Family therapy focuses on improving communication, relationships, and dynamics within a family system. A family can be a wide range of people who care about each other and call themselves a family.
This form of talk therapy (psychotherapy) involves working together with as many family members as needed in a therapeutic setting to address problems, issues, conflicts, or concerns affecting the family.
Family therapy can help members understand and support each other while working through difficult issues together. If a member experiences a mental health condition such as depression, behavioral issues such as substance abuse, or if there are unresolved family conflicts, family therapy can also be very helpful.
Licensed Marriage and Family Therapists (LFMT) often lead family therapy. It may also be with a psychologist, therapist or counselor with special training in working with families. They provide guidance, education, and support to you and your family members.
Read on to learn more about how family therapy works.
Common Issues Addressed
Family therapy can help with various challenges, including:
- Communication issues
- Conflicts between family members
- Mental health conditions (e.g., depression, anxiety, substance use disorders)
- Childhood behavioral conditions (e.g., ADHD, conduct disorders)
- Major life changes (e.g., divorce, death, moving)
Process and Structure
Family therapy is a collaborative process. It aims to enhance understanding, empathy, and support among family members. The ultimate goal is to cultivate a more cohesive and functional family unit.
Family therapy sessions typically involve:
- Regular meetings with a licensed mental health professional, often a Licensed Marriage and Family Therapist (LMFT)
- Participation of all involved family members
- Discussion of each person’s experiences, hopes, and concerns
- Exploration of family dynamics, roles, and patterns
- Implementation of interventions and techniques to facilitate positive changes
Key Components of Family Therapy
There are a number of typical steps in family therapy [1] [2].
Assessment and Goal Setting
The therapist may begin by:
- Building rapport with each family member
- Gathering information about family history, dynamics, and presenting issues
- Collaboratively setting clear, specific, and achievable therapy goals
- Establishing expectations and clarifying roles for each family member
Therapeutic Techniques
Family therapists employ various approaches tailored to the family’s needs, including:
- Psychoeducation: The therapist shares information with the family about mental health, improving understanding, communication, and coping strategies to support recovery and relationships.
- Structural therapy: Focuses on reorganizing family dynamics by addressing boundaries, hierarchies, and subsystems to improve relationships and resolve dysfunctional patterns.
- Systemic therapy: Views the family as an interconnected system, addressing relational patterns and communication to understand and resolve issues within the family unit.
- Bowen Systems therapy: Emphasizes understanding family emotional systems, differentiation of self, and multigenerational patterns to reduce anxiety and improve individual and relational functioning.
- Narrative therapy: Helps families reframe and reinterpret their stories, focusing on strengths and empowering them to overcome challenges and reshape their identities.
- Communication exercises: Improve listening, expression, and understanding among members, fostering healthier interactions and resolving conflicts through structured activities and role-playing.
- Role-play: Involves acting out scenarios to explore perspectives, practice communication, and resolve conflicts, fostering empathy and healthier interactions within the family.
- Art therapy: Uses creative expression to explore emotions, improve communication, and resolve conflicts, fostering connection and understanding through shared artistic activities.
Skill-Building
The therapist helps families develop specific skills to enhance family functioning:
- Coping strategies: Teach members stress management, communication skills, and problem-solving techniques to strengthen relationships and navigate challenges together effectively.
- Communication skills: Focus on active listening, expressing emotions clearly, and resolving conflicts constructively to enhance understanding, connection, and harmony within the family.
- Conflict resolution techniques: Include active listening, negotiation, and problem-solving to address disagreements, foster understanding, and create healthier, cooperative family dynamics.
- Problem-solving methods: Involve identifying issues, brainstorming solutions, evaluating options, and implementing strategies collaboratively to address challenges and improve family functioning.
Restructuring Dynamics
Family therapy aims to:
- Reframe negative patterns: Shifts perspectives on behaviors, highlighting underlying intentions or strengths to reduce blame and foster healthier, more constructive interactions.
- Establish healthier boundaries: Involves defining clear, respectful limits to improve individual autonomy, reduce conflict, and foster balanced, supportive relationships within the family.
- Promote more adaptive behaviors: Encourages positive actions, effective communication, and problem-solving to replace dysfunctional patterns and enhance family harmony and resilience.
- Improve interactions and communication between family members: Involves teaching active listening, empathy, and clear expression to strengthen connections, resolve conflicts, and build healthier relationships.
Effectiveness: Research Evidence
Clinical references support the effectiveness of family therapy for adults with depression and other mental health issues. In an analysis of a number of studies, results showed [3]:
- There is evidence showing that the average treated case in couples and family therapy fared better after therapy compared to untreated cases across a range of mental health problems in adults.
- Systemic couples therapy combined with antidepressant medication led to a significantly higher rate of treatment responders and fewer patients on antidepressants at 15 months follow-up compared to standard treatment for depressed inpatients.
- Behavioral couples therapy improved marital relationship quality, which in turn accounted for the alleviation of depressive symptoms in adults.
- Family-focused therapy combined with mood-stabilizing medication was effective in reducing relapse and rehospitalization rates in adult patients with bipolar disorder.
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Sources
[1] Cleveland Clinic. 2022. Family Therapy.
[2] CAMH. Family Therapy.
[3] Carr, A. 2009. The effectiveness of family therapy and systemic interventions for adult-focused problems. Journal of Family Therapy, 31, 46-74.
