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7 Nov

The End of an Era in Family Therapy – Remembering Dr. Salvadore Minuchin

Photo Credit: Susan Farley for The New York Times

With the passing of Salvadore Minuchin, M.D. last week, the field of family therapy lost a giant who helped define the field. Dr. Minuchin was a pioneer who pushed the boundaries and was responsible, along with his colleagues, for developing what has come to be called structural family therapy. Much of Minuchin’s work was done here in Philadelphia at the Philadelphia Child Guidance Clinic and Children’s Hospital of Philadelphia during the 1970’s and 1980’s.

Among his psychiatric peers, Minuchin was often seen as a maverick who challenged the prevailing orthodoxy of the profession. He believed that traditional methods of treatment were unsuited for certain populations. However, instead of blaming the patients for not responding to the traditional forms of psychotherapy, he molded his therapy to meet the needs of his patients. When working with low socioeconomic patients and their families, he developed a crisis-oriented, action-based therapy that addressed the needs of these families for change in the present.

His therapeutic approach downplayed the need for reflection and insight, which were thought to be the key to change at the time. Instead, he focused on changing patterns of behavior that kept families stuck in dysfunctional cycles. This therapy proved to be highly effective and now is one of the most accepted forms of family therapy in the world. In cases where patients were unresponsive to traditional therapy, Minuchin called for therapists to acknowledge their responsibility to cater to the needs of the patient.

Never one to shy away from difficult problems, Minuchin also dove into groundbreaking work in the field of psychosomatic medicine, changing the prevailing model from an individual one to a family-based model. His work with families with an anorectic child was a clear paradigm shift in how to treat this life-threatening disorder.

Minuchin was a master teacher, as well as master clinician and theorist. He wrote prolifically and under his guidance, the Philadelphia Child Guidance Clinic became one of the most influential training centers in the country. Thousands of social workers, psychologists, psychiatrists, and other mental health  clinicians, wishing to improve their family therapy skills, sought training there. Some were lucky enough to work there, including several current members of the Council for Relationships staff.

I was fortunate to have worked with Sal for many years and know that his legacy is multifaceted. Above all, I will always remember him as an advocate for the marginalized and disenfranchised in the mental health system. He taught me that every individual and family has its strengths and that it is the therapist‘s responsibility to identify those strengths and build on them.

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