Family therapy is a type of therapy that employs interpersonal strategies to address issues affecting the health of a family. The central idea in family therapy is that individual problems must be examined within the framework of the family and how it affects others within that unit. Changing interaction patterns is a big part of family therapy, whether it involves dealing with a large group of people or just a couple. Family therapy is distinguished from other forms of counseling by the scope and perspective taken to examine interactions.
The modern definition of family is more inclusive than in years past, as it is often defined by a therapist as including anyone who plays a long-term supportive role in someone’s life. Such relationships are seen as very beneficial to most individuals, and therapy is often implemented to maintain the strength of those relationships in the event of substance abuse, mental health issues, medical problems, or other hurdles that may arise in a person’s life.
According to the American Association for Marriage and Family Therapy (AAMFT), the average number of sessions for family therapy is 12, and less than 15 percent of families continue with more than 50 sessions. Approximately 90 percent of people report emotional improvement following therapy. In addition, AAMFT found that more than 6 million people in the United States see a family therapist every year.
Family therapy is a specific kind of therapy and should only be practiced by specialists in this field. However, there is more than one type of family therapy. The Bowenian form is a type that can focus on an individual without bringing a third party into the session. This is done in situations where the presence of a family member may incite anxiety or stress in the client. The therapist and client will work through issues together without the third party present. A major part of this kind of family therapy is differentiation, in which an individual learns to manage their emotional reactions to family members. Strategies like writing letters to family members instead of reacting in the moment have proven to be effective in strengthening connectedness within the familial unit.
The systemic model of family therapy chooses to focus on what is behind the behavior patterns within the structure of a family, as well as what subconscious factors are leading to this behavior. This involves multiple parties in the therapy sessions, with the therapist acting as a neutral party. While the therapist will usually play a more passive role in Systemic Family Therapy, they will confront clients with questions when the time is right. Each client has the chance to speculate on what they believe are the underlying causes of certain behaviors.
Salvador Minuchin’s model of structural therapy examines the power structures within a family. This method focuses on the hierarchy of a unit and stresses the importance of parental roles. Structural therapy asks parents to examine their power roles within the family and to focus on working together when dealing with children. Within this method, it’s important that a single individual doesn’t gain too much power.
Jan Haley’s strategic method is much more direct than other kinds of family therapy, and it is often selected by those who want to participate in therapy for a short period of time. In this case, therapy includes homework assignments to be completed outside of the therapy sessions. Identification of symptoms that may be damaging familial relationships is a key part of the strategic method, and these symptoms are often turned around onto the members of the family. This is done in an effort to turn something negative into something positive.
Intergenerational therapy acknowledges the patterns that often arise due to the generational dynamic within a family. This method examines how previous generations of a family can affect the current dynamic. A therapist using this model will often try to show a family how their interactions and patterns of behavior are not unique to that single family but have been experienced by others as well.
Types of Family Therapy
Couples therapy is a common form of family therapy. Couples therapy sees two people in an intimate relationship come together to try to solve a problem they are experiencing within their relationship.
Issues that require couples therapy include:
- Marital problems
- Domestic violence
- Difficulty conceiving a child
- Problems with adolescent behavior
Couples therapy usually sees the two individuals attend sessions together. Sessions are commonly an hour long and occur once per week. Relative to other forms of therapy, couples therapy is often done on a short-term basis, though especially complex issues may take longer to deal with effectively. How the therapy is conducted can vary from therapist to therapist, depending on their preferred model of family therapy. The therapist uses sessions to observe how the parties interact with each another, serving as a mediator when necessary.
Couples therapy often aims to provide participants with:
- An increased awareness of how an individual’s behavior affects the other person
- Skills to better cope with challenges the couple will face
- The ability to recognize and change unhealthy patterns within the relationship
- Improved communication and help in solving problems
Systemic Family Therapy focuses on the family as an emotional unit and how each part of that unit relates to it as a whole. The Bowenian model is often used in Systemic Family Therapy, and it emphasizes looking at the broader picture and how an individual affects that picture. Therapists also employ other methods, such as structural, strategic, and inter-generational methods, into Systemic Family Therapy.
Differentiation is a key element in Systemic Family Therapy, as self-identification can aid in individuals achieving contentment through personal efforts. The triangulation of a three-person family is also important in some cases, as it can actually serve as a more stable support system than that of a couple. How parental behavior may trickle down into that of a child is also examined.
Family Behavior Therapy has a history of helping families dealing with mental illness issues. It has also proven to be quite effective for adults and adolescents suffering from substance abuse, according to the National Institute on Drug Abuse (NIDA). It is not only beneficial regarding the substance abuse issue but can also address any co-occurring problems.
Roles of Family Members
To foster the success of family therapy, it’s important to include the appropriate family members in therapy sessions. Usually anyone directly related to a specific issue should be present. If the primary issues involve the parents and not the children, then the children do not need to be involved. At times, extended family members could be contributing to issues experienced by the immediate family and, in such cases, those extended family members should be involved in therapy. The therapist can help the family determine which family members should be involved in sessions.
When dealing with the individual who is in treatment, there is a lot other family members can do to assist their recovery. Offering ongoing support and helping them to follow treatment guidelines can be very beneficial, according to Behavioral Health Evolution. Learning about the mental health or substance abuse issue they are struggling with and getting in tune with the recovery program that is involved with is key. This can allow a family member to make sure pharmacological treatment is adhered to correctly, ensure that therapy sessions are attended, and contribute more effectively during family therapy sessions.
Family members can assist in the development of coping skills as well. Usually this simply entails being there for an individual to talk to when they are dealing with stressful or challenging circumstances. In this scenario, one can assist the person in solving the problem practically, showing them a blueprint they can use in the future. Family members can remind their loved one of coping strategies they learned in treatment, helping them to manage stress and other triggers as they arise.
Family members can also encourage their loved one to embrace healthy living in all areas of life. Encouraging them to eat a healthy diet, get some form of daily exercise, and maintain a regular sleep schedule can help them to stay on track with overall wellness, and this can assist in avoiding relapse.
While family therapy offers individual in recovery and their families many benefits, support is the critical factor that must extend outside therapy sessions as well.