Family therapy may be a term that you are familiar with, or it may be new to you. But just what is family therapy?
Family therapy is a therapeutic approach that is based on systemic thinking. That is, it views individuals as an integrated part of their family system. The central premise of family therapy is that problems and challenges faced by individuals cannot be fully understood or addressed in isolation, but are best understood within the context of their relationships. As a therapeutic approach, family therapy aims to understand family dynamics and build healthy interactions within family systems, rather than to focus on the struggles of individual family members.
There are many different theoretical models of family therapy.
Below is a short description of three well known models.
Structural Family Therapy concerns itself with changing the ‘structure’ of a family, that is, with changing the patterns of interactions, roles, and boundaries that shape the family system. This aim stems from a belief that individual problems are maintained by dysfunctional family structures, and that when family structures change, the life of each individual member also changes. An example of dysfunctional structures might include overly rigid interpersonal boundaries (which limit the amount of contact with outside systems, as well as limit opportunities for warmth and nurturance with others in the family) or overly diffuse interpersonal boundaries (which could result in over involvement between parent(s) and a child and an inappropriate intrusion into one another’s world). An aim in therapy can be to support family members to develop a balance between diffuse and rigid boundaries, thus creating healthy and clear ‘rules’ for members about who participates in interactions and how.
Narrative Therapy is based on the premise that life is complicated, and that we develop ways to explain it. Our explanations, the stories we tell ourselves, organise our experience and shape our behaviour. Our stories have a powerful influence upon our lives in that we tend to notice only those things that fit with our dominant story. Contradictions to our story, even if they represent a desired event or outcome tend to go unnoticed. For example, if parents have subscribed to the popular representation of teenagers as wild and rebellious, and if they believe their own teenagers are difficult, messy and unappreciative, those are the behaviours they are more likely to notice and remember. An important aim in therapy is to transform negative narratives by highlighting exceptions to the dominant story, thus paving the way for new, more hopeful narratives and behaviours to evolve.
Milan Systemic Family Therapy views the family as an interconnected system and recognises that individual emotions and behaviours are deeply influenced by the family’s communication patterns and dynamics. An aim of therapy is to interrupt the unseen patterns of control between family members. This is achieved by having conversations with family members in the presence of each other to allow for the introduction of new information into the family system. These conversations also aim to challenge erroneous beliefs, and help families to reframe their understandings or assumptions about why individual members behave as they do.
Despite some significant differences, all schools of family therapy tend to have in common a belief that, regardless of the origin of the problem, and regardless of whether family members consider it an ‘individual’ or ‘family’ issue, there is great benefit in involving families in finding their own solutions. And given that the solutions often come from the ideas, wisdom, and strengths of the family members themselves, family therapy is often able to facilitate lasting changes that benefit all members of the family system.
What can I expect if I decide to attend a family therapy appointment?
It is likely that all members of the family will be asked to attend an initial family therapy appointment. This is an important opportunity for everyone to hear each other’s concerns, and to be able to voice their own worries and understandings. Given that there are generally more voices to be heard there will often be extra time allowed for this session.
You can expect to leave the session with a richer understanding of how the other members of your family are thinking and feeling about some of the significant things that are happening for you all. With access to this new information it is likely that you will not feel as ‘stuck’ as you did when you arrived. Information from this session will then guide how future appointments will unfold.
Who is family therapy suitable for?
While family therapy can benefit any families that are struggling with relational challenges, it can be particularly effective when working with parents and children or adolescents. Families will often be referred for family therapy even though only one or two members are having a particularly difficult time. If someone recommends that you give family therapy a try it is not necessarily because they are thinking that ‘the family’ are contributing to the problem, but rather it can be a recognition that the family are likely to play an important role in finding the right solutions.
- Minuchin, S & Nichols, M.P. (1993) Family healing: Strategies for hope and understanding. New York: the Free Press
- Nichols, M.P. &Schwartz, R.C. (2001). Family therapy: Concepts and methods. Needham Heights: M.A. Allyn and Bacon.
- White, M & Epston, D. (1990). Narrative means to therapeutic ends. New York: W.W. Norton & Co.
Heather is a warm and friendly therapist with over three decades of experience working with children, young people, couples, and families. Her desire to understand each individual's unique story serves as the cornerstone of her therapeutic relationships and informs the subsequent therapeutic journey. As a family and systemic therapist, Heather's primary focus is to provide support to children and young people within the context of their family relationships. She is also committed to fostering positive collaborations with other parties, such as medical practitioners and school teams, when appropriate.