Innovative Contribution to Family Therapy Award:
C. Christian Beels

Steve Rosenheck

This year AFTA is recognizing Chris Beels for Innovative Contributions to Family Therapy. I first met Chris about twenty-five years ago. In 1980 he asked Bill MacFarlane and me to come to the New York State Psychiatric Institute and help him begin a new training program for psychiatrists who had completed their residencies: the Fellowship in Public Psychiatry. I worked with Chris in that program until he retired in 1987, and we have been strong friends ever since. It is a pleasure and an honor to distill his rich contribution to family therapy and describe his career.

Chris's contribution to family therapy had its origin in his psychiatric residency at the Albert Einstein College of Medicine in the early 1960s, and it is there that the description of his career should begin. In 1961 Chris did an elective rotation at the Westchester Square Day Hospital, one of a handful of day hospitals in the entire country at the time. The director of the Day Hospital was Israel Zwerling, a genuine pioneer. Zwerling had two passions. To begin with, he was a social idealist with a cause. In 1961 phenothiazines had been available for only six years, and the nation's reliance on custodial hospitals remained essentially unchanged. Zwerling was dedicated to the imperative of helping to find a humane alternative. In research at the Westchester Square Day Hospital he produced one of the first American studies demonstrating that a day hospital could function as an alternative to acute hospitalization. Zwerling's other passion was family therapy. He had trained with Nathan Ackerman and was an early convert.

Chris absorbed Zwerling's two passions and began almost immediately to interpret and synthesize them in his own way. After his residency, he spent three years between 1964-67 working on Lyman Wynne's unit at the NIMH, studying schizophrenia and the family. Then he returned to the Department of Psychiatry at Einstein to supervise and teach.

By the time Chris returned to Einstein an original and rather brave agenda had begun to take shape in his mind concerning the place of family work in community-based care for those with severe mental illness. Chris knew that any vision of community care had to include work with the patient's family, and he believed the field of family therapy was uniquely equipped to discover what that work should be. He had also started to see, however, that many of the clinical habits and founding assumptions of family therapy unwittingly blamed parental caregivers, minimized the confusing magnitude of severe mental illness, and breathed condescension towards the hard work of established service delivery systems. If family work in community-based care was to be done correctly, family therapy would have to jettison these habits and founding assumptions and essentially start from the ground up. It would also have reach out beyond its usual audience. With respect to this challenge Chris was especially concerned about psychiatrists. In community-based care leadership roles typically flowed to this group, and somehow or other it had to be engaged.

With hindsight it is clear that Chris pursued this new agenda in a single-minded, though continuously evolving way for the next 20 years. A crucial first step came in 1970. That year Chris accepted a position at Bronx State Psychiatric Center as director of in-patient and out-patient services for a specific catchment area. He called the operation The Family Service and, together with a treasured group of Einstein colleagues, designed a new model of care. The model made multiple family groups the central mode of intervention and integrated them tightly with crisis intervention, a day hospital, and an in-patient unit in a way that had never been done before.

Chris directed The Family Service for three years. On the foundation he created, however, the Service lasted until the late 1980s. His work at the Family Service had another long-term consequence, as well. As a result of the experience, Chris began to produce papers on family work with the severely ill in the publication style that became his hallmark. He wrote in a distinctive, literate voice, miraculously free from jargon, and published in wide range of journals, addressing family therapy, professional psychiatry, and schizophrenia, respectively.

In 1975 Chris left Einstein/Bronx State and joined the Columbia University Department of Psychiatry and New York State Psychiatric Institute. During the next five years his activity branched into three new directions.

• Receiving an M.S. in Epidemiology in 1980, Chris began a series of papers in which he used current literature on social support to generate new ideas and new questions about the course and management of schizophrenia.
• In 1979 the National Alliance for the Mentally Ill (NAMI) was formed by families with a member suffering from schizophrenia. Chris recognized the significance of NAMI instantly, and began to work tirelessly to support the New York State and City chapters.
• In 1980, utilizing resources provided by the New York State Office of Mental Health, Chris founded the Fellowship in Public Psychiatry in the Columbia Department of Psychiatry. Conceptualized by Chris with great thoroughness, the purpose of the new program was to provide comprehensive post-residency training to psychiatrists aspiring to leadership in the field of community-based care. More than twenty years later the Fellowship is one of the largest post-residency psychiatric fellowships in the nation, training ten fellows each year.

In 1987 Chris retired from Columbia and began a new chapter in his life. His goal was to have more time to paint, an art in which he is highly accomplished. At this point his active work in the field of community care for the severely ill receded, as planned. His contribution to the field of family therapy, however, did not. Rather, it took new form.

In the 1990s Chris commenced a series of publications, including a book length memoir, in which he looked back on the history of the family therapy and engaged with the field on how it thinks about itself. In this work he returned to a type of discourse he had initiated for himself many years before in an influential Family Process paper co-authored with Andrew Ferber in 1969, titled "Family Therapy: A View." With hindsight, we can see Chris even in that early paper trying to look past family therapy theory in order to describe closely what family therapists actually do. In his current work, Chris is undertaking to think directly and with great originality about the problematic, ever ambiguous role that "theory" has played in family therapy's evolution, speaking in his unmistakable, literate voice, as always.

Chris Beels' pioneering, multi-faceted contribution to serving the families of the severely ill by itself does honor to AFTA's award for Innovative Contributions to Family Therapy. His current writing adds even more. It has been a privilege for me to work with Chris and to have him as a friend. On this occasion it is a tremendous pleasure for me to congratulate him.