What Is Family Therapy?
Family psychotherapy is a specific type of group therapy where all of the clients in the therapeutic situation are related and treated by at least one therapist. According to one of the classic works on family therapy, Family Therapy in Clinical Practice, family therapy is often identified by a number of different names that actually describe the relationships that the individual members and the group have, such as marital therapy (marital couples), couples therapy (partners that may or may not be married), systems therapy (where typically family members who live together are part of the group), and several others.
Therapists delivering family therapy can have backgrounds in any of the major therapeutic schools of psychology, including Cognitive Behavioral Therapy, psychodynamic therapy, humanistic therapy, or any subtypes of these.
The Goals and Principles of Family Therapy
As a formal form of therapy, the different types of family therapy attempt to understand and identify how the particular family or relationship structure affects whatever issue is being treated. For instance, when applying family therapy to substance use disorders, it is well known that the family structure often affects individuals in the family who have substance use disorders, and an individuals in a family unit that has a substance use disorder can affect the structure and processes occurring in the family. The ultimate goal of a family therapist is to strengthen the relationships in the family system, identify and realign power structures so there is more of an equitable distribution of power, understand and foster the relationship of the communication system and the family, and address other problems that lead to the family being unbalanced or in distress.
In order to accomplish the above goals, the family therapist will try and understand the family unit as both a single entity and a group that is composed of different individuals.
Using this type of approach, there are a number of basic assumptions that family therapists from different psychotherapy paradigms share.
- The different members in a family system represent separate individuals who exist independently and also exist as part of the family unit. This means that personal experience can contribute or take away from the coherence of the family.
- The family itself is a separate and identifiable entity (that is obviously composed of different individuals).
- Issues occurring to any single person in the family unit not only affect them but can also influence the family, and issues affecting the family will often differentially affect each family member.
- Some issues can affect the family system and its members in a negative fashion and may lead to disequilibrium in the family or the development of dysfunctional relationships in the family. The possible effects of such dysfunctional relationships can include:
- Some members of the family isolating themselves from the family unit
- Individuals in the family beginning to distrust one another
- Certain members of the family being dishonest with other family members
- Family members keeping secrets from each other
- Other members of the family forming alliances with one another against family members
- Some family members trying to take control of the entire situation
Any of these issues can result in the family unit being unbalanced and unable to be a source of nurturing relationships and support for its members. For instance, individuals with substance use disorders may induce an element of tension in the family unit that can result in severe stress, members of the family aligning against the person, the person not being honest with the rest of the family, and others trying to control the situation or isolate themselves from it. This can lead to a number of issues with stress, anxiety, depression, and other psychological issues in the members of the family and may result in exacerbating the individual’s substance use disorder or the development of substance use disorders in others.
A family therapist would attempt to restore balance in the family and get family members to work on the issue together. The therapeutic process results in the family learning strategies that are rational and functional to address the particular issues.
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The Advantages of Family Therapy
Family therapy has been empirically demonstrated to be effective in the treatment of a number of issues that are traditionally thought of as best addressed in individual therapy, such as the treatment of family members who have substance use disorders, eating disorders, and personality disorders. Family therapy has also been shown to be effective at helping the family to participate in the treatment of individuals with very severe psychopathology, such as schizophrenia. Although the standard primary treatment for schizophrenia remains the administration of medications for the individual, family therapy can help family members to adjust to the individual’s disorder and learn to better communicate with the person and foster positive emotional experiences.
Family therapists attempt to improve the problem-solving skills of family members and the family unit, concentrate on honest communication and acceptance between family members, help the family learn how the personal actions of its members affect the family unit, and educate members on how the family unit itself affects individual members.
Several of the recognized benefits of family therapy include:
- Helping families with members who have experienced a crisis or families that have experienced a crisis as a unit (e.g., the death of the important family member) come together and address the situation
- Working on developing honesty and trust in family members who have historically not trusted one another
- Helping families address issues with stress and tension that disrupt the family’s functioning and efficiency
- Developing a supportive family environment in cases where there was little support among family members and the relationships are characterized by isolation and apathy
- Working on acceptance and forgiveness
- Resolving conflicts that occur between family members that disrupt the family unit and have been ongoing
Even though family therapists spend a great deal of time explaining how individual relationships affect the overall family unit and how the overall family unit can affect individual relationships, family therapy is not simply a method of tutoring or instructing individuals on psychological principles.
Several misconceptions regarding family therapy have existed for quite some time. These include that family therapy is primarily designed for couples or married individuals, is most useful for parents who have children with behavioral problems, typically blames parents for the actions of their children due to unsound parental practices, or is not effective if not all members of the family are involved in it. All of these represent misconceptions regarding family therapy, and none of them are true. Perhaps the biggest misconception is that individuals involved in family therapy are often assigned blame for whatever problems exist. Competent therapists attempt to foster nurturing relationships where individuals accept reality and forgive issues that deal with past resentments. Depending on the paradigm the therapist uses, family therapists have a number of different empirically validated approaches to assist both the family as a unit and its individual members.
It is not unusual for individuals to attend both individual therapy to focus on their own specific problems and to attend group therapy to benefit from interactions in a group setting. Similarly, it is not uncommon for individuals with specific types of problems, such as substance use disorders, eating disorders, issues with depression, etc., to attend individual therapy sessions that focus on their issues specifically and for them to be involved in family therapy that helps the individual adjust with the family unit to whatever issues are present. However, family therapy can also be the major form of treatment without participation in individual therapy for individuals with a number of different issues, including substance abuse, eating disorders, and other behavioral issues.
Thus, family therapy is useful in addressing a number of specific issues that affect relationships within the family unit as well as specific aspects of individual behavior.
Much of the recent research regarding family therapy has indicated that it can be extremely useful in addressing individuals who have issues with substance abuse, and it is a viable alternative to other forms of group therapy.
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