Habla Mi Idioma? An Exploratory Review of Working Systemically with People from Diverse Cultures: An Australian Perspective

This paper presents a review of the literature informed by both grounded theory and phenomenology, which explores how culture is addressed in the family therapy field with particular emphasis on Australia. The primary aim of the study is to identify the issues and relevant publications that can inform and guide Australian family therapists in working with clients from culturally and linguistically diverse backgrounds. The secondary aim is to provide recommendations that may inform research directions and clinical practice. The results indicate that this challenge is not unique to Australia; indeed the issue is ubiquitous across the Western world. This paper attempts to provide an impetus for future dialogue and to precipitate discussion around the development of a culturally sensitive approach in the Australian family therapy field.     

The COVID‐19 Pandemic: An Evolving Story. Professional and Personal Insights using Self and Culture as Agents of Calm and Healing after a Year of Co‐habitation with Imminent Threat

Being a cross‐cultural systemic therapist, clinical supervisor, and educator means that culture and language are central to my work. They provide a scaffold to develop deeper understanding, increased trust, and connection between myself and my supervisees, students, and clients and facilitate a process for the latter to connect to their own selves and values. Given the fear and uncertainty generated by the COVID‐19 pandemic, there exists a pervasive activation of the sympathetic nervous system in the community. In this article, I present two case studies as examples of a cross‐cultural/cross‐linguistic approach that facilitates two clients to find a place of comfort and calmness and consequently a balancing activation of the para‐sympathetic nervous system. First is a client who, due to the overwhelming pandemic chaos, suddenly exhibited a host of signs and symptoms of a functional neurological nature, which she experienced as a lack of control and disconnection from her body, her primary language, and herself. Within a trusted therapeutic relationship that draws on the culture and primary language of the therapist, the client regains connection with language and enhances her ability to communicate and connect with her body. Second is an international student who is encouraged to use her culture of origin and primary language to induce calmness, reconnect with herself, and return to the familiar as a ‘known’ collectively inclusive, comforting, and nurturing environment.     

Systemic Practice in the Time of COVID: Conversations Among Culturally Diverse Therapists

The COVID‐19 pandemic has changed the delivery of clinical services and education of health professionals, including family therapists. This paper distils two separate Zoom conversations between myself (as the lead author) and two eminent family therapists, Professors Maurizio Andolfi and Harry Aponte, where challenges and opportunities for the profession during and after the pandemic are discussed. Creativity and resourcefulness are two important elements therapists and educators have needed to access during the pandemic to find alternative ways to continue to provide clinical services and teaching. Most therapists have transitioned using online technology and various platforms such as Zoom and Skype; for some this has been a somewhat familiar experience, for most it has been a novel one. Key themes emerged from the conversations including the personal and professional ‘lived experiences’ of the pandemic; the financial impact on clients and students; the importance of touch for human social connection; the use of ‘self’ as an instrument of change and alternative platforms of service delivery and teaching. We reflected on what has been lost, such as the nuances inherent in face‐to‐face human interactions, and what has been gained, such as observing families in situ in their own environments.     

Systems thinking: fostering collaboration and connections to strengthen the field. A conversation with Umberta Telfener

Umberta Telfener is a highly respected figure known for her diverse contributions to various facets of family and systemic therapy. Her leadership style has earned her a reputation as somewhat of a ‘cultural anthropologist,’ reflecting her aptitude for creating connections, establishing relationships, and developing partnerships. Her unique ‘Umberta style’ is known for boundless energy, active leadership, and fierce commitment to challenging the status quo. Despite being in office for just a year at the European Family Therapy Association (EFTA), Umberta has conceived and developed numerous projects, establishing networks with practitioners, and systemic thinkers across the world. Rooted in classical philosophical training, her pursuit aligns with the systematic study of fundamental questions about existence, reason, knowledge, value, mind, and language. Umberta's role reminds one of a ‘Chasqui,’ a Quechua term for a ‘messenger,’ which aptly describes her agile networking skills. She actively communicates and shares vital messages, supporting the international community of systemic practitioners. This paper is based on an in-person conversation held in July 2023 at Umberta's country home in Tuscany. Our discussion delves into her extensive professional experience, from training at the Philadelphia Child Guidance Clinic, being mentored by Boscolo and Cecchin in Milan, to her leadership role as the current EFTA president. Umberta reflects on early pioneers who influenced her thinking and her impactful work with systems.     

The influence of the Milan approach—Part 2. The legacy of Boscolo and Cecchin and their Paduan connection: A conversation with Andrea Mosconi

The Milan approach, pioneered by Selvini-Palazzoli, Boscolo, Cecchin, and Prata, has significantly contributed to the field of psychotherapy, particularly in the realm of systemic and family psychotherapy. While rooted in systemic principles and concepts, over time the original Milan group demonstrated differences in their clinical orientations and practices which led to their regrouping into two teams. The paper explores the divergences in their views and directions on family dynamics and the role of symptoms within the system. It delves into the influence of Boscolo and Cecchin, two of the ‘Milan Four’ on the Centro Padovano di Terapia della Famiglia. Drawing from a conversation with Andrea Mosconi, a mentee and collaborator of Boscolo and Cecchin, the paper examines the reconfiguration of the original ‘Milan Four’ team and its impact on their clinical approach. Key Milan principles and concepts such as hypothesising, circularity, and neutrality are examined with particular emphasis on the work of Boscolo and Cecchin's systemic work. These principles, intertwined and interconnected, provide a fertile ground for the construction of multiple hypotheses and circular questioning. The paper also highlights the concept of reflexivity, which originates from Bateson's work and plays a crucial role in family relations and communication while explaining the birthplace of paradox taking place when two levels of meaning are ‘confused.’ The Milan approach continues to be highly regarded, as its early concepts and ideas have evolved and left a lasting impact on the field of family therapy. By reflecting on the distinct contributions of Boscolo and Cecchin, and using examples, Mosconi offers valuable insights into the rich legacy and ongoing relevance of the Milan approach to contemporary therapeutic practice.     

The Ackerman Institute: a journey of culture and diversity over six decades. A conversation with Evan Imber-Black

The Ackerman Institute for the Family, established in 1960 by Dr Nathan Ackerman, stands as one of the oldest and most respected family therapy institutes in the United States. Ackerman pioneered the integration of systemic insights into group settings, emphasised the crucial role of family in therapy, and advocated for the advancement and acceptance of family therapy. ‘The Ackerman’ played a pivotal role in launching Family Process, the first journal dedicated to academic activities in family therapy. Diversity and inclusion have been central tenets of Ackerman philosophy, evident in its programs, training courses, and staff composition. This commitment has produced a veritable cadre of family therapy leaders who have contributed significantly to both the Ackerman Institute and the profession, influencing policy decisions and clinical practices. One of the most esteemed and respected thought leaders and innovators of our field, who played a vital role in the legacy of several institutions, including the Ackerman, is Dr. Evan Imber-Black. She served as a long-time faculty member and director of the Ackerman Center for Families and Health. Her expertise encompasses the exploration of family rituals and family secrets, with a focus on the importance of rituals in providing meaning, identity, and connection across diverse cultures and family life cycles. As editor of Family Process for 8 years, she highlights the importance of examining scholarly work in the context of cultures as a requirement – we do not stand outside the culture – we are active participants. This paper is based on a conversation with Dr Evan Imber-Black, held in June 2023, delving into her personal and professional experiences, her connection to the Ackerman Institute, and her influential work on family rituals and secrets. Through this exploration, the paper sheds light on her commitment to diversity and the lasting impact of Dr Imber-Black's contributions to family therapy.     

The influence of the Milan approach: Five decades of intergenerational change. A conversation with Matteo Selvini

The ‘Milan Approach’ made an enormous contribution to psychotherapy and psychiatry and has been viewed as a bedrock in the family therapy field. Mara Selvini-Palazzoli made a revolutionary shift in the early 1970’s to abandon individual therapy and adopt family therapy to treat anorexia in young women. The goal of the three systemic principles; hypothesising, circularity and neutrality, proposed by the Milan Team is to elicit a useful method to interview families which encourages the production of meaningful information. The Milan group took special care of language. Rather than overly focusing on the label and referring to schizophrenia as a diagnosis, for instance, they used the term ‘families in schizophrenic transaction’. This perspective more realistically explored the origin of problems while looking at ways how to effectively generate change. In the early stages of its development, heavily influenced by the work of the MRI, the team adopted a pragmatic and strategic approach, however the focus gradually shifted towards semantics and the story of the system. While the ‘systemic identity’ was the principal guiding principle, the model was also influenced by social constructionism. This paper is a distillation of a conversation held with Matteo Selvini, son of Mara Selvini Palazzoli. We discussed the four key influential figures who developed the ‘Milan approach’, Selvini Palazzoli, Boscolo, Cecchin and Prata. The focus of the conversation is on Mara and on her influence shaping the approach, its evolution through the years leading to the creation of the Scuola di Psicoterapia Mara Selvini Palazzoli. Matteo also shares his own influence in the evolution of the school through the intervening years. He explains the adapted version of the Milan approach and the amalgam of the original and emerging therapeutic concepts. His key messages to therapists are the importance of working in teams and client follow-ups.     

La metafora: the power of metaphors and creative resources in working systemically with families and children with autism—a conversation with Carmine Saccu

Metaphors are valuable tools of expression, which give meaning to situations and allow the spontaneous processing of feelings and emotions. As therapists, we can support clients to develop and create their individual metaphor to explain their own meaning of experiences or communicate their perception of problems. Creativity provides us with a rich landscape to explore, expand, and enrich ourselves as therapists and consequently our clients. As systemic therapists, we are responsible for the co-creation of a human process, which has at its core safety in allowing expression, connection, and movement. Through a respectful and curious approach, we can develop pathways to tap organically into our ‘creative selves’ while reaching into our clients' creativity and selves as catalysts for connection and positive change. Creative resources and therapies have been successfully used in psychotherapy to enhance the mental and emotional well-being of children, particularly children with autism who have limited verbal capacity or who are non-verbal. These children also wish to be understood in expressing their thoughts and feelings; however, they use other methods of communication – sometimes obvious, sometimes not. Therefore, it is important that a therapist can access diverse ways to support the child through this process. The creative use of animals in therapy neutralises spaces, eliciting calm, safety, and healing. This is particularly the case when working with this group of children. This paper is derived from my conversation with an elder statesman of the family therapy profession, Professor Carmine Saccu. He is a jovial master storyteller who craftfully communicates via metaphors. Through creative means, play, and humour, he has developed a remarkably unique way of working with children, especially non-verbal children with autism. He uses his canine, co-therapist Mafalda, as a powerful resource and intervention strategy to safely elicit engagement and connection in the therapeutic space.