[Referral and family therapy. A systemic analysis]

To describe the characteristics of demand, family structure and the referral process for families attended at a Family Therapy Unit over a two-year period.

A retrospective, observational study.

A Family Therapy Unit in the Public Health System.

A randomised sample of 80 families out of the 136 referred to the Family Therapy Unit during 1990 and 1991, with a 95% C.I. and 0.05 alpha error.

The family 'referrer' (the person who requests help) was the mother of the Patient Identified (PI) in more than half the cases, whereas it was the father in only 10%. The PI was a son or daughter in 56.25% of cases, usually a son. The family dysfunction was identified in the couple in 71 of 80 cases (88.75%). The most common symptoms of the PI were psychotic disorders (23.75%) and behavioural disturbances (22.5%). Families were referred from Mental Health Teams (MHT) in 80% of cases; in more than 75%, the MHT's demand did not coincide with the family's. 70% of these families had previously visited more than one therapist.

The structure of relationships within the families in our study is of a hypofunctioning peripheral father and a mother over-involved with a symptomatic son. On most occasions, a non-explicit parent-spouse conflict underlies the symptomatology expressed by the PI. The severity of the basic conflict and resistance to change affect the intensity of the expressed symptom and the appearance of new Pls, which means further referrals to progressively more specialised care levels.