The Assisi Manifesto

by Maurizio Andolf i and the International Faculty

In July 2023, over a thousand psychotherapists from over 50 countries and of every orientation
gathered in Assisi (Italy) for three days to celebrate family therapy, its impact and potential, and to
exchange ideas. The conference was entitled Family Therapy: The Road that Connects Individual and Social
Resources. It was initiated by the Accademia di Psicoterapia della Famiglia in Rome, and was sponsored
by the American Academy of Marital and Family Therapy (AAMFT), the Australian Academy of Family
Therapy (AAFT), the Asian Academy of Family Therapy (AAFT), the European Family Therapy
Academy (EFTA), and the World Association of Social Psychiatry (WASP).
While there were three official languages — English, Italian, and French — many different
languages were heard among the excited participants attesting to the conference’s global appeal and
influence. This manifesto is an outgrowth of that meeting and the many participants who offered their
ideas of what is critically important in working with families, synthesized by an International Faculty of
family therapy leaders.

Family therapy as an innovative mental health treatment emerged 70 years ago in the U.S. and
spread throughout the world as a revolutionary intervention, often at odds with prevailing treatment
modalities that targeted intrapsychic dynamics. Shifting the focus from individual disorders and com-
plaints to include the family and the community was not just a different approach; it was a political
turning point that contextualized the “identified patient” and highlighted therapeutic resources within
the family and their social environments. For a long time, therapists, all over the world identified them-
selves as being part of the family therapy movement, belonging to a large community of professionals.

Mental health treatment has become a standard and common practice in many countries, and
DSM diagnostic language has entered the vocabulary of everyday life. However, the overreliance on
hospitalization and overuse and at times abuse of labels and medications have increased due to the search
for a quick and inexpensive fix. Financial pressures on underfunded mental health systems also played a
role as did the global cultural rise of narcissistic individualism at the expense of relational connectedness.
Family fragmentation compounded by atrocities and wars all over the world, displacement and forced
migrations, gender and wealth inequality, and climate change pose huge challenges for families and
ultimately individual wellbeing.
We declare with this Assisi Manifesto the need to acknowledge the interconnectedness of indivi-
duals, families, communities, and societies, and incorporate family therapy as a vehicle for accessing
resilience and healing. With the fresh perspectives and enthusiasm of the younger generations of family
therapists and the emerging movement of therapists in Asia, Latin America, Africa, and Eastern Europe,
along with the lessons we learned through our history, we seek to reinvigorate an understanding of fami-
lies and communities, their cultural values and resources.

We are gravely concerned about the dramatic rise in adolescent mental health issues, since the
beginning of the COVID pandemic. Teenagers are more at risk in a fragmented and toxic society where
family disintegration, single parenthood, and absent fathers are becoming the norm. Unresolved parental
and intergenerational conflicts, and marginalization along with the deleterious impacts of social media,
are damaging adolescents’ healthy development, resulting in a variety of symptoms and disorders that
threaten to morph into persistent and universal traits. Yet, their voices remain unheard, particularly in
therapeutic contexts in which they are absent or removed from the therapy room. Young children cannot
be seen anymore as individual problems or as isolated victims of abuses. They have a voice to be heard
and relational competence to be used in therapy for family healing.
With this manifesto, we assert that it is essential to listen to youth voices without prejudice and
labelling. They speak for themselves as well as for their families. Their voices, sometimes arrogant or
bizarre, angry and provocative, are often a desperate cry for love and care. We need to go beyond psychia-
tric categories and symptoms in order to understand their needs and their constraints, to be able to see
them holistically within their relational bonds. We must do so, without parent blaming and also by
acknowledging and understanding the difficult human conditions overburdened parents must not face
alone. We know from the extant research that family therapy works, and is an effective empirically-based
therapeutic modality with children and teenagers in any given culture.
Couple crises are complex and multifaceted, encompassing a large range of issues that can challen-
ge the stability and harmony of all relationships. These crises are often seen as private battles, but are both
a symptom and a cause of problems within the larger family system. Couple crises are emotionally conta-
gious within the family system, particularly in the case of divorce. Extended family, children in particular,
and even friends experience the emotional fallout of the couple’s crises, assuming caregiving responsibili-
ties or becoming triangulated in spousal conflict. This manifesto recognizes the interconnectedness of
couple crises (including those of same-sex and non-traditional family units) with the broader family
structure, offering a path to couples for healing and resilience within the family with a multigenerational
approach as a component.
Death is an inevitable condition of our existence. However, we die and suffer in different ways
according to our cultural traditions, religions, and spiritual beliefs. Categorizing mourning as healthy or
pathological based on outdated individual, temporal, linear stages of grief is inaccurate and reductionistic.
As family therapists, we can facilitate relational processes that strengthen families and facilitate coping
with expected life events as well as traumatic losses linked to the violence, wars and forced migrations
we are currently witnessing on an unprecedented, global scale. As multigenerational systemic and com-
munity therapists, we understand how such experiences impact families over generations, and intervene
to help them overcome current and historic traumatic and painful experiences by promoting recon-
nection and forgiveness.

Our world is increasingly divided and fractured by cultural discrimination, economic injustice,
racism, homophobia, transphobia, sexism, political repression, warfare, and natural disasters; we must
recognize not only the vulnerability of families and children caught in these difficulties, but also their
resilience in coping and surviving. As family therapists, we recognize the pressing need of a manifesto that
values flexibility and guides practice inside the therapy room but also, where families are – in the streets,
shelters, churches, and community centers. Additionally, our manifesto is a call for action, advocating for
social justice via empowerment, inclusivity, and the recognition and establishment of basic human rights.
Working with families and communities is not easy. We advocate intensive professional training,
based on established theories and methods along with clinically supervised field practice. In addition,
psychotherapists must do ongoing work on understanding the traumas, adversities, losses, failures,
resilience, and coping in their client families and also their own. The Assisi Manifesto is a declaration to
contact our professional associations, universities, and private training Institutions in order to encourage
them in this direction. In this way, we hope to increase a sense of belonging and scientific exchange
among a large global community of family-based professionals.
Considering the current political and religious divisions in our world as evidenced by growing popu-
list political movements, devastating wars in Eastern Europe, the Middle East, Africa, Asia and elsewhere,
as well as waves of migrants and refugees, now more than ever, it is time to recognize and strengthen the
family as the foundation of society and thus an important vehicle for healing. It is in this spirit that we
submit this manifesto, which has been endorsed by the Assisi Conference Sponsors.
November 23, 2023

Maurizio Andolfi, Child Psychiatrist, Director of the Accademia di psicoterapia della Famiglia, Italy.
The international Faculty:
Mary E. Hotvedt, PhD, Regent. Western New Mexico University, U.S.A.
Michael LaSala, PhD, LCSW, Professor, School of Social Work, Rutgers University, U.S.A.
Alejandro Astorga, Clinical Psychologist, Director of the Multigenerational Center, Santiago de Chile.
Bawany Chinapan, Clinical Director, Andolfi Family Therapy Center (AFTC), Kuala Lumpur, Malaysia.
Ivy Daure, PhD in Psychology, Director of the Art of Psychotherapy Collection, Publisher ESF
Sciences Humaines, France.
Joel Elizur, PhD, Associate Professor Clinical Child & Educational Psychology Program, The Hebrew
University of Jerusalem, Israel.
Vanessa Espaillat, PhD, Director of CONTINUUM – Centro de formación y psicoterpia,
Dominican Republic.
Olga Falceto, Child Pychiatrist, Coordinator Instituto da Família de Porto Alegre, Brazil.
Mustafa Qossoqsi, PhD, Chief Psychologist Dpt. of Psychiatry, English Hospital in Nazareth.
Cofounder of the Arab Psychological Association, Israel.
Christine Senediak, Clinican Psychologist, Director Clinical Supervision Services - Sydney Family Therapy
Institute, Australia.
Tazuko Shibusawa, PhD, Executive Officer Shibusawa Eiichi Memorial Foundation, Japan.
Greet Splingaer, Clinical Psychologist & Orthopedagoque, Director of Family Training Institute and Family
Therapeutic Centre Rapunzel, Belgium.
Ovidio C. Waldemar, Child Psychiatrist, Co-coordinator Instituto da Família de Porto Alegre, Brazil.