Max Siporin

Marriage and Family Therapy

in Social Work
Marria~e and .family ~herapy continue to be an important part of
th~ ~asI~ social services provided by social workers. There is
a distinctive conceptual, value, and technical orientation to the
trainin.g g~ven in s~cial w?rk for this area of practice, and for the
practice Itself. ThIS special competence merits greater attention.

Max Siporin is Professor of Social Work, School of
Social Welfare, State University of New York, Albany,
New York. He is also a Fellow and "Approved Super-
visor" of the American Association for Marriage and
Family Therapy.
MARRIAGE THERAPY AND FAMILY therapy are
traditional and basic social work services.
Social workers have provided these services
as part of the core of social work practice
since the beginning of the profession. In addi-
tion, marriage and family therapy content has
long been taught in schools of social work as
part of the core educational curriculum of
preparation for social work practice. Recent
historical accounts, including those of social
workers, of the development of this area of
practice have been grossly inaccurate in deny-
ing, depreciating, or neglecting this rich tradi-
tion. Thus, in 1975, James Frame,' a promi-
nent family therapist, could say that a young
and suddenly popular phenomenon called
l. James L. Framo, "Personal Reflections of a Family
Therapist," Journal of. M.arriag~ and Family Counseling
1 <.1?75): 15-28.. For similarly biased accounts, see also,
Philip J. Guerin, Jr., "Family Therapy: The First
Twenty-Five Years," in Family Therapy, ed. Philip J.
Guerin, Jr. (New Y ~rk: Gardner Press,. 1976), pp. 2-22;
Floren~e ~,as!ow, Training of Marital and Family
The:aplsts.. In Supe~vision, Consultation, and Staff
Training In the Helping Professions, ed. Florence W.
Kaslow et ~l. (San Francisco: Jossey-Bass, 1977), pp.
199-234;.WIIlIam C. Nichols, "Education for Marriage
and Family The.raplsts: Some Trends and Implications,"
Journal of Marital and Family Therapy 5 (1979): 19-28;
and Sue Walrond-Skinner, Family Therapy (Boston:
Routledge and Kegan Paul, 1976).
family therapy was still widely resisted and
"pressure from students is forcing some
departments of social work to give a course
on family therapy."
This article will attempt to provide a more
accurate description and evaluation of the
place of marriage and family therapy in social
work practice and in social work education.
The findings of a national survey of schools of
social work on the teaching of marriage and
family therapy are discussed and related to
current educational issues. The terms
marriage-family treatment, counseling, and
therapy are used here synonymously. What is
distinctive about social work practice orien-
tations in this field will be identified, and the
learning experiences and reactions of students
will be considered. Suggestions are made for
improving educational and professional
~olicies and programs. This discussion is par-
ticularly relevant to current trends in our
soc~ety, marked as it is by severe and per-
vasive breakdowns in marital and family life,
and to social work's contribution toward a
more family- and marriage-nurturing society.
History and Traditions
Although the history of family and
marriage therapy can be traced back to an-
cient religious practices and, later, to the use
of home visitors by religious organizations,
the secular enterprise of professional social
work did not begin until the early nineteenth
century. In 1818, the New York Society for

Social Casework: The Journal of Contemporary Social Work © 1980 Family Service Association of America

11
the Prevention of Pauperism appointed a
network of "ward visitors" to counsel the
poor and conduct a scientific social survey.
They were" ... to become acquainted with
the inhabitants of the district, to visit fre-
quently the families of those who are in in-
digent circumstances ... and by suitable and
well timed counsel, to excite them to such a
course of conduct as will best promote their
physical and moral welfare. "2
Joseph Tuckerman, in 1832, described the
work of a "friendly visitor of the poor" as ob-
taining a family's confidence and affection,
addressing himself to "the deep affections of
a parent's heart ... [to] teach parents of the
importance of a good parental example," as
well as helping the father and two of the
children into employment." In 1845, the First
Annual Report of the New York Association
for Improving the Condition of the Poor
proudly presented the society's "relief' ac-
tivity with clients, "nearly all" of whom were
families who were visited repeatedly in their
homes by the society's visitors:
In a later period, Josephine Shaw Lowell, a
pioneer leader in the development of
professional social work, advised the friendly
visitors to "find out all about the man in the
family" rather than dealing exclusively with
the woman. She urged that "the man and
woman should be seen and advised with
together about their present condition and
future plans."! In 1882, the "Handbook for
Helpers" of the London Charity Organiza-
tion Society gave as a basic "principle of
decision" that "adequate relief' should be
provided in the "adequate treatment of a
family.i"
By 1890 another oft-given principle of
"charity" work was the need to treat the
2. Raymond A. Mohl, Poverty in New York. /783-/825
(New York: Oxford University Press, 1971), p. 247.
3. Joseph Tuckerman, "An Introduction," in Baron De
Gerando, The Visitor of the Poor (Boston: Hilliard,
Gray, Little and Wilkins, 1832), pp. iii-xxx.
4. Annual Reports ofthe New York Association for Im-
proving the Condition of the Poor (New York: Arno
Press, 1971), p. 22.
5. Josephine Shaw Lowell, "Duties of Friendly
Visitors," as quoted in: Mrs. James T. Fields, How to
Help (Boston: Houghton, Mifflin, 1884), p. 86.
6. M. W. Moggridge, Method of Almsgiving-Hand-
book for Helpers (London: John Murray, 1882), p. 35.
12 Social Casework: The Journal of Contemporary Social Work (January 1980)
family as a unit-that "the family must be
taken as a whole, otherwise the strongest
social bond will be weakened."! This was
emphasized by Mary Richmond, who ex-
pounded a full and careful assessment of a
family group, including care for accuracy
concerning the history and nature of the
marital relationship. Typically, this was to be
done with the family members seen together
in the home as the foundation of treatment
"with the family group as a whole. "8 Even
what is today called "family network
therapy" was widely provided in its own way,
as described by Richmond, in the form of
"charitable cooperation," aiding a family
through the use of its internal and social
resources, its "field of forces," of kinfolk,
neighbors, friends, and religious, educational,
and work associations, as well as the official
or formal charity and governmental
resources."
As practiced prior to 1917, casework was
categorized by Bertha Reynolds as "group
work with families.":" What was called
"charity," and then "social treatment" or
"casework" (the latter two terms are still
used today), consisted of a combination of
services. Currently, these services are called:
psychotherapy, marital therapy, family
therapy, group therapy, network therapy,
parent training, family life education, crisis
intervention, community work, the provision
of community resources (including financial
aid and homemaker, foster care, adoption,
and residential care services), case advocacy,
and social action. The charity organization
societies in the United States clarified these
functions and domain by a collective decision
in 1919 to rename themselves as family
7. Franklin B. Sanborn, "Indoor and Outdoor Relief,"
Proceedings. National Conference of Charities and
Correction. 1890 (Boston: George H. Ellis, 1890), pp. 71-
80.
8. Mary E. Richmond, Social Diagnosis (New York:
Russell Sage Foundation, 1917).
9. Mary E. Richmond, "Charitable Cooperation,"
Proceedings. National Conference of Charities and
Correction. /90/ (Boston: George H. Ellis, 1901), pp.
298-313. In addition to the use of a visual figure of
several concentric circles given in this paper to represent
the social network and resources of a family, Richmond
also experimented with drawings of linked circles, such as
is now called an "ecomap." Communication to the
author from Dr. Muriel W. Pumphrey, St. Louis,
Missouri, 29 October 1978.
welfare and service societies and their
national association from the "American
Association for Organizing Charity" to the
"American Association for Organizing
Family Social Work."!'
Trends in Practice
Although 1917 is generally thought of as
the turning point to the "psychiatric era in
social work," there was a continued effort to
develop situational and social therapy ap-
proaches in social work with couples and
families. Thus, Harriet Mowrer and others
made a remarkable effort to integrate new
sociological, sociopsychological, and psy-
chiatric insights into the method of family
casework, including the use of "conference
techniques" for the conjoint treatment of
married couples." Gordon Hamilton,
Florence Hollis, and Charlotte Towle forged
a similar, though psychoanalytic, "psy-
chosocial approach.'?" Even at the height of
the psychoanalytic period in 1943, M. Robert
Gomberg" reemphasized that the "basic
focus" of family casework is its "respon-
sibility to the family as a whole," in a concern
with "family unity and coherence" and with
10. Bertha C. Reynolds, "Rethinking Social Casework,"
Social Work Today 5 (April 1938): 5-8.
II. Margaret E. Rich, A Belief in People (New York:
Family Service Association of America, 1956), p. 83. The
American Association for Organizing Family Social
Work is now known as the Family Service Association of
America.
12. See Harriet R. Mowrer, Personality Adjustment and
Domestic Discord (New York: American Book .Co.,
1935); Ada E. Sheffield, Social Insight in Case Situations
(New York: Appleton-Century Co., 1937); and Pauline
V. Young, Social Treatment in Probation and Delin-
quency (New York: McGraw-Hill, 1937).
13. Gordon Hamilton, Theory and Practice of Social
Case Work (New York: Columbia University Press,
1940); Charlotte Towle, Social Case Records from
Psychiatric Clinics (Chicago: University of Chicago
Press, 1941); Florence Hollis, Social Case Work in Prac-
tice (New York: Family Welfare Association of
America, 1939); and Florence Hollis, Women in Marital
Conflict (New York: Family Service Association of
America, 1949).
14. M. Robert Gomberg, "The Specific Nature of
Family Case Work," in A Functional Approach to
Family Case Work, ed. Jessie Taft (Philadelphia:
University of Pennsylvania Press, 1944), pp. 111-47; and
"Counseling as a Service of the Family Agency," and
"The Gold Case, A Marital Problem," in Family
Casework and Counseling, ed. Jessie Taft (Philadelphia:
University of Pennsylvania Press, 1948), pp. 191-261.
Siporin: Marriage and Family Therapy
the "strength of family organization." This
meant assisting family members with their
roles and relationships in order to "help a
family to achieve a more normal balance"
and directly help parents with their marital
roles and relationships, including conjoint in-
terviews in their homes.
The psychoanalytic model did, however, in-
fluence family agencies to adopt concurrent
individual therapy under psy.choanalytic
supervision as a preferred mode of helping
parents and married couples. There was still
an evident assumption that working with the
marital relationships of parents was at the
center of family treatment; this remains an
axiom of family therapy today.
In the early 1940s, there was a major in-
crease in the need for and social work provi-
sion of marriage counseling services, which
accelerated after the Second World War.
This led, in the late 1940s and early 1950s, to
a redevelopment of situational and social
system approaches to social work practice,
including the emergence of a clearer systemic
(organismic, holistic) perspective, a so-
ciocultural concern, and a focus on advanc-
ing unit diagnosis and therapy for couples and
families." Such trends marked the ac-
complishment of a process through which a
needed personality theory and therapeutic
procedures with individuals were explored
and adapted into core social work practice
theory. It also constituted a conscious return
to traditional social work helping tasks for
family and marital welfare, which most social
workers had continued to carry out in daily
practice with married couples and family
groups. By the late 1950s and during the
1960s, there was a further thrust in the
development of the "family therapy
15. One significant trend was the move to integrate
casework and group work, see Gertrude Wilson, Group
Work and Case Work (New York: Family Welfare
Association of America, 1941); and Hamilton, Theory
and Practice, pp. 235-56. On the turn to marital unit and
family unit diagnosisand treatment, see Patricia Sacks,
"Establishing the Diagnosis in Marital Problems," Jour-
nal ofSocial Casework 30 (May 1949): 181-87; and Otto
Pollak et al., Social Science and Psychotherapy for
Children (New York: Russell Sage Foundation, 1952). In
addition, M. Robert Gomberg and Frances T. Levinson,
eds., Diagnosis and Process in Family Counseling (New
York: Family Service Association of America, 1951), has
articles on family and marital diagnosis which antedate
the work of Nathan Ackerman and his association with
the Jewish Family Service in New York City.
13
movement," marked by the application of
general systems theory and of family helping
procedures in the treatment of mental dis-
orders, as well as by an enthusiastic embrace
of family therapy by psychiatrists and psy-
chologists, accomplished with the generous
aid of social workers.
Until recently, social workers were
recognized by the general public and other
helping professionals as being expert in and
having almost exclusive domain in marital
and family practice. Thus, in mental health
settings, individuals were treated by psy-
chologists and psychiatrists, but family
groups and spouses were automatically
assigned to social workers. This pattern and
its recognition of the social work domain
have declined precipitously in recent years.
Major factors contributing to this decline
have been the aggressive competition from
other helping human service professions and
the passive responses to such competition by
social workers. There is a resistance within
schools of social work to the development of
doctoral programs for those providing direct
service. Powerful social trends, for example,
in a general public reaction against elitist
professionalism are also in operation.
However, the decline in social work prestige
and social recognition for this practice area
has had a deleterious effect on social work
education, as well as on the profession as a
whole."
Social Work Educational Programs
The traditional focus on helping family
groups has meant that, from their inception,
social agency in-service training and
academic social work programs have also
emphasized a preparation for family and
marriage counseling. The first course at the
first school of social work in the United
States," the Summer School in Philanthropic
Work, established by the New York Charity
Organization Society in 1898, was "The
Treatment of Needy Families in Their Own
16. Max Siporin, "Doctoral Education for Direct-
Service Practice in Social Work," Journal of Educa-
tion for Social Work 9 (Fall 1973): 78-86.
17. Elizabeth G. Meier, A History of the New York
School ofSocial Work (New York: Columbia University
Press, 1954), p. 13.
14 Social Casework: The Journal of Contemporary Social Work (January 1980)
Homes." Family treatment was widely
adopted as the core curriculum area for all
schools of social work as they were es-
tablished across the country. Thus, in a 1931
survey of the curricula of professional schools
of social work, Maurice Karpf found that
"Family case work is the only subject in
which every school offered at least one
course," with no other "subject or field
recognized as indispensable by all the
schools.'?"
The Milford Conference of 1929 expressed
and influenced a shift toward a generic con-
ception of social treatment (or casework) as
concerned with helping individuals as well as
family groups." It also influenced a shift in
schools of social work away from field-setting
types of casework courses to generic first-
year methods courses in social treatment or
casework that included content on work with
individuals, married couples, and family
groups. Specialized courses on family treat-
ment were offered largely as second-year elec-
tives and, gradually, these also became
method-oriented rather than geared toward
field-setting functions. For example, a
second-year elective course on family treat-
ment was taught for many years at the New
York School by Gordon Hamilton, and later
by Florence Hollis. Hollis also taught a
course on marriage counseling at Smith
College beginning in 1955, and then .at
Columbia University beginning in 1961; by
1961, both courses were method-oriented."
This academic content was reflective of and
also helped to guide the field work ex-
periences of social work students, which con-
tinued to be heavily oriented toward work
with family members and married couples, in
the psychiatric, school, and correctional
agencies, as well as in the primary social
agencies. With the increasing specialization
of social agency functions in recent years,
there was, undoubtedly, a drift away from the
18. Maurice Karpf, The Scientific Basis ofSocial Work
(New York: Columbia University Press, 1931), p. 329.
19. Social Case Work-Generic and Specific-A
Report ofthe Milford Conference (New York: American
Association of Social Workers, 1929).
20. Personal Communication to the author from
Florence Hollis, 21 September 1976. The author has
taught elective courses on marriage therapy since 1969
and on family therapy since 1972.
traditional standard of direct work with
family groups and married couples as a uni-
versal requirement for all social casework
(clinical) students. That all clinical students
should have such practicum assignments has
become a problematic standard for certain
schools in certain areas of the country.
Current Educational Preparation
It is in such a historical context that the
current situation with regard to educational
preparation for this area of social work prac-
tice may be examined. In the fall and winter
of 1975-1976, a questionnaire was sent out by
the author to all graduate schools of social
work or social welfare in the United States.
Responses were received from seventy-six of
the eighty schools. A number of respondents
wrote spontaneously and feelingly about their
programs and this curriculum area, for the
most part expressing their dissatisfactions
and describing the lacks of offerings, content,
suitable texts, and theoretical and technical
rationale for both the teaching and the prac-
tice of marriage and family therapy. In both
the questionnaire and the responses, the terms
counseling, treatment, and therapy were
largely used synonymously.
Seventy (90 percent) of the seventy-six
schools reported that instruction was given on
the specific content of family and marriage
counseling/therapy in their required methods
courses-on social work practice, casework,
or social treatment." In addition to these re-
quired courses, fifty-two (68 percent) of the
schools gave elective courses on family
therapy, twenty-five (33 percent) on marriage
therapy, and thirty-five (46 percent) on com-
bined marriage and family therapy. Most
direct service students took these elective
courses. In one school, eleven sections were
offered in one year, with a limit of eighteen
students per section; in other schools, fifty or
more students were admitted to course sec-
21. Bulletins of all the schools of social work or social
welfare in the United States during 1976-1977 revealed
that content on family and marriage counseling is given
in required or elective courses in the master's degree
programs in all schools except Brandeis. This content has
not been required of all students, probably for the past
ten years, since the Council on Social Work Education's
Curriculum Policy Statement of 1969. It may again be
required of all students in accordance with the new
C.S.W.E. policy statement on the core curriculum.
Siporin: Marriage and Family Therapy
tions in these electives. The student demand
for this content was thought to be met ade-
quately by only 61 percent of the schools with
regard to family therapy, but by only 41 per-
cent of the schools with regard to marriage
therapy. Eighty percent of the respondents
considered family therapy to be a legitimate
area of practice specialization, and 67 percent
accepted this categorization separately for
marriage therapy. A large number of schools
offer this content in their undergraduate re-
quired method courses and also as electives.
This survey indicates that family and
marriage therapy remains a core element in
graduate social work educational programs.
This is true even though the special nature of
this content is partly obscured by its inclusion
within generic or casework method courses. It
also is evident that there is much feeling of
need on the part of social work faculty for
help with content and instructional materials,
as well as much unmet student demand for
such instruction, particularly in marital
therapy. There is a substantial consensus on a
conception of family and marriage therapy as
a legitimate area of specialization in social
work practice.
The rubric of marital and family therapy
recognizes the commonalities of working with
married couples and with family groups.
However, neither the schools nor the social
work profession have granted recognition of
such a specialization. Social workers have
had to seek recognition and accreditation for
their expertise in such an interdisciplinary
organization as the American Association for
Marriage and Family Therapy. Social
workers used to, but no longer, constitute the
largest proportion of its membership."
Distinctive Practice Orientation
From such a tradition of practice and
education, social workers have developed a
distinctive base of knowledge and values, a
22. Personal communication to the author from Leta M.
Shattuck, Administrative Director, American Associa-
tion for Marriage and Family Therapy, 19 April 1979. In
1977. social workers constituted 20 percent of its
membership. It is to this organization that the Office of
Education, U.S. Department of Health, Education, and
Welfare, has granted the authority as the official ac-
crediting body for academic and clinical training
programs in the United States.
15
unique theoretical position, and a special style
and mode of practice in marital and family
therapy. This distinctive approach has had lit-
tle recognition and has been grossly slighted,
even by social workers. A great deal of
reciprocal influence should be acknowledged
between social work practitioners and the
theorists and practitioners from other helping
professions, such as Ackerman, Bowen,
Jackson, Haley, and Minuchin-many of
whom were taught this content by social
workers. However, the distinctive char-
acteristics of social work practice continue to
identify social work marital and family
therapy, and it is these special characteristics
that are highlighted here.
Social work practice in this field has long
asserted an explicit value system, and an
acceptance of societal task-functions assigned
to the social work profession. Thus, social
workers, and the social agencies in which
most of them are employed, have accepted a
public contract to help people strengthen their
marital and family lives, to recover from or
avoid destructive deviant behavior, or marital
and family dysfunction, and to develop social
institutions, along with their policies,
provisions, .and services, that can support op-
timal marital and family functioning.
As mediators in the dialectical processes of
social stability and social change, social
workers help individuals, couples, and
families adapt to the vast changes taking
place in society in family forms and structures
and in sex-role relations. Social workers value
the worth, autonomy, and realization of the
individual, family, and community, while
recognizing that these are inherently in-
terdependent and reciprocal phenomena and
processes. An effectively functioning family is
understood to be based on complementary,
satisfying, and efficient role performances
and expectations of individual family
members, as well as on access to and use of
community resources and supports."
Marriage and family dysfunctions express a
mismatch and exchange imbalance between
the expectations and resources of family
members and of the family and its milieu.
23. Ludwig L. Geismar, "Family Disorganization: A
Sociological Perspective," Social Casework 59
(November 1978): 545-50.
16 Social Casework: The Journal of Contemporary Social Work (January 1980)
This base of behavior and social theory and
social work values is consistent with a par-
ticular need on the part of many social
workers to profess liberal and radical political
positions and to appear very tolerant, ad-
vanced, and liberated in their attitudes and
lifestyles. Social workers encourage and sup-
port varied forms of deviant behaviors, but
also attempt to control their excesses so that
they may have constructive ends. Sometimes
this leads to extreme, faddish, and illogical
positions, as in the current contradictory
overemphasis on self-fulfillment, self-as-
sertion, equality, and autonomy, along with a
traditional value commitment to social
responsibility, altruism, equity, and the
viability and stability of marital, family, and
community life." Perhaps a tolerance for
such contradictions is necessary to facilitate
the dialectic process of synthesis and evolu-
tion for social work as a profession, as well as
for society. Marriage and family therapy now
has the character of a social movement and is
the subject of a fervent ideology, within social
work and other helping professions, as a new
road to personal and social reform.
It is from such an ideological position that
current legal definitions of marriage and
family are questioned and the exploration of
variant lifestyles and values in new marriage
and family forms, such as the cohabiting or
homosexual couple and communal families,
are supported. Social workers seek ways to
help strengthen the lives of childless married
couples, one-parent female-headed families,
socially isolated or small nuclear families,
and weakened kin networks. Recent attacks
on the institutions of marriage and family and
the values of children have been countered by
reaffirmation of their contributions to in-
dividual and social welfare. Social workers
encourage preventive approaches, in terms of
social provisions, particularly for life-stage
transitions and also in terms of family life
education and marital and family enrichment
programs, which are viewed as essential
modes of marital and family therapy.
24. See Lois N. Glasser and Paul H. Glasser,
"Hedonism and the Family: Conflict in Values," Journal
of Marriage and Family Counseling 3 (October 1977):
11-18; and Charles Frankel, "The Impact of Changing
Values on the Family," Social Casework 57 (June 1976):
355-65.
Empirical Knowledge and Skills
Social workers have an unexcelled fund of
knowledge about well-functioning and
dysfunctioning marriages and families'
developmental life cycles, stage transitions:
and tasks; and the nature, sources and effects
of difficulties and conflicts and how such
problems are constructively and destruc-
tively resolved. They understand cultural
struc~ural-functional, and process aspects of
marnages. and famili~s, in reciprocal psy-
chodynamic and sociodynamic terms: the
match of needs and expectations on conscious
and unconscious, intrapsychic and interper-
sonal levels, behavior that expresses individ-
ual motivation and relationship-interaction
patterns, personal and group contracts and
scripts, individual and group behavior
patterns ~nd coping mechanisms (such as
scapegoating, role flexibility and the use of
violence), and .what makes th~se patterns nor-
matIv~, adaptive, defensive, or pathological.
. Social workers are well acquainted with the
different forms and styles oflove and intimate
r~l~ti?nships (with and without sex), the
VICIS.sItudes of affection and reciprocity, and
the Issues of equity and equality. There is a
spec.i~l knowledge of the life processes of
families and couples under stress: reactive
behavior in many types of crisis situations;
what makes some couples "holy deadlocks,"
"empty shells," or "sadomasochistic"; what
m~~es some families or couples prone to
CrISIS, abuse, or poverty, or strong, stable, in-
tegrated, flexible, and resilient in the face of
adversity. There is a particular appreciation
for .the many w~ys in which couples and
family groups are interrelated with supportive
or nonsupportive social networks, ethnic and
other cultural forms, and social institutions.
This involves a comprehensive understanding
of the powerful effects of social institutional
arrangements and provisions: the importance
of work, income, and money-management
compe~ence; the operations of social policies
on societal and local organizational levels-in
governmental, public welfare, educational,
correctional, and other agencies; how people
deal and negotiate with institutional
bureaucracies and representatives their rules
policies, and procedures, in orde: to stay out
of trouble and obtain needed resources."
Siporin: Marriage and Family Therapy
Based on this distinctive body of knowledge
and values, social workers also have a distinc-
tive set ~f skills in helping married couples
and family groups. Traditionally, this has
consisted of skills in assessment and interven-
tionyrocedures with individuals, couples, and
family units in flexible dyadic, triadic, and
collective relationships. Meetings are held
privately with individuals, and conjointly with
two or more members, in the office, home,
work, school, and other community settings.
Social work assessment procedures char-
acteristically have given emphasis to viewing
the individual and situation or system gestalt.
They also have emphasized client participa-
tion, so that the diagnostic process is shared
and conducted in such a way as to have direct
therapeutic effects. Thus, spouses and family
memb~rs are helped to a better understanding
o.f th~Ir problems, personality patterns, and
situations, to redefine their problems and
s~tuations in more positive cognitive construe-
tions, and to comt,nit themselves to change.
Because work WIth groups and community
res?urces has been a basic component of
social work educational curricula, this has
profoundly influenced social work ap-
pro~ches to marriage and family therapy. 26
SocI.al wor~ers have long been adept in
lea?~ng .famlly and other types of groups, in
facilitating group discussions and decision
making, in negotiatang collective objectives
25. See, for example, Sheila B. Kamerman and Alfred J
Kahn, "Explorations in Family Policy," Social Work 2i
(l9?6): 181-86;. and Carol H. Meyer, "Practice and
Policy: A Family Focus," Social Casework 59 (May
1978): 259-65. On family relationships with institutional
bur~aucracles, see Robert M. Rice, American Family
Policy: Content and Context (New York: Family Service
Association of America, 1977); Otto Pollak, "The
Outlook for t~e American Family," Journal ofMarriage
and the Family 29 (February 1967): 193-205; and Lynn
Hoff~an and Lorence Long, "A Systems Dilemma,"
famIly Process 8 (September 1969): 211-34. On family
income and money management, see Frances L. Feld-
man, The F,amily in Today's Money World, 2d ed. (New
York: Family Service Association of America, 1976).
26. Grace L. Coyle, "Concepts Relevant to Helping the
Family as a Group," Social Casework 43 (July 1962):
347-~4; and Gertrude W.ils~~ and Gladys Ryland, "The
Family as a Unit of Service, Social Work Practice 1964
(New York: Columbia University Press, 1964), pp. 222-
39. On the use of community resources, see: Gordon
Hamilton, Theory and Practice of Social Case Work 2d
ed. (New York: CO,lum?ia University Press, 1951), 'pp.
83-144; and Max Siporin, Introduction to Social Work
Practice (New York: Macmillan, 1975), pp. 310-22.
17
and task programs, and in enabling
collaborative efforts that result in individual
and group rewards and achievements. They
serve both as team leaders and as team
members. They also have been especially
skilled in working with subunits and the total
unit of the family, as well as with varied social
networks of situationally significant others
and organizations within the ecology of
family-agency-community-milieu relation-
ships. In addition, they are skillful in melding
and orchestrating these multidimensional ac-
tivities in comprehensive task programs that
can meet systemic and individual member
needs. Social work interventive programs
have emphasized active participant-observer
roles, and a kind of group leadership that
seeks to improve system structure and func-
tioning processes through optimal internal
leadership and self-change task activities.
The Integrational Approach
Still further, there is a characteristic and
widely practiced social work approach to
marriage and family therapy that is con-
cerned with the complex interrelations of in-
dividual personality and social systems. A
number of leading social work family
therapists have referred to this as an
"integrational" approach." This uses a
27. See, for example, Sanford Sherman, "Family
Therapy," in Social Work Treatment. 2d ed., ed., Fran-
cis J. Turner (New York: Free Press, 1979), pp. 459-79;
Gerda L Schulman, "Teaching Family Therapy to
Social Work Students," Social Casework 57 (July 1976):
448-57; and Virginia Satir who, though not associated
with this school, used the term "integrational" to
categorize her systems perspective in her Conjoint
Family Therapy. 2d ed. (Palo Alto, Calif.: Science and
Behavior Books, 1967), p. 179. Other members of the
"integrational" school are: Arthur L Leader, "The Role
of Intervention in Family Group Treatment," Social
Casework 45 (June 1964): 327-32; Frances L Scherz,
"What is Family-Centered Casework?" Social Casework
34 (October 1953): 343-49; and Celia Brody Mitchell,
"Family Interviewing in Family Diagnosis," Social
Casework 40 (July 1959): 381-384. Representative work
of M. Robert Gomberg, Frances Levinson Beatman,
Sonia E. Penn, Elsa Leichter appear in Gomberg and
Levinson, eds., Diagnosis and Process in Family
Counseling. See Also: Alice Overton, "Serving Families
Who Don't Want Help," Social Casework 34 (July
1953); 304-309; Irene Josselyn, "The Family as a
Psychological Unit," Social Casework 34 (October
1953): 336-343; Otto Pollak, "A Family Diagnosis
Model," Social Service Review 47 (March 1960): 19-28;
and Max Siporin, "Family-Centered Casework in a
Psychiatric Setting," Social Casework 37 (April 1956),
167-74.
18 Social Casework: The Journal of Contemporary Social Work (January 1980)
systems perspective and a multidimensional
focus on psychodynamics (particularly from
psychoanalytic theory) and sociodynamics,
on the interfaces and reciprocal interplay of
the structures and functioning processes of in-
dividual family members, family groups, in-
stitutional organizations, and communal
cultural forms. Attention is given to the in-
terdependencies of subjective and intersubjec-
tive experiences, of social-self identities and
family-communal roles, and of intrapersonal,
interpersonal, and wider social conflicts.
There is a concern with matching person and
situation, with developing inner competence
and systemic adequacy of structure and effec-
tiveness of operational processes, and with
personal individuation, role complemen-
tarity, and unit cohesion.
A basic aim is to enable people to elicit,
maximize, and use internal and external
resources, so as to enhance individual and
corporate family identity, self-esteem, and
self-realization. Traditionally, much impor-
tance has been attached to the use of
educational and group problem-solving help-
ing procedures. Central interventive prin-
ciples call for an induction of the couple or
family unit into the role of clienthood, and for
problem-situation redefinitions that shift the
locus of conflicts from intrapsychic to in-
terpersonal levels of interaction, where they
can be directly confronted and resolved. It is
shocking to realize that this valuable social
work "integrational" approach and its
representative practitioners (such as
Gomberg, Beatman, Leader, Sherman,
Mitchell-Brody, Scherz, Schulman, and
Leichter) have had little or no recognition in
the professional literature by psychiatrists,
psychologists, and even social workers that
purports to present and evaluate the diverse
theoretical schools of family therapy.
The Ecological Model ofPractice
The "integrational" approach represents
an application of the wider "psychosocial
casework" and ecological social work orien-
tations." It is eclectic and integrative, ac-
28. On "psychosocial" casework, see:. Hamilton, Theory
and Practice of Social Casework. Florence Hollis,
Casework (New York: Random House, 1964);and Fran-
cis J. Turner, Psychosocial Therapy (New York: Free
Press, 1978).
cepting varied specialized theoretical orien-
tations." It also is being extended by current
developments in social work theory and prac-
tice, particularly in the shift to a more explicit
and operational "ecological" model of prac-
tice." As applied to marriage and family
therapy, this moves further away from
medical models of psychotherapy for
pathology of parents or spouses, and of
family treatment for interfamilial pa-
thology." The ecological orientation encour-
ages a broader concern with the life situ-
ations of clients, in extended family, work,
neighborhood, and social networks, and with
institutional organizations and cultural
arrangements. And it also encourages a
regard for contributions that can be made
(through agency, professional, and political
channels) to needed changes in family policy
and social institutions by way of research,
family advocacy, and other social action.
This kind of a professional practice posi-
tion by social workers in marriage and family
therapy enables the more responsive and ap-
propriate development of programs and ser-
vices for new kinds of needs and problems
29. Representative of such specialized therapeutic orien-
tations are: Harry J. Aponte, "The Family-School Inter-
view: An Eco-structural Approach," Family Process 15
(September 1976): 303-13; Rubin Blanck and Gertrude
Blanck, Marriage and Personal Development (New
York: Columbia University Press, 1968); Andrew Curry,
"Toward a Phenomenological Study of the Family," Ex-
istential Psychiatry 6:27 (1967): 35-44; David Hallowitz,
'The Problem-Solving Component in Family Therapy,"
Social Casework 51 (February 1970): 67-75; Nathan
Hurvitz, "Interaction Hypotheses in Marriage
Counseling," Family Coordinator 19 (January 1970): 64-
75; James E. Lantz, Family and Marital Therapy: A
Transactional Approach (New York: Appleton-Century-
Crofts, 1978); and Michael D. LeBow, "The Behavior
Modification' Process for Patent-Child Therapy,"
Family Coordinator 22 (July 1973): 313-19; Satir, Con-
joint Family Therapy; Richard B. Stuart, "Operational
Interpersonal Treatment for Marital Discord," Journal
of Consulting and Clinical Psychology 33 (June 1969):
675-82; and Ralph H. Stewart et aI., "An Object
Relations Approach to Psychotherapy with Marital
Couples, Families and Children," Family Process 14
(June 1975): 161-78.
30. See Carol H. Meyer, Social Work Practice. 2d ed.
(New York: Free Press, 1976; Siporin, Introduction
to Social Work Practice; and Carel Germain, ed., Social
Work Practice (New York: Columbia University Press),
1979.
31. Eda G. Goldstein, "Mothers of Psychiatric Patients
Revisited: An Ecological Perspective," and Ann Hart-
man, "The Extended Family as a Resource for Change,"
in Social Work Practice. ed. Carel Germain, pp. 151-73,
239-66.
Siporin: Marriage and Family Therapy
presented by clients today. Direct services are
provided with single-parent and communal
families, with nontraditional forms of family,
marital, and couple life, with sex role and
family role changes, and with population, and
residential shifts, including the renewed im-
migration of varied ethnic groups. Unlike
past crisis periods, social workers today have
a vastly augmented stock of social provisions,
resources, and technology with which to re-
spond to these social transitions and changes
in couple and family values and lifestyles."
Such a professional social work orientation
is also of demonstrated effectiveness." There
is evidence of public support for social work
practice within the family and other social
service agencies, as well as in private practice.
In addition, there is the competition for
valued social work jobs that has emerged in
recent years from other professional and oc-
cupational groups, particularly from psy-
chologists. Practitioners from such groups
have asserted a special competence in family
and marriage therapy and have sought ac-
credition through membership in the
American Association for Marriage and
Family Therapy. This kind of competition,
and borrowing from social work expertise, es-
pecially now about community work, testifies
to the high value of social work marriage and
family therapy, as well as to the rewards of
providing social services to a clientele that
previously only social work cared about.
Teaching and Learning
Marital and family therapy is a demanding
discipline that requires a high order and wide
range of personal qualities, of professional
knowledge, attitudes, and skill. Teaching this
body of theory and skill to social work
students in both class and field involves help-
ing them, through major tasks in learning, to
prepare for competent practice and to
develop a professional identity as a social
32. Alfred Kadushin, "Social Work and the American
Family, Then and Now: 1920-1978," Smith College
Studies in Social Work 49 (November 1978): 3-24.
33. Dorothy Fahs Beck and Mary Ann Jones, "A New
Look at Clientele and Services of Family Agencies,"
Social Casework 55 (December 1974): 589-99; and
Dorothy Fahs Beck, "Research Findings on the Outcome
of Marital Counseling," Social Casework 56 (March
1975): 153-81.
19
worker who also is a family and marital
therapist. In addition, there are important
side effects that a number of students regard
as having equally direct values for their per-
sonal maturation and their own preparation
for marriage and family life.
Students are taught to carry out a
systematic assessment of a couple or a family,
of its structure and functioning processes, its
problems and milieu. Here the use of role-
playing exercises and assignments in working
up genograms and ecomaps are emotionally
meaningful to students." They learn valid
models of normative well functioning and
deviant systems and how to use classifications
that distinguish between normal, variant, and
pathological patterns within particular
milieus, without attaching blame or stigma to
the person or family. They are taught the
basic skills of developing and formulating a
social study report.
Students learn the skills of applying varied
behavior and practice theories, of using a
repertoire of intake, interventive, and
evaluative procedures and techniques. Sex
therapy, with its combination of behavior
modification and psychodynamic procedures,
is now generally accepted as a valid helping
mode and is widely provided by social
workers." This content is a basic element in
class and field teaching. Because marriage
and family therapy requires an assertive,
often directive stance, students need to learn
to gain and maintain control of the helping
process and situation without controlling the
people involved-who are treated in accord
with the basic ethical principles of respect,
acceptance, and self-determination. Learning
in such tasks is helped by the presentations of
audiovisual material, the instructor's own
helping experiences, and discussions of the
"subjective side" of family and marital
therapy by various writers."
This kind of content encourages the
development of a healthy self-awareness and
appropriate self-disclosure and the working
34. Ann Hartman, "Diagrammatic Assessment of
Family Relationships," Social Casework 59 (October
1978): 465-76.
35. Harvey L. Gochros and LeRoy G. Schulz, eds.,
Human Sexuality and Social Work (New York: Associa-
tion Press, 1971).
36. Virginia Satir, "When I Meet a Person," in Tidings
20 Social Casework: The Journal of Contemporary Social Work (January 1980)
through of certain value dilemmas. Students
learn to come to terms with their own biases
and "unfinished business" about themselves
and their family relationships. Such
"emotional work" of learning is anxiety
producing and growth enhancing.
Students need to accomplish these learning
tasks without confusing the public-profes-
sional and private spheres of their lives, with-
out an imposition of an instructor's "ad-
vanced" biases, and without "therapeutizing"
what should remain an educational ex-
perience. To cope with the stresses and dif-
ficulties of practice in this field requires
recognition by students of the values of link-
ing themselves to personal and professional
mutual support groups and of the need to use
educational and supportive supervision and
consultation as they are indicated.
Implications for the Field
At this critical juncture of historical
development in social work practice and
education, there are important choices to be
faced. The above considerations yield certain
conclusions and some suggestions for im-
proving the present state of affairs. First, it is
evident that much greater recognition must
be given to the rich and long tradition within
social work of the provision of family and
marriage therapy as basic social services. Sec-
ond, there is a need to recognize that training
for marriage and family therapy has been a
core element in professional social work
education since its inception and continues to
have a central place in social work un-
dergraduate and graduate programs. This is
obscured to some extent by the conception
of social work method as casework, group
work, community organization, and so on.
Third, it is therefore indicated that social
work educational programs clarify and cer-
tify that such instruction is given. This can be
done, for example, by requiring specifically
labeled courses in marriage and family
therapy and also by specifying this content in
of Comfort and Joy, ed. Robert S. Spitzer (Palo Alto,
Calif.: Science and Behavior Books, 1975), pp. 111-27;
Schulman, "Teaching Family Therapy"; Framo,
"Reflections of a Family Therapist"; and Sidney M.
Jourard, "Marriage is for Life," Journal of Marriage
and Family Counseling I (July 1975): 199-208.
other academic and field courses within the
curriculum, as well as including it in the doc-
toral programs.
Family and marriage therapy is regarded
by many social work practitioners and
educators as a distinct area of specialization.
There is a need for accreditation that has not
been met by the social work profession. It is a
need that is important because of the
meanings of such accreditation. It signifies to
the public that the practitioner is properly
trained and has the requisite expertise and
ethical commitment to provide a valued and
specialized service of high standards. It is a
form of protection for the clientele and the
community, in that it is accompanied by sanc-
tions against the violation of practice stan-
dards. It also is responsive to the desire for
specialized and expert service by many in-
dividuals who will pay for such certified ser-
vice directly or through insurance.
Practitioners want this official recognition
and certification of their expertise, and they
would prefer to have it from their own
professional peers and organizations. This is
a need that also becomes more pressing with
the accelerating movement within the state
legislatures to adopt licensing regulations for
marriage and family therapy and of state and
federal agencies to require as a basis for fund-
ing that educational programs clearly provide
a preparation for such practice. Membership
within the American Association for
Marriage and Family Therapy can continue
to have advantages for its social work
members, though not fully meet their needs.
Finally, then, it is incumbent upon the social
work profession, the family agencies, the
schools of social work, and, particularly, the
National Association of Social Workers to
move with full deliberate speed to provide ac-
creditation for this practice specialization.
Summary
Social work has developed a distinctive and
valuable body of knowledge, values, and skills
in helping couples and families. It has iden-
tified a well-developed "integrational" ap-
proach to marital and family therapy that is
used as a basic orientation by many social
workers and expresses a "psychosocial" and
"ecological systems" perspective. Social
Siporin: Marriage and Family Therapy
workers are open to and have adopted and
adapted a wide range of special therapeutic
schools. This professional orientation is of
demonstrated effectiveness. It enables social
workers to be more responsive to the needs of
people in the present societal ferment and to
emerging developments in marriage and cou-
ple relationships and family life. Social
workers need, therefore, to recognize and
take pride in the distinctive social work ap-
proach to marriage and family therapy and,
through research on its theory, principles, and
procedures, to make a conscious effort to
further its development.
Current educational programs appear now,
much more than in the past, to serve conjoint
purposes of helping students learn the com-
petencies of knowledge, attitudes, and skills
and of helping them to use this learning for
the tasks of personal maturation. Marriage
and family therapy is a demanding and haz-
ardous discipline, and its learning is both
challenging and anxiety producing for
students. The current confusions surrounding
educational and therapeutic needs in this area
pose certain dilemmas for students and
educators that warrant explicit exploration.
It has been noted that a major shift has
taken place in the social work identity and do-
main with regard to marital and family
therapy. As Kadushin points out, social
workers in marriage and family practice show
a loss of confidence and of consensus about
family values that formerly were char-
acteristic traits." Social workers have been
under attack, and their previous societal rec-
ognition and esteem have declined. Yet, in
this area of practice, the real expertise of
social workers is greater than ever. Bertram
Beck suggests that it is now time for social
workers to assume a role of social leadership
for the human service professions and that
social work is uniquely qualified for this new
function;" The assumption of social
leadership in our society, however, requires
that social workers validate and assert their
traditions and special competence, par-
ticularly for marriage and family therapy.
37. Kadushin, "Social Work and the Family."
38. Bertram M. Beck, "Humanizing the Human Ser-
vices," in Toward Human Dignity. ed. John W. Hanks
(Washington, D.C.: National Association of Social
Workers, 1978), pp. 5-14.
21