What is Family Therapy?
Family therapy is a specialised type of group therapy designed to address specific issues that affect the psychological health of a family. It is an evidence-based form of therapy that can be used as a primary mode of treatment or as a complementary approach alongside other therapies.
All kinds of challenges and issues can disrupt the healthy functioning of a family, such as:
- mental and behavioural health disorders
- major transitions, such as moving house, having a baby, divorce or separation
- financial problems
- unexpected illness, death or unemployment.
Most families face challenges and experience some sort of dysfunction at one time or another. Many find their own ways to navigate these times, and will have some in-built resilience that they can rely on.
However, some families may face challenges that seem insurmountable, for a variety of reasons. They can be left feeling overwhelmed, unsure what to do for the best, or find themselves stuck in repeating patterns of harmful or hurtful behaviours. These families will benefit from family therapy, with support from a trained therapist, to overcome the hurdles they face and become stronger as a family unit.
Family therapy is based on the understanding that challenges and issues cannot be addressed and solved successfully in a vacuum. It is unique in that problems are viewed through a broader lens and as part of the complex system of the family unit. As such, no blame is placed on any one individual, but rather the therapy helps families explore how the whole family contributes to any problem and, importantly, the solution.
In creating a safe space, with professional support, family therapy enables family members to:
- get to the root of their problems
- communicate more effectively with each other
- express and explore difficult thoughts and emotions
- better understand each other’s experiences, behaviours, views and needs
- work cooperatively to identify and resolve family problems
- build on family strengths to make useful changes in their relationships and lives
- create a better functioning home environment, restoring balance.
Family therapy can also provide education in the skills required for healthy family functioning, including communication, conflict resolution, and problem-solving. Learning and improving these skills also increases the likelihood of success in overcoming family challenges in the future.
The term ‘family’, in family therapy, is not limited to blood relatives, but is used to describe any group of people who care about each other and call themselves a family. This can include close friends, romantic partners and caregivers.
Family therapy typically uses a variety of techniques from treatments such as cognitive behaviour therapy (CBT), interpersonal therapy, dialectical behaviour therapy (DBT) and solution-focused therapy. The techniques used will depend on the specific challenges a family is facing, as well as the unique dynamics of each family.
Research shows that family therapy is beneficial for children, young people and adults of all ages, and is highly effective in the treatment of a very wide range of mental health conditions, including:
There are some situations where family therapy techniques may not be appropriate, for example where there is an active abuser within the family, or where one or both parents are psychotic (or diagnosed with antisocial or paranoid personality disorder).
There are no major risks involved in receiving family therapy with a trained professional, if family members seek therapy with openness, honesty and a willingness to change. It is an evidence-based and safe method to bring about positive change and healing for all members of a family.
What are the Different Types of Family Therapy?
Family therapy can be used as a standalone treatment or as a complementary approach, and can be delivered in many different ways, depending on the types of problem being treated.
Some of the most common types of family therapy include:
- to provide useful information, to better understand a mental health disorder
- to explain and support medication and treatments
- to offer training and support in self-help and self-care skills
- to provide a safe space to release emotional frustrations.
- Intergenerational Therapy
Structural family therapy explores the framework of a family – looking at patterns, behaviours, and family relationships as they emerge during therapy sessions. Problems – and their symptoms – are understood in terms of family interaction patterns, with an emphasis on the whole family and how it is organised.
With this approach, the therapist is usually an active participant, observing, learning, interacting with and supporting family members. They will often spend time with the family beforehand, in order to observe and learn about the dynamics between members, so they can then identify and chart where adjustments need to be made. These adjustments typically focus on modifying behaviours and strengthening relationships, improving interactions between family members and setting appropriate boundaries.
The goal with structural family therapy is for the family itself to create a healthier family structure, with positive communication and interaction between all members.
This type of therapy is based on ‘family systems theory’, which recognises that a family is more than just the sum of its individual members. The approach focuses on the idea that if one family member has a problem, it influences the whole family dynamics and not just the individual – and vice versa. For example, a parent struggling with depression or a substance use disorder cannot undergo treatment in isolation – their disorder impacts the whole family unit and the dynamics within that family will also have an affect on their condition and recovery.
Systemic family therapy then, views the family as one holistic unit and takes into account the entire family’s emotional tone, attitudes, and feelings. Attention is focused on the dynamics among family systems, rather than on individual issues and personal reflection. Typically, the therapist remains neutral during this approach, allowing family members to take the lead on exploring and developing their own solutions, only assisting in creating solutions if the family becomes stuck.
With this type of therapy, there is no direct identification of a single root cause to any problem, the whole family attends therapy together as a shared experience, and the therapist acts as a facilitator for the family's own change.
Strategic family therapy takes a more direct approach and focuses on family functions and processes. Therapists who use this technique believe that change can be achieved quickly, without necessarily going into any in-depth analysis of the problem’s source. It mainly explores family behaviour outside the therapy sessions, and concentrates on processes, such as problem-solving and communication.
Strategic methods are used to interrupt old patterns – such as how certain family members interact and how decisions are made – in order to create opportunities for new patterns to emerge. Homework is typically given, for the family work on together and then share with the therapist during follow-up sessions.
This approach tends to use innovative techniques and strategies to help families improve their communication and problem-solving skills together. It has been shown to be particularly effective when working with substance use and eating disorders.
Psychoeducational therapy provides education, information and support to those seeking or receiving mental health services, along with members of their family, caregivers and friends. In psychoeducational models, the underlying theory is that when families have sufficient information about the nature of a disorder – along with specific strategies for coping with it effectively – it can significantly decrease conflict and the likelihood of relapse after treatment.
Family psychoeducation strategies have emerged as a strongly supported evidence-based practice in the treatment of bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and borderline personality disorder.
Psychoeducation can be provided in a number of ways, but generally has four main goals:
Psychoeducation can be delivered through online or electronic formats, as well as through participation in sessions with a trained professional.
This type of family therapy concentrates on functional and non-functional processes within families, across generations. It looks at the conflicts that can arise between different generations within a family, breaking down communication barriers and cultivating understanding.
This approach believes that most family conflicts arise due to the differences between generational behaviour patterns, morals and expectations. It aims to support families in exploring these differences, improving communication and encouraging open-minded attitudes.
Therapists often use the concept of the genogram, which is similar to a family tree but with considerably more information included. A genogram, in addition to mapping family structure, can help to outline the relationships between family members and identify any dysfunctional patterns. Families can then work together to adjust and strengthen relationships and reduce conflict.
All types of family therapy are designed to help families improve communication, develop healthy problem-solving and coping skills, and enhance their sense of connection to one another.
There is no single form of family therapy that is distinctly advantageous over another, although some modalities may be better suited to certain problems than others. Studies have repeatedly shown that families who attend therapy together report better life outcomes than those who do not, so any type of family therapy will be of benefit to those seeking to improve family relationships and dynamics.
What are the Benefits of Family Therapy
Families can benefit in many ways from attending therapy together, when specific circumstances are putting a strain on family relationships and disrupting harmony within the family unit.
By providing a safe and open environment, family therapy can support families in addressing and overcoming a wide variety of issues, including divorce, death of a loved one, financial difficulties, and major transitions. This holistic approach has also proven highly effective in treating a range of mental health conditions that impact a family as a whole, such as depression, substance abuse or addiction, food issues and anxiety disorders.
With guidance and support from a trained therapist, family therapy benefits families by helping them to:
- identify and reduce sources of conflict and stress within the family, that are disrupting the family’s functioning and efficiency
- reestablish and improve communication between family members
- understand how personal actions affect the entire family – and vice versa
- find ways for healthier expression of difficult emotions
- better understand each other’s experiences and perspectives
- work on acceptance and forgiveness
- understand and respect the points of view and opinions of other family members
- appreciate and value each other’s needs
- develop a deeper sense of empathy, honesty and trust towards one another
- develop and maintain healthy, clear boundaries – preventing codependency
- identify and improve family patterns and dynamics
- learn and promote problem-solving skills and coping skills
- learn healthy conflict resolution skills
- build on family strengths to develop a more supportive family environment and to strengthen bonds
- bring back and support family members who may have been isolated.
Family therapy helps family members, caregivers and friends to better understand and support each other. It helps to significantly reduce family conflict and provides a valuable range of skills and tools that families can use during therapy and well into the future.
For the process to be truly beneficial, it is essential that all family members keep an open mind, are ready to address the issues that are impacting their family, and willing to make the necessary changes to heal and restore balance.
If family therapy sounds like something that could benefit you and your family, please contact us to find out more.