Basic Family Therapy

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The challenge facing the authors of texts that address the multiplicity and complexity of problems that may afflict families can be intimidating. Philip Barker has addressed this challenge head-on in each of the editions of this book. This task has been greatly facilitated by the contributions of the new co-author, Jeff Chang, and in this edition provides a clear, easily read and readily understandable introduction to family therapy. Much has happened in the field of family therapy since the fifth edition of Basic Family Therapy was published in 2007.

New developments covered in this book include:

  • Emotionally Focused Therapy
  • The Gottman approach to couples therapy
  • Mindfulness and psychotherapy
  • The common factors approach to psychotherapy and to family therapy
  • The increased emphasis on empirically supported treatments
  • High-conflict post-divorce parenting

Basic Family Therapy will be of value to readers new to family therapy and to those in the early stages of training.


Philip Barker is Professor Emeritus of Psychiatry in the University of Calgary. Now retired from active clinical practice, he practiced family therapy, and supervised many students from the early 1970s. A Life Fellow of the Royal College of Psychiatrists and a Life Member of the Canadian Psychiatric Association, he is the sole author of the previous five editions of BPF.

Dr Jeff Chang is an active proponent of family therapy: he will promote the book at future presentations.


Foreword ix

Introduction xiii

1 The Development of Family Therapy 1

Family therapy’s early years 1

1990s and the new millennium 9

Summary 13

References 14

2 Healthy Families and Their Development 19

Ethnic variations 21

The functions of families 21

Family development 22

The clinical importance of family developmental stages 23

Optimal family functioning 24

Summary 26

References 26

3 Some Basic Theoretical Concepts 27

Theories derived from individual and group psychotherapy 27

Other theories that have been used in family therapy 28

Other concepts and terms 41

Summary 46

References 46

4 Adopting and Refining a Model of Family Therapy 50

The nature of theories and models 50

Developing your model of family therapy 52

Selecting and adapting a model of family therapy 54

Summary 54

References 55

5 Models for the Assessment of Families 57

Critical distinctions in assessment 58

Conceptual approaches to family assessment 59

The Beavers Systems Model of Family Functioning 64

The Darlington Family Assessment System 66

Respective utility of family assessment models 67

Summary 68

References 68

6 The Family Diagnostic Interview 70

The initial contact 70

Joining the family and establishing rapport 71

Defining the desired outcome 75

Reviewing the family’s history, determining its developmental stage and constructing a genogram 75

Assessing the current functioning of the family 79

Developing a diagnostic formulation 83

Offering the family feedback and recommendations 84

Discussing and arranging the next step 85

Feedback to referring professionals 86

Summary 86

References 87

7 Establishing Treatment Goals 88

Defining the desired state 89

Intermediate and final goals 92

Motivating families to consider and set objectives 92

Summary 93

References 94

8 When Is Family Therapy Indicated? 95

Basic criteria for employing family therapy 96

Differing views on the place of family therapy 97

Some views on indications 98

The ‘decision tree’ 100

Contraindications for family therapy 103

Summary 105

References 106

9 Practical Points in the Treatment of Families 108

Involving reluctant family members 108

Maintaining a therapeutic alliance 113

Involving children in family sessions 115

The therapist’s use of self 118

Transference issues 118

Contracts 119

The spacing of sessions 119

Confidentiality 120

Observers 121

Co-therapy 123

Summary 125

References 125

10 Common Family Problems and Their Treatment 127

Introduction 127

Task accomplishment problems 127

Serious basic task accomplishment problems 132

Communication problems 134

Poorly defined and dysfunctional role patterns 137

Summary 144

References 144

11 Complex Problems and Second-Order Change 147

Interrupting problem patterns 147

Techniques focusing on changing meaning 156

The use of humour 161

Strategic teams 162

A second-order cybernetic approach: therapy as conversation 163

Summary 167

References 168

12 Other Therapeutic Approaches 172

Experiential approaches 172

Video playback 175

Family music therapy 175

Family art therapy 176

Family play therapy 177

Family resilience and ecological interventions 178

Family therapy and serious mental illness 182

Mindfulness practices 186

Innovative formats for service delivery 187

Conclusion 190

References 190

13 A Method of Therapy 199

Treatment by stages 200

Termination in family therapy 211

Summary 212

References 213

14 Couple Therapy 215

The history of couple therapy 215

General considerations in couple therapy 217

Current approaches to couple therapy 220

Divorce therapy and mediation 227

Sex therapy 228

Summary 230

References 231

15 Terminating Treatment and Dealing with Treatment Interruptions 236

Treatment contracts 236

Open contracts 237

Indications for ending treatment 238

How to terminate treatment 241

Termination tasks and ritual 243

Emotional and psychological aspects of termination 243

Follow-up 244

Dealing with treatment interruptions 245

Summary 246

References 247

16 Teaching and Learning Family Therapy 248

Who learns family therapy? 250

The different possible learning experiences 251

Methods of learning family therapy 251

Audiovisual aids 253

Objectives 254

Learning family therapy skills 255

The content of training 256

Supervision 257

Learning to supervise 258

Consultation 260

Summary 263

References 263

17 Research in Family Therapy 265

Why is family therapy research important? 266

Is family therapy effective? 266

What makes family therapy effective? 267

Is family therapy cost-effective? 270

How can practitioners be more involved in research? 270

Summary 271

References 272

18 Ethics and Family Therapy 275

Informed consent 277

Therapists’ values 278

Confidentiality 279

Ethical decision making 281

Keeping informed and up to date 283

Ethical issues in family therapy research 283

Summary 284

References 284

Appendix 286

Index 291


It was a pleasure and a privilege to read the sixth edition of this book.  It is more difficult, however, to write an adequate introduction, as there are few enthusiastic phrases that have not already been invoked to describe the various editions of Philip Barker’s book that have appeared since the first in 1981. 

I would like to be clear that this is an eminently readable book for those who are new to the discipline. Anyone who is not new to the discipline, however, and has seen a previous version will know this; readers and reviewers before me have commented on the skill of the author, who could write a book on the complex and theoretically diverse domain of family therapy that is at once scholarly yet thoroughly accessible. Readers of previous editions will find the update worthwhile and may be reassured to note a familiar ordering to many of the chapters.

Glenda M. MacQueen, MD, FRCPC, PhD. - Vice Dean, Faculty of Medicine, University of Calgary, Canada