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A Therapeutic Service where Relationships are Nurtured

Systemic Therapy

All human beings are psychologically and socially shaped by the experiences we have had in our families and communities, from birth. Children learn ‘how to be’ in relationships and the world they engage with – including how to cope with setbacks, transitions, stress, tragedy -through these experiences. We take these patterns of relating and reacting into our adulthood as automatic and default responses to our experiences.

We are born as social beings and from birth our relationship with our primary caregivers is crucial for our survival. Without responsive, nurturing care children cannot experience healthy development. Childhood attachment insecurity is a risk factor for psychological difficulties across the lifespan (Cassidy and Shaver, 2016).

Since not all families cope equally well with stress and adversity, especially when there have been other factors present like poverty, discrimination, inter-generational trauma, parental absence or ill-health etc, many people may not have sufficient and healthy coping mechanisms. We know that through alternative experiences in relationships that feel safe, secure and emotionally responsive, people can develop new patterns of relating and communicating that increase their ability to cope with difficulties in their lives.

In a nutshell for me it means: our beliefs about ourselves and others, our relationships with others and ourselves are created and recreated through our interactions with others, within different contexts.

There is conclusive evidence that systemic family therapy works for a range of problems and that it is in some cases more effective than individual therapy (Carr, 2019) This is especially true for common emotional and conduct problems in childhood and adolescence, like anxiety disorders, depression, grief, bipolar disorder, self-harm, school refusal, OCD, eating disorders, somatic problems and early-onset psychosis in adolescence. Systemic and family interventions are also recommended for children who have suffered developmental trauma or may suffer from PTSD.

Systemic Family Therapy developed in the 1970’s. It has it’s origins in Systems Theory and Social Constructionism. Systemic therapists are interested in the meanings each person gives for other’s people’s behaviours and the interactions between them. Not one position would be seen as definitive, but multiple perspectives would be invited, welcomed and encouraged. The therapist would be curious about the stories people tell about themselves and others and how everyone’s story interacts and shapes the lived ‘reality’ of what those involved experience. Through skillful questioning the therapist would introduce alternative narratives, that may change the meaning of certain experiences for individuals.

Systemic Therapists pay attention and show curiosity about how language is used. They would be mindful to consider issues of power and how it impacts on relationships and individuals. They would look for how patterns of behaviour and meaning may repeat (or not) in different contexts or relationships and how this may bring strength and resilience or maintain problems and difficulties in relationships.

Other methodologies that Systemic Therapists often draw on are Appreciative Inquiry, Brief Solution-focussed Therapy, Narrative Therapy and Communication Theories like the Coordinated Management of Meaning.


Carr, A (2019) Family Therapy and Systemic Interventions for Child-focused problems: the current evidence base in Journal of Family Therapy Vol 41 (2)

Cassidy, J. and Shaver, P. (2016) Handbook of Attachment (3rd edition) New York: Guildford Press

Hedges, F (2005) An Introduction to Systemic Therapy with Individuals Palgrave McMillan

NICE Guidelines

Smith, G. (2013) Working with Trauma – Systemic Approaches. Palgrave McMillan