At one time, the word “family” meant people related by blood, marriage, or adoption. Today the definition embraces the many close relationships that form the foundations of your life — whether you share DNA or a legal connection.
Because these relationships are so important to your physical and mental health, family therapy may be helpful in many situations that affect family relationships and dynamics.
Some examples include situations where you or someone you love is grappling with:
- financial problems
- marital issues
- communication breakdown
- conflict over one or more issues
- a big life transition
- a serious illness
- a mental health condition
- a substance use disorder
Here’s a look at what family therapy is, the techniques that are used, and what to expect if you decide to try family therapy.
The phrase “family therapy” implies that the members of a family seek counseling together as a group.
Though it helps if everyone in the family participates, family therapy doesn’t necessarily mean that your whole family must be involved.
It means that the therapy focuses on family interactions and dynamics.
Family therapy is generally short-term and focuses on specific goals. It explores the patterns, conflicts, and ways of communicating in your family system.
Family therapy may benefit you and your family by:
- improving communication skills
- providing skills for coping with challenging situations
- offering new insight and understanding
- identifying problem areas within the family
- providing strategies for handling conflict
- improving and strengthening relationships
Family therapy may be guided by one of the following evidence-based treatment approaches, or your therapist may blend elements from several different approaches.
Let’s take a closer look at the approaches most often used with family therapy.
Systemic family therapy
This therapy approach considers the family as a unit, in which each member’s actions affect the other people in the family and affect the family as a whole.
Therapy is aimed at understanding family processes, how they influence people, and how they change over time — with the goal of improving family interactions.
Structural family therapy
Developed by Salvador Minuchin in the 1960s, structural family therapy is based on the idea that emotional and behavioral concerns in children and teens are often connected to dysfunctional family structures.
Treatment focuses on understanding boundaries and subsystems within a family so that everyone can interact in more productive ways.
It also focuses on developing appropriate boundaries and strengthening the relationships among the family members.
Brief strategic family therapy
This approach to therapy is generally limited to around 12 sessions. The goal is to identify and restructure the family interactions that lead to the problematic behavior of a child, teen, or young adult.
The therapist will probably focus on strengthening positive patterns and making changes to family behaviors that aren’t helpful for a young person in crisis.
The therapist will also likely assign homework to assess and adjust the ways in which the family communicates.
Family therapy often includes opportunities to learn more about mental health conditions that are affecting family relationships, along with evidence-based treatments for these conditions.
Family therapies often share certain goals. These usually include:
- exploring how family members interact with one another
- identifying and improving any unhealthy communication patterns in the family system
- marshalling the family’s strengths and resources
- equipping the family with better problem-solving skills
Although each therapist has an individual style, here’s a basic idea of what family therapy could look like:
During the first meeting, you and your therapist will likely discuss the issue that brought you and your family members to therapy.
Your therapist will give each person an opportunity to talk about what they think are the main problems they or the family is facing and why.
For the next several sessions, your therapist will probably gather information from you to build up a picture of your family and how it works, including:
- your family history
- family roles
- parenting and discipline approaches
- coping skills your family has used
Your therapist will form an understanding of the crises your family weathered and how you dealt with them together and as individuals.
Your therapist may ask you to think and write about who has power in your family and how decisions are made.
If your therapist takes a strategic approach to family therapy, you may discuss how the problem that brought you to therapy serves a specific function in your family.
If your family used certain coping skills, you may be asked to think and talk about whether those strategies still work.
Mapping the family structure
If your therapist uses a structural approach, the next step might involve the therapist creating a map that explains your family’s hierarchy.
The map may help describe how authority and boundaries work in your family, including the ways that they may be changing over time.
Creating a treatment plan
Family therapists are generally more interested in solving problems than in assigning blame for them.
Working together, you and your therapist will likely discuss a plan that outlines what you — and any members of your family participating in therapy — can do to change unhealthy communication and problem-solving.
Your treatment plan may also involve looking at ways to boost your family’s special strengths.
Family therapy is generally provided by a mental health professional who has been specially trained in psychotherapy for couples or family systems.
Generally, family therapists have advanced degrees (master’s degree or PhD) in a mental health field focused on marriage and family therapy.
To become state-licensed, marriage and family therapists must complete a supervised clinical fellowship (usually 2 years).
Therapists who have a master’s degree must also complete a licensure exam conducted by the Association of Marital and Family Therapy Regulatory Boards.
On the other hand, the licensing exam for therapists with PhDs is conducted by the Association of State and Provincial Psychology Boards.
Finding the right therapist for you and your family is important for the success of your therapy. It’s OK to take your time, ask questions, check credentials, and even “interview” therapists to find a good fit.
Here are some things to consider:
- Is the therapist licensed in your state?
- Does the therapist have experience treating families with similar issues?
- Do you feel heard and supported in therapy sessions?
- If you have health insurance, is this therapist in your network?
- How close to your home or work is the therapist’s office?
- Does the therapist offer virtual mental health services?
You may be able to find a marriage and family therapist through the American Association for Marriage and Family Therapy.
Most individual, small group, and employer-provided health insurance plans offer mental health coverage.
If you have questions about whether your family therapist is an approved provider, you can speak with your plan administrator or contact your insurance provider directly.
Medicaid and Medicare plans also offer mental health coverage. If you’re covered under Medicaid, you can reach out to the Medicaid office in your state to get a better understanding of the guidelines for family therapy.
If you have original Medicare (Part A and Part B), you can contact Medicare to find out whether your family therapist is a Medicare-approved provider.
If you have Medicare Part C (Medicare Advantage), you’ll need to speak with your insurance provider for coverage details.
If you don’t have insurance coverage, you may be able to locate low cost family therapy in your area through the following resources:
Family therapy is a type of psychotherapy that focuses on family dynamics and building healthier interactions within family systems. It can be especially helpful if you or someone in your family has:
- relationship or financial issues
- marital problems
- a substance use disorder
- a mental health condition
Working with your therapist, you and your family members can identify patterns that may be problematic by exploring your family’s problem-solving skills, boundaries, authority structures, and communication habits.
Your therapist will then work with you on creating a plan that improves communication and problem-solving skills for your family.
Family therapy won’t necessarily resolve every conflict you and your family encounter, but it may help you develop healthier coping skills and more productive ways of communicating with each other.