Therapeutic Thoughts of the Week:

James Framo: Theory in Clinical Practice

Therapeutic Thoughts of the Week – James Framo: Theory in Clinical Practice

This week’s Healthy Minds “Therapeutic Thoughts of the Week” is intended to provoke thought and discussion pertaining to James L. Framo’s work as it relates to theory of change, the role of the therapist, and therapeutic techniques.

James Framo is considered a pioneer within the field of marriage and family therapy. Mr. Framo implements family-of-origin sessions which involve members from different generations. Framo incorporates in his work techniques that facilitate couples to achieve congruent communication as well. Framo also facilitates in his work differentiating self for each individual from each other.

Background of the approach:
James Framo is best known for his work regarding family-of-origin therapy, which he views as a branch of multigenerational work from a systems approach. Mr. Framo views family-of-origin sessions as an intrinsic component to the therapeutic process for change to occur and be maintained. Framo particularly prefers to conceptualize his work from a family-of-origin viewpoint with married couples. Within a family-of-origin session, Mr. Framo works toward discovering issues from the old family being projected onto the new spouse and family. His aim in a family-of-origin session is to foster a greater sense of self and to provide an opportunity for a healthy, appropriate, corrective parent or sibling experience.

Role of Therapist and Technique

Framo only meets with couples conjointly and will not meet w/ only one partner unless it is within a family-of-origin context. Framo will typically meet with couples for a few sessions and work towards transitioning the couple to participating in his couples group. Framo recommends using a co-therapist preferably one of the opposite sex specifically when working with heterosexual couples. A co-therapist is helpful to assist in tracking behaviors and cues during the session which allows for co-therapists to share in the responsibility for managing the session. Framo has found couples align quicker with the therapists when both a male and female co-therapist is present.

Framo notes that the techniques he employs in session varies according to whether he is meeting w/ a family, a couple, or a couple within a couple’s group. However, he consistently recognizes the individuals in the relationship as well as the relationship as representing two different entities. Framo works with couples and families to develop congruent communication. He teaches congruent communication by asking couples or family members to recite what they believe they heard the other person say. Framo also works to develop self in the relationship(s) and will change the “rules” in the relationship accordingly by prescribing paradoxical tasks, reflection, confrontation, interpretations, and eliciting of affect (Framo).

Framo also uses personal disclosures to normalize feelings of grief, loss, shame, anger, and disappointment. Framo draws from his own life-experience as a father, husband, and son to normalize and align with his couple or family. Today, Framo will make concessions when appropriate to specific clientele and mix socially with clients upon termination. One example, Framo noted was attending a couple’s group termination party with his wife.


Framo recognizes the value and power which the role of therapist possesses within the therapeutic relationship. This theorist understands the importance in identifying with their families on a human being level. Framo view’s therapeutic techniques as a sign of power and is cautious and aware as how to implement them when meeting with families. Although, a therapeutic technique may be implemented by the therapist the same in every session, its impact will vary dependent upon the relationship, which the therapist maintains with the family. Framo acknowledges the power, which he can maintain in a therapeutic session as role of therapist, but incorporates himself in an empathic, non-judgmental role. James L. Frame embraces his role as a therapist to empower not to control.

David P Sanchez, Psy.D., LMFT
Healthy Minds Licensed Provider

This week’s Healthy Minds “Therapeutic Thoughts of the Week” is intended to provoke thought and discussion regarding the application of one theoretical framework into clinical practice.

Becvar, D. S. & Becvar, R. J. (1993). Family therapy: A systemic integration (2nd ed.). Boston, MA: Allyn & Brown.

Framo, J. L. (1996). A personal retrospective of the family therapy field: Then and now. Journal of Marital and Family Therapy, (22)3, 289-316.

Framo, J. L. (1992). Family-of-origin therapy: An intergenerational approach. New York, NY: Brunner/Mazel Publishers.

2018-07-10T18:25:30-04:00March 23rd, 2015|Mental Health, Psychiatry, Psychology, Therapeutic Thoughts of the Week|

Leave A Comment