Child and adolescent psychiatry and family therapy. An overview

This article has provided an overview of the complex relationship between family therapy and child and adolescent psychiatry. Emphasis has been placed on the fact that the controversy and polarization that earlier characterized the relationship have delayed, but not blocked, the full integration of family therapy into child and adolescent psychiatry. Child psychiatrists and family therapists have been able to move beyond dichotomous polemics to combine the two fields in clinical practice, which has led to meaningful convergence in research and services. Family research has yielded important new directions for clinical practice in the areas of attachment, alcoholism, conduct disorder, and schizophrenia spectrum disorders. It also has led to models of family continuity that have considerable potential for interrelating and possibly integrating different family therapy models. Family research also has uncovered family factors in the intergenerational transmission of psychopathology that can inform clinical practice. Convergence in the clinical domain has led to improved assessment and treatment across a wide range of child, adolescent, and family developmental, emotional, behavioral, and mental disorders. Finally, this article has reviewed the controversy over family systems therapy and the development of new directions in theory and practice to which this controversy has led. Despite the possibility that these new directions might lead to significant disruption and interference in the process of convergence, careful examination of the controversy and the new developments in practice suggests that rather than producing division between the two fields, the new developments, especially narrative therapy, are more likely to bring the two fields closer, particularly in the realm of interventive interviewing in family therapy.