The development of family therapy and systemic practice in Europe is sustained and far reaching. Early practice in Europe both paralleled and complemented development in North America, and innovated theory and policy in its own right. The American family therapy pioneers probably had most influence in Ireland and the UK, with their emphasis on empiricism, whilst mainland Europe spawned development of systemic practice within different philosophical traditions. Currently, we may say that integrative practice is celebrated, with a mature field wishing to incorporate ideas from other psychotherapeutic and social science traditions. Ethically, this enables more choice for families and individuals within both public sector and private sector mental health services.