Family themes: transmission and transformation.

This article describes a method for doing therapy that uses multisystemic themes that combine meaning and action to facilitate therapeutic change. By identifying central themes that operate at the individual, dyadic, triadic, whole family, intergenerational, and sociocultural levels, the therapist is able to develop effective interview questions and design useful interventions. In this method, behavioral symptoms are framed as a current manifestation of an overarching theme. This orientation enables family and therapist to de-pathologize symptoms and work collaboratively toward change. Case examples from a wide variety of families with differing presenting problems, interactional patterns, three-generational histories, and cultural backgrounds, illustrate the efficacy of the method.