Functional and Dysfunctional Families 447
Family Therapies: A Comparative Overview 451
The Role of the Therapist 451
Assessment Procedures 452
Insight and Action Modes 454
Contents xv
Key Methods of Intervention 455

Crisis, Brief, and Long-Term Family Therapy 457
Goals of Treatment 458
A Final Word on Theoretical Integration 459
Psychopharmacology and Family Therapy 464
Summary 466
Glossary 467
References 477
Name Index 516
Subject Index 524
List of Boxes
CASE STUDIES
Box 1.2 A Traumatized Family Rebounds from a Sudden Crisis 8
Box 1.6 A Couple in Conflict Seek Help over Money Issues 17
Box 2.4 A Religious Couple Divides into Two Single-Parent Households 50
Box 2.5 A Lesbian Couple Adopts a Child 55
Box 3.4 Counseling a Latino Family 68
Box 3.8 A Couple Confronts Domestic Violence 77
Box 4.5 An Immigrant Family Faces an Intergenerational Conflict 98
Box 4.6 Using an Ecomap in Family Assessment and Therapy 102
Box 6.3 A Therapist Reports Parental Abuse 149
Box 7.5 Object Relations Therapy with a Distressed Couple 177
Box 8.5 Ghosts from the Holocaust 210
Box 8.7 A Farming Couple Faces a Dilemma 213
Box 8.11 Taking a Relationship into Account 220
Box 8.12 A Contextual Therapist Elicits a Family’s Relational Resources 222
Box 10.3 Structural Therapy with a Divided Stepfamily 278
Box 11.1 Treating an Alcoholic Symptom 289
CLIN ICAL NO T E s
Box 1.7 Contrasting Linear and Circular Causality 22
Box 2.6 Heterosexual Therapists Working with Gay and Lesbian Couples 58
Box 3.2 Recognizing Strengths in African-American Families 63
Box 3.3 Cultural Sharing 65
Box 3.6 Transition into Parenthood 75
Box 3.9 Example of Gender-Sensitive Family Therapy Techniques 79
Box 4.2 Family Rules and Family Dysfunction 90
Box 4.4 Negative and Positive Feedback Loops 94
Box 5.2 Social Workers and Family Therapy 117
Box 5.3 Motivation in Couples Therapy 118
Box 6.2 Avoiding Malpractice 143
Box 6.4 Computer Technology and Confidentiality 150
Box 6.5 Limits of Confidentiality 151
xvi
List of Boxes xvii
Box 6.6 Termination of Therapy 154

Box 7.1 Eclecticism and Integration in Current Family Practice 158
Box 7.2 Learning to Use a Specific Model 159
Box 8.1 A Feminist Challenge 195
Box 8.6 Constructing a Genogram in Family Therapy 212
Box 8.8 Using “I-statements” in Family Therapy 215
Box 8.10 Treatment Technique: Have Partners Speak to the Therapist’ 217
Box 9.1 Symbolic-Experiential Therapy’s Distinguishing Features 227
Box 9.5 A Gestalt Family Therapy Credo 238
Box 9.6 Satir’s Eight Aspects of the Self 242
Box 9.8 Outlining the EFCT Change Process 250
Box 9.9 Attachment Injuries May Result in Rage 251
Box 9.10 Steps in the EFT Treatment Manual 252
Box 11.9 A Humanistic Set of Strategies? 312
Box 12.1 Ten Underlying Assumptions of Behavioral Therapy 316
Box 12.2 Some Common Cognitive Distortions Among Couples 320
Box 12.3 Some Characteristics of Behavioral Family Therapies 321
Box 12.4 Homework Assignments as Therapeutic Aids 325
Box 12.5 Parental Disagreement About Child Treatment 329
Box 12.9 Individual or Conjoint Sexual Status Examinations 340
Box 13.2 Some Characteristics of Social Constructionist Therapies 350
Box 14.1 A Dominant Story: “I’m a Good Student” 372
Box 14.3 Practicing Externalizing 379
Box 14.6 Clients Keep Significant Communications 384
Box 15.2 Psychoeducational Guidelines for Families and Friends of Schizophrenics 397
Box 15.3 Common Family Adaptations to Chronic Illness 399
Box 15.4 Psychosocial Types of Illness 400
Box 15.5 Strategies for Medical Family Therapy 401
Box 15.7 Underlying Factors in Premarital Counseling 405
Box 15.8 Paying Attention to the Referral Source 407
Box 15.9 Preparation for Marriage 408
EviDence-Based Practice
Box 1.4 Dual Work Families 11
Box 3.1 Therapists’ Background Influences Assessment and Treatment 62
Box 3.5 Changing Educational, Work, and Family Roles 74
Box 4.1 How Digital Media and Social Networking Are Affecting Families 88
Box 5.1 How Disturbed Families Deal with Emotions 115
Box 5.5 Core Competencies in Practicing Family Therapy 133
Box 6.1 The Movement toward Evidence-Based Practice 142
Box 13.7 Support for SFBT 359
xviii List of Boxes
Box 15.1 Families With Mental Disorders 396

Box 15.10 Children of Divorce 411
Box 16.1 Quantitative–Qualitative Collaboration in Family Research 420
Box 16.5 Efficacy Studies Versus Effectiveness Studies 439
Box 16.6 Assumptions Underlying Evidence-Based Therapy Research 440
FAMILY DIVERSITY
Box 1.3 Therapy for ethnic minority families following disasters 9
Box 2.1 Family diversity may modify life cycle stages 31
Box 2.2 Migration and the Life Cycle 39
Box 8.3 Bowen and diversity 205
Box 8.9 Coaching for Family Reentry 216
Box 10.1 Structural Family Therapy with Diverse Families 257
Box 12.7 Conducting a Sexual Status Examination 338
Box 13.10 Using SFBT across cultures 367
Box 14.2 Culture and cultural meaning in narrative therapy 377
T hinking Like a Clinician

Box 1.1 Appreciating Family Narratives 6
Box 1.5 Assessing One’s Own Possible Biases 15
Box 2.3 Attachment Injuries May Result in Rage 46
Box 3.7 Challenging Stereotypes 76
Box 4.3 Family Rules 91
Box 4.7 Systemic Thinking Habits 103
Box 5.6 Developing Core Competencies 134
Box 6.7 Ethical and Professional Dilemmas 155
Box 7.6 Family Therapy and Object Relations 179
Box 8.4 Detriangulation and Differentiation 208
Box 9.3 S-EFT 235
Box 10.2 Assessing a Family 269
Box 10.4 Monitoring Dysfunctional Sets 281
Box 11.2 Relabeling 291
Box 11.4 Strategic Family Therapy 295
Box 11.5 Symptoms: Voluntary or Involuntary Efforts at Control? 298
Box 11.6 Even-Handed Alliances 299
Box 11.8 Exploring Interpersonal Patterns 310
Box 12.6 Negotiating a Contingency Contract 334
Box 13.6 Using an SFBT Perspective in Family Therapy 358
Box 13.9 Using a Linguistic Perspective in Family Therapy 365
Box 14.5 Unique Outcomes 382
List of Boxes xix
Box 14.7 Narrative Therapy 385

Box 14.8 Recent Research 387
Box 15.6 Working With a Person With HIV 403
Box 15.9 Preparation for Marriage 408
Box 15.11 Negotiations Within a New Stepfamily 413
Box 16.3 Using Observational Methods for Assessing Family Functioning 429
Box 17.1 Formulating Your Own Theoretical Orientation 465
THERAPEUTIC ENCOUNTER
Box 5.4 Advancing a New Epistemology 130
Box 7.3 Ackerman’s Active, Challenging Interventions: A Clinical Vignette 168
Box 7.4 The Cinderella Story: A Case of Splitting? 172
Box 7.7 Cinderella Revisited: A Case of a Self Disorder? 182
Box 8.2 Bowen’s Self-Differentiation from His Family of Origin 203
Box 9.2 Working with Symbolic-Experiential Family Therapy 232
Box 9.4 Whitaker: The Person of the Therapist 236
Box 9.7 Satir Clarifies Family Communication 246
Box 11.3 Strategically Designing a Novel Solution for a Chronic Problem 294
Box 11.7 An Anorectic Adolescent and the Family Game 308
Box 12.8 Conducting a Sexual Status Examination 339
Box 13.1 Constructivism and Social Constructionism 348
Box 13.3 A Therapist Initiates a Solution Process 352
Box 13.4 Either/Or or Both/And Choices 353
Box 13.5 Asking the Miracle Question 355
Box 13.8 Hermeneutics and Collaborative Therapy 364
Box 14.4 Overcoming Dominant Problem-Saturated Stories 380
Box 16.2 Home-Based Services 427
Box 16.4 What Within-Session Mechanisms Stimulate Change? 436
Foreword by Michael White
Michael White had a special place in our hearts, both personally and professionally.
He is sorely missed.
Irene Goldenberg
The publication of this text represents an achievement of extraor-

dinary scope in which Irene and Herbert G oldenberg bring to-
gether more than five decades of d evelopments in the ideas and
practices of family therapy. Extraordinary scope, because in doing
this these authors have not been content to incorporate just the
principal developments in this field. In the space of this one text,
Irene and Herbert Goldenberg also trace many of the tributar-
ies that have branched out of those developments in ideas and
practice that have been accorded mainstream status in the field of
family therapy.
Before reading this text, I had made some assumptions about it. To cover the history of
developments in a field like family therapy, one in which there has been little orthodoxy and
great diversity, would surely require considerable economy of writing. Overview, a word from
the book’s title, seemed to my mind to imply a very limited perspective. I was expecting the
sort of academic writing that would provide a reasoned gloss of developments through the
history of family therapy. I had forecast the sort of dry account of these developments that is
intended to provide the reader with a passing knowledge of this broad subject matter. I had
assumed that the authors of such a text would have little option but to rein in their ambitions
for the reader’s engagement with this material and to keep modest their hopes for the reader’s
experience of its reading—perhaps simply to hope to kindle the reader’s interest in specific
ideas that might be pursued through consulting more dedicated sources.
Not so! Upon reading this book I discovered that Herbert and Irene Goldenberg had not
been content to offer their readers a summary account of developments that simply conveys
a passing knowledge of this material. Despite the limitations associated with an economy in
writing imposed by the circumstances, these authors have produced a highly engaging text
that introduces the reader to the profundity of the principal ideas and practices of family
therapy, while at the same time rendering the complexities associated with these ideas and
practices readily available to the comprehension of the reader. Rather than acquainting the
reader with a passing knowledge, this text takes him or her to a vantage point that allows a
vital, close-up view of the terrain.
xx
Foreword by Michael White xxi
How is this achieved? This text does not constitute the expected “armchair exposition.”
Instead, it is alive with the adventures initiated and the journeys traveled through the history
of family therapy. The reader gains a strong sense of the authors’ significant personal experi-
ences of these adventures and journeys, of their intimate familiarity with many expeditions
into new territories of ideas and practices. In the reading of this text, one is left with no doubt
that Herbert and Irene Goldenberg have been at the scene, actively joining with others over
many years in explorations of new forms of human inquiry. In this recounting, these authors
succeed in evoking the original spirit of these developments in human inquiry and the in-
spiration that was an outcome of numerous efforts to think beyond what has been routinely
thought about people’s lives and their relationships. These authors also succeed in conveying
to the reader the excitement of these adventures and journeys—the sense of actually undertak-
ing these expeditions.
The authors also engage readers vitally through user-friendly writing devices that pro-
vide a scaffold for comprehension of the text. The text is organized with functional headings
and subheadings, with topics divided into six parts: “Fundamentals of Family Psychology,”
“The Development and Practice of Family Therapy,” “The Established Schools of Family
Therapy,” “New Directions in Family Therapy,” “Clinical Research: The Synergy of Science
and Practice,” and “Family Theories and Family Therapies: An Overview.” Each chapter is
thoughtfully structured and replete with helpful and concise summaries and recommended
readings. The judicious use of tables, illustrations, and quotes contributes to this easy-to-use
composition. Particularly important is the even-handed and respectful way in which Irene and
Herbert Goldenberg present the various developments in the history of family therapy and
the available critiques of these developments. This fair-mindedness encourages the reader’s
fuller involvement with the text—it recruits the reader’s contemplation and rouses his or her
fascination.
I believe there is something for everybody to be found in this book. For those new to the
field of family therapy, this book provides a gripping account of the history of developments
in the family therapy field, of the continuities and discontinuities in these developments, and
of many context- and era-specific influences that have contributed to the shape of these de-
velopments. For other readers, this book offers a ready reference to, and will instigate further
explorations of, those developments that have most captured their imaginations and exercised
their minds. For yet other readers, this text provides a source of renewed reflection on the
history of their own family therapy practice and will encourage a richer appreciation of the
traditions of thought that have shaped their work. And, of course, this text gives many readers
an opportunity to become more fully acquainted with traditions in thought and practice that
they might not otherwise be familiar with.
Apart from these comments about what is in store for you as you open the pages of this
book, I will include here a few comments about the authors. Although there is much that can
be said about their own contributions to the family therapy field over a considerable period of
its development, my desire here is to say something about the personae of Irene and Herbert
Goldenberg, for I would like you to get to know them just a little as I have known them.
xxii Foreword by Michael White
Although I had been expecting this book to represent a relatively limited summary of the
history of developments in the field of family therapy, I was nonetheless not surprised to find
these expectations so contradicted in my reading of this text. I had met Herbert and Irene
Goldenberg on various occasions over the years, principally in the context of workshops that
I have given in the Los Angeles area. I first became aware of their presence in these workshops
some years ago. I recall, toward the end of one of these events, being asked some particularly
thought-provoking, searching, and persistent questions about some of the ideas and practices
I had been discussing. In this workshop context, the questions—coming in particular from
two people in the room—provided a foundation for conversations that contributed to signifi-
cant clarification of certain similarities and distinctions in a range of ideas and practices.
At the end of the workshop, I approached these two figures for personal introductions.
Through this and my subsequent contacts with Herbert and Irene Goldenberg, I have come
to admire the breadth of their experience, the scope of their knowledge, and their capacity for
thoughtfulness. All of these qualities are so evident in this book. But they have contributed
much more than this to the family therapy field. I have also come to admire the part that
their strong social consciousness and their generosity of spirit play in their personal and pro-
fessional worlds. Herbert and Irene Goldenberg are always quick to recognize transgressions
of the principles of fairness, equality, and justice; and they are never tardy in naming these
transgressions. They are also quick to offer support to those who have experienced unfairness,
inequality, and injustice. And, in their efforts to challenge these wrongs, Herbert and Irene
Goldenberg manage to stay true to their principles of understanding and to their appreciation
of difference and diversity. In this way they make it possible for people to find new places in
which to stand in the territories of their lives and work. When I am in the presence of Irene
and Herbert Goldenberg, I know that I am in good company.
Michael White (1948–2008)

Codirector of Dulwich Centre
Adelaide, South Australia
Preface
With each new edition of Family Therapy: An Overview, we have the opportunity to tell once
more the evolving story of the profession. Even in the four years since the eighth edition, the
theory and clinical practice of family therapy have changed in important ways that affect ev-
eryone involved. Students, researchers, professors, and clinicians all need to know not only the
origins and history of family therapy but the very latest in what it means to work as a family
therapist. Changes emerge from within the field as well as in response to a wide range of pres-
sures and other influences from society at large. In Family Therapy, ninth edition, we strive to
honor our past as well as understand and explain present-day developments.
Our Mission in Writing Family Therapy: An Overview

The purpose of our book is to convey to new and returning readers alike the excitement of
the field as it develops over time. We hope to impart to readers an attitude of theoretical
and clinical openness that appreciates past, present, and future developments. We feel it is
important to constantly challenge our own biases whether in working with clients or in con-
sidering different theoretical approaches to our work. Indeed, the ninth edition goes further
than previous editions in considering the clinical value of integrating theories both in terms
of expanding personal boundaries and in better appreciating how the diversity of our client
population reminds us that no one approach to practice can tell us the whole story about how
best to work. Postmodernism reminds us again and again that there is no final truth about
our theories and practices. As clinicians, we must continually challenge ourselves to accept
and celebrate this revelation. We can never know it all, but we can keep learning. Family
Therapy, ninth edition, is designed to help support this lifelong commitment to personal and
professional growth. Indeed, our commitment to revising the book reflects our own ongoing
commitment to remaining open to challenging our own biases and remaining open to change.
The Tradition and Present-Day Developments

Family therapy, with its revolutionary emphasis on systems thinking and the search for iden-
tifiable and recurrent family patterns, first emerged in the mid-1950s. By the 1970s, having
been inspired by such trailblazers as Virginia Satir, Salvador Minuchin, Jay Haley, and Carl
Whitaker, many who were accustomed to working with individuals had “caught the bug”—
become convinced of the therapeutic power of understanding individual behavior in the con-
text of the family system. The more we learned, the more we came to grasp the influence of
larger systems—race, social class, gender, ethnicity, sexual orientation—on the functioning
of the family and its individual members. Postmodern thinking introduced us to the further
xxiii
xxiv Preface
importance of language and belief systems in understanding how people construct their views
of reality.
The initial edition of this book attempted to provide a comprehensive textbook offering
an overview of the field—not merely a biased description of any one of the specific models
then vying for the clinician’s attention—based on the assumption that an even-handed ac-
count could prove a useful guide to others interested in entering the field of family therapy. As
stated in the first edition, published in 1980, the goal was to offer readers a balanced presen-
tation of the major theoretical underpinnings and clinical practices in the field. We promised
not only to provide an overview of the evolving viewpoints, perspectives, values, intervention
techniques, and goals of family therapy but also to attempt to keep pace with the field’s clin-
ical and research developments. That promise continues to be the goal in this latest edition.
What’s New in the Ninth Edition?

We have introduced new features to the text in this edition to reflect important issues in fam-
ily therapy and advances in the field. These features include:
• Highlighted material on key themes of family therapy. Framed boxes in select col-
ors with an icon designating special themes throughout the text:
Family Diversity. We have added boxes to highlight individual and group
diversity perspectives, issues, and research relevant to the chapter content
throughout the book so that students are challenged to think about how the
material relates to diverse populations.
Thinking Like a Clinician. Many new and revised boxes present clinical
challenges and opportunities for the reader to respond to and learn from.
Readers are asked to address clinical situations—many taken from real-life
therapy situations—from different theoretical perspectives. These boxes are
intended to heighten self-exploration regarding individual thoughts, feelings,
and experiences relative to the different models presented.
Evidence-Based Practice boxes. Recent research relevant to the chapter
content and the practice of family therapy is featured in these boxes.
Case Study. Examples of therapy cases that illustrate the material in that
chapter, these boxes help students apply the concepts to family therapy.
Clinical Note. These boxes feature succinct information or suggestions about
using the chapter ideas in family therapy.
Therapeutic Encounter. Clinical vignettes and dialogue are featured in these
boxes to provide insight into the way in which ideas manifest in the words of
the clients and the therapist.
• Inclusion of professions that practice family therapy. Examples and material
throughout the text illustrate that family therapists come from many professions,
including social work (CSWE), MFT (AAMFT), psychology (APA), and counseling
(CACREP).
Preface xxv
• Updated references and cited material. Every chapter in this edition includes up-to-
date references and presents the latest thinking about its issues. Materials from sources
(for example, family therapy models or figures and model depictions, as well as direct
quotations) have been updated to the latest published versions.
• Learning Objectives. Each chapter begins with select student learning objectives that
align with the content of the chapter. Content specific to each objective is identified
throughout the text.
• Increased attention to LGBTQ families. More attention is given to LBGTQ issues
throughout the book, including chapter content and the student exercises. Several of
the Thinking Like a Clinician boxes raise real-life issues faced by LBGTQ families.
• More concise content. We carefully edited the entire volume to provide valuable in-
formation aligned to the reading assignments of contemporary classes.
• New Recommended Readings. Many chapters feature new or updated texts in the
recommended readings section at the end of each chapter. These may help faculty and
students reference source materials for themes in the chapter.
In addition to the general changes just outlined, we have made many chapter-specific
changes that reflect today’s knowledge and clinical practice. The following are included among
the important more specific changes:
• Chapter 1: Enhanced coverage of social and cultural diversity in family therapy with
new material on family forms and diversity perspectives, including a new Family Di-
versity box focused on how family therapists may assist minority families experiencing
natural disasters.
• Chapter 2: An increased focus on family life cycle development, including expanded
coverage of dynamics related to divorce, single-parent families, remarried families, and
families with gay or lesbian members. A new figure depicting recent demographics of
one-parent families demonstrates key aspects of these families.
• Chapter 3: Now titled “Diversity in Family Functioning,” this chapter provides a
foundation for developing a multicultural framework and sequences from culture and
ethnicity to gender issues to socioeconomic diversity and social justice perspectives in
family therapy. Recent research, demographics, and theoretical-clinical applications
are provided.
• Chapter 4: Now titled “Systems Theory and Systemic Thinking,” this chapter pres-
ents systemic thinking as a paradigm shift from typical Western thought. It presents a
new figure to convey a systemic perspective and recent examples of systemic concepts
in the practice of family therapy. The section on critiques of systems theory has been
revised to reflect recent developments. There are new insets on social media and the
family and systemic thinking.
• Chapter 5: We clearly delineate the progress of family therapy across decades. New
material regarding core competencies for family therapy, including standards created
by different professional organizations, is provided in this edition.
xxvi Preface
• Chapter 6: We explicitly include the legal and ethical perspectives on family therapy
by different professional organizations, referencing the ethics codes of those organi-
zations. A new table that compares the ethics codes of four organizations is provided.
We reference recent advances in professional practice, including the Affordable Care
Act. Information on the practice of and ethical problems associated with “e-therapy”
is also included.
• Chapter 8: We added material on the assessment and measurement of differentiation
in Bowen theory, as well as research about the use of Bowen constructs with diverse
populations.
• Chapter 9: There is new material about research on therapist practices and the client’s
experience of emotion in symbolic-experiential family therapy. Material is added on
steps in the change process in emotionally focused therapy and recent research that
demonstrates evidence for the effectiveness of the approach.
• Chapter 10: Material addressing research evidence for the structural model, particu-
larly with diverse populations, is added.
• Chapter 11: Information on brief strategic family therapy and the substantial
evidence for its effectiveness is added.
• Chapter 12: Clarifies the relationship of behavioral and cognitive-behavioral approaches
to couple and family therapy. There is a new section on the Gottman method, including
an outline of his research-based predictors of divorce and overview of the Sound Rela-
tionship House model, with diagram. There is a new summary of recent research regard-
ing behavioral couple and family therapy. Finally, there is substantial new material on
functional family therapy and sex therapy, as well as diversity aspects of all the models.
• Chapter 13: Recent advances in each model are described. New material on the ev-
idence for solution-focused brief therapy and the use of the approaches with diverse
populations is presented.
• Chapter 14: A recent model of the life narrative, including a figure, is presented. We
also clarify ideas like “the absent but implicit” and “externalizing” in Michael White’s
thinking and the way techniques like letter writing may adapt with new technology.
There is new material about the way narrative functions in diverse populations and
the creative use of postpositivist thinking and methods to demonstrate the clinical ef-
fectiveness of narrative therapy.
• Chapter 15: This chapter is now titled “Population-Based Family Treatments” to
capture the variety of client populations served by family therapy. It has significant
new material about families and schools; individual mental disorders in the family
context (depression, anxiety, substance abuse, eating disorders, schizophrenia); pri-
mary medical care and the family; gay and lesbian families; relationship education
(including u pdates on Prepare-Enrich and PREP); family violence; and divorce and
stepparenting; all feature recent research and clinical applications.
• Chapter 16: This chapter is now titled “Evidence-Based Family Therapy” to
recognize the importance of connecting research and practice in contemporary
Preface xxvii
family therapy. We present the value of both qualitative and quantitative methods
in family therapy research, as well as ways postmodern therapies can demonstrate
evidence for effectiveness. There is new material on assessment, including s ections
on couple assessment and individual assessment in family therapy, and new
content on process research, including intersession client input techniques. The
findings of three major family therapy review studies are included in the outcome
research section, and a new table depicts the evidence for family therapy with
particular issues.
• Chapter 17: New material is provided on common factors and the role they play in
interaction with model-specific change factors in effective family therapy. We clarify
the difference between eclecticism without theoretical unification and integration
based on some unifying rationale, noting challenges to theoretical integration, yet
highlighting recent approaches that advocate for or attempt integration in a coherent
fashion. A student exercise in formulation of a personal theoretical orientation has
been enhanced for this edition.
Ancillaries
Cengage Learning is committed to providing the most effective and up-to-date ancillaries
our audience requires. As with past editions, Family Therapy: An Overview is supported with
teaching and learning supplements to enhance the course experience. These are outlined
below.
MindTap® Counseling MindTap® for Goldenberg/Stanton/Goldenberg’s Family Therapy: An
Overview, 9th Edition is the digital learning solution that helps instructors engage and transform
today’s students into critical thinkers and provides students with the tools needed to better manage
their limited time, with the ability to complete assignments whenever and wherever they are ready
to learn.
Cengage Learning Testing Powered by Cognero® Cengage Learning Testing Powered
by Cognero® is a flexible, online system that allows you to: import, edit, and manipulate
content from the text’s test bank or elsewhere, including your own favorite test questions;
create m
ultiple test versions in an instant; and deliver tests from your LMS, your classroom,
or wherever you want.
Acknowledgments
This is to acknowledge my new co-author, Mark Stanton. Without his superb up to the min-
ute knowledge, his extraordinary editing skills and his general overall knowledge of the field,
I could never have accomplished the completion of this book. He has the best work habits of
any academic that I have worked with over my many years.
Thank you Mark!
Irene Goldenberg
xxviii Preface
We would like to express our appreciation to Michael Lee, Doctor of Psychology student at
Azusa Pacific University, for his outstanding work as a research assistant on this edition. Mark
Stanton is grateful for the support he received from his wife, Kathy, and his children, April,
Erin, Chelse, and Sean.
In every edition of Family Therapy: An Overview, we pay keen attention to the needs
of instructors and their students in preparing our new manuscript. The ninth edition is no
exception. We wish to thank the following reviewers for their insights as the new edition
was evolving. Their comments and suggestions for change were invaluable resources in the
preparation of the ninth edition:
Rebecca Koltz – Montana State University
Catherine Weigel Foy – Northwestern University
Cindy Silitsky – St. Thomas University
Victoria Fitton – Michigan State University
Gary Bischof – Western Michigan University
Irene Goldenberg and Mark Stanton

1
Adopting a Family
Relationship
Framework Learning Objectives
LO 1 D
escribe the diversity of
contemporary families
LO 2 E
xplain the importance of family
structure and interactive patterns
A family is far more than a collection of individuals sharing
LO 3 J ustify a resiliency-based
a specific physical and psychological space. While families understanding of family dynamics
occur in a diversity of forms, cultures, and complexities in LO 4 E
xplain how gender, race, and
today’s rapidly changing society, each may be considered a ethnicity influence families and
natural, sustained social system1 with properties: family therapy
LO 5 D
iscuss the evolution of family
• an evolved set of rules
therapy from cybernetics to
• many assigned and ascribed roles for its members constructivism
• an organized power structure
• intricate overt and covert forms of communication
• numerous ways of negotiating and problem solving
that permit various tasks to be performed effectively
The relationships among members of this microculture are

deep and multilayered, and they are based largely on a
shared history, internalized perceptions, and assumptions
about the world, and a sense of purpose. Within such a sys-
tem, individuals are tied to one another by powerful, dura-
ble, reciprocal, multigenerational emotional attachments and
loyalties that may fluctuate in intensity and psychological dis-
tance between members over time yet persist over the life-
time of the family.
Each family system is itself embedded in a community
and society at large. It is molded by its existence at a par-
ticular place and time in history and shaped further by a
multitude of interlocking phenomena, such as race, ethnic-
ity, socioeconomic status, family life cycle stage, number
of generations in this country, immigration status, sexual
Terms in boldface are defined in the Glossary at the back of the book.
1
1
2 CHAPTER 1
orientation, religious affiliation, the physical and mental health of its members, level of educa-
tional attainment, and family values and belief systems.
All these factors and many others influence the system’s development, beliefs, standards
for acceptable behavior, degree of flexibility in meeting both normal developmental chal-
lenges and unanticipated crises, and in general its adaptability and stability over time.
Before turning to these influences, we shall examine several basic ideas that characterize
most family systems.
Family Systems: Fundamental Concepts

All families create and socialize new members, and although most ultimately give these mem-
bers autonomy and do not expect them to live under the same roof into adulthood, family
membership remains intact for life. The power of the family is such that despite the possi-
ble separation of members by vast distances, sometimes even by death, the family’s influence
remains (Kaye, 1985). Even when a family member experiences a temporary or permanent
sense of alienation from the family, he or she can never truly relinquish family membership.
Should divorce occur, co-parenting may continue, and the former marriage continues to be
recognized with the designation of “ex-spouse” (McGoldrick & Shibusawa, 2012). For most
of us, relationships with siblings are likely to represent our longest continuous commitments
(Cicirelli, 1995).
As McGoldrick, Carter, and Garcia-Preto (2010) point out, families are subject to unique
constraints. A business organization may fire an employee viewed as dysfunctional, or an em-
ployee may resign if the structure or values of the company are not to their liking. The pres-
sures of family membership allow few such exits, even for those who move a great geographic
distance from their family of origin. Further, unlike members of nonfamily systems, who can
generally be replaced if they leave, family members are irreplaceable. Should a parent leave
or die, for example, and another person be brought in to fill a parenting role, the substitute,
regardless of successful effort, can never replace in the same way the lost parent’s personal and
emotional ties to the remaining members.
Growth and change in families and the individual members who compose them occur
concurrently, and understanding their interactions is essential in carrying out any reparative
or preventive work (Nichols & Pace-Nichols, 2000). In the process of growing up, family
members develop individual identities but nevertheless remain attached to the family group,
which in turn maintains an evolving identity or collective image of its own. These family
members do not live in isolation but rather are dependent on one another—not merely for
money, food, clothing, and shelter but also for love, affection, mutual commitment, compan-
ionship, socialization, the expectation of long-lasting relationships, and fulfillment of other
intangible needs. They maintain a history by telling and retelling their family “story” from
one generation to the next, thus ensuring a sense of family continuity and shaping the ex-
pectations of members regarding the future. To function successfully, members need to adapt
to the changing needs and demands of fellow family members as well as the changing expec-
tations of the larger kinship network, the community, and society in general (DeGenova,
Stinnett, & Stinnett, 2011).
Adopting a Family Relationship Framework 3
Apart from its survival as a system, a well-functioning family encourages the realization
of the individual potential of its members—allowing them freedom for exploration and self-
discovery along with protection and the instillation of a sense of security.
Constantine (1986) distinguishes between what he calls “enabled” and “disabled” family
systems. The former succeeds at balancing system needs as a family unit while simultaneously
facilitating the interests of all its members as individuals. Enabled families invent procedures
that attempt to satisfy the conflicting interests of their members. Constantine maintains that
to do less, or to prevail at the expense of certain members, reflects family disablement, often
manifested in unstable, rigid, or chaotic family patterns.
Some families, unfortunately, are so depleted as a result of external or internal stress (pov-
erty, migration to a country where they lack language skills or understanding of unfamiliar
customs, serious health problems, legal issues, unforeseen accidents) that they may need com-
munity support. Low-income families receiving social assistance and working-poor families in
particular may increase their chances for success and self-sufficiency when they receive such
social support. Pigott and Monaco (2004), Canadian community workers in a multiservice
center in Toronto, describe the debilitating effects of poverty and living in inadequate housing
in unsafe neighborhoods. Often led by a lone parent or parents who are unavailable or working
for long periods, with few siblings and limited contact with grandparents, such f amilies feel
isolated and defeated. They need social networks (healthcare facilities, after-school programs,
recreation centers, libraries, community agencies). Being a part of such a social system often
represents a step toward reducing isolation and increasing the possibilities of more effective
self-care and improved quality of life.
LO 1 Today’s Families: A Pluralistic View

Traditionally, entrance into a family system has been seen to occur only through birth, adop-
tion, or marriage. Today’s outlook, however, makes room for other committed family house-
holds beyond legally married heterosexual couples and their children (McGoldrick & Carter,
2010). There are further divisions and complexities within each type of family structure,
brought about by early or later marriages, interracial coupling, foster parenting, informal
kinship adoptions, social class position, and so forth. In general, an inclusive 21st-century
definition of family must go beyond traditional thinking to include people who choose to
spend their lives together in a kinship relationship despite the lack of legal sanctions or
bloodlines.
It no longer is realistic to speak of a typical American family, since contemporary life
is filled with families with differing living arrangements, styles of living, and organizational
patterns. As Goldenberg and Goldenberg (2002) observe:
The idealized, nostalgic portrait of the American nuclear family depicts a carefree, white fam-
ily with a suburban residence, sole-provider father in a 9–5 job, and a full-time, stay-at-home
mother always available when the children return from school. Both parents are dedicated to
child-rearing and remain together for life; children are educated in a neighborhood school and
attend church with their parents on Sunday; plenty of money and supportive grandparents are
available. (p. 10)
4 CHAPTER 1
Not only is such a depiction of intact (middle-class) family life alien to the vast majority
of people today, but there is doubt about whether it ever existed (Coontz, 1992). Although
divorce was less common in the past, families were often disrupted by the early death of a par-
ent or by abandonment by a breadwinner. Changes such as remarriage, child placement with
relatives, foster care, and orphanages often followed. So, despite the idealized picture of family
life, the risk of not growing up in an intact family has been a part of American life for some
time (Walsh, 2012b).
Marriage and intact family life, as Coontz (2005) observes, may be viewed as a social
invention that in its earliest form emerged from the division of labor between men and women
in early societies and served to ensure family survival and efficiency, as men and women were
assigned different but collaborative, complementary roles. Today’s occupational opportuni-
ties, the evolution of women’s rights, a more flexible commitment to marriage as a permanent
union, and the expectation of greater love and intimacy in marriage have changed expectations
regarding marriage. What has broadened our view of family life is the visible impact of working
mothers, single-parent households, dual-earner families, long-term unmarried cohabiting cou-
ples, never-married couples with children, stepfamilies, adoptive families, and same-sex couples
living together with or without children. Even our very sense of kinship itself has become more
fluid over the recent past, as suggested by high divorce and remarriage rates (Diderich, 2008).
Just as our view of how families are formed has changed, so too has our understanding of
the structure of family life. We turn now to the structural aspects of the family.
LO 2 Family Structure
Families typically develop certain basic structural characteristics and interactive patterns that
they utilize to respond to internal and external stresses. These are founded on shared assump-
tions and family narratives and determine the manner in which families adapt and cope with
life changes and challenges.
Basic Structural Characteristics

Whether traditional or innovative, adaptive or maladaptive, efficiently or chaotically orga-
nized, married or committed life partners with or without children, a family inevitably at-
tempts, with varying degrees of success, to arrange itself into as functional or enabling a group
as possible so that it can meet its shared needs and goals without consistently or systemati-
cally preventing particular members from meeting their individual needs and goals (Kantor
& Lehr, 1975). To facilitate the cohesive process, a family typically develops rules that outline
and allocate the roles and functions of its members. Those who live together for any length of
time develop repeatable, preferred patterns for negotiating and arranging their lives.
Even in a family crisis situation or where there is severe conflict between members, fam-
ilies are typically resistant to change and often engage in corrective maneuvers to reestab-
lish familiar interactive patterns. Regardless of format (e.g., nuclear family or s tepfamily) or
ultimate success, all families should work at promoting positive relationships among members,
attend to the personal needs of their constituents, and prepare to cope with developmental or
maturational changes (such as children leaving home) as well as unplanned or unexpected
crises (job dislocation or loss, divorce, death of a key member, a sudden acute illness). Some-
times, families will reorganize to develop their own special styles in order to adjust to the
challenges of life.
Family Interactive Patterns

Families typically display stable, collaborative, purposeful, and recurring patterns of interac-
tive sequences. These largely go unnoticed by outsiders, frequently are unstated, and are not
always understood by the participants themselves. Nonverbal exchange patterns among family
members, in particular, represent subtle, coded transactions that transmit family rules and
functions governing the range of acceptable behaviors tolerated by the family (for instance,
that a son does not speak before his father speaks, and he himself can take his turn only after
his wife has spoken). Such patterned interactions are jointly engaged-in, highly predictable
transactional patterns generated by all family members on cue, as though each participant
feels compelled to play a well-rehearsed part, like it or not.
Minuchin, Lee, and Simon (1996) illustrate this point with the following easily recogniz-
able examples:
The complementary construction of family members requires long periods of negotiating,
compromising, rearranging, and competing. These transactions are usually invisible, not only
because context and subject constantly change but also because they are generally the essence
of minutiae. Who passes the sugar? Who checks the map for directions, chooses the movie,
changes the channel? Who responds to whom, when, and in what manner? This is the cement
by which families solidify their relationships. (p. 30)
Shared family rituals—holiday celebrations, christenings, confirmations, bar and bat
mitzvahs, graduations, weddings, funerals, wakes—are part of ongoing family interaction pat-
terns that help ensure family identity and continuity. Rituals are symbolic actions that help
families adapt to change rather than struggle against it at the same time that they reaffirm
their group unity in dealing with a life transition. They anchor family members to the past,
providing a sense of family history and rootedness, while at the same time implying future
family interactions. Participating in rituals links the members not only to the family system
but also to the wider community and culture (Imber-Black, 2010).
Family Narratives and Assumptions

A family is a maker of meaning (Constantine, 1986), and our individual judgment about what
constitutes reality is a function of the beliefs and stories that the family (as well as the culture)
imparts about their experiences (Becvar, 2000). Throughout the course of its development, a
family fashions and helps instill fundamental and enduring assumptions about the world in
which it lives. As a result, the meanings and understandings we attribute to events and situ-
ations we encounter are embedded in our family’s social, cultural, and historical experiences
(Anderson, Burney, & Levin, 1999). Box 1.1: Thinking Like a Clinician is designed to help
you appreciate how therapists might begin to appreciate the importance of family narratives.
The narratives or stories a family recounts help explain or justify their structure and inter-
active patterns. Despite any differences or disagreements between members, the core of family
6 CHAPTER 1
BOX 1.1 Thinking Like a Clinician
Appreciating Family Narratives

Alert therapists pay attention to the unfolding narratives of the families with whom they work. To gain
experience in listening to narrative developments, respond to the following prompts as you consider
the narrative of your own family.
What family mementos or stories connect your family to a previous generation?
How does your family express its problems or limitations (by anger, attacking
the outside world, withdrawing from the outside world, etc.)?
What roles do you find the family has assigned to individual members (such as
“brother is the smart one,” “sister is the athlete,” or “father is the depressed
one,” etc.)? Can you discuss your role?
Have any losses (of a home, job, family members through death, etc.) affected
the way your family values itself?
Does your family strongly identify with an ethnic, racial, or religious heritage?
Has your family retained its socioeconomic position over generations?
Have gender or sexual identity issues been important in your family narrative
(gay parents, transgender family member, etc.)? Describe.
What is the role of education in your family?
How important is achievement (monetary, social class, education, athletic,

etc.) as a value to your family?
Describe an important family ritual, and explain how it influences the family’s
appreciation and understanding of itself.
membership is based on acceptance of and belief in a set of abiding suppositions or shared constructs about
the family itself and its relationship to its social environment. These constructs are often limited by social
class expectations and restraints that influence what members of that class consider to be possible, acceptable,
conceivable, or attainable in their lifetimes. Language and dialogue thus play crucial roles in how human be-
ings come to know the world and how they interpret or make sense of their subsequent experiences.
Some families generally view the world as trustworthy, orderly, predictable, masterable; they are likely
to view themselves as competent, to encourage individual input by their members, and to feel comfort-
able, perhaps enjoyably challenged, as a group coping with life. Other families perceive their environment
as mostly menacing, unstable, and thus unpredictable and potentially dangerous; in their view, the outside
world appears confusing and at times chaotic, so they band together, insist on agreement from all members
on all issues, and in that way protect themselves against intrusion and threat. Thus, the narrative a family
develops about itself, which is derived largely from its history, passed on from one generation to the next, and
influenced by social class expectations, has a powerful impact on its functioning.
The ways in which individuals and their families characteristically deal with their lives are not based
on some objective or “true” view of reality but rather on family social constructions—unchallenged views
of reality created and perpetuated in conversation with one another, possibly carried on over
generations. Such views may act as blinders or restraints—limitations a family places upon
itself by its beliefs and values—that prevent its members from noticing other aspects of their
lives or seeing other behavioral options. Members of these families typically construct a ratio-
nale for why undesirable behavior continues and how they have no alternative but to live their
lives in spite of it (Atwood, 1997).
In the postmodern outlook, there is no “true” reality, only the family’s collectively agreed-
upon set of constructions, created through language and knowledge that is relational and
generatively based, that the family calls reality. As we will illustrate throughout the book, the
postmodern view has had a powerful influence on how many family therapists view family
life—the social basis for acquiring knowledge—and how these therapists work collaboratively
with families to generate new possibilities and co-construct alternative narratives (Gerson,
2010; White, 2007).
LO 3 Family Resiliency
One aspect of the family is its resiliency, that is, its ability to thrive and maintain relatively
stable psychological and physical functioning even under adverse conditions. All families face
challenges and upheavals during their life cycle from within and without their structure; some
are expectable strains (brought on by such potential crises as retirement or divorce or remar-
riage), while others are sudden and untimely (an unforeseen job loss, the unexpected death of
a key family member or family friend, a holdup or rape or other violent and life-threatening
experience, an earthquake or flood). However, not all families react to these potentially dis-
turbing and disruptive events in the same way. Some may experience prolonged distress from
which they seem never to recover; others suffer less intensely and for shorter periods. For some
families, recovery may appear to come quickly, but they later begin to experience unexpected
health problems or somehow never again enjoy life the way they once did. Nevertheless, there
are large numbers who manage to cope with the temporary upheaval or loss, rebound, and
move on to the next challenge. This ability to thrive and maintain relatively stable psycholog-
ical and physical functioning after extremely aversive experiences, often showing only minor,
transient disruption, reveals a great deal about a family’s resilience (Bonanno, 2004). Box 1.2
presents such a case.
Few if any families can expect to avoid exposure to stress, loss, or potentially traumatic
events at some points in their life cycle. At the same time, as illustrated in Box 1.2, fami-
lies have the potential for growth and repair in response to distress, threat, trauma, or crisis,
emerging stronger and more resourceful than before (Walsh, 2012a). A family as a whole, or
one or more of its members, may manifest dysfunctional behavior during periods of persistent
stress, but family processes may mediate the person’s recovery, allowing the family system to
rally, buffer stress, reduce the chances of dysfunction, and support optimal adaptation.
Rather than view resiliency as a rare or special set of qualities a family may or may not
possess, Masten (2001) contends that such recuperative skills are common phenomena aris-
ing from ordinary adaptive processes successfully mastered by most children in the process of
development. She maintains that a relatively small set of global factors support resilience in
8 CHAPTER 1
BOX 1.2 Case Study
A Traumatized Family Rebounds from a Sudden Crisis

When Hurricane Katrina hit New Orleans in 2005, retained their belief that together they would
thousands of lives were disrupted as people lost meet the challenge. After a short period in which
their homes and possessions, their jobs, and both felt downcast and despondent, Paul looked
sometimes loved ones who were caught up in the up old high school friends, finally landing a job at
subsequent floods. Paul and Margaret, both in a construction company, where his architectural
their early 30s and near the beginning of their ca- skills made him a desired employee. Margaret,
reers, had come to New Orleans 3 years earlier, he no longer able to afford child care and struggling
as an architect, she as a real estate broker. When with the responsibilities of being a full-time mom,
forced to leave their newly purchased home, began to recognize some of the satisfactions that
which had been devastated by the hurricane, they came with being a stay-at-home mother, some-
were unable to recover any articles or possessions. thing she had not contemplated in the past. With
With their 1-year-old daughter, Christine, they fled no choice but to make decisions regarding where
in their car to the West Coast to move in with his and how they would live, they reassessed their pri-
parents for an indefinite period as they planned orities, recognized how much being together as
their suddenly disrupted future. a family meant to them, and acknowledged that
Although their marriage had been a relatively they were young people with resources who would
stable one, it now faced several crises simultane- learn to adapt.
ously: addressing questions of how to earn a living, Initially confused and despairing, feeling des-
where to live, how to arrange child care, how to re- perate at times during their first months in a new
sume a social life, and so forth. Living with Paul’s environment, they gradually realized that they
parents was difficult, since the house was crowded, needed to reorganize their lives to face the new
his mother was ill, his father was upset by the in- challenges. The new situation was hardly to their
trusion of the baby, and Paul and Margaret felt too liking, but they had each other, their child, and
old to now be living with and be largely supported faith in their relationship. Forming new friendships,
by his parents. Arguments broke out between fam- retaining a sense of humor, and recasting the crisis
ily members, and in general the home was filled they faced as a challenge rather than a defeat all
with tensions between the couples. helped. As they moved into their new small apart-
Despite the strain on their relationship, Paul ment, they retained the dream of returning to New
and Margaret, each with a history of personal Orleans soon, better prepared as a family to deal
as well as professional achievement, ultimately with future adversity.
children: connection to competent and caring adults in the family and community, cognitive
and self-regulating skills, a positive view of oneself, and motivation to be effective in the envi-
ronment. Moving away from a search for deficits or pathology in families in favor of seeking
its strengths and potentials—family resiliencies—is part of the evolving movement of positive
psychology (Seligman & Csikszentmihalyi, 2000; Sheldon & King, 2001). Here, researchers
and therapists have begun to study the nature of effective functioning and adaptation, paying
close attention to human capabilities and adaptive systems in individuals and families.
Walsh (2012a) identifies some key family processes in family resilience: (a) a consistent
and positive belief system that provides shared values and assumptions so as to offer guide-
lines for meaning and future action (e.g., viewing disruptions as milestones on their shared
life passages without assigning blame and recasting a crisis as a manageable challenge);
(b) the family’s organizational processes (how effectively it organizes its resources) that provide
the “shock absorbers” when confronted with stress (e.g., remaining flexible, open to change,
connected to each other); and (c) a set of family communication/problem-solving processes that
are clear, consistent, and congruent and that establish a climate of mutual trust and open
expression among its members (maintaining a shared range of feeling, shared decisions, cre-
ative brainstorming). Boyd-Franklin (2010) notes that working with ethnic minority families
during trauma r equires culturally sensitive interventions (see Box 1.3).
While some families may be (temporarily) shattered by crises, others emerge strength-
ened and more resourceful. Rather than view a symptomatic family member as a vulnerable
victim, thus pathologizing the family, the emerging viewpoint is that while problems may cer-
tainly exist within the family, family competencies nevertheless can be harnessed to promote
self-corrective changes. Resilience should not be considered a static set of strengths or qualities
but as a developmental process unique to each family that enables families to create adaptive
responses to stress and, in some cases, to thrive and grow in their response to the stressors
(Hawley, 2000). Adopting a resiliency-based approach in working with families calls for iden-
tifying and fortifying those key interactional processes that enable families to withstand and
rebound from disruptive challenges.
How the family organizes itself, how it retains its cohesion, how openly it communicates
and problem solves together to cope with the threat largely forecasts its ability to recover.
An affirming belief system aids the process. The support of a network of friends, extended
family, clergy, neighbors, employers, and fellow employees and the availability of community
BOX 1.3 FAMILY DIVERSITY
Therapy for ethnic minority families following disasters

Boyd-Franklin (2010) explored how African-American • Disasters that require relocation may fragment
families adapted to Hurricane Katrina in order to kin networks in collectivistic cultures, upsetting
inform family therapists as they provide services to the support mechanisms typically used by the
ethnic minority families following disasters. Her key families
points include: • Ethnic minority children, adolescents, and the
elderly may have special needs in the aftermath
• Disasters require cultural sensitivity and re-
of trauma and therapists must pay attention to
spectful treatment that understands the differ-
these concerns
ent perspectives of cultural and racial groups.
• Spirituality and religion may be especially
For example, many African Americans believed
important to some ethnic minority families in
that race contributed to slow government
coping with tragedy
response to the tragedy while few Whites en-
• Family systems therapy is appropriate for col-
dorsed that rationale
lectivistic ethnic minority families because it is
• Therapist insensitivity to perceived racism may
strengths-based and facilitates resilience
exacerbate the trauma for African-American
• Family systems approaches recognize the need
families
to assist families as they interface with a variety
• Family therapists need to recognize that an-
of agencies and organizations in the aftermath
ger in the face of perceived racism may be a
of trauma
healthy response and facilitate coping
10 CHAPTER 1
resources often contribute to family recovery. See Box 1.3 for a discussion of the role of spiri-
tuality within the family as an affirming belief system.
As Karpel (1986) emphasizes, even chaotic, disorganized, abusive, and multiproblem fami-
lies have resources. Here he is referring to the rootedness, intimacy, support, and meaning a fam-
ily can provide. In poor families, especially, the members need to feel their self-worth, dignity,
and purpose; resilience is facilitated for them if they experience a sense of control over their lives
rather than viewing themselves as helpless victims of an uncaring society (Aponte, 1994, 1999).
In general, what factors increase the likelihood of greater family resiliency? Goldenberg
and Goldenberg (2002) suggest the following:
All families possess the resources, and thus the potential, for resilience. In traditional fami-
lies, usually organized according to some form of generational hierarchy, those with greater
resilience are able to balance intergenerational continuity and change and to maintain ties
among the past, the present, and the future without getting stuck in the past or cut off from it.
Clarity and ease of communication also characterize such families; a clear set of expectations
about roles and relationships within the family is provided. In whatever type of family form—
whether led by never-married mothers, stepfathers, two working parents, or grandparents—
resilient families respect individual differences and the separate needs of family members.
These families have mastered successful problem-solving strategies by developing reparative,
resiliency-enabling processes that promote endurance and survival. (p. 12)
The resiliency construct challenges the family therapist to attend to the family’s resources that
can be mobilized to deal with a present crisis or adversity (as opposed to a deficit-focusing model
directed at detecting what’s wrong with the family). It is intended to have an empowering or en-
abling effect as it encourages the family to search for resiliencies, including previously untapped
resources, within its network of relationships. Successfully managing a crisis together deepens the
family bond and strengthens its confidence in its capacity to prevent or manage future adversities.
LO 4 Gender, Race, and Ethnicity and Family Therapy

In our discussion of resiliency, we noted that often strains on the family occur from outside
the family system. Indeed, and much more broadly, the structure, interactive patterns, nar-
ratives, and assumptions of a given family have many and varied influences from the outside
world. As we note throughout the book, the family and the social universe within which
the family finds itself are mutually informing in a complex and ever-changing relationship.
Two of the most influential social forces that affect the creation, development, and meaning
making of a family are gender and cultural diversity, to which we now turn.
Gender Roles and Gender Ideology

Typically, indoctrination into different socially based gender role behavior in the family begins
early in life for males and females. While biology undoubtedly plays a determining role in gen-
der differences, most of the differences (value systems, personality characteristics, roles, prob-
lem-solving techniques, attitudes toward sexuality, etc.) result from learning that is reinforced
by society and passed down across generations (Philpot, 2000). As a result of their differ-
ing socialization experiences, supported by general societal (and specific cultural) stereotypes,
members of each sex for the most part develop distinct behavioral expectations and are granted
disparate opportunities and privileges. Males and females typically grow up with different
senses of entitlement, exercise differing degrees of power, and have differing life experiences.
Gender shapes our individual identity and expectations, our role and status within our
family, and the real and perceived life choices open to us (Haddock, Zimmerman, & Lyness,
2003). Men traditionally have played the more powerful role in most heterosexual families: a
man’s career moves and personal interests were apt to be prioritized; less was expected of him
in carrying out household chores; he was likely to be granted the major (or final) influence
in family decisions; his leisure time and discretionary spending were given primary attention;
and he was expected to have less emotional investment in family relationships.
However, as society’s awareness of the crucial role of gender—as a determinant of per-
sonal identity, sociocultural privilege, or oppression—has grown in recent decades, largely be-
cause of women’s increased employment and the feminist movement, so has recognition of the
need to overcome gender inequalities and stereotypes that limit psychological functioning for
both sexes (see Chapter 3) and for men and women to co-construct new interactive patterns
(Avis, 1996). As a consequence, gender-role changes in recent decades have had a powerful
impact on family structure and functioning. As the percentage of women in paid employment
has risen, couples have needed to redefine at-home responsibilities of men and women; and
overall, the pattern of gender-linked behaviors, expectations, and attitudes regarding a family’s
sex-defined roles has begun to change. See Box 1.4: Evidence-Based Practice to learn more
BOX 1.4 EVIDENCE-BASED PRACTICE
Dual Work Families

Today’s average American family is apt to have class play a decisive role in how such families man-
two working adults and to rely on the income of age best to cope. In single-parent households, the
both partners for economic survival. Typically, they sole parent is almost certain to be working outside
face a major challenge in determining how best to the home (Galinsky, 1999).
balance work and nonwork tasks (Barnett & Hyde, Barnett and Hyde (2001) suggest that the fa-
2001). Employed married women now spend ther who spends long hours caring for his children
less time in child care and household tasks than while his wife works a different shift may resent
they did 30 years ago, and correspondingly, their child caregiving because he perceives it as a
employed husbands spend more time on those “woman’s job” and thus may get little benefit from
home-based activities. Inevitably, such shifts have his new father role. Similarly, if a wife works out-
caused striking changes in the relationships be- side the home but prefers to be at home because
tween men and women; in many cases, they have she believes it is a woman’s duty to be a full-time
resulted in family instability as couples try to work mother, she may not benefit from her new work
out differences in their gender-role ideologies (the role. Men have often been socialized to believe
extent to which they hold traditional or nontradi- they are carrying out their role within the family by
tional views of the social roles of men and women). working, while working women sometimes worry
Fraenkel and Capstick (2012) have examined the that they are being bad mothers (Coltrane, 1998).
challenges of navigating work and family respon- In general, those who adopt a more egalitarian
sibilities in two-parent, two-income families, rec- attitude benefit more from combining work and
ognizing that race, ethnicity, immigration status, family roles than do those with more traditional
gender identity, sexual orientation, and social gender-role ideologies.
12 CHAPTER 1
about how contemporary two-income families and gender ideology affect each other. Male
and female role differences have become less clearly defined today as many families, especially
those led by the younger generations, struggle to find more flexible, if not yet fully worked-
out, patterns for living together harmoniously in a dual-working household. Time pressures,
how best to juggle work and family obligations, who takes time off from work to care for a
sick child—these are some of the day-to-day issues two-income families typically face. In the
case of working-class dual earners, a sick child may become a family crisis if their jobs do not
permit time off for either parent.
Cultural Diversity and the Family

Cultural factors, largely overlooked by family therapists in the past, now play a central role
in our understanding of family life. Increased immigration, particularly over the last 20
years—the largest two-decade influx in American history—has added substantially to our
appreciation of the primacy of cultural diversity in our society. Values, rituals, common trans-
actional patterns, ways of communicating—even the very definition of “family” in different
cultures—all require examination if unbiased and comprehensive family assessment and ef-
fective counseling are to be provided (Aponte & Wohl, 2000). The importance of kinship
networks, the roles of extended family members, expectations regarding male and female be-
havioral patterns, levels of acculturation and ethnic identification, and socioeconomic power
or lack thereof vary for different groups and have an impact on how (and how well) families
function.
For example, while the historically dominant American (Anglo) definition of family
typically focuses on the intact nuclear family, Italians tend to refer to family as the entire
network of aunts, uncles, cousins, and grandparents—all of whom are likely to be involved
in family decision making. African Americans are apt to think of family as a wide network
of kin plus long-time friends and other community members. For the Chinese, family
includes all their ancestors and descendants (Hines, Garcia-Preto, McGoldrick, Almeida, &
Weltman, 1999).
In Ethnicity and Family Therapy, McGoldrick, Giordano, and Pearce (2005) present
descriptions of common structural patterns between families from more than 40
different ethnic groups, underscoring that family therapy clients from each group may
make different assumptions about the therapeutic process, emphasize different family
issues of importance to them, and bring different problem-solving tools and resources
in dealing with those issues. Boyd-Franklin (2003a) has elaborated on African-American
life experiences, as has Hayden (2001) in describing Irish-American life and Falicov
(2013) in offering guidance in considering the cultural context while working with
Latino families.
McGoldrick and Ashton (2012) emphasize the need for clinicians to examine the various
facets of their own identity, their own ethnicity and cultural heritage—and to become
aware of their own cultural biases and prejudices—in order to increase their flexibility and
c ompetence to work with clients they are likely to encounter in our multicultural society. As
they note:
Cultural competence requires not a cookbook approach to cultural differences but an appreci-
ation for the often hidden cultural aspects of our psychological, spiritual, and physical selves,
a profound respect for the limitations of our own cultural perspective and the ability to deal
respectfully with those whose values differ from our own. (p. 239)
Social class differences also add to diversity between families, shaping the resources, ex-
pectations, opportunities, privileges, and options of their members (Kliman, 2010). Depend-
ing to a large extent on social class membership, work may be fulfilling or demoralizing; a
means to achieving upward mobility or a dead end; filled with satisfactions or boredom; or, in
the case of the underclass, frequently nonexistent (Wilson, 1996).
Kliman and Madsen (1999) emphasize that more than family income is involved in class
definitions; the interplay of ethnicity, religion, and education also influences perceived social
status. As they illustrate:
A professor is seen as being in a higher class than a contractor who has equal income—unless
the professor is a Latina single mother and the contractor is an Anglo-American man from “an
old family.” Women’s and children’s class standing plummets after divorce. A Black executive
has less effective class standing than White subordinates when trying to hail a cab, join a coun-
try club, buy an elegant house, or insure his children’s class stability. In restaurants and hotels,
Whites may ask him to serve them. (p. 89)
Boyd-Franklin and Karger (2012) draw attention to the complex interplay of race and so-
cial class. Beyond the simplistic equation of Whites as middle class and Blacks as poor, consid-
erable variety occurs within each group. They note, for example, that a Black family classified
as poor because of low income may have middle-class values, aspirations, and expectations for
their children.
In describing a complex interaction of ethnicity, social class, and gender, Sarmiento and
Cardenal (2009) note how differently the relationship between depression and poor fam-
ily functioning are experienced by Latino men and women. Further, they indicate that the
pressure to acculturate affects Latinos differently. Non-Latino therapists will need to appre-
ciate a very wide range of factors to work successfully with members of this population. See
Chapter 3 for more details.
Social class and a family’s socioeconomic status have only recently been given sus-
tained scholarly attention. In addition to the impact of material wealth or its absence on
the family, the experience of classism—a bias against people from social classes different
from one’s own—may also have an impact on family functioning. Liu (2010) notes that
the impact of social class and classism on mental health functioning crosses racial, eth-
nic, and social lines and significantly contributes to a sense of well-being. He argues that
any attempt to understand individuals must include an understanding of how economic
issues contribute to experienced difficulties. As with any other bias, therapists need to
explore their own reactions to working with people of social classes and economic statuses
different from their own.
14 CHAPTER 1
Those most vulnerable to poverty are nonwhite minorities, single mothers, children under
18, and the elderly (Lott & Bullock, 2001). As we describe family behavior patterns through-
out this text, it is important to bear in mind how client lives are constrained by the larger
forces of racial, cultural, sexual, and class-based inequalities (McGoldrick & Hardy, 2008). In
addition to these forces, we may add the impact of differences in terms of religion, sexual ori-
entation, gender, and immigration status. Indeed, it no longer makes sense to consider any of
these forces as separate influences when working with people therapeutically. They all interact
and contribute to the context within which therapists may begin to understand both clients
and themselves (Rastogi & Thomas, 2009).
Impact of Gender and Cultural Influences

on the Therapist and Therapy
As we have noted throughout this chapter and will continue to do throughout the book, an
expanded view of family life compels therapists to broaden their own understanding of what
life is like for those whose backgrounds may be quite different from their own. Culturally com-
petent therapists continually reexamine their thoughts and feelings about others (Ponterotto,
Casas, Suzuki, & Alexander, 2010).
For example, therapists need to consider how gender has influenced their personal devel-
opment. Knudson-Martin and Laughlin (2005) note, for example, that it is not unusual for
heterosexual therapists working with families led by same-sex partners to experience uninten-
tional bias. They suggest that family therapy has been based on a view of sex and gender that
creates a dichotomous sense of self and other (therapist and gay person) in which the “other”
becomes a “type” rather than a living and breathing person. They note that the unintentional
creation of categories may limit flexibility in working together and advocate a “postgender”
approach organized around a relationship model based on equity rather than gender. Alterna-
tively, the emergence of polyamory, a multiple-partner form of family in which adults openly
consent to intimate relationships with more than one person, may challenge family therapists
who identify with monogamy (Anapol, 2010).
Therapists also need to consider whether the gender of the therapist matters in therapeu-
tic outcomes. Clients select therapists based on many criteria such as the therapist’s age, race,
religion, and sexual orientation. Of course, gender is also a factor in selecting a therapist. In
family therapy the gender of the therapist may cause difficulties as when, for example, the fa-
ther insists on seeing a male therapist when his wife and daughter would prefer a female ther-
apist. While gender choice might affect the beginning of therapy, research suggests that the
gender of the therapist does not appear to influence clinical outcomes, except in some cases
involving adolescents. However, other criteria may moderate or mediate the impact of gender
(Blow, Timm, & Cox, 2008).
An additional element in this process of self-discovery is for therapists to learn how biases
felt toward people from backgrounds different from their own may influence the therapy.
Even well-intending therapists may encounter obstacles to effective work when an unexpected
bias emerges. See Box 1.5: Thinking Like a Clinician to help explore your own possible biases.
BOX 1.5 THINKING LIKE A CLINICIAN
Assessing One’s Own Possible Biases

Imagine that each of the following “clients” enters your therapy office. Try to picture each one in turn,
and then write down any thoughts and feelings about the person or people that occur to you. This ex-
ercise is personal and need not be shared with anyone, so be as honest with yourself as possible. Do
any of your reactions surprise you? In what way or ways? Could any of your reactions interfere with your
ability to work with the client? If so, how?
• An extremely underweight 15-year-old girl
• A father with tattoos of naked women on his arms
• A boy wearing eye makeup and lipstick
• Parents of a 12-year-old boy who are in their 60s
• (If you are straight) A lesbian couple who kiss each other just as they sit down
• (If you are gay) A straight couple who kiss each other just as they sit down
• A family with seven children
• An African-American man with his White girlfriend
• A transgender individual considering gender-related surgery
• A severely overweight boy eating an ice cream cone
• A pregnant mother who is obviously intoxicated
• Two gay men with their adopted Asian-American daughter
• A client obviously much wealthier or much poorer than you
The impact of such forces as race, ethnicity, gender, sexuality, socioeconomic status, and
so forth on client and therapist identity development are so important that we take them up
in greater detail in Chapter 3.
Shifting Perspectives of Family Therapy

Scientific models help shape the boundaries of a discipline and set the agenda regarding the
subject matter and methodology to be followed in seeking answers. When one set of attitudes,
philosophies, viewpoints, procedures, or methodologies dominates scientific thinking—
known as a paradigm—solutions to problems are sought within the perspective of that school
of thought. However, should serious problems arise that do not appear to be explained by
the prevailing paradigm, scientific efforts typically occur in an attempt to replace the existing
system with a more appropriate rationale.
Shifting Paradigm: From Individual Psyche to Family System

During the first half of the 20th century, psychotherapy, most often in the form of Freudian,
or classical, psychoanalysis, tended to focus on the inner world—the intrapsychic world—of
an individual, even as family relationships were seen as influencing it. Although Freud wrote
extensively on the family’s influence on an individual’s personality, he generally advocated
Another random document with
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Tras esta lucha estaba la Cierva
en Menalo, con sus pies de metal
y cuernos de oro, á quien con
gran trabajo Hércules mataba
triunfante con los ricos despojos
de su empresa.
Assimismo desterraba las
Harpías, por voluntad del Rey
Fineo.
Luego, más trabajosamente,
dividía los altos montes de Calpe
y Abila, por donde el fiero mar
estrechamente passasse.
Más allí se mostraba con las
pesadas colunas en sus hombros.
Tras esto, en la ribera del mar,
libraba á Hesiona, hija de
Laomedón, matando la fiera que
para su comida la buscaba.
Después, á aquel que, por
voluntad de los Dioses, en el
monte Cáucaso, viendo comer
sus hígados de una cruel águila,
brevemente criaba otros donde el
mismo tormento se le diesse.
Más adelante estaba cuando la
gente Pigmea, al pie del monte, le
quiso matar viéndole dormido.
Y cuándo llevó los pueblos
franceses atados á su lengua.
Y cuándo al que con sangre
humana engordaba sus caballos
dió el mismo castigo, haciéndole
manjar dellos.
Y cuándo en las bodas mató los
Sagitarios: veíase el Centauro
Nesso muerto con sus saetas, al
tiempo que al passar el río Eveno
le llevaba á Deyanira.
Llegado, pues, al fin desta
historia, se veía lastimosamente,
casi en venganza de la
quebrantada pierna del Dios Pan,
cuándo la celosa mujer, con la
engañosa camisa que el Centauro
le dió, pensando remediar su mal,
fué causa de mayor daño, porque,
vistiéndosela el ausente marido,
con la furia del pestífero veneno
que en sí tenía se le pegó á las
carnes, y abrasándole los
tuétanos y entrañas, el sinventura
Hércules, fuera de su sentido,
vertía los humildes sacrificios,
derribaba los templos y arrancaba
los duros troncos, y procurando
desnudarse, despedazaba sus
mismas carnes, descubriendo los
propios huessos y nervios por
donde, como de gran hoguera,
salía un espesso humo, y él,
mirando á los cielos con amargo
rostro, á ratos de su crueldad
parecía que se quexaba, y otros
pedía socorro á tan insufrible y
dolorosa muerte, á veces que, sin
sentido, destruyendo sus carnes,
se tendía en tierra y callaba.
Estaba sobre un altar, en medio
del templo, el vestido, el cayado y
la lira de Apolo, aquel mismo
apero con que moró en las
selvas, y por las altas colunas
sembrados infinitos despojos de
pastores y fieras, cayados y
zampoñas, cabezas de los lobos
y pies de águilas, versos y prosas
que no poca hermosura
acrecentaban al grandioso
templo. Pero Siralvo, que en
Filida veía el de su alma, pocas
señas pudiera dar de lo que aquél
tenía; y ella, que no dudaba los
efectos de su valor, no lo hacía en
volver la luz de sus hermosos
ojos al enamorado pastor,
robándole nuevamente, á cada
vuelta, el alma, y dejándole cada
vez nueva vida con que viviesse.
En tanto que esto passaba, Sasio
y Arsiano vinieron allí por orden
de Mandronio, y viendo junto
cuanto en la música podía
desearse, amén de Filardo y
Matunto, que si no eran más no
eran menos, acordaron de
entrarse en el jardín del templo,
que, aunque pequeño, era lleno
de frescura y deleite. Nunca
Vertuno tuvo los suyos
compuestos con tanta destreza
como éste lo estaba sin arte; las
flores y hierbas, las aguas y las
aves que en él moraban, todo era
extremadamente bueno. Pues
como dentro se vieron, Florela,
que tiernamente á su señora
amaba, mirando su hermosura y
la habilidad de los pastores con la
comodidad del tiempo y del lugar,
pidió encarecidamente que,
tomando el sujeto de la beldad de
Filida, cantassen; deseo fué el de
Florela que todos le tenían, y
tocando el principio de la empresa
á la gentil Belisa, desta manera
comenzó su canto, y desta fueron
por su orden prosiguiendo:
BELISA
Las ondas quiere sulcar,
el agua en red oprimir,
el fuego quiere medir
y el viento quiere pesar
el que pretende loar,
Filida, vuestra figura,
siendo el comenzar locura
é impossible el acabar.
ARSIANO
Lazos de amor son aquellos
do Amor tiene su prisión,
pues sin dar en corazón
nunca hace tiro dellos;
hablo de vuestros cabellos,
por cuya gran excelencia
el sol no tiene licencia
sin deslumbrarse de vellos.
FINEA
El lugar esclarecido
sobre los dos claros ojos,
de mil sangrientos despojos
á costa ajena teñido,
es duro campo corrido
de la Muerte y del Amor,
donde él es el vencedor
y ella el premio del vencido.
ALFEO
Soles sois con que
alumbráis,
rayos con que derretís,
saetas con que herís,
licor con que remediáis
los ojos con que miráis,
en quien se mira el Amor,
ó para hablar mejor,
los ojos con que matáis.
FLORELA
Vuestras mejillas,
sembradas
de las insignias del dia,
florestas son de alegría
de la eterna trasladadas,
donde no por las heladas
ni por las muchas calores
faltan de contino flores
divinamente mezcladas.
SASIO
El alinde que divide
las dos florestas reales,
con frescuras celestiales
los rayos del sol despide;
á la misma invidia impide
su proporción aguileña,
y aunque es medida pequeña,
al Amor inmenso mide.
FILENA
Vuestra boca no es coral
ni vuestros dientes aljófar,
que el aljófar es azófar
y el coral bajo metal;
mas es puerta principal
fabricada dal primor,
archivo do tiene Amor
todo su bien ó su mal.
PRADELIO
La coluna generosa
deste edificio tan claro,
más que del mármol de Paro,
más que blanca poderosa
es la garganta graciosa,
fuente rica de dulzor,
donde la fuerza de Amor
segura y libre reposa.
CELIA
Vuestro pecho no hay
braveza
que no se amanse con él,
ni hay quien pensando en él
no esforzasse su flaqueza,
á quien dió naturaleza,
por mezclar gracia y rigor,
de la leche la color
y del hierro la dureza.
CAMPIANO
Lo que falta por contar,
después de la blanca mano,
á quien el sentido humano
es imposible loar,
no quiero en ello hablar;
que aunque la fe, como
diestra,
tan altos bienes nos muestra,
son más para contemplar.
MANDRONIO
Vuestra discreción loara,
á no haber considerado,
que como quedo agraviado
el cuerpo, al alma agraviara;
á Vos sola es cosa clara
que concede la razón,
que hiráis al corazón
cuando amaguéis á la cara.
SIRALVO
Yo no me hallo bastante
á proseguir este intento
bien, hasta que el
pensamiento
se pierda por arrogante,
Razón diga y Amor cante
y lleve la Fe el compás,
donde queda más atrás
quien passa más adelante.
No acabaran tan presto los

pastores si la bella Filida, que,
con una gravedad suavíssima,
estuvo escuchando sus loores, y
acrecentando la causa dellos en
su soberano semblante, no los
atajara, tomando á Belisa la lira, y
obligada de su liberal condición,
vuelta á Siralvo le dixo: Pastor,
yo quiero cantar una glossa tuya,
de una canción ajena á que soy
muy aficionada, porque me la dió
Florela y porque la glosa lo
merece. Bien basta tu afición,
dixo Siralvo, para su
merecimiento, y la merced que
nos haces para que todo el
mundo quede invidioso de
nuestra ventura; y con esto
Filida, alegrando tierra y cielo,
comenzó á tañer y cantar, y los
pastores á suspenderse
oyéndola.
FILIDA
Canción.
Mi alma tenéisla vos,
y yo á vos en lugar della,
¿á quién da más gloria Dios?
á ella sin mí con vos
ó á ella con vos y sin ella?
Glossa.
Aquel venturoso día
que Amor, con industria y arte,
me robó cuanto tenía,
fué tanta su cortesía,
que os dió la más noble parte,
y como solo mi oficio
es contentar á los dos,
por principal ejercicio
mi cuerpo está en su servicio,
mi alma tenéisla vos.
Bien galardonado voy
si sirvo como cautivo,
pues cuando en la cuenta
estoy,
hallo que es lo que recibo
mucho más que lo que doy;
en gran deuda me dejáis,
no quedaréis sin querella,
pues por favor ordenáis
que vos mi alma tengáis
y yo á vos en lugar della.
En la gloria que se ven,
han movido gran cuestión
cuerpo y alma sobre quién
consigue más alto bien,
y entrambos tienen razón.
El alma dice que allá
está contino con vos;
el cuerpo que os tiene acá:
¿quién, señora, juzgará
á quién da más gloria Dios?
Firmes en su diferencia,
cada cual lleva victoria,
sin que se dé la sentencia,
porque es tal la competencia,
que acrecienta más la gloria,
y como se ven en calma
en este pleito los dos,
que no importa, dice el alma,
que ya se le dió la palma
á ella sin mí con vos.
Aquí comienza á juraros
el cuerpo que la dejó
por poder mejor gozaros,
y concluyendo en amaros,
la duda en pie se quedó.
Mas dixo Amor que él saldría,
cerrados los ojos della,
porque en vuestra compañía,
á mi alma escogería,
ó á mí con vos y sin ella.
Callaron las aves, cessó el viento,

paró la fuente, y pienso que el sol
se olvidó de su camino, mientras
la sin par Filida cantó estos
versos, y acabados, con un
donaire igual á su hermosura,
volvió la lira á Belisa, como
corrida de haber cantado; pero los
pastores, que de su llaneza como
de su beldad estaban cautivos,
vueltos unos á otros alabaron la
hora en que el cielo había juntado
en Filida cuanto bien por el
mundo repartía. Esso no, dixo
Florela, que lo que en Filida hay
no se halla en el mundo junto ni
repartido. Passo, pastores, dixo
Filida, que me afrento mucho de
oirme loar, y no quiero que en mí
cesse la música: gusto tanto de
canciones viejas bien glossadas,
que esso me hizo cantar, y cierto
es la cosa en que el poeta
muestra mayor ingenio. Una muy
nueva sé yo, dixo Siralvo, y diréla
con tu licencia. Para esso, pastor,
dixo Filida, tú la tienes, y más si
es tuya. Primero, dixo Siralvo,
que te diga el dueño, quiero
decirla y saber lo que te parece.
SIRALVO
En mi pensamiento crecen
mis esperanzas y viven;
en el alma se conciben
y en ella misma fenecen.
Glossa.
Porque en el mal que me

hiere
perpetua pena reciba,
el Amor ordena y quiere
que en mi pensamiento viva
lo que en mi ventura muere;
pues si alguna vez se ofrecen,
ó de lejos aparecen
esperanzas de mi bando,
en vuestra gracia menguando,
en mi pensamiento crecen.
¿Do llegará mi tormento?
Pues por caminos tan agros
do no llegó entendimiento,
suben á hacer milagros.
Ventura y mi pensamiento,
en ello gloria reciben,
y en libertad se aperciben
á morir desesperadas
y en él están sepultadas
mis esperanzas y viven.
Aunque falsas, lisonjeras,
mil veces vengo á pensar
que deben ser verdaderas,
viéndolas en el lugar
do suelen estar las veras,
y aunque por milagro aviven,
en parte inmortal se escriben;
que como su vanidad
se engendra en la voluntad,
en el alma se conciben.
En noble parte nacidas,
en noble parte criadas,
nobles aunque van perdidas,
noblemente comenzadas
y en nobleza concluídas;
al pensamiento obedecen,
y en su prisión resplandecen
y su natural guardaron,
que en el alma comenzaron
y en ella misma fenecen.
A todos contentó la glossa de

Siralvo, y más á Filida, que vió
en sí la causa della, y
pareciéndole hora de que los
pastores descansassen, mandó á
Florela por señas lo que había de
hacer, y al punto se puso en
medio de todos una mesa ancha,
limpia y abundante de dulces y
regaladas viandas, que del
albergue de Vandalio habían
traído, y sin esquivarse Filida de
comer con los pastores, todos
juntos lo hicieron, salvo Finea y
Alfeo, que de secreta mano se
habían sentido trabar los
corazones, y entre el viejo dolor y
el nuevo, estaban con una
suspensión en los espíritus, que
sin poderse ellos entender,
fácilmente los entendieron todos.
¡Oh grande y poderoso Amor!
¿será possible que Alfeo,
muriendo ayer por Andria,
bellísima cortesana, hoy se
enamore de la serrana Finea?
Verlo he menester para creerlo,
que Finea de Alfeo, menos
maravilla me hace, porque,
aunque rústica y criada en
aspereza, es muy discreta y
hermosa, y Alfeo excessivamente
aventajado al pastor de quien ella
era despreciada. Si nuevamente
estos dos se aman, cosa es que
no se podrá encubrir: alcemos las
mesas, levántense los pastores y
queden solas Filida y Celia en el
fresco jardín; que los demás en el
templo podrán passar la siesta,
donde hallarán á Filardo, que, á
excusa de Silvia, se volvió tras
ellos, y aunque había gran rato
que allí estaba, no quiso entrar al
jardín, antes, saliendo á la ribera,
por un pequeño resquicio del
muro estuvo mirando y oyendo lo
que passaba, y cuando sintió que
los pastores al templo salían,
adelantóse y entró primero. Filena
y Pradelio holgaron poco de verle,
pero Campiano íntimo amigo
suyo, con gran caricia le recibió y
assí luego los dos se apartaron, y
por otra parte Florela y Siralvo,
Pradelio y Filena, Belisa y
Mandronio, Sasio y Arsiano, á un
lado del templo se pusieron á
concertar alguna fiesta, para
entretener aquella tarde á la
hermosa Filida, y la mejor les
pareció representarle la Egloga
de Delio y Liria y Fanio, pastores
de aquesta ribera, que con sus
casos habían dado mil veces
materia á los poetas. Belisa tomó
la persona de Liria; Sasio, la de
Delio, y la de Fanio, Arsiano, y
mientras en baja voz estaban
ensayándose, Alfeo y Finea en
algo se ocuparon: sentados los
vió Siralvo á una parte del templo,
hablando menos palabras que
solían, demudados de su color
natural. No pudo tanto consigo
que no se llegasse á ellos, y
antes que nada les preguntasse,
Alfeo le dixo, cuanto los pudiera
preguntar: Siralvo mío, por tres
partes me siento combatir y por
todas tres vencer: las sinrazones
de Andria contrastan mi afición,
tus consejos me mudan la
voluntad, la beldad de Finea me
cautiva. A mí me enamora todo,
dixo Siralvo; ¿pero á ti, serrana,
qué te parece? ¿Qué estás
hablando por mí? dixo Finea.
¿Pues qué haremos, dixo Siralvo,
de Andria y Orindo? Lo que ellos
hicieron de nosotros, dixo Alfeo, y
con esto se dieron las manos de
no faltarse jamás, tomando al
Dios de los pastores por testigo; y
llenos de contento y placer se
fueron con los que ensayando se
estaban. Campiano y Filardo
siempre se estuvieron apartados,
y bien se le echó de ver al pastor
el mal que por Filena sufria, pues
sin bastar su dolor ni el
menosprecio con que le dejaba,
se iba tras ella, sin poderse
refrenar en sus deseos. No tomó
la sin par Filida mucho tiempo de
reposo, antes, sintiendo que los
pastores en el templo esperaban
que los llamasse, mandó á Celia
que lo hiciesse, y assí fueron
todos al jardín, salvo Belisa, Sasio
y Arsiano, que se quedaron para
entrar representando, y después
que todos se sentaron, por orden
de Filida, los tres que habían
quedado, entraron por la suya,
como aquí veremos.
EGLOGA
Fanio.—Delio.—Liria.
LIRIA
Floridos campos, llenos de
belleza,
en cuya hermosura, sitio y
traza,
gran estudio mostró
Naturaleza.
En vosotros se halla
espessa caza
de aves, bestias y animales
fieras,
y tanta flor y fruto, que
embaraza.
En vosotros, majadas y
praderas,
donde se ven ganados
abundosos
y en medio los inviernos,
primaveras.
No faltan los pastores
querellosos,
que forman al Amor quexas
sin cuento,
y otros, regocijados,
venturosos.
Unos, al ejercicio dan su
intento,
cuál corre, salta, tira, lucha ó
canta,
cuál en los huertos pone su
contento.
Aquél enxiere, siembra,
poda ó planta,
otros con su ganado se
recrean,
viendo desde las sombras
copia tanta.
Mira los cabritillos que
pelean,
y después á sus madres van
buscando,
que con ubres pesadas los
desean.
Allí ve sus zagales
ordeñando;
allí las cabras que la nueva
hoja
no con poca codicia van
buscando.
Una al agua parece que se
arroja,
otra en lo mas espesso está
mordiendo,
que el rigor de la zarza no la
enoja.
Luego ve la ovejuela, que
paciendo,
apoca simplemente lo que
halla,
lo más dificultoso no
queriendo.
Y si Orión se mueve á dar
batalla,
permite que el pastor pueda
avisarse
y con flacos ingenios mitigalla.
Veréis á los carneros
alegrarse;
veréis las hormiguillas
polvorosas,
ciegas, unas con otras
encontrarse.
Las ánades bañarse
presurosas,
y lamerse al revés el buey el
pelo,
y pacer las becerras más
golosas.
Cuervos, grajas, cornejas
para el cielo
suben y bajan luego con ruido,
y tornan para arriba con su
vuelo.
Oyese en las lagunas el
sonido
de las cantoras ranas en más
grado
que en el sereno tiempo le han
tenido.
Vese de blancas aves
ayuntado
más número que suele en
valle ó sierra,
y el cabrío dormir más
apretado.
Escarba la ovejuela por la
tierra,
y la golondrinilla á la corriente,
con pobres alas hace flaca
guerra.
Al fin esto se passa
brevemente,
y en tanto, en la abrigada
cabañuela,
arropado el pastor poco lo
siente.
Después que nieva, que
ventisca y hiela,
el nuevo sol su claridad
extiende,
con que el mundo afligido se
consuela.
Después, cuando á bañarse
al mar deciende,
hallándose en la noche escura
y fiera,
con las anchas hogueras se
defiende.
Todo se acaba en dulce
primavera
después que, fenecida esta
contienda,
llena de paz el cielo la ribera.
Y contra el sol, en monte, en
valle, en senda,
los árboles, ó en selva ó
bosque ameno,
no sufren que su lumbre al
suelo ofenda.
Con el frescor de su confuso
seno,
la altiva haya y el ciprés
frisado,
con cuerpo assaz de duro
fruto lleno;
El laurel siempre verde,
preservado
de la ira del cielo, y el espino
de más puntas que hojas
adornado.
Con su rebelde fruto ayuda
el pino,
aguda hoja y enredado saco,
del pacífico olivo de contino.
No se precia, entre todos,
de más flaco,
ni el olmo que á las nubes se
avecina,
con la planta gentil del libre
Baco.
Allí se extiende la robusta
encina,
con sus antiguos brazos y el
precioso
cidro, que á todos su cabeza
inclina.
Y el pobo y el castaño, alto,
ñudoso,
con las soberbias frentes
acopadas,
uno en corteza feo, otro
hermoso.
Las ricas palmas de hojas
espinadas,
triunfante premio de gloriosa
estima,
con los racimos de oro
coronadas.
La que defiende con la
espessa cima
que no caliente Febo el agua
clara,
en pago, el agua al tronco se
le arrima.
No se podrá decir que le es
avara,
que si el agua no pierde, el
tronco gana,
ella le da frescor cuando él la
ampara.
Siembra el manzano la
postrer manzana,
siembra el racimo la noguera
fría,
el jazmín nieve y el madroño

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Family Therapy - An Overview 9th

Edition Irene Goldenberg

Irene Goldenberg Mark Stanton Herbert Goldenberg

Irene Goldenberg Mark Stanton Herbert Goldenberg

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PART I Fundamentals of Family Psychology 1

2 Family Development: Continuity and Change 29

A Family Life Cycle Stage Model 35

3 Diversity in Family Functioning 60

4 Systems Theory and Systemic Thinking 84

Family Homeostasis or Adaptation? 92

PART II The Development and Practice

6 Professional Issues and Ethical Practices 136

PART III The Established Schools of

8 Transgenerational Models 190

9 Experiential Models 224

The Therapeutic Process 230

10 The Structural Model 254

Assessing Family Interactions 268

11 Strategic Models 283

12 Behavioral and Cognitive-Behavioral

PART iv New Directions in Family Therapy 345

14 Social Construction Models II: Narrative Therapy 370

15 Population-Based Family Treatments 390

Family Violence 410

PART v Clinical Research: The Synergy of

PART vI Family Theories and Family Therapies:

Key Methods of Intervention 455

Box 6.6 Termination of Therapy 154

Box 15.1 Families With Mental Disorders 396

T hinking Like a Clinician

Box 14.7 Narrative Therapy 385

The publication of this text represents an ­achievement of extraor-

Michael White (1948–2008)

Our Mission in Writing Family Therapy: An Overview

The Tradition and Present-Day Developments

What’s New in the Ninth Edition?

Irene Goldenberg and Mark Stanton

The relationships among members of this microculture are

Family Systems: Fundamental Concepts

LO 1 Today’s Families: A Pluralistic View

Basic Structural Characteristics

Family Interactive Patterns

Family Narratives and Assumptions

BOX 1.1 Thinking Like a Clinician

Appreciating Family Narratives

What family mementos or stories connect your family to a previous generation?

Has your family retained its socioeconomic position over generations?

How important is achievement (monetary, social class, education, athletic,

BOX 1.2 Case Study

A Traumatized Family Rebounds from a Sudden Crisis

BOX 1.3 FAMILY DIVERSITY

Therapy for ethnic minority families following disasters

LO 4 Gender, Race, and Ethnicity and Family Therapy

Gender Roles and Gender Ideology

The publication of this text represents an achievement of extraor-

Impact of Gender and Cultural Influences