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Family Therapy for Addiction & Mental Health: Types of Family Counseling

Two women learning about types of family therapy

Family therapy is a type of psychotherapy that focuses on relationships within the family and the larger environment. It aims to reduce conflict and distress by addressing the dynamics between family members and couples. Rather than focusing on individual conflicts, it emphasizes improving patterns and symptoms within the group. By adopting a systematic and relational approach, it provides strategies for changing interactions and relationships. Various successful family counseling techniques fall under the umbrella of a family therapy program.

Types of Therapy and Family Counseling

There are many different types of therapy used in addiction and mental heath treatment, and one of the forms of therapy used that focuses on relationships is family therapy. Below are some of the common forms of family therapy and counseling which may be used in the treatment of substance use and mental health issues:

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 then understand what changes and 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. In fact, 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, they are not particularly concerned with the history and evolution of a problem within the family unit. Instead, they are 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

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.

Transgenerational Therapy

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.

Communication Theory

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.

Relationship Counseling

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

Usually, a therapist will use most—if not all—of these tactics:

Identifying Strengths

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

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.

Perspective Taking

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

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. 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. 

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 toward a more optimistic outlook of the family unit. To motivate the family to change, they must feel hopeful and energized.


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. Once these 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 then start to see the other’s side in a positive light. 

Benefits of Family Therapy

Family therapy is one of a number of different types of therapy which can be beneficial in the treatment of addition and mental health issues. This is due to in part the recognition of how substance misuse not only impacts the individual but also the wider family unit and beyond. Below are some of the different benefits of family therapy and counseling:

  • Engagement of family in the recovery process.
  • Reduced risk of relapse.
  • Reduced stress levels.
  • Ability to set clear boundaries.
  • Codependency reduction.
  • Increased awareness of signs of relapse and addiction.
  • Improved communication.
  • Development of a strong support system.

Finding Family Therapy Near Me in Tennessee

Family therapy takes many different forms but generally it works toward 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. Contact Apex Recovery today at (877) 881-2689 to speak to our specialists. Once you do, our family therapists can ready to help you and your family.

Call Our Toll-Free Hotline 24/7 at 877.881.2689