In Defence of a Modern Medical Model: Purism and Eclecticism in Family Therapy*

Abstract

Family therapists criticise the ‘medical model’ for relying on linear causality, focusing on pathology rather than health processes and tending to coerce the family into preconceived models. These criticisms might be legitimately levelled at 19th Century models but not at modern medical models which include the circularity of general systems theory, attention to ecological field, and understanding of reciprocal influences of many factors such as emotions, antibodies, genetic endowment, nutrition, interpersonal relations, environmental stress, and symbiotic micro‐organisms. This modernised medical model is consistent with modern family therapy theory which integrates general systems theory, ecological theory, communication theory, small group process, role theory and metaphoric communications. Family therapy purists define themselves by contrasting their differences with ‘the medical model’. Eclecticists tend to be practitioners who use broad theoretical frames of reference and commonsense, straight‐forward, direct intervention where it is likely to work but will resort to indirect, metaphoric or paradoxical intervention for the more complex and resistant family.