May 8, 2009

HEALTH PLUS: Systemic psychotherapy is distinguished by its respectful, collaborative approach, writes MARIE MURRAY

LATER THIS month systemic psychotherapists will gather from all over Ireland to discuss new ideas and developments in the model and practice of systemic psychotherapy.

While there is increased attention to the importance of psychotherapy as a way of addressing human distress, perhaps one of the less known and least understood models of therapy is that which is called systemic therapy, of which the more familiar family therapy is an offshoot.

Of course people undertake therapy with all kinds of ideas, beliefs and expectations of what it will entail and with expectations or concerns about themselves in the therapeutic situation. But what specifically is the systemic therapy approach?

Systemic psychotherapy is distinguished by its respectful, non-impositional, collaborate approach. The core of systemic therapy is collaboration.

Therapist and client work together in a most respectful partnership to consider how problems should be addressed. While systemic therapists are aware of their expertise in facilitating the kinds of conversation that can bring people towards solutions to their problems, they never assume that they are the experts on other people’s lives. On the contrary, they acknowledge that the client has superior knowledge about his or her own life story.

Questions are important: carefully thought out, finely tuned questions are the essence of this therapy. Indeed, systemic therapy is about asking questions and listening to the answers in an exceptionally attentive, reflective manner, so that the most important aspects of the client’s life can emerge and be understood.

Systemic therapists also believe there are many ways of looking at problems. They value the idea of multiple perspectives rather than singular fixed irrefutable truths. Systemic therapists will, therefore, be most interested in the client’s opinion on the problem and its solutions rather than imposing the therapist’s view on the situation.

At the same time, the therapist may offer new ideas and be a sounding board for other ways of thinking about situations; opening a space for new ways of going forward in life that may not have been considered previously.

Systemic therapists are also trained in conducting therapy conversations with several people in the room at the same time. They are happy if clients wish to have other people who may be helpful to the therapy conversation accompany them to some sessions, such as family members or friends.

This is particularly helpful with children and adolescents where exploring the situation with the network of people who are significant in the young person’s life is important. Systemic therapy is a most appropriate model for all kinds of complex family difficulties.

Systemic therapists acknowledge that for some people who have acquired formal mental health diagnoses, these descriptors are helpful. However, they are equally aware that individuals and their families can experience such categorisations as limiting and stigmatising and so systemic therapists find it useful to discuss the context, meaning and implications of these professional labels with their clients.

Systemic psychotherapy emphasises relationships: recognising that people are social beings who do not live in isolation. How people experience themselves, the stories they tell about themselves and their views of the world depend upon conversations and relationships with others.

This is why systemic therapists often draw an extended family tree, which is called a “Genogram”, with clients, through which they explore relationships, beliefs and life events across generations and encourage clients to consider themselves in relation to others on this family tree.

In all therapy conversations, the systemic therapist keeps the focus of the discussion on the search for solutions to the dilemma the client is facing to find the most useful way forward for that person. Sometimes this means that the therapy is short. In other situations it may be a more extended process.

In every case, the systemic process allows for clients and therapists to meet again in the future, beyond the initial period of consultations, as the contours of life and its many complexities ebb and flow.

The website of the Family Therapy Association of Ireland,, provides further information on this form of therapy.