Family Therapy

What is family therapy?

Family therapy is a form of treatment that involves all members of the family rather than working with one person alone. It helps the whole family to make changes. Often mental health problems are hard to change without support from the family. Many child and teenage problems improve a great deal when the family changes how they deal with the child.

By improving family relations, emotional or behavioral problems are also improved. In therapy the family will:

• Join in the treatment sessions.
• Seek to understand what family behaviors may help or hinder their child.
• Learn different family behaviors that will help the child to make positive changes.

Family therapy may be the best treatment when a child or teen:

• Is aggressive or defiant.
• Has an eating disorder such as anorexia or bulimia.
• Has a medical problem which is worsened by psychological factors For example, children with asthma or diabetes often have worse physical symptoms when they feel stressed or in conflict with members of their family.
• Is abusing drugs or alcohol.
• Is struggling to adjust to a family change such as a divorce, death in the family, or family move.

How does family therapy work?

Each family is a whole unit, which is more than simply the people who make up the family. The whole family has a system of behaviors and rules that they use with each other. What affects one family member affects other family members. The family system of behaviors and rules have become habits that family members may not think about, but they keep acting on them. Most of the family's behaviors may be healthy, but some may need to change for a child to get better. The family therapist first helps the family understand patterns of what they say and do. Then the therapist helps them to change patterns that may be causing problems.

The therapist will start by observing the family. The therapist will watch as they talk about their interactions and recent family events. As therapy progresses, the therapist will begin to point out or question patterns of good and bad interaction. For example, in a family with a defiant teenage boy the therapist might notice that the teen argues with his mother over schoolwork, but not with his father. The therapist might suggest that mother and son show how they usually act and talk about schoolwork during the session.

As therapy progresses the therapist will probably give the family homework to try between sessions. The homework may help them understand patterns. Sometimes homework helps the family practice new patterns. For example, in the family with the defiant teenager the therapist might:

• Have the father supervise schoolwork for a week to see what happens.
• Ask mother and son to practice new ways of talking about schoolwork at home for 2 weeks.

What happens during family therapy sessions?

For each session the therapist will ask to see all or some of the family members. At times the therapist may ask to just see the parents or just the children. Who is asked to attend may change based on what the issues are and who is most involved with them. With teenagers, having parents and siblings in the treatment sessions can be very powerful. With children younger than 11 or 12, the therapist may divide sessions into individual time with children and time with parents.

At the start of each session the therapist will check on what has happened around issues which are the focus of treatment.

Next the therapist will chose 1 or 2 things to focus on. These will be discussed. The therapist may ask family members to role play how they talk about things or how they behave at home.

The therapist will help the family understand the way they talk and act with each other. The family learns which behaviors are healthy and which are not.

The therapist will come up with a plan for the family to change those interactions which are not helpful. This may involve practice in the session or assigned homework to practice out in the real world.

What are the benefits?

• It focuses on the whole family not just one person.
• There is a chance to practice changing how family members act and talk to each other.
• Once family members understand how they interact, they can continue to make needed changes long after therapy is over.
• Many families see large improvements after 10 to 15 sessions.

How do I find a family therapist?

There are several resources you can use to find a family therapist. Ask questions and get referrals from people who you know and trust. The following people or organizations may help you begin the search for a competent therapist:

• Your family healthcare provider.
• Your clergyman, school teachers, or school counselors.
• Friends or family members who have been in therapy.
• Your employee assistance program (EAP) at work.
• Community mental health or human service agencies.
• The Yellow Pages of your telephone directory.

Written by Gayle Zieman, PhD, for RelayHealth.
Published by RelayHealth.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.