This article situates family therapy in the politics of evidence‐based practice. While there is a wealth of outcome research showing that family therapy works, it remains on the margin of mainstream therapy and mental health practice. Until recently it has been difficult to satisfy ‘gold standards’ of randomized control research which require manualization and controlled replication by independent investigators. This is because systemic family therapy is language‐based, client‐directed and focused on relational process rather than step‐by‐step operational techniques. As a consequence family therapy is an empirically supported treatment unable to join the evidence‐based club. The politics here concerns what is ‘evidence’, who defines it and the limitations of a scientist‐practitioner model. Therapy is art and science and its research needs to be grounded in real‐life clinical practice. Common factors such as personal hope and resourcefulness and the therapeutic relationship contribute more to change than technique or model. While arguing for a wider definition of science and evidence it is politic to seek evidence‐based status for family therapy. Family therapy is a best practice approach for all therapists where systemic wisdom helps to decide what to do with whom when. A systemic‐practitioner model is informed by quantitative and qualitative research and holds modern and postmodern perspectives in tension, a stance I call paramodern. Family therapy is both scientific and systemic; it is a science of context, narrative and relationship.

In this paper a common ground between psychoanalysis and family therapy is discussed in terms of postmodern theorizing in both disciplines. Recent systemic, narrative or social constructionist thinking in psychoanalysis and a psychoanalytic turn in family therapy offers the possibility of a shared epistemology. This is described in terms of a critical not‐knowing stance which allows for the therapist’s/analyst’s contribution of meaning, interpretation and knowledge in therapeutic conversation. Here the holding of not knowing and knowing together provides a narrative container for personal meaning and thinking to develop. This ‘knowing not to know’ is what a postmodern psychoanalysis has in common with family therapy: both are ways of being with persons to help them develop and hold their own knowing. This therapeutic process is illustrated in a clinical vignette of narrative child family therapy. For what one knows does not belong to oneself. (Marcel Proust, Remembrance of Things Past, p. 898)

This article integrates family therapy in contemporary child and adolescent mental health services as an evidence‐based practice. An integrative practice model is proposed where contextual approaches like systemic and narrative therapy complement and enrich individual problem‐focused models such as biological psychiatry and cognitive therapy. This is based on an ethic of hospitality towards all therapy discourses and the following best practice guideline: ‘To make optimum space for a systemic and narrative understanding contributes to evidence‐based practice in a contemporary mental health service.’ After discussing some dilemmas of integrative practice, I illustrate the therapeutic process by a detailed example of integrative family therapy with a depressed suicidal adolescent.

As in the arts and humanities and other social sciences, post‐modernism is quickly gaining orthodoxy in family therapy. This paper presents a social‐realist and deconstructive critique of recent post‐modern thought in family therapy. From the perspective of the French philosopher Jacques Derrida, it suggests that family therapy is neither modern nor post‐modern, but both/and these alternatives, that is, para‐modern. In deconstructive thought, philosophical dualities like realism/social constructionism, cybernetic/post‐cybernetic, systemic/narrative co‐exist in an absurd double logic. Like writers of literature, the para‐modern family therapy ‘puts forward’ a theory or method not as an ideology of truth, but as a play of irony. She/he works simultaneously inside and outside family therapy discourse, open to a wide range of images and metaphors.

This paper examines the current issue of power and intervention in family therapy from the perspective of Jacques Derrida's philosophy. In a deconstructive reading which presents power as both real and socially constructed, it negotiates the border between such dualities as knowing/ not-knowing, interventionlnon-intervention, and power/non-power. The paper tracks Goolishian and Anderson's approach to therapy as deconstructive in practice, but not in theory, and discusses a double view ofpower in relation to both Bateson and Foucault. It suggests that power is both endemic to the context of family therapy and an illusion of epistemology. The paper concludes with a discussion of the wider question of ethics in relation to technology.