The term family can mean many different things to different people. The definition can span those you share a legal connection or DNA with, but can also include those you share a close relationship with who have been pivotal to shaping your life.
No matter the description, family members shape us to become who we are – for better or for worse. We develop our habits, beliefs, vocabulary, customs, and how we see the world from them. We also model relationships from our family interactions and base how we love on them. For example, if someone grows up within a dysfunctional family that has difficulty connecting, they may also find it difficult to connect with others.
As these connections play a key role in shaping and maintaining our mental and physical health, it’s vital that they are treated with care. This is where family therapy can step in.
What is Family Therapy?
The term family therapy (or family counseling) simply means when multiple members of a family undergo group counseling to address specific issues that are impacting their health and functioning. Speaking to a trained mental health professional – acting as a third party objective viewpoint – in a safe environment can allow issues once brushed over to be addressed. Generally, groups set and work towards specific goals of family therapy, looking to explore unhealthy conflicts, patterns, and communication to improve family relationships.
Some situations where family therapy may be helpful include:
- Communication breakdown
- When a family member has difficulty expressing emotions
- Conflict over one or more issues
- A big life transition
- Financial problems
- Marital conflicts
- Domestic violence
- Child-parent conflicts
- Developing a healthy relationship after divorce
- Inconsistent Parenting
- Mental health conditions, e.g., depression, anxiety, eating disorders
- A substance use disorder
- Serious illness
Who Does Family Therapy Help?
Having problems within your family system is extremely common and a part of being human. After all, each individual has their own personality, ethics, and views about the world, therefore conflict is likely to arise between other family members.
Family therapy may be helpful to assist in working through these issues in the most effective way possible and in building healthy relationship dynamics. Even when there are no specific problems in the family, discussing their relationships in therapy can be extremely helpful.
This kind of family therapy offers families benefits no matter what the age of its family members – from young children to the elderly. Getting young children involved in these sessions can actually help the therapist decipher the underlying issues in the family.
Mental health conditions or problematic behavior in children are usually just a symptom of a much larger problematic dynamic within the family, though are easier to spot and confront than the more complex underlying issues. This is why behavioral and emotional problems in children are the most common reason people visit a family therapist.
While the entire family may need some guidance from a mental health professional to solve their familial issues, there is often an “identified patient” – for example, a parent with a substance use disorder or a child with a mental health issue. Although it helps when as many family members as possible are involved in the therapy sessions, not all have to be involved to see effective results. The family systems theory states that a change in the behavior of one family member can influence other people in the family to also change. Therefore, treating the identified patient alone may help shift current family relationships for the better.
Family therapy is not just for individuals who live in the same household. Therapists will often ask the identified patient to invite people who they regard as their family to the sessions. This is anyone who has played a long-term supportive role in a person’s life, including extended family members, stepfamilies, in-laws, friends, mentors, and more.
What is the Difference Between Family Therapy and Family Counseling?
Family therapy and family counseling are usually interchangeable terms. Both have similar goals – allowing family members to work through barriers and mental health problems – though the key difference is the background of the person running the sessions.
A family counselor typically needs a bachelor’s degree in a related field and provides general support to a client. They usually work with people dealing with life challenges, whereas a family therapist more specifically focuses on treating mental health conditions. To become a therapist, a person usually needs a master’s degree and a license to be able to practice.
Most clinicians running family therapy sessions will be therapists, due to the chance of mental health issues needing to be addressed. Asking the person running the sessions about their education and credentials is the best way to find out if they are a family counselor or therapist. Family meet and greets are also a great time to ask any questions they may have about the specific counseling or psychological approach they will tale
What is it Like Experiencing Family Therapy?
Family therapy is generally short-term, with an average of 12 sessions, creating a goal of an end date for the treatment.
Elements of these sessions are likely to vary from week to week, based on the events that transpired in prior meetings. For example, one week an individual in the family may be asked to come alone, whereas the next it could be helpful for a large group of extended family to be present.
However, working on individual therapy for too long can be isolating and stop cohesive progress as a unit. The therapist is likely to work with as much of the family as possible in as many sessions as possible as this provides members with as much knowledge as possible about the expectations and discoveries made during therapy.
Types of Family Interventions
There are a number of evidence-based treatment options that can be used to approach family issues. Family therapy employs different exercises and techniques from behavior therapy, interpersonal therapy, cognitive therapy, and individual therapy. Depending on the therapist and the specific situation, different elements from different approaches may be blended into one treatment plan.
The setting of these sessions can also vary, with different therapists or counselors offering in-person, at-home, or online sessions. Which one a family chooses should be based on where they feel most comfortable.
Bowenian Family Therapy
Bowenian family therapy is more applicable when individuals cannot or do not want to involve certain family members in treatment. The sessions are built on two basic concepts:
- Triangulation: the natural tendency to want to vent to a third party instead of the person causing a direct problem. Sometimes the third party can assist in relaying the information between the two people having issues.
- Differentiation: learning to become less emotionally reactive
Systemic Family Therapy
These therapy sessions consider the family as a whole. Here, each family member’s actions are reviewed to see how they have impacted each individual and the collective family unit is considered. Therefore, this kind of therapy focuses on the unconscious meanings and communications behind an individual’s behaviors.
The aim of systemic family therapy is to improve family interactions by gaining insight into how each individual’s actions influence each other and how they change over time.
Structural Family Therapy
This technique was developed in the 1960s by Salvador Minuchin, based on the problems that arise in the family due to its structure rather than specific behaviors.
It is largely focused on the emotions and behavior of the children in the family, believing that concerns in this area stem from dysfunctional family structures. Structural family therapy sessions focus on understanding subsystems, hierarchy, and boundaries within the family. Gaining this insight allows for appropriate boundaries to be set up and helps strengthen relationships among all the members.
Family therapists often use “acting out” conversations and scenarios during this kind of therapy, allowing each individual to understand each other better.
Brief Strategic Family Therapy
Brief strategic family therapy usually consists of around twelve to sixteen sessions and is the most direct. In this kind of therapy, the therapist will assign homework in between each session, with the purpose of assessing and adjusting the way each family member goes about communicating and making decisions. The therapist also takes the position of power during these sessions, allowing certain family members who usually have trouble communicating to do so more effectively.
Its goal is to identify patterns of interaction between family members that lead to problematic behavior of adolescents in the family. This understanding allows for:
- The family system to be restructured in a healthier way
- Strengthening of positive patterns
- Changing behaviors that aren’t helpful for the child or young person going through a difficult time
- Adjustment towards healthier communication
Research has found that this type of therapy has long-term benefits and is much more effective at treating adolescent substance use than other treatments such as parent training groups and group therapy. The study also found it to be effective in reducing both short and long-term arrests and incarceration rates.
If a family member is experiencing a mental health condition, it is vital for the rest of the group to be educated about it. This way, they gain a better understanding of what the person is going through and improve how they function as a whole. Mental illness can be trying, scary, and upsetting for a whole family to deal with, but with knowledge comes the ability to better support each other. A study found that psychoeducation of the entire family helps the person living with the condition to have a better outlook on it and reduces the rate of relapse for substance abuse disorders.
What are the Goals of Family Therapy?
Although each focuses on a different means to get there, all types of family therapy aim to reach similar goals. These could be emotional, psychological, or behavioral and may include:
- Exploring patterns of interactions between family members
- Offer collective insight and understanding into the problems of each family member
- Identifying and improving any unhealthy communication patterns
- Learning strategies to better handle conflict and improving the family’s problem-solving skills
- Strengthening relationships
- Providing a mental health diagnosis within a family context
Benefits of Family Therapy
The benefits of family therapy sessions vary between each individual case, though there is evidence that these sessions are an effective way to approach familial issues.
One main benefit of family therapy is the fact it can improve communication of the whole family unit. The therapy sessions allow people to feel heard, seen, and understood in a safe space where lines of communication can be opened. This allows the family unit to explore how they communicate, address issues on this front, and learn healthier ways to express their thoughts and feelings.
However, this can only happen through the willingness and collaboration of all family members. As already mentioned, not all people in the family need to be present in the sessions, though they need to be receptive and open to the change of their other family members and themselves.
Helps Set Clear and Healthy Boundaries
Boundaries are an important part of every relationship, although when they are not clearly defined and enforced, unhealthy patterns of behavior can arise. A research paper, published in the Encyclopedia of Couple and Family Therapy, found that dysfunction arises when families do not stick to clear boundaries.
For example, if parents do not set boundaries in their household, the children may take on their roles. Respecting boundaries is also equally important, with adult children commonly cutting off communication with family members when these are not respected.
Family therapists will help assist in building and explaining each family member’s boundaries so they can be understood and respected going forward by all parties. This builds connectedness and decreases the amount of conflict within the unit.
Teaches People to Embrace Change
Every relationship humans have will go through both good and bad times. Family therapy teaches people the skills to know how to best tackle the harder times, learning both conflict resolution skills and how to better support each other. This kind of counseling also helps build problem-solving skills, improves mental health, and increases self-esteem, all useful for improving each individual’s quality of life in all other areas.
Other Benefits of Family Therapy
Some other benefits can include:
- Improves family relationships and dynamics
- Helps define someone’s role within the family
- Addresses and diminishes dysfunctional interactions
- Builds coping tools for family members
- Improves the family’s problem-solving abilities
Family therapy can be particularly useful in decreasing the risk of mental illness in adolescents. Studies have also shown family therapy can effectively address children’s issues – such as substance abuse, depression, offending behavior, and conduct disorders. Another study found that regardless of gender, these sessions can have a huge impact on reducing the number of internal and external problems adolescents encounter.
This paper also revealed that parents who undergo family therapy report their family being closer after the sessions, though female parents were more likely to find it useful than male parents.
Functions of a Family Therapist
The purpose of a family therapist is to act as a guide on the journey to a more functional family. They are not there to judge and decide who is innocent or guilty, but to simply make a difference in their patients’ lives.
Each therapist may approach family therapy in a slightly different manner, though here’s a rough idea of how a family’s journey may play out.
This first meeting will consist of a general overview of why the family has come to therapy sessions in the first place. Each individual will be given the chance to talk about the personal and collective issues they and their family are facing.
Over the course of the sessions, the therapist will ask certain questions to build information about the family as a whole. This may include learning about:
- The family history
- The family roles
- Parenting and discipline approaches used
- Coping skills each family member recruits
Gaining insight into these factors allows the therapist to form a picture of the crises the family has endured and each individual’s response to it. The problem that brought the family to therapy is currently serving a function that may be discussed, alongside how effective the coping strategies being used are.
Mapping the Family Structure
If a structural approach to treatment is taken, the next step may involve creating a map of the family’s hierarchy. The map can help lay out how authority and boundaries work within the family unit and how they have changed over time.
Treating the Family Issues
With all of this gathered information, the therapist can help the family work together towards solving their problems and work towards the group’s set goals of family therapy. Therapy can help the members adjust their communication, problem-solving approaches, and boost the family’s strengths.
At Feinberg, we understand how difficult and draining facing family issues can be. That’s why our team of expert family therapists will do all we can to make this trying time a little easier. We are able to provide personalized treatment plans for each family’s specific case. Contact us today for more information to start you and your family on your journey to create a better functioning home environment.