By Ellen Braaten, PhD

Posted in: Grade School, Parenting Concerns, Teenagers, You & Your Family

Topics: Behavioral Issues, Relationships

Family therapy emphasizes the idea that a child lives and grows in relationship to others, particularly in relationship to members of his or her own family. There are many different family therapy approaches. They are too numerous to list here, but nearly all of them assume that the child’s “problem” doesn’t just reside with the child but is partially determined by variables in the larger family system. Unlike most other types of child therapies, which focus on the child as an individual, family therapy entails working with the entire family system to heal problematic relationships and to mobilize family resources to help both the child with the “presenting problem” and the family. One of the goals of this therapy is to help family members discover the role they play within the family’s social structure. Another objective is to help family members communicate better with one another and to learn new ways of preventing or resolving conflicts. This not only benefits the child who is symptomatic but also the rest of the family.

In family therapy, a child’s personality – how he thinks, feels, and acts – is viewed as the result of the complicated interactions and relationships within the family. Within the family system, there are subsystems, such as the marital subsystem (the mom and dad) and the sibling subsystem (the children). The way these systems interact can result in a family being balanced or not, but certain events and situations can cause even the best families to become imbalanced. For example, when Larry was in 3^rd grade, his dad lost his job. Larry’s parents started fighting constantly about money – to the point where Larry was too anxious to sleep at night. Within a few months, Larry started performing poorly at school and getting into fights on the school bus. While the initial referral was for Larry to receive therapy to help him with his aggressive behaviors, the therapist soon realized that Larry’s behavior was just a symptom of the stress within the family. Even after his father started working again, the family system failed to regain its stability. Poor communication strategies had developed, resentments had built up, and Larry’s behavior was disturbing to both his parents and his 12-year-old sister, who had recently started becoming truant from school. Family therapy was a place in which all these problems could be addressed simultaneously. While a therapist might be tempted to focus solely on Larry’s aggressive behavior and recent school failure, using this therapeutic process to address the communication problems between the parents, help the parents better address their child’s recent misbehaviors, and strengthen the family bond was a much more powerful way to help every member of the family.

Various types of mental health professionals can provide family therapy, but it is usually provided by therapists who have expertise in this area. They are often referred to as “Marriage and Family Therapists.” Many psychologists, psychiatrists, social workers, and other mental health experts have training in this area. Before engaging in treatment with a professional, it is important to ask him or her about their qualifications. Questions can include: Do they have additional training in family therapy? How many families have they treated? What types of problems have they successfully treated? It is important to find a licensed mental health professional. Many marriage and family therapists are credentialed by the American Association for Marriage and Family Therapy (AAMFT), which sets specific criteria for eligibility. However, there are many qualified licensed professionals who are not members of AAMFT, so it isn’t crucial that the professional you choose has this specific qualification.

It is not uncommon for a family to participate in family therapy along with other types of mental health treatment. For example, Larry’s father realized he had been depressed since he lost his job and didn’t feel like himself even after he found a new one. He started attending individual therapy along with family therapy. In addition, Larry started talking to the guidance counselor at school about his aggressive behavior. These additional therapies were significantly helpful adjuncts to the family therapy process.

During family therapy, the therapist will often focus on one or more of the following areas:

• Providing family members with information about how families generally function, and particularly how their own family functions
• Looking at the family as a whole instead of focusing on an individual child’s “problem”
• Teaching better communication skills
• Helping the family identify areas of conflicts and situations that may make certain family members anxious or angry
• Helping all family members to feel better about themselves and realize they are not alone
• Using the strengths within the family to help all family members handle their problems

Family therapy is often a short-term treatment, but the number of sessions varies depending on the severity of the problems and the willingness of the family members to engage in treatment. Not all family members will attend each session. At the beginning of treatment, the family and therapist will set goals, and the therapist will determine who needs to attend particular sessions. For example, if the problem is due to a lack of communication between the parents, the therapist might have the parents come in for sessions twice a month. The children may come alone one other time during the month, and the entire family will convene once during the month. There are no hard and fast rules for scheduling family therapy appointments, so it is critical for families to work with a trusted and qualified therapist.

More information about Family Therapy can be found on the website operated by the American Association for Marriage and Family Therapy (AAMFT).