Family and individual therapy: comparisons and contrasts

Psychoanalytical and family therapies are contrasted: psychotherapeutic change involves a change of frame. The new frame in family therapy is the system; for analytical therapy it is the unconscious, but there are striking formal similarities between them. To achieve this change, there are two basic modes of therapy, reflective and directive, each containing elements of both. An essential ingredient in therapy is an uncoupling of action from effect, which occurs in play; psychotherapy can be seen as a special type of play. In family therapy, the therapist may useful playful paradox: 'therapeutic double binds'. Transference, the vehicle of psychoanalytical therapy, is a metaphorical relationship that is also essentially playful--serious but not real. Some guidelines for considering the relative indications and contraindications of family and individual psychotherapy are offered.