Chapter one is an overview of how the helping professions began to perceive the need for dealing with the family system, rather than fixing individuals out of the context of the family. There is a discussion of, among others, Gregory Bateson's work, which is a foundational approach to understanding the roots of communication problems in human problems. There is also a discussion of Murray Bowen's work, wherein he took a child (the identified patient) out of the family, to his clinic, and "fixed" the child, and discovered that when the healthy child was returned to the family system, the symptoms returned. This was a time, in the late 1950s, when therapists began to examine the role of the family system in "creating" symptoms.
Also, the role of marriage therapy and small group dynamics in the evolution of family therapy is examined.
Chapter two walks the reader through a typical family's therapy, from the first meeting to the decision to end therapy. In the process, the reader examines, among other items, the following concepts: relationship of the presenting problem, as told by the clients, to the practitioner's theoretical approach; the "systemic context", meaning an analysis of the family system, what its equilibrium is and how that contributes to problems; the structure of the family, which was a primary approach the family therapy in the early years; family communication styles and how they contribute to problems; and various external issues like alcohol and drug abuse, marital infidelity, and abuse, and how they affect therapeutic outcomes.
Chapter three discusses the fundamental concepts of Family Therapy, as it has evolved over the years, including the role of cybernetic processes in families, and a breakdown of General Systems Theory, which is a skeleton of systems that was first applied to biological and other sciences, and later was applied to families. The discussion moves to Constructivism, which is about how people perceive reality, and why that affects family members. Then some specific higher level concepts, such as triangulation, complementarity and whether it is good or bad for family members, family structures including coalitions and opposing groups, resistance to change efforts, and the effects of gender and culture on families.
Chapters four through eleven examine the classic schools of family therapy, and chapter four starts with the Bowen family systems therapy approach.
Murray Bowen was a psychiatrist who extracted troubled children from their families, brought them to his hospital, and helped them with their problems. When they were healthy, he returned them to the family, but discovered that often as not, their symptoms returned. In the process of examining that phenomenon, he began to treat the family as a system. He focused on a few common problems he discovered in families: differentiation of self, emotional triangles, emotional processes that carried forward across generations, emotional cutoff of family members, the position of an individual among siblings, and society’s processing of family emotions. The chapter discusses normal family processes, how family systems “cause” behavior problems, the goals of his systems therapy, what conditions Bowen school sees as necessary for behavioral change, and how they assess families.