What is Family Therapy?

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The familial system is complex and can form in many ways. The people you include in your family may be related by biology or love. Family can be a source of lifelong support or emotional pain. Some families are a little of both. When relationships become strained, family therapy techniques can help repair them.

Difficulties among family members come in many forms. This post explains how family therapy can help strengthen and heal the family unit.

How Family Therapy Helps

Family therapy is a type of psychiatric treatment designed to help people address concerns and build stronger relationships with one another. While there are many reasons to go to therapy, this type of therapy aims to improve communication and support so that the family unit can function better.

A trained therapist will use different family therapy techniques to:

  • Encourage family members to talk about their challenges
  • Teach family members how to listen to each other effectively
  • Improve communication skills
  • Support the entire family as they work through challenges
  • Enhance problem-solving skills
  • Resolve conflicts within the family unit
  • Promote individual and family growth

Some tasks a family therapist performs include:

  • Assessing clients through interviews, discussions, observations, and formal assessment tools
  • Diagnosing and treating mental health disorders
  • Developing individualized treatment plans
  • Conducting therapy sessions with couples, families, and individuals
  • Helping families improve communication skills and strengthen bonds

A family therapist is a highly trained mental health professional who provides the skills and tools necessary to empower a family to work together and solve their problems as a team.

How It Works

Some families need to attend therapy for months before they see improvement and others only need a few sessions. A skilled therapist knows how to apply family therapy techniques and they will customize a treatment plan to meet each family’s needs.

Your therapist may suggest individual therapy, group sessions, and other types of treatments. You can use different strategies to meet your therapy goals, but some of the techniques and tools below may be included in your program.

  • The Systems Perspective in Family Therapy – Family Systems Therapy is a type of psychotherapy that views the family as a whole. From the family systems perspective, relationships are symbiotic, meaning that individuals are influenced by the family unit, and the unit is influenced by each person in the group.
  • Assessment and Diagnosis in Family Therapy – You can expect your therapist to gather information for the first several sessions. That means they’ll ask a lot of questions and begin observing the family dynamic. They may ask about your reasons for attending therapy, approaches to parenting and discipline, family roles, history, or coping skills. This information will give the therapist an idea of how your family functions, its strengths, and its weaknesses.
  • Setting Goals and Developing Treatment Plans – The goal of a therapist is to help you solve problems. They do not assign blame to specific family members. You will work with your therapist to understand the family’s goals and once these goals are known, the therapist can create a treatment plan to help you meet them. Then, for the rest of your sessions apply techniques to help you reach the goals you set together.

Techniques Used in Family Therapy

Family therapy entails more than describing problems in front of a mental health professional. A therapist is also a teacher who can help your family learn. They can teach you new ways of talking to and interacting with each other, including some of the methods below.

  • Active Listening and Validation – Active listening is a way to assure someone else that you heard them. Paraphrasing what the other person said is the main method used in active listening. Repeating another person’s words back to them shows you’re listening and validates their feelings. It also allows you to make corrections if you misunderstood what your family member said.
  • Family Sculpting or Mapping – Family sculpting is a nonverbal technique used to replay past events. One person is chosen to be the “sculptor.” They place the family in a scene representing each member’s attitudes, roles, and positions. Like talking, sculpting is interactive but doesn’t require a high level of verbal skills. Younger or less talkative family members can still take part.
  • Genograms and Family Histories – A genogram visually represents a person’s family. Genograms include much more information than a typical family tree. Family relationships and history, including medical and mental health histories, might all be included in a genogram. A family therapist might recommend making a genogram to help identify transgenerational patterns. It can help people see how their families of origin impact their relationship behavior.
  • Role Play and Communication Exercises – Role play is used to improve communication and it may involve two people pretending to be in a real-life scenario, a family conflict or misunderstanding, or the therapist may offer a fictional scenario. Taking on the other person’s role and speaking and acting in the way you perceive them can increase understanding. It can also help family members develop more effective ways to communicate with each other.
  • Homework Assignments and Skill Building – What happens in the therapist’s office is important, but families must practice the skills they’re learning in real life. A therapist might ask each family member to keep a journal or to read a specific article or book before the next session. More formal assignments like completing worksheets are also common. But homework can also be fun and it could include a family outing or playing games that make you cooperate and communicate.

Types of Family Therapy

Clinicians have developed various philosophies and types of therapy, so there is more than one approach that may work to resolve a family’s issues. Each type of therapy has its own strengths and weaknesses.

A family therapist may combine techniques from many therapy types to develop a treatment plan that best serves your family’s needs. Of course, they will share their recommendations with you and your family, and you should tell the therapist if any of the approaches excite you more than others or if there are ones you want to steer away from.

Structural Family Therapy

Structural Family Therapy focuses on the way family members engage with one another. The family is viewed as a structural system. The therapist’s role is to help restructure the way the system operates.

There are key concepts of structural family therapy. They include examining the hierarchies of power within the family system and family boundaries.

Techniques used in this approach include:

  • Joining – Setting expectations for treatment
  • Mapping – Understanding the way the family functions
  • Unbalancing – Challenging family members to reconsider their perceptions
  • Reframing – Engaging the family in the process of reframing problems that may arise due to their unique dynamics
  • Enactment – Planning for the future

The goal of structural therapy is to help the family unit reorganize how they interact to create a more cohesive unit that can adapt to changes together.

Strategic Family Therapy (SFT)

Strategic Family Therapy (SFT) is a short-term family therapy commonly used for families that include children struggling with behavioral issues. SFT is based on the idea that the family unit fulfills the most important role in the development of a child.

Key concepts of strategic family therapy include the idea that there is a connection between all family members, and each member’s habits impact everyone else.

Techniques applied in SFT include:

  • Joining – Creating a therapeutic alliance between the family and the therapist
  • Tracking – The therapist learns more about the family’s patterns and problems
  • Restructuring – A variety of techniques for changing the dysfunctional ways family members interact

The goal of Strategic Family Therapy is to address dysfunctional interactions and behaviors. Therapists help children overcome whatever challenges they’re experiencing.

Narrative Therapy

Narrative Therapy is one of the most well-known family therapy techniques. Narrative Therapy focuses on the stories you tell yourself and carry throughout your life. These stories influence the way you see yourself and the world.

Key concepts of Narrative Therapy are viewing the person and their problem separately and taking apart storylines.

Techniques applied during narrative therapy include:

  • Telling Your Story – Putting your narrative together
  • Externalization – Separating people from their problems
  • Deconstruction – Breaking the narrative down into smaller, more approachable parts
  • Unique Outcomes – Challenging the narrative to consider alternative stories

The goal of Narrative Therapy is to help people find and use their voices. Becoming an expert in their own life empowers people to live more authentically.

Solution-Focused Brief Therapy (SFBT)

Solution-focused Brief Therapy is one of the world’s most widely used family therapy techniques. This short approach respects the client’s wisdom to know what is best for their life. SFBT is used as a stand-alone treatment or combined with other therapy styles.

Goal setting is the key concept in SFBT. As a solution-focused approach, clients are encouraged to find solutions in the “exceptions.” An example is when a child with behavioral issues responds appropriately.

The most impactful technique used in SFBT is asking the “miracle question.” The therapist asks the client to describe life if a miracle occurred overnight that solved their problem. They then ask more questions to try to lead the client to solutions.

SFBT aims to help the client find their own solutions quickly.

Emotionally Focused Therapy (EFT)

Emotionally Focused Therapy views family conflict as hurtful interactions resulting from the desire to be close. Therapists specializing in EFT don’t believe poor communication or poor parenting is the major cause of struggle. Instead, family members struggle because they don’t feel their bond is secure.

Key concepts of EFT include:

  • Understanding negative cycles
  • Strengthening listening skills
  • Helping children connect with their parents

The goals of EFT include reframing family distress and meeting attachment needs.

Cognitive-Behavioral Family Therapy (CBFT)

Cognitive-behavioral Family Therapy is a popular treatment approach focusing on current thoughts and behaviors, not the past. CBFT helps clients recognize how negative thought patterns influence their behavior while giving them tools to adopt more positive thinking and behavior.

Techniques used in CBFT include:

  • Psychoeducation – Explaining the role that thoughts and emotions play in behavior
  • Cognitive Restructuring – Identifying unhelpful thoughts so they can be modified
  • Behavioral Activation – Encouraging the family to take part in rewarding activities together
  • Communication Skills Training – Teaching skills such as assertiveness, active listening, and conflict resolution
  • Problem-Solving Training – Teaching family members how to identify problems and find solutions
  • Relaxation Techniques – Showing the family techniques that can help reduce stress and anxiety
  • Exposure and Response Prevention – Exposing family members to what they fear while keeping them engaged

Cognitive-behavioral family therapy aims to lower conflict and increase family bonds.

Bowenian Family Systems Therapy

Bowenian Family Systems Therapy is one of the lesser-known family therapy techniques. Psychiatrist Murray Bowen developed this approach, suggesting problematic behavior patterns are passed down through generations.

Techniques applied in Bowenian Family Systems Therapy include:

  • Genograms – Visual mapping of family history and behavioral information
  • Differentiating Emotions – Helping family members see their emotions within the family unit
  • I-Statements – A communication technique that highlights the needs of the speaker
  • Triangles – A symbol of family stability that helps to create support and healthy balance
  • Intergenerational Patterns –Identifying persistent patterns between generations
  • Normalizing Challenges – Preparing clients to face future challenges outside of therapy

The main goal of Bowenian Family Therapy is to break harmful patterns and develop healthy individuality among family members.

Paying for Treatment

Before making an appointment, most people want to know if family therapy covered by insurance. In most cases, the answer is yes. Most major insurance providers are required by law to provide at least some coverage for mental health services. Factors that affect your insurance coverage include your area, which services you’re receiving, and your individual insurance policy.

Coverage amounts are higher for in-network providers, which are therapists or clinics that accept payment from your insurer. Having out-of-network insurance does not automatically disqualify you from seeing the therapist of your choice, but your out-of-pocket expenses may be higher.

Verifying your insurance coverage is simple. Most providers will verify your policy for free if you ask. For more information, call your insurance agent or the office of the counselor you’re considering seeing.

If you don’t have insurance for family therapy, some clinics provide sliding scale fees and lower rates for families with lower incomes. You might also be eligible for an employee assistance program. Asking the therapist’s office or your employer about these benefits.

Finding the Right Family Therapist

Effective therapy begins with finding the right therapist for your family. Remember that even a highly skilled and recommended therapist may not be right for your family.

Tips for finding a mental health professional include:

  • Consider credentials and specializations
  • Ask friends for recommendations
  • Ask your doctor for a referral
  • Research and interview potential therapists
  • Assess candidates for compatibility and their therapeutic approach

Don’t discount therapy if the first therapist you meet with isn’t a good fit. The right help for you is out there.

All Counseling makes finding a family therapist who will understand your family’s needs easy. Visit our therapist directory to find a family therapist to fit your needs.