Cultural family therapy

Domain V · Systemic, relational, group & community · Vincenzo Di Nicola · 1985 · McGill University, Montreal, Canada

What it is

CFT is a model, not a manualised protocol: a synthesis of family therapy and transcultural (cultural) psychiatry, developed by the Canadian psychiatrist and family therapist Vincenzo Di Nicola, first at McGill University (1985 papers) and later at the Université de Montréal. It was built for…

Format

• No published phase protocol. None of the sources reached sets out numbered phases, session counts or criteria for moving between phases. Di Nicola presents nine tools, some of them actions (e.g. spirals) and some of them lenses (e.g. masks), introduced chapter by chapter and shown working together…
• Format. Family sessions with whoever is relevant, including extended kin; individual and orphaned adults where the family is absent (the four "orphan cases" of Ch. 8); intercultural consultation in which Di Nicola acts as consultant to other therapists and families (Ch. 1; 1994 paper "The strange…

Who practises it, and how they are trained or regulated

• What it is. CFT is a model, not a manualised protocol: a synthesis of family therapy and transcultural (cultural) psychiatry, developed by the Canadian psychiatrist and family therapist Vincenzo Di Nicola, first at McGill University (1985 papers) and later at the Université de Montréal. It was built for families across cultures, especially immigrants, refugees and minorities living within a mainstream society, and…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• Reverting to individual work because it is easier. Working signs: members address each other directly in session.
• The opposite error: endorsing family control that harms a member (coercion, violence). Belonging goals never override safety. Working signs: goals both generations can sign up to.
• Self-evident meanings (the things nobody explains because "everyone knows"); these are where translation is most needed. It is working when members start translating for each other and fewer…
• Reframing that excuses a persisting impairment; developmental, hearing and language assessments still needed. Working signs: speech or functioning increases first in the most bridged settings.
• Insider therapists over-identifying or being recruited into one side of an intergenerational culture conflict; outsider therapists being kept at the level of polite formality. Working signs: the…

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.