ABSTRACT

The family therapy field has recognised it is sometimes not enough to expect children’s problems to change just because the systemic meaning for the family has been addressed, or because the parents have been helped with their problems. ‘Playful’ approaches that directly focus on the child’s problem have been developed within the narrative therapy approaches to balance earlier systemic practices that may have risked ignoring the child’s perspective. Balance, though, is the key word for us. Now the field has recognised the need for direct work with children, and the potential for working with children’s stories, it is important not to throw out earlier systemic ideas and approaches (Vetere and Dallos 2003). The systemic paradigm enabled us to shift the focus from intra-psychic pathology to interpersonal relationships and their contexts. Conceptualising people’s difficulties in terms of patterns of interaction has been one of the most productive contributions of systemic thinking to the understanding and re-construction of mental health problems. The recognition that different levels of context can give different meanings to behaviour and relationships helped us think about wider social and cultural influences on people and their relationships, while also considering how relationships themselves can change lived experience and influence more widely held beliefs.