Since the foundation of the Institute for Mental Health in Belgrade in 1963 there has been a long tradition of continuous clinical and research work in the field of alcoholism and family, in which the author participated constantly.

 

The evolution and historical context of Belgrade Multisystemic/Ecosystemic Model (ESTA) have been described shortly and chronologically - as an interaction between clinical experience and the most important research projects. The author gives an overview of about ten mainly international research projects - vitally connected with development of clinical theory and practice: from traditional, biomedical, individually oriented model (1963, abstinence rate 28%) via group, socially oriented model (1968, 36% of abstinence) to integrative, ecosystemic, biopsychosocial model (1973, 70-80% of abstinence and better quality of life). The author built Multisystemic family-oriented approach in 1973 and constantly developed it up to these days. Evolution and key points of the model during the past 4 decades are illustrated by diagram in detail.

 

In conclusion, the most important results are summarized and discussed, especially superiority of family- based approaches to treatment of substance abuse problems. In this context, Belgrade multisystemic framework, combined with postmodern/constructionist ideas, a workable intergration of “old and new” concepts/interventions - as the theme of the twenty-first century, opens great possibilities and new perspectives in the reality of constantly changing society.