What is family therapy?
You may have heard of family therapy, but unsure of what exactly it is or how it is different from individual therapy. In short, family therapy is a type of family that involves multiple family members, as opposed to one individual. Families are unique, complex systems, and the delicate balance that exists within families depends on the interactions between members.
Parents, children, grandparents, stepparents, step siblings, and extended family may all be part of the family unit. Within families, everyone’s individual beliefs, thoughts, and emotions vary. The behavior of each family member impacts the other individuals in the family and the entire family system. Family therapists acknowledge the importance of understanding the balance of a family system as a whole, as well as each individual within the system. In family therapy, families attend sessions together with the same therapist and the family as a whole is considered the client.
How do I know if my family would benefit from therapy?
Life in New York City can be rewarding and dynamic, and it can also be challenging and overwhelming. No one is immune to life’s stressors and challenges, and everyone needs support from time to time. When one family member is experiencing unusually high levels of stress, emotional distress, or behavioral challenges, it can strain the family unit as a whole.
Family rhythms and routines may also be impacted by transitions, such as a move, change in financial situation, divorce, or remarriage. When children are experiencing challenges in school, or a family member has been diagnosed with a mental health condition, family members may feel unsure how to support their loved ones and cope with stress.
Moreover, challenges with communication may contribute to stress felt by family members with a mental health disorder (Dattilio & Epstein, 2005). Family therapy can help families understand how to better support members who are struggling with a mental health disorder. If you are noticing that your family has been struggling with problem solving, communication, a new health or mental health diagnosis, or are experiencing a new stressor or challenge, family therapy may be an avenue for support.
What issues can family therapy help treat?
Family therapy can help resolve conflicts that arise between family members and help families cope with stressors, such as long-term illness or shift in dynamics. It can be helpful to address problems from a systems perspective because each family member’s behavior influences the other members, as well as the system as a whole. Issues such as ongoing conflict, communication challenges, changes in family structure, and transitions can all be addressed.
Family therapy can help with school refusal behaviors and obsessive-compulsive disorder in children (Carr, 2019). Studies have also found that family therapy can be an effective treatment for depression in early adolescents and children (Trowell et al., 2007), and that children with anxiety disorders showed improvement when families were involved in treatment (de Groot et al., 2007). One study found support for family-based treatment of adolescent anorexia (Le Grange et al., 2015). In addition, research has shown support for family interventions that are aimed at treating child and adolescent behavioral challenges.
For children and adolescents with behavioral challenges, family therapy can have long-lasting positive impacts, even following treatment (von Sydow et al., 2013). Family therapy can also provide parent training and skill development. Several parent management training programs exist to provide parents with skills for supporting children with various mental health diagnoses. These programs focus on training parents, though children may attend some sessions (Reichenberg & Seligman, 2016).
Parent training interventions can be effective for children who have been diagnosed with autism spectrum disorder or attention-deficit hyperactivity disorder (Reichenberg & Seligman, 2016). Research has also shown positive impacts of family therapy for adolescents who exhibit behavioral challenges, such as delinquent behavior or substance use. (Robbins et al., 2003).
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What will happen during family therapy?
Your therapist will work with you and your family to build on existing strengths and work toward shared goals. The therapist will conduct an assessment to identify any areas that are causing individual distress or issues that are negatively impacting the overall family system. Individual and family goals will be established.
Sessions may vary in which family members attend. For example, sessions may include all identified participating family members, or family members may meet with their therapist in smaller groups or individually. Patterns of communication and behavior will be explored and the therapist will work with family members to build insight and gain new skills.
Treatment progress will be assessed both on the individual level and the family level. During the course of treatment, communication and problem-solving skills can be improved in order to facilitate change to the family system and establish more adaptive patterns of behavior. This will allow your family to solve problems in the here and now, as well as to cope with future challenges. Research supports working on problem-solving and communication skills for improving functioning in couples and families (Dattilio & Epstein, 2005).
How long does family therapy last?
Just as all families are unique, the duration of family therapy will be specific to each family. Family therapy is generally short-term. However, treatment may be longer based on the issues at hand.
For example, a family with multiple challenges or with family members who present with complex issues may require a longer course of treatment. Together with your family, your therapist will conduct an assessment of the current situation, develop individual and family goals, and discuss a treatment plan, including the expected duration of treatment.
How can I find a family therapist in NYC?
Many different therapists provide family therapy. Marriage and family therapists (LMFTs), psychologists (Ph.D. or Psy.D.), clinical social workers (LCSWs), and mental health counselors (LMHCs) may all provide family therapy. You can find a family therapist by asking your primary care doctor or child’s school for a referral, or by searching online.
The techniques each therapist uses will differ based on their therapeutic orientation and approach, so it can be helpful to speak with a therapist about their practice. As therapists understand the importance of a good fit in order for therapy to be successful, many therapists offer a free consultation where you can learn more about their approach and see if they will meet your family’s needs.
What techniques will a NYBH therapist use in family therapy?
Therapists at NYBH utilize a variety of techniques in therapy and will personalize treatment to fit your family. Therapists may provide coaching about how to improve communication skills, such as developing active listening and how to communicate feelings effectively and empathically. They may provide family members with psychoeducation, or information and education about various mental illnesses or psychological problems that impact the family system.
Families may engage in role plays, which can help to practice new skills and build insight into how one person’s behavior influences the family unit and individual members. Cognitive restructuring, a technique that teaches individuals how to challenge and change unhelpful thought patterns, may be used. Family members will be provided with homework between sessions, which may include things like journaling, maintaining a thought record, or rehearsing new skills. If you are interested in learning more about family therapy at NYBH, reach out for a free consultation today.
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References
Carr, A. (2019). Family therapy and systemic interventions for child‐focused problems: The current evidence base. Journal of Family Therapy, 41(2), 153–213. https://doi.org/10.1111/1467-6427.12226
Dattilio, F. M., & Epstein, N. B. (2005). Introduction to the special section: The role of cognitive-behavioral interventions in couple and family therapy. Journal of Marital and Family Therapy, 31(1), 7–13. https://doi.org/10.1111/j.1752-0606.2005.tb01539.x
de Groot, J., Cobham, V., Leong, J., & McDermott, B. (2007). Individual versus group family-focused cognitive-behaviour therapy for childhood anxiety: Pilot randomized controlled trial. The Australian and New Zealand Journal of Psychiatry, 41(12), 990–997.
Le Grange, D., Lock, J., Agras, W. S., Bryson, S. W., & Jo, B. (2015). Randomized clinical trial of family-based treatment and cognitive-behavioral therapy for adolescent bulimia nervosa. Journal of the American Academy of Child and Adolescent Psychiatry, 54(11), 886–94.e2.
Reichenberg, L. W. & Seligman (2016) Selecting effective treatments: A comprehensive, systemic guide to treating mental disorders. Wiley.
Robbins, M. S., Turner, C. W., Alexander, J. F., & Perez, G. A. (2003). Alliance and dropout in family therapy for adolescents with behavior problems: Individual and systemic effects. Journal of Family Psychology, 17(4), 534–544. https://doi.org/10.1037/0893-3200.17.4.534
Trowell, J., Joffe, I., Campbell, J., Clemente, C., Almqvist, F., Soininen, M., Koskenranta-Aalto, U., Weintraub, S., Kolaitis, G., Tomaras, V., Anastasopoulos, D., Grayson, K., Barnes, J., & Tsiantis, J. (2007). Childhood depression: A place for psychotherapy. An outcome study comparing individual psychodynamic psychotherapy and family therapy. European Child & Adolescent Psychiatry, 16(3), 157–167. https://doi.org/10.1007/s00787-006-0584-x
von Sydow, K., Retzlaff, R., Beher, S., Haun, M. W., & Schweitzer, J. (2013). The efficacy of systemic therapy for childhood and adolescent externalizing disorders: A systematic review of 47 RCT. Family Process, 52(4), 576–618. https://doi.org/10.1111/famp.12047
