The roots of family therapy are often traced to the decade following World War II, and to the challenges and problems caused by the large-scale reunification of families who sought mental health counseling to address them. Roles that had been traditionally filled by the broader community, including extended family, schools, and religious organizations, became the purview of clinical providers. These providers began to turn their attention increasingly to the family system as an integrated unit, where previously the focus had been almost exclusively on the individual and the problems of the “patient.”

An important early influence on the development of family therapy as a theoretical field was the work of Gregory Bateson (Bateson et al., 1956). Bateson, a linguist and anthropologist, applied concepts from communications and cybernetics to human communication, including within family systems. Most notably, in collaboration with other researchers, Bateson developed the double-bind theory as a proposal for understanding the etiology and symptoms of schizophrenia. The double-bind refers to situations in which a person receives contradictory messages or injunctions through different forms of communication. For example, a parent whose words convey love for a child but whose actions express disdain or detachment. When the contradictory injunctions demand a response from the child, who is unable to satisfy both
and perceives a threat of punishment for not doing so, the double-bind can trigger anxiety, stress, and confusion. Ultimately, over repeated such instances the child may become suspicious of all communication and may respond to the confusing messages with equally disjointed communication of their own. This was suggested to be the onset of the schizophrenic illness. Although researchers today no longer attribute the etiology of schizophrenia to parental behaviors or specific forms of maladaptive parenting, the influence of the theory lies in its departure from individual models that emphasize only the inner psyche, in favor of an emphasis on relationships and interpersonal systems.

Another proposal for the etiology of schizophrenia that exerted an early influence on the field of family therapy was the work of Frieda Fromm-Reichmann on the so-called schizophrenogenic mother (Fromm-Reichmann, 1948). The theory posited that distant and aloof, but possessive and manipulative mothers, in combination with passive and ineffective fathers, cause children to feel inadequate and bewildered and ultimately to develop schizophrenia. Like the double-bind, the schizophrenogenic mother theory is no longer viewed as an empirically sound theory for the etiology of schizophrenia, but it remains important for its impact on family therapy and contribution to the shift toward a systemic family-based view of psychopathology.

Other early contributors to the field include Theodore Lidz who emphasized the importance of maladaptive fathering and disrupted marital relationships, Murray Bowen who emphasized multigenerational transmission of unhealthy relationships, Nathan Ackerman who published the first paper addressing treatment with an entire family in 1937 (Ackerman, 1937), John Bell who was among the first to regularly meet with families in a clinical setting, Carl Whitaker who began working with families during the 1940s and organized early family therapy conferences that included interviewing families behind a one-way mirror, and many others.

By the 1960s, family therapy had gained a respected place in the field of mental health, although it remained dominated, at least in practice, by social workers rather than psychologists or psychiatrists who continued to focus on the individual patient and on intrapsychic processes rather than interpersonal systems. A journal, Family Process, was established and remains highly influential to this day, although numerous other journals that emphasize family-based approaches have since come into existence. And despite the early focus on adults with mental illness (and in particular schizophrenia), applications of family therapy to the problems of children and adolescents also emerged.

The work of Salvador Minuchin is particularly influential in this regard. Minuchin developed structural family therapy, a theory-driven approach to family therapy grounded in empirical research and inspired by his work with youth in underprivileged communities (Minuchin & Nichols, 1998). Structural family therapy aims to map relationships between family members and to dislodge unhealthy patterns of intra-family transactions, allowing the emergence and stabilization of healthier and more adaptive patterns.

Although much of the work in the field of family therapy occurred in the United States, important centers also emerged in other locations. Notably, Mara Selvini-Palazzoli founded the Institute for Family Studies in Milan, a group that became highly influential in the field for a long time.

The 1980s are the decade many consider to be the heyday of family therapy. Journals dedicated to the field proliferated, national and international professional associations sprung up with many active members, the American Psychological Association established a division dedicated to family psychology, and professionals could become board certified in family therapy. This surge in focus on family therapy also led to certain criticisms, including that the field was placing excessive focus on pragmatic solutions, at the expense of deep and full understanding of the family system in which the problems are emerging, and that treatments were being advanced without enough empirical evidence to support their efficacy. In recent decades, family therapy has broadened its scope and has placed increased emphasis on establishing competency benchmarks for clinicians and on establishing evidence-based practices for the field.