The therapist, sanity, madness and the family

As an applied discipline, family therapy requires firm conceptual foundations and highly developed skills in practice. Herein lies the problem. Families and troubled family relationships are not easy to understand, and providing effective therapeutic help to all members of the family demands considerable personal skills and sophisticated techniques. Family therapists in search of useful theories have raided, among others, psychoanalysis, cybernetics, systems theory, constructivism, social constructionism and postmodernism. There has been a succession of competing "schools" of family therapy, linking these theories more or less effectively to their own patented therapeutic techniques.

For trainees in family therapy the result is understandably bewildering. What has been needed for a long time is a clear, non-partisan and integrative analytical account of the field that does justice both to the richness of its conceptual foundations and to the creativity of its methods. I am delighted, therefore, to welcome two books that, in their different ways, resoundingly achieve these aims.

Rudi Dallos and Ros Draper present an engagingly readable history of ideas and practice in three phases from the 1950s to the present in An Introduction to Family Therapy . A great merit of their integrated approach is that they do not require the reader to discard earlier, useful models, but rather enable us to see them in a cultural and political context. One consequence is that they can reassess the relevance and application of ideas that have tended to be submerged, concerning emotions and psychological attachments. The presentation of the book is excellent. Chapters contain outlines of key people, places and events, succinct summaries of concepts and schools, intelligent commentaries and topic-based reading lists. This book will be a godsend to tutors as well as to students, as it contains a series of observational and role-play exercises to develop key skills and formats for exploring communication styles and beliefs with families.

Alan Carr's Family Therapy is an impressive achievement. His presentation of concepts and models is comprehensive and detailed, and organised in terms of behaviour patterns, beliefs and contexts. He draws on these to offer an integrative formulation model of therapy that clearly links the assessment of problems and strengths to interventions. Carr's is a sophisticated position in that he emphasises the social construction of problems but advocates that some formulations may be more useful than others. Chapters review this evidence and illustrate the application of family therapy in cases including child abuse, drug abuse and schizophrenia. These provide specific guidelines for therapists, but with less of an emphasis on skills development.

John Carpenter is professor of applied social studies, University of Durham.