How to Tell If It's Time to Consider Family Therapy

Toxic family dynamic? There are several different approaches to family therapy, but each is designed to allow everyone to work together.

Family Therapy
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Luckily, more and more people feel comfortable bringing up the idea of individual or couples therapy without fear of shame or judgment. Some folks (including celebs such as Harry Styles and Mindy Kaling) even talk about their own therapeutic process publicly on social media and in the news, creating a dent in the stigma that surrounds mental health and mental illness. While you may not be hearing people talk about family therapy as much as other forms of therapy, the practice has likely crossed your mind if you've ever analyzed your relationship with your parents or a sibling.

If you have questions about the process, or, heck, even just sat at one too many comfortable family dinner tables, read on for more info about family therapy, including who its best for and what you can expect to get from these sessions that might differ from other forms of therapy.

What Is Family Therapy?

Family therapy is exactly what it sounds like: therapy for families of all kinds. It is designed to address things that affect a family's psychological and emotional health, such as major life transitions, family stressors, mental health issues, or general communication issues. For example, maybe you're struggling to effectively communicate with your parents or want to understand how to best support a cousin who's experiencing depression. Family therapy can sometimes be the primary treatment modality and sometimes can be a complementary approach. For example, someone could be in weekly individual therapy but have family therapy one to two times per month to support the work that's going on in the individual sessions, and vice versa.

The goal of family therapy is to encourage collaboration and understanding throughout a family so that members can come together around whatever is going on in their lives. For example, suppose a college student is experiencing challenges at school and with friends. In that case, family therapy will focus on the family dynamics and patterns that may be contributing to these challenges rather than simply looking at the student's behavior. Once everyone involved is aware of the dynamics and patterns, the family can be proactive and come together to support this person in adjusting in a holistic way.

There are several types of family therapy, just like there are several different types of individual and couples therapy. Some therapists become experts in one of these modalities, and others become proficient in a few to integrate them into an eclectic approach. Some of the most common (and popular) types of family therapy are:

The goal of family therapy is to encourage collaboration and understanding throughout a family so that members can come together around whatever is going on in their lives. For example, suppose a college student is experiencing challenges at school and with friends. In that case, family therapy will focus on the family dynamics and patterns that may be contributing to these challenges rather than simply looking at the student's behavior. Once everyone involved is aware of the dynamics and patterns, the family can be proactive and come together to support this person in adjusting in a holistic way.

There are several types of family therapy, just like there are several different types of individual and couples therapy. Some therapists become experts in one of these modalities, and others become proficient in a few to integrate them into an eclectic approach.

Some of the most common (and popular) types of family therapy are:

Internal Family Systems Therapy

Created by psychologist Richard Schwarz, internal family systems therapy (IFS) focuses on healing the parts of each person that are wounded, restoring mental harmony so that once each person feels more aligned and at peace, the whole system (aka family) can be at peace. Make sure you find a therapist trained specifically in IFS, as it's an additional certification from what someone would learn in a typical graduate school program.

Functional Family Therapy (FFT)

Functional Family Therapy (FFT) is best used for "at-risk youth" who have been referred by some sort of system (juvenile justice, school, child welfare, etc.). This is typically a shorter-term form of family therapy and can sometimes be provided at school, home, child welfare facility, or even probation or parole site. Since this particular type of family therapy is so specific, it would most likely be recommended as treatment, not asked for specifically by the client or family.

Structural Family Therapy

Structural family therapy focuses on the system of the family — how the people in the family interact and how they can work to improve communication. Additionally, agreements, boundaries, and rules can be set to structurally shift the family dynamics and how the family functions.

Family Constellation Therapy

Family Constellation Therapy approaches treatment by drawing from a few different modalities, including family sculpting, systemic family therapy, Gestalt therapy, psychoanalysis, psychodynamic therapy, hypnotherapy, and Zulu beliefs. It's a therapeutic approach designed to help reveal the hidden dynamics in a family to address any stressors impacting them — and then heal them.

Strategic Family Therapy

"Strategic family therapy is a cross-cultural intervention designed for families with children or adolescents," according to Alisha Powel, Ph.D., L.C.S.W. "It addresses factors leading to family instability and dysfunction where the adolescent shows behavioral issues or has difficulty with emotional regulation. The focus is to improve the family dynamics that may actually be contributing to the unhealthy behaviors." It is strategic (hence the name), and aims to provide all family members with the skills to practice healthy communication.

Narrative Family Therapy

Narrative therapy focuses on the stories you've told yourself about your life, family, and experiences. Some narratives that you tell yourself are healthy and valuable, while others result in mental distress. According to narrative therapy theory, mental health symptoms can occur when there is an unhealthy, negative, or misunderstood narrative. Narrative therapy is not limited to family work; There are ways of using narrative therapy in individual, couples, and group work.

How to Know If You'd Benefit from Family Therapy

While some people and family situations will benefit more from specific types of therapeutic practice, as detailed above, most people can find value and growth in going to family therapy.

It can be helpful for most families to go to therapy simply because people are not often taught about effective and healthy communication in school, and therapy can be a great place to do that.

Additionally, it's tough to see your own patterns of behavior and how they interact with those you love, and a family therapist is trained to do that. So, if you're having conflict with a family member or see it happening amongst others, try therapy. And, if you're not having conflict yet, but want to preventatively build up a tool-kit for when stuff happens, family therapy is still a great idea.

In deciding whether individual, couples, or family therapy is best, don't put that burden on yourself — ask a therapist (or multiple). A good recommendation is to find three individual therapists, three couples therapists, and three family therapists and have free consultations with all of them. Let them know what's going on, what your hopes are for your work together, and let them know that you're not sure what type of therapy is best for the situation. They'll be able to ask questions to help you (and your family members) figure that out.

What to Expect from Family Therapy

What you can expect can vary greatly, based on the type of family therapy and provider. I would try to temper your expectations of the process and focus on showing up the best you can. Be real, honest, vulnerable, and supportive of your other family member(s), and listen to what the therapist recommends in terms of the process.

Your provider may want to meet with all of you every single session or could recommend alternating between family sessions and couples sessions. The number of sessions suggested will vary greatly depending on the presenting problem, the type of family therapy being utilized, what your goals are, and if insurance is being used. (Often, insurance only covers a certain number of sessions.)

Ideally, you want to find a therapist who is new to everyone in the family and has never worked with any of the members individually. They may be open to meeting with every person in the family individually or even talking to any other therapists treating members of the family to get context, but starting fresh together as a group may help everyone feel heard. It also helps avoid any confirmation bias on the side of the therapist if they currently work with one or more family members.

Just as with any other new and vulnerable venture, starting family therapy can be daunting. Try to focus on your why. Why do you want to go? What is the outcome you're looking for? What do you want relief from? What generational patterns do you want to break? Once you've figured that out, family therapy may help you iron out any issues you're facing with family members, or help you understand each other better.

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