EP09 Keynote 05 – Reflections on Family Therapy – Salvador Minuchin, MD

Description:

After a brief description of Family Therapy on the 1960s, and an equally brief description of where it is today, we will make a comparison of the success of family therapy in Europe and the shrinkage in the U.S. A new model of family assessment in four easy steps will be described.

Educational Objectives:

1. To compare and contrast the different ways of doing Family Therapy.
2. To describe the four steps of family assessment.

*Sessions may be edited for content and to preserve confidentiality*

Outline:

Salvador Minuchin's Reflections on Family Therapy

• Opens with humor about aging, quoting George Burns

• Reflects on the beginnings of family therapy in 1958 and its enduring relevance

• Cites Don Jackson’s 1952 work on familial metastasis as pivotal in shifting psychoanalytic thought

• Recalls early family therapy work at Penn and with diverse populations

Early Years and Evolution of Therapeutic Approach

• Describes early practice at Willowbrook with disadvantaged children and families

• Developed a three-stage session model to address family dynamics

• Focused on understanding diverse family roles and real-time interaction

• Emphasized present-moment engagement while considering past influences

Personal Background and Professional Development

• Shares upbringing in Argentina and medical training during political unrest

• Served in Israeli army during the War of Independence, shaping professional resilience

• Recounts early challenges after immigrating to the U.S.—language, culture, professional integration

• Highlights his wife Pat’s influence on his evolving therapeutic identity

Challenges and Achievements in Philadelphia

• Took on professorship in child psychiatry at Penn University

• Faced resistance integrating family therapy into medical models

• Helped build the Philadelphia Child Guidance Clinic into a landmark institution

• Worked with diverse populations and refined a hands-on, dynamic therapeutic style

Influence of Different Therapeutic Movements

• Engaged with influences like the Milano group and feminist critiques

• Maintained a critical stance while borrowing useful techniques

• Evolved toward a more questioning, humorous, and collaborative stance

• Advocated for optimism and therapist-client partnership in change

Postmodernist and Collaborative Approaches

• Acknowledged postmodernism’s influence—resistance to dominant narratives, focus on social context

• Discussed Galician and Anderson’s collaborative approach and the value of “therapist ignorance”

• Critiqued postmodernism’s lack of structure but remained open to useful elements

• Continued advocating for directive yet flexible therapist engagement

Narrative Therapy and Evidence-Based Approaches

• Reflected on narrative therapy’s emphasis on alternative personal stories

• Respected Michael White and maintained an ongoing dialogue with him

• Critiqued narrative therapy’s limits, especially regarding structure and efficacy

• Addressed constraints of evidence-based models for complex populations like juvenile offenders

Current Therapeutic Approaches and Future Directions

• Emphasizes helping family members take responsibility for one another

• Sees the therapist as a facilitator of hope and co-healer with the family

• Concerned about over-pathologizing children; calls for sensitive, inclusive approaches

• Envisions future family therapy as collaborative, adaptive, and hopeful

Final Reflections and Legacy

• Reflects on a lifetime in therapy and his influence on the field

• Encourages therapists to maintain optimism and responsibility

• Speaks candidly about aging, future projects, and collaboration in Hong Kong

• Closes with gratitude and a call for continued learning and connection in therapy