Everything You Need To Know About Family Therapy

Mother holding daughter at psychologist office

Every family has its struggles. Life throws curveballs, tragedies happen, and conflicts arise. It can be hard to weather these storms without the support of a trained and licensed professional. That’s where family therapy comes in. It is a wonderful option for families looking to strengthen their connection and get through difficult times in a positive and constructive way.

What Is Family Therapy?

Family therapy is a type of psychological counseling provided by a clinical social worker or licensed marriage and family therapist. It helps family members improve communication, resolve conflicts, or navigate difficult times such as the loss of a loved one or a divorce. Unlike individual counseling, which views problems as residing within the individual, family therapy views problems as patterns or systems that need to be adjusted

The term family therapy doesn’t refer to the number of people who are present in the therapy session, but instead to a specific perspective or framework for dealing with issues that arise within the context of familial relationships. Family here is not just about blood relatives, but can include anyone who plays a long-term supportive role in one’s life. Improved family relationships will help alleviate family tensions and conflicts, but can also benefit an individual’s mental health.

Who Should Seek Family Therapy?

People seek family therapy for a variety of reasons. Some may seek family therapy because they have family issues they want to solve, which often intensify due to lack of communication. Others may want to improve their relationship with certain family members like a mother and an adolescent daughter or parents with a child who is struggling at school. Some families experience an upsetting or traumatic event like divorce, loss, or severe accident that requires the assistance of a counselor to work through the emotional impact. Other families might seek support to cope with a mentally ill family member or someone struggling with substance use disorder.

When a family member is suffering from serious mental illness or addiction, family therapy often provides an additional form of support in conjunction with other types of individual treatment for the person who is struggling.

For example, for a relative who has a serious mental illness such as bipolar disorder, family therapy can help members cope better as a unit, though the person with bipolar should continue to take their medications, see a therapist one-on-one, and participate in their individualized treatment. Similarly, for a relative battling addiction, the family can attend family therapy to provide additional support while the affected person continues to participate in residential treatment. Families may even participate in family therapy if the relative battling substance use disorder hasn’t yet sought out treatment.

What Are the Different Types of Family Therapy?

Practicing family therapy involves a very specialized skill set. All Marriage Family Therapists (MFT) are required to do some family counseling as part of their training and many Licensed Clinical Social Workers (LCSW) are trained in family counseling as well, but not all. Most forms of family counseling incorporate elements from social systems theory, which argues that problematic behaviors in family members are created and influenced by the internal dynamics of the familial system.

Below is an overview of the primary types of family therapy, so you can decide which type of counseling is best for you.

  • Bowenian Therapy: This type of family therapy is ideal for those who cannot or do not want to bring family members into the therapeutic setting. Bowenian therapy leverages two primary concepts: triangulation and differentiation. Triangulation refers to the natural tendency to diffuse anxiety or conflict by involving a third party (i.e. a father complaining to his daughter about his wife). Differentiation refers to developing skills to react in a less emotional manner in your relationships with family members. Exercises such as letter writing are used to help decrease the intensity of emotional reactions and increase connectedness among family members.
  • Structural Therapy: This model is especially helpful for parents dealing with behavioral or emotional issues in their children (or amongst siblings). Structural therapy focuses on adjusting and strengthening the family system to make sure the parents (or adult caretakers in the home) are in control and that both children and adults set appropriate boundaries. The therapist will often “join” the family in order to observe, learn, and improve family relationships and make sure no one person or dyad (two people) in the family system has too much power.
  • Systemic Therapy: This form of therapy is focused on the unconscious communication and meaning behind family members’ behaviors. In the systemic model, the therapist takes a neutral and distant approach, allowing family members to gain a deeper understanding of their issues and problems as a family. This approach views power as an unconscious game that plays out and contributes to problems within the family, rather than belonging to any one person in the family.
  • Strategic Therapy: This is a briefer and more direct form of therapy, great for families looking to see results in a short period of time. The therapist assigns family members homework to help change the way they interact with one another, specifically with the person identified as having the “problem” or “symptom.” These homework assignments help the therapist assess the underlying issues and teach the family how to communicate and make decisions in a more productive manner. In this type of therapy, the therapist holds the position of power, allowing other family members, who may not usually be granted authority, to more openly express their needs and emotions.

What Happens During Family Therapy?

Therapists employ many different methods, exercises, and techniques in any given family therapy session. Some of the issues that are typically covered in sessions include:

  • Child and adolescent behavioral problems — including academic struggles, substance abuse, or eating disorders
  • Grief — coping with the loss of a family member
  • Mental health — understanding and supporting a family member’s experience with anxiety, depression, or another mental health condition like schizophrenia
  • Domestic violence
  • Major trauma — an event or change that impacts the entire family such as relocation to a new house, natural disaster, or incarceration of a family member
  • LGBTQIA+-related issues
  • Infertility
  • Marital conflicts or financial struggles
  • Divorce
  • Substance abuse
  • Adjustment to a new family member in the home (i.e. birth of a sibling, adoption, foster children, a grandparent entering the home, or a new stepparent)

Seeking family therapy — whether in-person or online — is a big step that should be celebrated. It can be scary at first, but trust that you are doing what you feel is best for you and your family and that you will all come out stronger on the other side of whatever you are going through.

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