What does family therapy focus on

Deborah C. Escalante

Overview

Family therapy is a type of psychological counseling (psychotherapy) that can help family members improve communication and resolve conflicts.

Family therapy is usually provided by a psychologist, clinical social worker or licensed therapist. These therapists have graduate or postgraduate degrees and may be credentialed by the American Association for Marriage and Family Therapy (AAMFT).

Family therapy is often short term. It may include all family members or just those able or willing to participate. Your specific treatment plan will depend on your family’s situation. Family therapy sessions can teach you skills to deepen family connections and get through stressful times, even after you’re done going to therapy sessions.

Why it’s done

Family therapy can help you improve troubled relationships with your partner, children or other family members. You may address specific issues such as marital or financial problems, conflict between parents and children, or the impact of substance abuse or a mental illness on the entire family.

Your family may pursue family therapy along with other types of mental health treatment, especially if one of you has a mental illness or addiction that also requires additional therapy or rehabilitation treatment. For example:

  • Family therapy can help family members cope if a relative has a serious mental illness such as schizophrenia — but the person who has schizophrenia should continue with his or her individualized treatment plan, which may include medications, one-on-one therapy or other treatment.
  • In the case of addiction, the family can attend family therapy while the person who has an addiction participates in residential treatment. Sometimes the family may participate in family therapy even if the person with an addiction hasn’t sought out his or her own treatment.

Family therapy can be useful in any family situation that causes stress, grief, anger or conflict. It can help you and your family members understand one another better and learn coping skills to bring you closer together.

How you prepare

You can ask your doctor or other primary care provider for a referral to a therapist. Family members or friends may give recommendations based on their experiences. You also can ask your employee assistance program, clergy, or state or local mental health agencies for suggestions for therapists.

Before scheduling sessions with a therapist, consider whether the therapist would be a good fit for your family. Here are some factors to consider and questions to ask:

  • Education and experience. What is your educational and training background? Are you licensed by the state? Are you accredited by the AAMFT or other professional organizations? Do you have specialty training in family psychotherapy? What is your experience with my family’s type of problem?
  • Location and availability. Where is your office? What are your office hours? Are you available in case of emergency?
  • Length and number of sessions. How long is each session? How often are sessions scheduled? How many sessions should I expect to have?
  • Fees and insurance. How much do you charge for each session? Are your services covered by my health insurance plan? Will I need to pay the full fee upfront? What is your policy on canceled sessions?
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What you can expect

Family therapy typically brings several family members together for therapy sessions. However, a family member may also see a family therapist individually.

Sessions typically take about 50 minutes to an hour. Family therapy is often short term — generally about 12 sessions. However, how often you meet and the number of sessions you’ll need will depend on your family’s particular situation and the therapist’s recommendation.

During family therapy, you can:

  • Examine your family’s ability to solve problems and express thoughts and emotions in a productive manner
  • Explore family roles, rules and behavior patterns to identify issues that contribute to conflict — and ways to work through these issues
  • Identify your family’s strengths, such as caring for one another, and weaknesses, such as difficulty confiding in one another

Example: Depression

Say that your adult son has depression. Your family doesn’t understand his depression or how best to offer support. Although you’re worried about your son’s well-being, conversations with your son or other family members erupt into arguments and you feel frustrated and angry. Communication diminishes, decisions go unmade, family members avoid each other and the rift grows wider.

In such a situation, family therapy can help you:

  • Pinpoint your specific challenges and how your family is handling them
  • Learn new ways to interact and overcome unhealthy patterns of relating to each other
  • Set individual and family goals and work on ways to achieve them

Results

Family therapy doesn’t automatically solve family conflicts or make an unpleasant situation go away. But it can help you and your family members understand one another better, and it can provide skills to cope with challenging situations in a more effective way. It may also help the family achieve a sense of togetherness.

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What Is Family Therapy?

Family therapy is a type of treatment designed to help with issues that specifically affect families’ mental health and functioning. It can help individual family members build stronger relationships, improve communication, and manage conflicts within the family system. By improving how family members interact and relate to one another, family therapy can foster change in close relationships.

Some of the primary goals of family therapy are to create a better home environment, solve family issues, and understand the unique issues that a family might face.

Types of Family Therapy

There are several types of family therapy. A few that you might encounter include:

  • Family systems therapy: This type is an approach that focuses on helping people utilize the strengths of their relationships to overcome mental health problems.
  • Functional family therapy: This is a short-term treatment often utilized for young people experiencing problems with risky behavior, violence, or substance use. It helps teens and families look for solutions while building trust and respect for each individual.
  • Narrative family therapy: This type encourages family members to each tell their own story to understand how those experiences shape who they are and how they relate to others. By working with this narrative, the person can start to view problems more objectively than just seeing things through their own narrow lens.
  • Psychoeducation: This type of treatment is centered on helping family members better understand mental health conditions. By knowing more about medications, treatment options, and self-help approaches, family members can function as a cohesive support system. 
  • Supportive family therapy: This type of therapy focuses on creating a safe environment where family members can openly share what they are feeling and get support from their family.
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Some therapists may stick with a specific type of family therapy. In contrast, others may take a more eclectic, multimodal approach that incorporates aspects of different types of treatment to suit the needs of the family.

Techniques

The techniques utilized in family therapy typically depend on factors such as the theoretical orientation of the therapist and the specific needs of the family. Some methods that may be utilized include:

  • Behavioral techniques: These methods often focus on skills training and psychoeducation to help family members address specific problems. For example, modeling and role-playing might be used to help family members resolve communication problems.
  • Psychodynamic techniques: These methods involve assessing how each family member interprets and responds to the problems they are facing. The therapist works with the family to develop new emotional insights and explore new ways of responding more effectively.
  • Structural techniques: These methods focus on helping family members with boundaries and power dynamics within the family. Such techniques can help families create new boundaries and establish routines that improve how the family functions.

Techniques used in family therapy focus on improving emotional awareness, assisting with major changes within a family, helping people accept things they cannot control, and improving communication and collaboration.

Other specific techniques used in family therapy may include learning to practice empathy, emotional validation, reflective listening, and cognitive reframing.

What Family Therapy Can Help With

Family therapy can help people with many different issues. Some of these include:

  • Behavioral problems in children or teens
  • Changes within the family 
  • Communication problems
  • Death of loved one
  • Divorce, separation, or marital problems
  • Parent-child conflicts
  • Problems between siblings
  • Parenting issues
  • Stressful events or major life transitions
  • Trauma

This type of therapy can also address individual mental health problems that can affect the entire family, such as anxiety, chronic illness, depression, and substance use.

Benefits of Family Therapy

Because this form of treatment addresses communication, family members can learn how to better share their thoughts and needs and resolve conflicts in a way that is less likely to damage relationships.

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This type of therapy also focuses on how family members can address an individual family member’s difficulties. For example, if one family member has a mental health condition, family therapy can help alter some conditions that sometimes contribute to the problem.

When individuals are affected by mental illness, family members may sometimes lack awareness of how to help. As a result, they may engage in behaviors that maintain or even worsen aspects of the illness. Family therapy can help members of the family learn more about what they can do to support their family member who has a mental disorder while preserving their own mental well-being.

Effectiveness

Research suggests that family therapy can be effective for a range of purposes. Some supporting evidence includes:

  • A 2018 review found that family therapy could be useful in treating adult-focused problems, including relationship distress, intimate partner violence, mood disorders, anxiety disorders, psychosis, alcohol issues, and adjustment to chronic physical illness.
  • A 2019 study found that family therapy helped improve different areas of family functioning to help teens who were experiencing mental health problems.
  • One 2019 review found that family therapy demonstrated effectiveness in treating conduct problems, emotional problems, eating disorders, somatic problems, and recovery from abuse or neglect. The study also found that it was useful either when utilized independently or as part of a multimodal treatment program.

Further research is needed to better understand how family therapy may be most effective and how it compares to other forms of treatment.

Things to Consider

Because family therapy involves talking about emotional problems and conflicts, it can be difficult and upsetting. In some cases, people may initially feel worse before they begin to improve. It is important to remember that a professional therapist is there to help members of the family work through these conflicts and handle the intense emotions that people may experience.

While family therapy can be useful for various issues, that doesn’t mean it is right for everyone or every situation. Some other types of treatment that may also be useful include cognitive-behavioral therapy (CBT) or child psychotherapy.

How to Get Started

Family therapy is often short-term, but it may also take place for a year or longer, depending on the situation and needs of the family. While it frequently involves all family unit members, it may also focus on those who are willing or able to participate in treatment. 

During therapy sessions, the therapist will ask questions to learn more about the problems that have brought the family to therapy. They will also look at other factors contributing to issues, such as underlying mental health conditions and environmental stress.

This type of therapy is often provided by licensed marriage and family therapists (LMFT), but it can also be practiced by other mental health professionals including licensed professional counselors, psychologists, and social workers.

If you are interested in trying family therapy, it can be helpful to ask your doctor for a referral or look for professionals in your area who specialize in this type of therapy. You can also search the online directory at the American Association for Marriage and Family Therapy website.

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