Family Therapy in Romania
Contemporary Family Therapy: An International Journal, Vol 35, No 1, March 2013, DOI 10.1007/s10591-013-9253-7
available on Springerlink
Zoltán Kónya & Ágnes Kónya
The article outlines the development of family therapy in Romania. Family therapy has a relatively brief history in this country, only beginning with the first training programs in the early to mid 1990s. However, as far as the number of professional associations is concerned, it is well represented on the map of psychotherapy approaches. There are several opportunities for training in family therapy. The accreditation of the training programs and the certification of the graduates of these programs is clearly regulated by law. From the legal point of view psychotherapy is considered a specialization of psychologists rather than an independent profession. The authors offer a brief overview of the history of family therapy in Romania, its present position in the health and social care system, the context of training, accreditation standards, the network of professional organizations and some of the possible future directions for family therapy. Finally, recently produced Romanian films are suggested as a medium for getting acquainted with the complex dilemmas faced by contemporary Romanian families.
Keywords: Family Therapy, Psychotherapy, Romania, Film and Family, Romanian Film
The authors’ personal connection with systemic family therapy started in July 1993 when they first met two family therapists, Patrick Sweeney and Colette Richardson from Ireland. Sweeney and Richardson were invited to a summer camp attended by students and young professionals interested in psychology and in helping their fellow humans. The event was organized in a small Transylvanian town called Gheorgheni. The two Irish family therapists presented an introductory workshop on the systemic view of family life. Fascinated by this new way of thinking, the authors invited them back to Romania to conduct an introductory course in family therapy. This course took place in Cluj, the second largest city in Romania, situated in central Transylvania. The outcome of this initial step was one of the first family therapy training programs in Romania, the “Ireland-Romania Family Therapy Training Project” (Kónya & Kónya, 2003; Sweeney, 2003).
The training enabled the authors to start a psychotherapy service in the city of Cluj, systemic therapy being the main approach to assisting clients. Though the authors both had medicine as their basic professional background (pediatrics and family medicine, respectively), after a while they both shifted their professional career in the direction of psychotherapy. The authors now also work as trainers and supervisors, being employed by AGAPE Life Care Foundation, a psychotherapy centre and training institute, member of EFTA-TIC since 2002. The authors are founding members of the Cluj Systemic Family Therapy Association, a professional training provider accredited by the Romanian College of Psychologists (CPR) and the Romanian Federation of Psychotherapy (FRP).
The article discusses family therapy in Romania. The first section describes the history of family therapy in this country. The second section explores the position of family therapy and systemic practice relative to the existing health, social care, and education system. Section three presents the training of family therapists (providers of training, criteria for training, and schools of family therapy embraced by trainers, training fees and resources for trainees). Section four describes national accreditation standards for training programs in psychotherapy. Section five briefly discusses the distinction between couple and family therapy on the level of practice and training. Section six presents the professional organizations of family therapists and some of the distinctive local developments. In section seven the authors describe their view of the future directions for family therapy practice and recognition in Romania. Finally, section eight suggests Romanian films produced in the new millennium as a useful medium for getting acquainted with some of the dilemmas faced by present day Romanian couples and families. Table 1 offers a timeline of the key developments connected with Romanian family/systemic therapy and Table 2 presents the Romanian family/systemic therapy organizations.
The earliest written report about family therapy in Romania was in an article from 1980 and describes the case of a twelve-year-old boy with school related behavior problems and the family therapy process that helped him improve (Vörös Kinda 1980). The author of this report was a clinical psychologist from Sfântu Gheorghe who had spent a couple of months studying psychotherapy in neighboring Hungary during the 1970’s. There she met the idea of working with families, watched live therapy sessions and, on returning to Romania, decided to put into practice a clinical approach unknown to the health care system she was employed by at the time. She convinced the management of her hospital to equip the clinical psychology office with a one-way screen and started seeing families as one among the many approaches in her repertoire.
The 1980s represented a dark period in Romanian history, characterized by poverty and increasing oppression by the communist regime. Psychology was considered a dangerous and unnecessary science and psychology departments at universities were closed already in 1977 (Stevens 1998).
The 1989 political turn had a dramatic impact on almost all aspects of life in Romania. It became possible for Romanians to freely express themselves, without having to fear the Securitate (the Romanian secret police). While during communism they were only allowed to travel abroad once in every two years and in most cases only to one of the Eastern block countries, now everybody had their own passport and were free to leave the country and to receive foreign visitors. During the dictatorship there was only one political „party”; now Romanians could vote for their preferred party in democratic elections. The communist regime had tried to control life on the most intimate level, preventing couples from using contraception; following the 1989 political turn contraception and abortion became available. During the last years of communism food was a scarce resource (e.g. the monthly ration for every citizen was 0.5 kg sugar, 100 g butter, 5 eggs, etc.); following 21 December 1989 food became readily available. There was a hope for a more efficient economy and for decent living conditions.
The transition from dictatorship toward a more democratic society and from communism toward capitalism was not painless. During the 1990’s the fight for political power sometimes lead to violent conflicts between different segments of society. For a large part of the population the transition meant becoming unemployed. Disappointment and economical hardship have made a lot of Romanians seek employment abroad.
Following December 1989 and the advent of a more democratic political system, the training of psychologists restarted and postgraduate training programs in different branches of psychotherapy were initiated. However, in most areas of psychotherapy there were no Romanian trainers, therefore teachers from abroad were invited. In the case of family therapy, these teachers came from countries like England (Hugh Jenkins), France (a team of trainers from the Unité Familiale Hospitaliere “Sainte Marie” from Clermont Ferrand), Greece (Kyriaki Polychroni), Holland (Anneke van Steenbergen, Ad van Heeswijk), Hungary (Tamás Kurimay, Piroska Komlósi, Katalin Barát, Csaba Rátay), Ireland (Patrick Sweeney, Colette Richardson), Israel (Noga-Nabarro Rubinstein), Norway (Gunnar Bustnes, Ragnhild Bustnes) and Serbia (Branko Gacic). These initial training courses took place in big cities with large universities (e.g. Bucharest, Cluj, Iaşi, Târgu Mureş and Timişoara).
The geographical distance between trainers and trainees as well as the language differences posed a number of challenges. Overcoming these challenges required creative adaptations. The time interval between training modules was often long (several months to even a year), and therefore the trainers had to make sure the time between meetings was used efficiently. For example, the Irish trainers brought several journal articles with them for the trainees to read in the period between two training sessions. Each month trainees were instructed to read a certain article, meet as a group, discuss the reading, and audiotape the discussion. The audio records were then sent to Ireland. The trainers listened to the tape and offered a written feedback to the group. In the present age of the Internet, this looks rather lengthy and inefficient. However, at that time it kept the trainees interested and motivated, and encouraged cooperation among the trainees. Many visitors to Romania had observed that Romanians generally find it difficult to collaborate with each other. Therefore, introducing systemic practice and teamwork early on represented both a challenge and a welcomed learning opportunity.
Another challenge connected with the training was accumulating the necessary number of hours of live supervision. With the help of a number of generous sponsors from Ireland, in September 1997 a training group of twelve intermediate students from Cluj was offered the chance of participating in a two-week intensive clinical practicum led by Nollaig Byrne and Jim Sheehan at the Mater Hospital in Dublin. This offered an opportunity to observe experienced teams at work and receive live supervision while working with families coming from a completely different culture. This experience boosted the trainnees’ self-confidence and encouraged them to start working with families. From the second half of the 1990s, some of the graduates from the above-mentioned training courses started to use family therapy as part of their job in the national health care system (e.g. as a clinical psychologist working in a psychiatric hospital). Others initiated family therapy services as private practices or services in the framework of non-governmental organizations. Table 1 summarizes the important events in the development of psychotherapy and family therapy in Romania:
Table 1. Family therapy in Romania: a timeline of key developments
- 1989: End of the Ceauşescu regime
- 1990: University psychology departments re-opened
- 1993: The Romanian Psychotherapy Association (ARP) is founded
- 1994-95: Start of the first family therapy training programs in Cluj, Târgu Mureş and Timişoara
- 1995: ARP joins EAP (European Association for Psychotherapy)
- 2000: ARP reorganized as the Romanian Federation for Psychotherapy (FRP)
- 2001: EFTA Conference in Budapest, attended by many Romanian family therapists
- 2002: Timişoara - the first important family therapy conference organized in Romania
- 2003: FRP accredited for awarding the European Certificate of Psychotherapy (ECP)
- 2004: The Romanian College of Psychologists (CPR) is established. Creation of a legal framework for the practice of psychotherapy.
- 2008: The first Romanian journal of systemic therapy is launched
- 2010: Bucharest hosts the EAP conference. Several internationally famous family therapists (Rodolfo de Bernart, Mony Elkaïm, Patrick Sweeney, Jim Wilson) contribute to the success of this meeting.
- 2012: Conference in Timişoara - Open Dialogue in psychotherapy and social practice, with contributions from representatives of the systemic-dialogical approach to therapy: Justine van Lawick, Peter Rober, John Shotter, Jim Wilson, Jaakko Seikkula, and Hans Bom.
Family therapy and health care, educational, and social services
At the present moment there are numerous professional organizations providing training in family therapy, with an impressive number of specialists graduating from the training programs each year. However, from a legal point of view psychotherapy is considered a specialization of psychologists rather than an independent profession (Legea nr. 213/2004). Consequently, at this moment of time psychotherapists, including family therapists, are not yet officially recognized as part of the national health and social care system. The graduates of the family therapy training programs can utilize their therapeutic knowledge and skills as psychologists, psychiatrists, family physicians, social workers, or remedial teachers, etc. Currently there are no official positions reserved for psychotherapists. As an alternative to practicing in the national health care system, individuals trained in familiy therapy can start a private practice or work under the umbrella of a non-governmental organization (e.g. as a member of a multidisciplinary team employed by an NGO dedicated to the prevention and treatment of substance abuse).
Collaboration between the national health and social care system and family therapy services is currently regarded as the exception rather than the rule. These systems are seen as parallel rather than interconnected. For example, in the average psychiatric hospital, consideration of the family context of the presenting problem and the possibility of referring a patient to a psychotherapy service is usually not on the mental map of service providers.
However, exceptions do exist, and since 1997 professionals working in the state system have increasingly referred clients to systemic therapists. The family therapy center where the authors consult regularly receives cases referred by a pediatric hospital (usually for a systemic assessment of a child presenting psychosomatic complaints), cases referred by the child protection service for violent escalations in the parent-adolescent relationship, and individual clients and couples struggling with a wide range of difficulties referred by the psychiatrist working in the outpatient clinic situated in the close proximity of the psychotherapy centre. The authors also offer training in family therapy and thus the other important connection with the health care system is through the trainees employed by a hospital or a school (psychiatry residents, clinical and educational psychologists, social workers, remedial teachers). On the one hand, they start applying the systemic ideas in their everyday hospital or educational practice, and, on the other hand, they refer families who are then consulted in the family therapy center as part of the supervised clinical practice component of their training.
Developing sensitivity to contextual influences on presenting problems is reflected in the way the trainees describe their experience of being introduced to systemic thinking. The following excerpt is from the end of the foundation year essay of a child psychiatry resident:
“I believe that this therapeutic approach fits the needs of the majority of the patients I consult and that in order to achieve therapeutic success, our interventions should not target the patient only but also act on the level of the family or social system they are part of.”
Training in family therapy
The main contexts for training are the family therapy associations. At present there are about 16 associations, institutes or foundations connected in some way with training in family therapy. They are located mainly in university cities like Bucharest, Cluj, Iaşi and Timişoara. These are non-governmental organizations founded by different professional groups for the purpose of training provision. They are accredited by the Romanian College of Psychologists (CPR) and/or the Romanian Federation of Psychotherapy (FRP).
The minimum length of the training is regulated by international (EFTA) and national (CPR, FRP) standards. For example, AGAPE Life Care Foundation provides a training of minimum 4 years duration, divided into an introductory (first year), intermediate (second year) and advanced clinical course (years 3 and 4). The part of the training specific to family therapy includes a minimum of 700 hours, 200 hours of which represent supervised clinical practice. The completion of the advanced clinical course often requires more than two years, depending on the rhythm of the accumulation of the necessary practice hours and the preparation of the written assignments by individual trainees.
The minimum fees for the training are regulated by the CPR. Most people interested in the training are young adults at the beginning of their career – psychologists, psychiatrists, social workers and priests – and usually have modest salaries. Fees in Romania may seem attractive from a Western European perspective; however for trainees they usually represent quite a sacrifice. If they are lucky, their employers will encourage their participation. In less fortunate cases the employers tolerate or frown upon it, but they almost never pay for their employee’s tuition. As a consequence, enrolling in family therapy training implies a significant investment on many levels and reflects a high level of personal interest and enthusiasm on the students’ part.
There is a great diversity among the different training courses in the way family therapy is defined and the specific orientations included in the curriculum. The training conducted by the authors is based on a social constructionist and second order cybernetics perspective. During the introductory year students are introduced to the basic systemic ideas and what the trainers consider the “main” schools of family therapy: Milan systemic, structural, strategic, solution focused, narrative, collaborative therapy and reflecting practices. Personal and professional development and self-reflective work is integrated in each phase of the training, but is given a special emphasis during the second year when trainees are invited to examine the ways experiences in their own families of origin might impact on their therapeutic work. Years 3 and 4 are mainly dedicated to live and retrospective supervision and the application of the systemic approach in different problem areas and with various client groups. Other training programs emphasize different aspects of family therapy, like the narrative approach, analytical couples work or brief strategic therapy.
Literature on systemic and family therapy was a scarce resource when the authors were students of this discipline. Trainees held in great awe the few photocopied articles their trainers brought with them from Ireland. In the era of the Internet, electronic libraries and e-books today’s trainees are in a much better position in this respect. A few of the classic family therapy books have been translated into Romanian (Nichols and Schwartz 2005) and, more recently, a number of introductory texts have been published by Romanian authors (Mitrofan and Vasile 2001, Trandafir 2008, Ceucă 2011, Kónya and Kónya 2009, 2012). A bilingual, English and Romanian journal has been initiated in Timişoara with the title Terapie sistemică / Systemic therapy, the first issue being published in May 2008.
On the level of universities, the training of social workers contains some elements of family therapy. Since 2010, the University of Bucharest has had a master’s program, entitled “Assessment, counseling and psychotherapy for the child, couple and family”.
National accreditation standards for training programs
During the 1990s there were no established accreditation procedures in place. This situation led to a certain amount of anxiety in professionals training in any branch of psychotherapy. “How will therapists be recognized?” was a recurring question at that time, raised and debated during training courses. Since then significant changes have occurred in this respect and as a result Romanian therapists and training programs can choose between two parallel routes for accreditation, or choose, as is often the case, to benefit of the blessings of both systems.
The Romanian Federation of Psychotherapy (Federaţia Română de Psihoterapie, FRP) provides one program. The FRP was established as the Romanian National Umbrella Organization (NUO) of the European Psychotherapy Association (EAP). The main objective of FRP and EAP is to establish psychotherapy as ‘an independent scientific discipline, the practice of which represents an independent and free profession’ in Europe (Statutes of EAP, 2010). At present FRP has 26 member associations, 7 of which are family therapy associations, each with an accredited training program. Although FRP is well integrated in the existing European professional structure for psychotherapy, it has not been able to promote a law that would regulate the practice of psychotherapy in Romania in accordance with the principles of the EAP Strasbourg-declaration. However, being accredited by this organization enables therapists with a certain experience to apply for the European Certificate for Psychotherapy, issued by EAP on the recommendation of the NUO (FRP).
The second organization providing accreditation is the Romanian College of Psychologists (Colegiul Psihologilor din România, CPR). The existing law regulating training in psychotherapy and psychotherapeutic work, accepted by the Romanian Parliament in 2004, establishes CPR as the only official body legally entitled to set standards for training and provide accreditation for training programs. While FRP sees psychotherapy as an independent profession, open to specialists coming from a wide range of professional background (medical doctors, psychologists, social workers, priests and others), CPR frames psychotherapy as one of the several competences or specialties psychologists can obtain. Professionals others than psychologists can also get accreditation through CPR, however they need to complement their training with certain courses in different areas of psychology and psychopathology.
According to the CPR guidelines (Colegiul Psihologilor din România 2009), training in family therapy is a post-graduate basic training (“formare de bază”) in psychotherapy. Upon successful graduation of the first two years of the training students can apply for the title ‘psychotherapist under supervision’, while completion of the whole training leads to the title ‘autonomous psychotherapist’. The milestones of professional development follow well-known template existing in the medical world: ‘specialist’ in psychotherapy (after a minimum of 5 years after achieving the ‘psychotherapist under supervision’ status) and finally ‘principal’ (consultant) psychotherapist (after another five years of experience). The highest professional level is that of the supervisor and trainer.
In order to become a family therapist, one needs to participate in a so-called ongoing complementary professional training provided by one of the professional associations accredited by CPR. In order to receive this accreditation, an association needs to meet the following criteria:
- At least four supervisors/trainers specialized in family therapy
- A professional body responsible for the selection, training, assessment and certification of trainees
- Detailed description of the training curriculum, examination procedures, modality of supervision and personal-professional development
- A commitment to respect the professional and ethical standards set by the CPR.
From a family therapy point of view, the CPR guideline for accreditation and certification offers an interesting reading. After defining psychotherapy, the document outlines the “recognized modalities/schools of psychotherapy” (Art. 22), grouping them in five major categories: (1) cognitive-behavioral, (2) dynamic, (3) Ericksonian, (4) brief, and (5) ‘humanistic-existential-experiential, systemic and transpersonal.’ Family therapy as such is not specifically mentioned, although psychotherapy with families is mentioned in the same document as one of several possible formats for practicing psychotherapy, described as an alternative to the individual or group format. In addition to category (5) including the term ‘systemic’, the specific examples offered by the document most connected with systemic family therapy occur in the parentheses following the (4) ‘brief’ category (brief solution focused therapy, competence and resource orientation, constructivist-collaborative and narrative approaches).
Family versus couple therapy
Psychotherapists practicing from a systemic perspective usually do not limit their activity to family work and consult a variety of different systems (couples, individuals, groups, professional teams, etc.). Advertisements for therapy services in most cases include both couple and family therapy. In a similar way, training programs are designed to equip students with knowledge and skills for consulting a variety of human systems, including couples and families.
For example, the Cluj Systemic Family Therapy Association’s training program is advertised as ‘training in systemic family therapy’ and contains a number of components that specifically address themes connected with couple work: the role of attachments and attachment styles in couple relationships, theories of intimacy (Weingarten 1991), techniques with special relevance for couple work (e.g. interviewing the internalized other, Haydon-Laurelut and Wilson 2011), the role of couple therapy in the treatment of depression (Jones and Asen, 2000), and the systemic approach to problems specific to the life of a couple (e.g. jealousy, infidelity, sexual difficulties). An example for such an input specifically addressing couple therapy was a two-day workshop in Cluj conducted by Jim Sheehan from Dublin in November 2011.
Professional organizations for family therapists
In most European countries there is one national family therapy association, member of the NFTO (National Family Therapy Organizations) chamber of EFTA. This represents all family therapists from the respective country and is responsible for the accreditation of training courses and the quality of the training. Training itself is provided by the different training institutes, some of these being members of the TIC (Training Institutes Chamber) of EFTA.
In Romania the situation is different. There is no single NFTO to which all family therapists belong. Instead, a number of smaller associations are scattered around the country. With a few exceptions, they provide both training and the certification of the newly trained therapists. Historically, each of these associations emerged as a result of the family therapy training courses described under the heading “history”. The basic understanding of what family therapy is varies from association to association, reflecting the teachings their founders received from their original teachers invited from abroad (Kónya and Kónya, 2007).
A search of the registers of the two main accrediting bodies (CPR, FRP) permits the identification of no less than 16 organizations involved in the practice, training and/or accreditation of family therapy. They are located mostly in the university cities, like Bucharest (4 organizations), Timişoara (4), Iaşi (3) and Cluj (3), the remaining two being in Miercurea Ciuc and Satu Mare, respectively. Almost all of them have been founded after the year 2000. All are accredited by the Romanian College of Psychologists and seven of the 16 by the Romanian Federation of Psychotherapy. The differing views about family therapy are reflected in the choice of the preferred term for family work: a preference for ‘counselling’, ‘therapy’ or ‘psychotherapy’, whether or not the adjective ‘systemic’ is included and the importance attached to making a distinction between family and couple work (see Table 2).
The Timişoara group was the organiser of the first national family therapy conference in Romania with international participation, entitled „Listening to the voice of the family” in June 2002. The title of last year’s conference was „The family in contemporary society: psychological, social and spiritual perspectives in dialogue” (14-15 September, 2012). Another initiative was the International summer school of family psychotherapy and systemic thinking (2010, 2011, 2012). The journal „Terapie Sistemică” is published in Timişoara by the Dianoia Association.
Iaşi is the capital of Moldova, the North-Eastern region of Romania, the home of three family therapy associations. In 2005 the Iaşi group invited Michael White to Romania to conduct a workshop with the title „Addressing the consequences of trauma”. The Child and Family Institute from Iaşi was the organizer of the conference “Open Dialogue in psychotherapy and social practice”, with the participation of outstanding representatives of the systemic-dialogical approach: Justine van Lawick, Peter Rober, John Shotter, Jim Wilson, Jaakko Seikkula and Hans Bom (24 -26 May 2012, Timişoara).
In Cluj one of the local initiatives has been the organization of free workshops on different themes connected with family therapy. The workshops are conducted by experienced family therapists and are attended by professionals with various backgrounds (school psychologists, psychiatrists, social workers, teachers, priests). The monthly workshops have begun in February 2011 and explored topics as varied as non-violent resistance, the Open Dialogue approach to psychosis, jealousy and pets in the family system. These „family therapy afternoons” offer a meeting place for professionals and a possibility for disseminating systemic ideas to a wider audience.
Another initiative by the Cluj group was connected with the introduction of family therapy practices in rural communities. While about half of Romania’s population lives in the rural area, psychotherapy services are concentrated in the cities. The “Transylvanian Plain Family Counselling Network” was a project funded by the European Union through the PHARE program (Kónya and Kónya 2009). It was the result of a collaboration between AGAPE Life Care Foundation and the local councils of eight villages in Cluj county, Transylvania. The key element of the project was the training of the social workers employed by the local councils in basic systemic consultation skills and mental health issues. From a systemic perspective, the main questions addresed by this initiative have been how to influence family systems by influencing the wider system that surrounds them and how to be helpful to families by assisting the professionals directly involved in their lives.
Table 2. Family therapy organizations in Romania
Preferred term for family work
Alianţa pentru Copil şi Familie
family and couple therapy
Asociaţia Română de Psihanaliza de Cuplu şi Familie
psychoanalytical couple psychotherapy
Asociaţia Crisdu Areopagus
systemic family psychotherapy
Asociaţia de Consiliere şi Terapie a Familiei
Asociaţia de Psihoterapia Familiei şi a Cuplului
systemic psychotherapy for families and couples
Asociaţia de Terapie Familială
Asociaţia de Terapie Familială Sistemică Cluj
systemic family therapy
Asociaţia de Terapie Familială şi de Cuplu Timişoara
family therapy, couple therapy
Asociaţia de Terapie Familială „Pro Familia”
Asociaţia Dianoia Institutul de Terapie Familială şi Practică Sistemică
systemic family psychotherapy
Asociaţia Multiculturală de Psihologie şi Psihoterapie
Asociaţia Română de Terapie Familială şi Sistemică
family and systemic therapies
Centrul de Formare şi Terapie pentru Copil, Cuplu şi Familie
Fundaţia AGAPE pentru Ocrotirea Vieţii
systemic family therapy
Institutul pentru Cuplu şi Familie
systemic psychotherapy for families and couples
Family therapy in Romania: directions for future development
One area where change would be welcome is the relationship between family therapy and the wider health and social care system it is (or should be) part of. There is a group of professionals, including family therapists, who hope that in the not too distant future psychotherapy, including systemic/family therapy, will develop into a recognized independent profession, separate from psychiatry and clinical psychology. Professionals could undertake training in family therapy in the knowledge that upon graduating there will be vacancies to be occupied as family therapists, with medical newspapers and social work journals containing job advertisements for family therapists or systemic practitioners.
The authors see a great potential in the introduction of the systemic approach and family work in different professional areas, like psychiatry, family medicine, social work and the field of education. As mentioned before, many family therapy trainees are psychiatry residents. The authors hope that they are going to use their systemic skills in their medical practice. One of the trainees, a young psychiatrist, has recently moved to Germany. Due to the German system of professional recognition he may not work in this country as a family therapist. Still, his colleagues have observed and appreciated his sensitivity to the family context of patients and his interviewing skills shaped by the training in family therapy. Hopefully, today’s residents will become tomorrow’s university professors and hospital directors and this might have an impact on the way the health care system is organized. Unfortunately, because of economical hardships, many of these young doctors choose the more attractive option of working in a Western European country like the UK, France or Germany. But those who remain in the country may have an important contribution to the transformation of psychiatric hospital practices. Change on this level might be reflected in routinely asking patients about their family circumstances, inpatient family therapy sessions taking place on the recommendation of the psychiatrist and further family work, provided by community mental health workers, being recommended to the patient on leaving the hospital.
Other areas where systemic ideas could be usefully applied are the education system, the domain of social work and family medicine. Family doctors, realizing that the complaints of many patients may be psychosomatic in their origin, might take an interest in developing their systemic interviewing skills. They could also refer some of their patients to psychotherapists, including family therapists. Romanian therapists and family doctors can draw on the experience of practitioners from other countries (e.g. Asen et al. 2004, Launer et al. 2005), connected with the use of systemic ideas in general practice.
Lastly, an important direction for further development should be the active involvement of family therapy practitioners in research, setting an example for their colleagues from other branches of psychotherapy. The authors would particularly like to see the spread of qualitative approaches investigating family experience and the therapy process. They believe that family therapists’ theoretical background and interviewing skills put them in a privileged position for appreciating, understanding and practicing such research.
Romanian families as reflected in recent Romanian cinematography
Films provide a good opportunity for getting acquainted with everyday life in a certain culture. They can enrich family therapists’ experience of family life; can be used in therapeutic work (e.g. recommending the viewing of a certain film for a family or a couple) and in the training of family therapists (Blumer 2010). The authors invite the reader to get acquainted with contemporary life and the preoccupations of families living in Romania through some of the more recently produced Romanian films, enlisted in Appendix 1. Sometimes referred to as the “Romanian New Wave”, they often explore family themes and invoke a feeling of realness in the viewer. A number of major themes connected with contemporary Romanian life can be identified in these films.
Theme 1: the memory and the legacy of the Ceauşescu period (1, 2, 3, 6)
4 months, 3 weeks and 2 days presents the depressing atmosphere of the 1980’s in way words cannot describe. Though more than two decades have passed since the end of the dictatorship, many believe that we still carry with us the heritage of this traumatic period (Ungureanu 2008). The enactment of dictatorial attitudes can be observed in The Death of Mr. Lăzărescu (in the attitude of the hospital doctors) and in Police, adjective (the way the boss treats his staff at the police station).
Theme 2: migration and working abroad (4, 5, 8, 9)
Working abroad is a common phenomenon, and since 1989 an estimated 10 to 15% of the Romanian population has left the country in search of economic opportunities in other parts of the world (Robila 2011). A common pattern is one or both parents working in the Western part of Europe while the children are being cared for by the grandparents or, in less fortunate cases, they are left to look after themselves. In If I want to whistle, I whistle one theme concerns an adolescent boy’s resentment toward his mother who had left abroad, leaving her children behind. The main heroes of Beyond the hills were both raised in an orphanage where they became friends. Voichiţa lives in a convent, Alina found work in Germany. Alina intends to take Voichiţa with her to Germany. The former’s visit in the convent leads to tragic consequences.
Theme 3: couple relationships in a rapidly changing society (4, 5, 6, 7)
One of the most memorable parts of the film Police, adjective presents moments from the everyday life of a young couple, where he is a policeman and she is a teacher. In Boogie the viewer can see the way subtle misunderstandings in communication build up and contribute to a major row and to one partner leaving the scene of the conflict. Later we can also observe the couple’s mutual efforts to repair the damage.
Given the huge number of Romanian individuals, couples and families living in different countries, family therapists from these countries are likely to meet them in the context of professional work. The authors believe that Romanian films can contribute to a better understanding of the cultural background and the dilemmas presented by these persons and families.
Appendix 1: Selection of Romanian films (2005-2013)
- The Death of Mr. Lăzărescu (Moartea domnului Lăzărescu, Cristi Puiu, 2005, 153 min). An incredibly realistic portrayal of the dark side of the health care system and of the paternalistic attitude of some medical professionals.
- 12:08 East of Bucharest (A fost sau n-a fost?, Corneliu Porumboiu, 2006, 89 min). The original Romanian title of this comedy is „was there or wasn’t” (...a real revolution in December 1989, in the Romanian city Vaslui).
- 4 months, 3 weeks and 2 days (4 luni, 3 săptămâni şi 2 zile, Cristian Mungiu, 2007, 113 min). The story of an abortion during the last years of the Ceauşescu era.
- Boogie (Radu Muntean, 2008, 102 min). A young couple with a small child visits a Black Sea resort to spend a weekend together, away from work. A marital conflict occurs as the husband, Bogdan (Boogie), meets his best friends from high school and decides to join them for a fun night, leaving his family on their own.
- First of all, Felicia (Felicia înainte de toate, Melissa de Raaf, Răzvan Rădulescu, 2009, 108 min). Felicia is a married woman, living in Holland and coming home to Romania for a short visit to her parents. The film presents one day from the life of this family. It offers a good illustration of enmeshment, double binding communication and the effect of chronic illness on family life.
- Police, adjective (Poliţist, adjectiv, Corneliu Porumboiu, 2009, 113 min). A film about the police investigation of a group of youngsters suspected for dealing marijuana. The young policeman leading the investigation, Cristi, believes the main suspect is not a dealer and should not be arrested as this would ruin the life of the teenager. His boss insists that the law should be heeded.
- Tuesday after Christmas (Marţi după crăciun, Radu Muntean, 2010, 99 min). The story of a day in the life of a family with a young child, including moments before the discovery of the husband’s infidelity and following this event.
- If I want to whistle, I whistle (Eu când vreau să fluier, fluier, Florin Şerban, 2010, 94 min). A story about a violent crisis situation in a prison for young delinquents.
- Beyond the hills (După dealuri, Cristian Mungiu, 2012, 155 min). The official submission of Romania to the Best Foreign Language Film of the 2013 Academy Awards.
- Child’s pose (Poziţia copilului, Peter Călin Netzer, 2013, 116 min), winner of the Golden Bear at the 2013 Berlin Film Festival.
Asen, E., Tomson, D., Tomson, P., & Young, V. (2004). Ten minutes for the family. Systemic interventions in primary care. London: Routledge.
Blumer, M. L. C. (2010). And action! Teaching and learning through film. Journal of Feminist Family Therapy, 22, 225-235, doi: 10.1080/08952833.2010.499703
Ceucă, E. (2011). Psihoterapia familială sistemică şi de cuplu. Concepte şi concepţii, vol. 1. Iaşi: Institutul pentru Cuplu şi Familie.
Colegiul Psihologilor din România (2009). Comisia de psihologie clinică şi psihoterapie. Proceduri de atestare, acreditare şi certificare http://www.copsi.ro/index.php?option=com_content&view=article&id=228&Itemid=87. Accessed 19 February 2013.
Haydon-Laurelut, M.,& Wilson, J. C. (2011). Interviewing the internalized other: Attending to the voices of the “other”. Journal of Systemic Therapies, 3, 24–37.
Jones, E.,& Asen, E. (2000). Systemic couple therapy and depression. London: Karnac Books.
Kónya, Á.,& Kónya, Z. (2003). Getting from five to six... in the Ireland-Romania Family Therapy Training Project. Feedback, 9, 26-28.
Kónya, Á.,& Kónya, Z. (2007). Family therapy in Romania. Context, 92, 2-4.
Kónya, Á.,& Kónya, Z. (2009). Terapie familială sistemică. Cluj-Napoca: Abel.
Kónya, Á.,& Kónya, Z. (2012). Terapie familială sistemică. Iaşi: Polirom. 2nd revised edition
Launer, J., Blake, S., & Daws, D. (Eds.) (2005). Reflecting on reality. Psychotherapists at work in primary care. London: Karnac.
Legea nr. 213/2004 privind exercitarea profesiei de psiholog cu drept de liberă practică, înfiinţarea, organizarea şi funcţionarea Colegiului Psihologilor din România. Publicat în Monitorul Oficial, Partea I nr. 492 din 01/07/2004.
Mitrofan, I.,& Vasile, D. (2001). Terapii de familie. Bucureşti: Editura SPER.
Nichols, M. P.,& Schwartz, R. C. (2005). Terapia de familie. Concepte şi metode. Editura Pearson Education.
Robila, M. (2011). Parental migration and children’s outcomes in Romania. Journal of Child and Family Studies, 20, 326-333, doi 10.1007/s10826-010-9396-1
Statutes of the European Association of Psychotherapy, voted AGM July 2010 (Bucharest)
Stevens, M. J. (1998). Professional psychology after communism: The case of Romania. Professional Psychology: Research and Practice, 29, 300-304.
Sweeney, P., (2003). The Ireland/Romania Family Therapy Traning Project. Feedback, 9, 23-25.
Trandafir, M. S. (2008). Terapie de familie, vol I. Bucureşti: Editura Universitară Carol Davila.
Ungureanu, I. (2008). Transgenerational transmission of communist trauma: The Romanian experience. Terapia Sistemică, 1, 6-10.
Vörös Kinda, K. (1980). Mire jó a családterápia? Tett: Természet, Ember, Tudomány, Technika, 15, 25-28.
Weingarten, K. (1991). The discourses of intimacy: Adding a social constructionist and feminist view. Family Process, 30, 285-305.
 EFTA TIC, the Training Institutes Chamber of the European Family Therapy Association
 In Romania the term ‘couple therapy’ (terapie de cuplu) is generally preferred to ‘marital therapy’.
» Family therapy in Romania
Context. The magazine for family therapy and systemic practice in the UK, August 2007
» Abortion in the family: a systemic perspective
„Abortion – causes, ramifications, therapy” International Conference organized by the Polish Academy of Science and the Warsaw Institute of Psychiatry and Neurology, 20-22 June 2004
» Family Therapy in Romania
Contemporary Family Therapy: An International Journal, Vol 35, No 1, March 2013, DOI 10.1007/s10591-013-9253-7