Family Therapy Intervention and the ‘Real Problem’ of an Eating Disorder: Implications for a Systemic Philosophy of Practice

ABSTRACT Family therapy intervention for eating disorders has deep roots in family therapy discourse and its evolution is closely entwined with wider developments in the history of family therapy over the past fifty years. In this paper we argue that this family therapy intervention holds seminal insights for longstanding debates within family therapy well beyond the domain of eating disorders. These relate to the limits of any exclusive social constructionist framing of family therapy and particularly that relating to our engagement with external reality. We draw on the paradigm of family therapy intervention with the ‘real problem’ of an eating disorder to make this case. The paper considers the potential in co‐constructivism and critical realism to expand our theoretical lens beyond social constructionism, to draw out and help formulate a systemic philosophy of practice encompassing the knowledge, expertise and values that underpin our work and based on which we inevitably take a position on reality whether this remains implicit or preferably is acknowledged and made available for reflexive critique.