Family therapy is a branch of psychotherapy focused on relationships and understanding individuals within their larger family and environmental systems. It focuses on both relationships between family members and couples, helping to reduce conflict and distress between groups of people. In family therapy, the counseling is less about viewing conflicts residing in the person and more about the patterns or symptoms that can be improved within the group. It provides a way of thinking in systematic, relational terms, and gives people a set of strategies for changing their interactions and relationships. There are a range of family counseling techniques under the umbrella of family therapy that have proven to be successful. The following are the most popular types of therapy and family counseling:
- Structural therapy
- Strategic therapy
- Systemic therapy
- Narrative therapy
- Transgenerational therapy
- Communication theory
- Relationship/Marriage Counseling
Structural Family Therapy
Structural family therapy works to understand how individuals within the group interact with spouses, parents, children, and other family members. It’s essentially an unpacking of the “matrix of identity.” Recognizing the structure of the unit—the hierarchies, sub-relationships, and boundaries—can help to strengthen the family. Once the structure is established, the counselors can begin to understand where changes and what types of family counseling services will help restructure the family in a positive way.
Strategic Family Therapy
Strategic family therapy is a type of family counseling that looks at patterns of interactions between family members. Strategic behavioral therapy is solution-based, and is about identifying solvable problems, setting goals and creating strategies to achieve them. When a therapist provides family counseling services, he or she is not particularly concerned with the history and evolution of a problem within the family unit, but is more concerned with helping individuals think strategically and execute solutions to deal with them.
Systemic Family Therapy
Systemic family therapy focuses on belief systems. Family members’ perceptions and socio-cultural beliefs play an important role in the family dynamic. The wider cultural context can create change in behavioral patterns and a systemic family therapist promotes family level solutions instead of perceiving something as an individual’s problem. Systemic therapy can be broken down into five parts:
- Deconstructing the problem
- Identifying patterns and feedback loops
- Beliefs and explanations
- Emotions and attachments
- Contextual factors
At its core, Systems Theory is a type of family counseling that believes the behavior of a system can only be understood by considering individual characteristics within it, and the relationship between those elements. Any problem is not specific to the individual, but part of a larger process involving many other people, behaviors, and meanings.
Narrative Family Therapy
Narrative family therapy assumes that all people are storytellers, each with their own individual narratives about how things are. Throughout the course of life, personal experiences become personal stories, and people give meaning to these stories—ultimately, they shape a person’s identity. Narrative therapy is a type of family counseling services that helps separate the person from the problem. It helps people rely on their own skills to view problems objectively, instead of through the lens of the narrative they have built up. As the narrator of their individual story, each person has the capacity to rewrite it. Teaching a person how to make room for other stories and framing the problems within the larger sociocultural context empowers them to objectify their problems.
To understand problems within the family, oftentimes it is important to first study the transgenerational history of the family. This mechanism works to understand past difficulties, which in turn allows the therapist and patient to predict future conflict. If the family has responded to past problems in a certain way, it can provide insight into predicting future dysfunction. It’s a type of family counseling that considers generational reactions and how they differ. This can be how kids react differently than their parents, for example, or how couples of different generations react differently.
Communication must play a central role in the modern family. This should come as no surprise, seeing that conflict resolution usually relies heavily upon open communication. This type of therapy works by strengthening the way in which a family communicates, developing new skills, strategies, and perspectives that allow them to solve their problems.
This approach to family counseling allows those with mental health problems to better understand their condition. In doing so, the therapist can equip them with tools to mitigate symptoms, control their behavior, and ultimately function better within the family unit. Additionally, the family is given the same tools in handling their loved one who has a mental illness. People who have been diagnosed with mental health conditions (or life threatening/terminal illnesses) need to better understand their own condition, and they need a strong support system around them. Psychoeducation has four primary goals:
- Open exchange of information among the family
- Medication and treatment support
- Training and self-help support
- Providing a safe place for discussion
Even minor everyday problems and stressors can make their way into relationships. Some types of issues that can be addressed by relationship counseling include: communication, differences in culture, mental health, infidelity, sexual intimacy, financial struggles, emotional distancing, and a general lack of trust. Once a couple decides to come together and acknowledge one or more of these issues, they can begin the process of finding the right therapist to help them move forward and strengthen their bond.
Family Therapy Tactics
Now that you understand the various forms of family therapy, what type of tactics are commonly used within this branch of psychotherapy? Usually, a therapist will use most—if not all—of the below:
- Reflective listening
- Perspective taking
- Collecting data
- Hope and reinforcement
- Authenticity and flexibility
In providing family counseling resources and services, a therapist will often look to pinpoint the strengths of individuals within the group. This strength-based approach not only builds goodwill and sets a positive tone for the sessions, it ultimately motives family members to address their most pressing issues. Therapists view the family from multiple lenses (within the family, peers, school, neighborhood/community) looking for strengths. To develop treatment goals, it is important for family therapists to establish the strengths of the family unit and the individuals within it. Therapists work to appraise each family member’s abilities and use their strengths to accomplish tasks, while simultaneously working to develop additional strengths needed to attain treatment goals.
Reflective listening is a basic clinical tactic used in family counseling that demonstrates the therapist is registering what an individual is saying. It can be as simple as regurgitating back to an individual what he or she just said verbatim, but can also just be a reflection of the sentiment to communicate understanding. Reflective responses are especially important in the beginning phases of family counseling services. As new patients share their thoughts and feelings, it conveys that the therapist appreciates what the individual and the family are going through and leads to productive sessions in the future. It is an important trust-building exercise within the treatment process.
Perspective taking is when the therapist will try to view problems from the family member’s viewpoint. They will work with the family member and ask them to recall a time or incident that produced negativity. Then the therapist will view the “negative” incident from the person’s point of view to understand the client’s feelings.
Collecting data is a basic practice of family counseling in which the therapist records the thoughts of the family members. It is a way of building evidence in order to refute negative attributions. For example, a therapist will need to record a thought (e.g. “The father doesn’t care about his daughter”) in order to work towards breaking this notion down. The therapist will then put together a list of behaviors that can help spark change. Once evidence has been established, the therapist can begin working with the family to disconfirm negative evidence. Opposite action is another strategy often used by family counseling professionals. First, the therapist records the original behavior and then elicits emotions that are opposing to that behavior. For example, a person who is feeling sad might watch a frightening movie, which will induce physical sensations that are incongruent with sadness. It’s a common-sense approach to combating negative feelings but it can be helpful. Replacing negative and stress inducing thoughts with their counterparts, especially when practiced over time, can yield great results for individuals.
Hope and Reinforcement
By the time a family makes their way into family counseling, they have likely already been told repeatedly by themselves, friends, and even other professionals how bad things have become. It is critical for the therapist to immediately counter this narrative and work towards a more optimistic outlook of the family unit. To motivate the family to change they must feel hopeful and energized. No matter the case, therapists will work to infuse positive and optimism in every stage of therapy. Simply showing up is reason alone for hope. A family therapist will often laud members of the family for being there and being present in sessions. Regardless of what ideas are exchanged or what progress is made, by making time to sit with one another the members of the family or the couple are committing to the group—the therapist highlights this, which becomes a tactic in itself.
Family members often view each other in a negative light. Reframing is shifting the perspective between family members, hoping to transform that negativity into positivity. Generally, it involves two stages: First, the therapist validates the perspectives of the family members. This is an important first step and must be applied universally so all parties know that their side of the story is being received. For example, the therapist might say to the daughter, “I understand why you get upset with your mom. She criticizes the people you hang out with and the way you dress. I understand why you think she is too protective and won’t give you the space you need.” To the mother, the therapist might say, “You do your best to give her moral values and respect, but the way she dresses is clearly her lashing out at you specifically.” Once the perspectives have been validated, the therapist can move on to stage two: alternate perspectives. The therapist will show how benign the issues are by reframing the perspectives. From there the family members can start to see the other’s side in a positive light. Perhaps the underlying reason the daughter feels like her mom is nagging her is just a sign of her love. Also, perhaps the daughter is only dressing differently to establish independence, which is totally normal for a girl her age. While this is a hypothetical, this is how these situations are typically explored. Authenticity and Flexibility A good family counselor will be authentic and flexible; working with a variety of families necessitates them to be. They have to be honest and consistent and they have to accommodate the entire family’s needs. It’s important for each family to find the professional that best fits their needs and can demonstrate the needed authenticity and flexibility.
Family Therapy and Recovery
Family therapy plays an important role in recovery. It’s no surprise that an addict’s behavior and struggles affect the well-being of their loved ones. By coming together as a unit, discussing the situation at hand and learning ways to cope, the family itself can become an even stronger support group for the addict in question. In most forms of treatment, addiction specialists will encourage the patient and their family to enroll in family therapy interventions, as it can be extremely beneficial for the healing process.
A Final Word
Family therapy takes many different forms but generally it works towards the same goal; to understand individuals within their family unit and to strengthen that system. It’s a fantastic tool for struggling couples, families, and those dealing with a loved one suffering from addiction or substance abuse. To that end, if you’re curious about family therapy, reach out to Apex Recovery to speak to their specialists, as they can provide family therapists that have a large wealth of experience! Sources:
- US National Library of Medicine. Collaboration in Family Therapy. Jul, 2015.
- American Psychological Association. Family Therapy: Theory and Practice. 1976.
- Journal of Marital and Family Therapy. Addendum To: the Profession of Couple, Marital, and Family Therapy. Jan, 2019
- Encyclopedia of Couple and Family Therapy. Applied Behavior Analysis in Family Therapy. Nov, 2014.