Course in Multigenerational Family Therapy

A family arrives because an eight-year-old has been labelled with ADHD. Most of the profession will now work to reduce the label. Maurizio Andolfi does something else: he treats the child's symptom as the occasion, not the target, and uses it as the door into a family history where a grandfather died and was never mourned, where one branch has been cut off for years, and where the couple has been quietly carrying all of it.

Multigenerational Family Therapy grew out of the pioneers of the field and departs from them on one decisive point. Bateson brought the context, Bowen the differentiation of self, Boszormenyi-Nagy the invisible loyalties, Framo the family of origin session, Minuchin the structure and its boundaries, Satir and Whitaker the experiential encounter. What almost all of them left out was the child. Andolfi reversed the direction of the inquiry and made the child the guide.

The course is built on real clinical material recorded in Italy, Australia, China, the Netherlands and the Dominican Republic, alongside training footage in which therapists work on their own family history. It is designed for family therapists, psychotherapists, psychologists, psychiatrists, social workers and counsellors working with children, adolescents, couples and families, and for those responsible for training them. No previous systemic training is required, but the course assumes clinical practice: what it offers is a way of seeing and a set of tools for the next family who walks in.

What this course covers

• Look at any presenting problem, in a child, an adolescent, a couple or an adult, within a three-generational frame.
• Engage the members who never arrive on their own, in particular fathers, siblings and grandparents.
• Use the family genogram as a living, therapeutic instrument rather than an intake form.
• Reframe symptoms as relational events and convert them into resources for the whole family.
• Work experientially, using space, movement, objects and the body, not conversation alone.
• Recognise the therapist's own family history at work in the session.

The three-floor house

The organising image of the method is a house with three floors: children, parents, grandparents. A family is never the two generations who happen to be sitting in front of the therapist; that is one slice of the cake. Most of what looks inexplicable on one floor becomes legible when the floor above is brought into view. A couple's chronic tension acquires an explanation upstairs, and a child's symptom appears exactly where an unfinished loss has been left unattended.

The bottom-up approach

Andolfi's central contribution is to reverse the usual direction of inquiry, working upwards from the children, who have witnessed family life and answer intergenerational questions with a directness adults rarely manage. The child draws the genogram, awards stars to family members, calls the aunt on the telephone, and becomes a co-therapist. The consequence is twofold: the family reaches material it could not reach directly, and a child who came in as the problem leaves feeling competent.

Where the method is tested

Three lessons take the approach into the situations clinicians find hardest. Adolescence is presented through ten key points, including the argument that it is not a stage of autonomy and that much adolescent disturbance rests on a failure of belonging rather than a failure to separate. Couple work is presented as intergenerational couple therapy, assessed through the we-ness of the couple, each partner's differentiation from their family of origin and the social level of friends and community. A further lesson is devoted to fathers as the missing presence in families and in therapy alike, absent even from attachment theory, and to how to engage them: never through the wife, always through the child.

The use of self

The final lesson turns the method on the therapist. Working without a desk in between means objectivity is an illusion and everything happens at the level of intersubjectivity. It covers the therapist's inner family always seated in the room, the shift from an external supervisor to an inner one, therapeutic silence, self-disclosure, and the professional handicaps work Andolfi has run for thirty-eight years.