In essence, a family provides a warm and nurturing context in which individuals can grow and evolve. Each member contributes actively to the well-being of the family and receives unconditional support when he/she goes through a difficult period.

Although the family is seen as an inexhaustible source of joy and fulfillment, there are times when family relationships can go sour. Often, the consequences of unhealthy family dynamics have a profoundly negative impact on its members’ emotional and mental health.

Let’s take a closer look at what is family counseling and how a family therapist can facilitate healthy family dynamics.

The Basics of Family Counseling

In a nutshell, family counseling is a form of psychotherapy that brings family members together to solve problems related to intrafamily dynamics and interactions.

Based on the belief that a family is one of the most valuable resources one can have, family counseling aims to reduce tensions between members by providing a space where everyone can share their concerns, struggles, needs, desires, and aspirations.

One issue that seems to come up quite often during sessions is the sense of failure and lack of understanding that results from being part of a group where individuals are neither seen nor validated.

The strategies employed by family counselors target the entire family system, requiring the presence of all the members who are actively or passively contributing to the problems at home.

By participating in both individual and group sessions, family members have the opportunity to voice their concerns, provide valuable input, and suggest possible solutions to restore balance and consolidate healthy intrafamily relationships.

The success of the therapeutic intervention depends significantly on how well members manage to cooperate with each other, their desire to change, and their willingness to take responsibility for the family’s well-being.

Why should I consult a family counselor?

Through individual and group sessions conducted by licensed family counselors, couples in distress can learn to:

  • Improve communication by creating space for every member to share his/her ideas, needs, and desires
  • Regain balance and optimize their role within the family
  • Defuse crises calmly and effectively
  • Overcome obstacles through collaboration and problem-solving skills
  • Pay close attention to family dynamics and respect others’ boundaries
  • Support each other through thick and thin
  • Identify and challenge dysfunctional beliefs about family life.

Now that we have a better understanding of what is family counseling, let’s take a close look at the evidence behind this approach.

What Are the Main Types of Family Therapy?

Experiential family therapy

The experiential approach emphasizes the importance of personal integrity, freedom of choice, independence, and openness to new experiences.

Some of the techniques that experiential therapists and counselors use are family art therapy, conjugal family drawing, and gestalt techniques.

The goal is to elicit intense emotional awareness and increased expressiveness, which can unblock communication and revitalize the family system.

Cognitive-behavioral family therapy

The cognitive-behavioral approach focuses on practical solutions that target specific problems that a family (or its members) might struggle with.

Its emphasis on precise objectives and self-help strategies makes cognitive-behavioral family therapy (CBFT) one of the most popular approaches.

Psychoeducation and parent training are some of the strategies employed by CBFT therapists and counselors.

Transgenerational family therapy

Also known as Bowenian therapy (after its founder), this approach is based on the idea that all humans have a common evolutionary heritage at a primitive functioning level.

Behaviors within a family tend to crystalize into regular patterns, which tend to repeat throughout generations.

The goal of transgenerational family therapy is to discover the root of dysfunctional patterns and help families carve out a new path, different than the one they were set upon by their family of origin.

Integrative family therapy

The integrative approach promotes a unitary understanding of human beings’ complexity, where body, mind, emotions, and spirit come together to create what we call experience.

This form of therapy uses a wide range of strategies, depending on the specific problems families are struggling to overcome.

In a way, integrative therapy is a collection of techniques gathered from the most well-known therapeutic approaches.

Does Family Counseling Really Work?

Given that family counseling addresses a different set of problems than individual therapy, mental health experts have developed specific strategies and approaches to assist families and couples in distress.

A recent paper published in Family Process revealed that attachment-based family therapy (ABFT) is a valid approach that offers family counselors a clear framework to address attachment ruptures and facilitate positive change. [1]

In a nutshell, ABFT is a family therapy approach grounded in attachment theory, which focuses on building secure attachment bonds between family members.

Furthermore, current evidence suggests that systemic interventions prove highly useful for families where children and adolescents struggle with emotional problems, eating disorders, conduct problems, and even abuse or neglect. [2]

Another popular intervention backed by rigorous empirical evidence is Functional Family Therapy. [3] This intervention program was designed to assist vulnerable families where adolescents are at risk of developing conduct problems, substance abuse, and violent acting-out.

As you can see, counselors and therapists often rely on more than one approach when it comes to family interventions. Depending on the family’s problem, mental health experts can choose from a wide range of strategies and techniques.

This diversity allows them to design interventions suited to each family’s specific needs and problems.

In fact, some experts argue that multidimensional and transdiagnostic approaches that target both families in distress and community settings can generate the best possible results. [4]

Overall, current scientific evidence highlights the effectiveness and importance of family therapy as a valid intervention for couples, children, and adolescents dealing with unstable or dysfunctional family environments.

What Does Family Therapy Involve?

We know for a fact that family is the core of society, bringing balance, peace, and well-being in everyone’s life. But families, just like the people who make them, are not perfect.

Each family member has his/her own set of values, opinions, or needs, and sometimes, getting the whole family on the same page can be quite challenging.

Family counseling aims to assist couples and families in reaching a consensus. It’s easier for families to overcome adversity and tension when members make an effort to understand each other and create space for everyone to have “a seat at the table.”

To gain an even better understanding of what is family therapy, let’s take the time to see how this process unfolds.

Evaluating family dynamics

The first thing a family therapist will do is evaluate the family dynamics. How members communicate, share concerns, divide responsibilities, make important decisions, and solve problems can say a lot about the quality of their interactions.

The evaluation process helps therapists and counselors determine the overall health of the family system. To achieve this goal, psychologists use questionnaires and detailed interviews that contribute to a comprehensive picture of the family dynamics and reveal dysfunctional patterns within the family structure.

By comparing this image with a standard or ideal family model(s), psychologists will then set up specific goals that help the family achieve the desired balance and harmony.

But since a family is a complex and dynamic structure, there’s more than one standard to which mental health professionals can adhere.

In fact, this standard depends on the therapeutic approach, cultural background, and other environmental factors.

However, there are several criteria that almost every family counselor follows:

  • Emotional expression
  • Family communication
  • Roles and responsibilities in the family
  • Interdependence and individuality
  • Family subsystems.

Creating a detailed intervention strategy

Once the therapist or counselor has a clear and detailed image of the family dynamics and the problems that members face, he/she will design an intervention plan based on specific, achievable, and flexible goals.

The purpose of each goal is to bring the entire family closer to a stable and healthy dynamic in which members validate each other’s needs, values, and opinions.

A detailed intervention strategy provides clarity and direction for both psychologists and the families who employ their services. Without a plan, the therapeutic process would be nothing more than a casual exchange of opinions.

Aside from a set of goals, the intervention strategy will also include different techniques and assignments that family members can use between sessions.

Just like individual therapy, family therapy requires active involvement and personal responsibility. You can’t just hand your problems to a counselor and expect him/her to fix them.

The more effort each family member invests in the therapeutic process, the better the outcome.

Assisting family members

A family counselor is neither the knower of all things nor the fixer of all problems.

But what he or she can offer is empathy, guidance, and a whole new perspective on the issues that your family is struggling with.

By providing emotional support and specific techniques, therapists and counselors assist family members (both individually and as a group) in cultivating good communication and healthy coping strategies.

This support comes in the form of individual sessions where each member can voice his/her honest opinion, or family sessions where members are encouraged to validate each other and offer mutual support.

The final goal is to strengthen the family system to the point where members no longer need a third party (family counselor or therapist) to de-escalate heated arguments and facilitate problem-solving.

What Happens in a Family Therapy Session?

Family therapy is a process that takes place in a comfortable and safe environment, which ensures confidentiality. By working side by side with a licensed counselor, family members can:

  • Identify the resources and positive aspects of the family
  • Improve relationships between partners, children, and other family members
  • Discover and validate their needs
  • Respect each other’s individuality and uniqueness
  • Develop practical problem-solving skills.

During family therapy sessions, members can address sensitive issues that affect the overall dynamic of the family without fear of judgment or criticism.

One-on-one sessions

Even though it’s called ‘family therapy,’ this process will occasionally involve individual sessions.

Given that some might not feel comfortable discussing private matters in front of their entire family, therapists will almost always set up individual sessions with each family member.

Through one-on-one sessions, a family counselor can gain a different perspective on the couple dynamics and discover problems that aren’t brought up during group sessions.

It’s also a chance for each member to work on individual issues that might contribute to dysfunctional family dynamics. In other words, one-on-one sessions with a licensed family counselor can help individuals achieve personal well-being, something that will positively impact the family system.

Family sessions

As you probably guessed, the core of family therapy is the group session where family members gather to discuss their problems under the guidance of a trained family counselor or therapist.

Although family sessions can sometimes feel tense and ‘heavy,’ they also provide members with a valuable opportunity to discuss the issues that they would generally keep to themselves.

Furthermore, family sessions are the ideal context in which psychologists can set the foundation for mutual understanding and support between family members.

Between-session activities

Psychotherapy is a process that takes place both during and between sessions.

Given that therapists or counselors interact with their clients (in this case, family) for about one or two hours per week, progress is typically the result of what happens between sessions.

Whether it’s individual, couple, or family therapy, clients will receive a set of techniques and assignments that help them overcome difficulties functionally and healthily.

In the end, the signs which indicate that therapy is evolving in a favorable direction are the responsibility and autonomy that clients develop from one session to another.

What Are the 3 Goals of Family Therapy?

Depending on the therapeutic approach and the specific problems that clients bring in therapy, each family therapist has a particular set of goals that guide the process.

However, most approaches gravitate around three fundamental goals that drive positive change.

Building strong communication channels

In essence, communication means the transmission and reception of verbal and nonverbal information between family members. It involves different skills that allow individuals to exchange information within the family system.

Family issues are relatively common and usually result from poor communication between members. In the absence of good communication, members fail to understand each other’s needs and find common ground. That can lead to marital problems, dysfunctional parenting styles, verbal and emotional abuse, or even divorce.

The first (and often most important) goal of family therapy is to identify communication blocks and help family members engage in honest and authentic discussions about their issues.

Here are some basic principles of effective communication within the family system:

  • There’s an appropriate amount of verbal and nonverbal messages, and the meaning of each piece of information passed from one member to another is as clear and straightforward as possible.
  • Important decisions are made only after consulting all members who will be impacted by a decision.
  • Conflicts are resolved through active communication, brainstorming, and non-judgmental exchange of ideas.
  • When communicating, family members use a calm, friendly, and positive tone.
  • Family members can understand not only the message but also the underlying emotional vibe.

Cultivating mutual understanding and support

Another common problem that leads to dysfunctional family dynamics is the lack of understanding and empathy.

In a way, this problem is closely related to poor communication between family members. In other words, it’s impossible to understand what your spouse or child is going through when you listen passively and don’t make an effort to resonate emotionally.

Empathy is an essential component of communication and relationships. The ability to understand what your loved ones experience on an emotional level has significant effects on the overall quality of your relationships.

For example, current evidence highlights the importance of empathy in forgiveness; a process families must undergo to overcome events like trauma, infidelity, or abuse. [5]

When family members exercise understanding and empathy towards one another, the family’s entire dynamic takes on a more positive tone, leading to effective problem-solving and a general sense of harmony.

Encouraging members to help each other through difficult times

As we discussed throughout this article, one of the fundamental goals of family therapy is to cultivate a sense of personal responsibility and mutual support.

A family is a system in which members cooperate and inspire each other to reach common goals. It’s like choreography; everyone must be in sync to create synergy.

That’s why the emotional or mental problems of one member will resonate throughout the entire family system.

In some cases, individual therapy for the family member going through a rough patch can restore balance within the family. Except there are times when dysfunctional family dynamics are at the core of individual problems.

With the help of a licensed professional, families can learn how to support each other and find practical solutions to prevent individual problems from crippling the entire family system.

Now that you have a better understanding of what is family therapy and the importance of consulting a family therapist, all that’s left to do is to set up an appointment.

References

[1]G. Diamond, J. Russon and S. Levy, “Attachment‐Based Family Therapy: A Review of the Empirical Support,” Family Process, vol. 55, no. 3, pp. 595-610, 2016.
[2]A. Carr, “Family therapy and systemic interventions for child‐focused problems: the current evidence base,” Journal of Family Therapy, vol. 41, no. 2, pp. 153-213, 2018.
[3]T. L. Sexton, “Functional Family Therapy,” in The Encyclopedia of Juvenile Delinquency and Justice, John Wiley & Sons, Inc., 2017.
[4]H. A. Liddle, “Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings,” Family Process, vol. 55, no. 3, pp. 558-576, 2016.
[5]J. G. Kimmers and J. A. Durtschi, “Forgiveness in Romantic Relationships: The Roles of Attachment, Empathy, and Attributions,” Journal of Marital and Family Therapy, vol. 42, no. 4, pp. 645-658, 2016.
author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings

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