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Chiesa, M. (1986). The Milan systemic approach to family therapy: an overview. Free Associations, 1(5):28-47.

(1986). Free Associations, 1(5):28-47

The Milan systemic approach to family therapy: an overview

Marco Chiesa

When I left Italy for London in May 1980 I had not heard of the ‘Centro per lo Studio della Famiglia’ in Milan. Yet I had qualified from the Medical School of Milan and had worked as a resident in Psychiatry in the Milan area for over a year. You may well imagine my embarrassment when I was asked by colleagues here in London about the method for which the group had become famous. The explanation rested in the fact that the ‘Centro per lo Studio della Famiglia’ had been founded as a totally private institution, with no contact with traditional and academic psychiatry; besides, their work had raised great interest and had obtained recognition abroad much earlier than it did in Italy where, as it often happens, one has to become internationally famous before domestic interest awakens.

The group has become one of the leading forces within the field of family therapy and K. Tomm (1984a) affirms that the Milan approach does represent a major new development not only in family therapy, but also in psychotherapy in general. In this essay, I shall try to outline the development of this complex approach and its most characteristic features.


The ‘Centro per lo Studio della Famiglia’ was started in 1967 by Mara Selvini-Palazzoli, a psychiatrist and psychoanalyst who had developed a special interest in anorectic patients. Very soon Luigi Boscolo — having just completed psychoanalytic training in New York — and four other pyschiatrists, psychoanalytically oriented, joined Selvini at the Centre. A research team was formed to study the effects of treating the whole family in cases of anorexia nervosa.

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