Family Therapy: A Guide to Improving Family Relationships

 

Family therapy aims to restore family balance, improve communication and solve family conflicts that generate tension. Family therapy is recommended when there are conflicts at home and you do not know how to tackle them. If your family is going through a difficult time, whether it’s stress, anger, grief, problems with your partner or children, financial difficulties, facing a situation of substance abuse, illness, etc. family therapy can help your family communicate better, and address conflicts in a healthier way. Find out everything about family therapy in this article: what it is, when to go, what it can help you with, what you should do and know before going to therapy, what you can do if a family member doesn’t want to go, how the sessions work and what activities are done in therapy, the different techniques and types of family therapy that exist, and much more! 

Family Therapy

Family Therapy

Conflicts affect all family members living in the same household. Actions, behaviors, and words of one family member might influence others. However, family therapy does not seek to find guilt, but rather to involve all family members, teaching them to change communication styles or behavior patterns. The main goal of family therapy is to implement positive changes in family functioning that will allow them to relate to each other in a better way.

What is family therapy?

Family therapy is a form of psychotherapy that addresses the behavior of all family members and how those behaviors affect not only individual members, but also relationships among members and the family unit as a whole. Sessions are led by a psychologist or a therapist trained in family therapy.

The range of problems addressed in family therapy is very wide. It includes marital or couple conflict, parent-child conflict, alcohol and drug abuse, erotic difficulties, grief, eating disorders, behavioral problems in children, problems with caring for the elderly, such as the management of parental or grandparent dementia. Problems such as depression of one of the members, anxiety, schizophrenia are also treated… as these problems have an impact on the rest of the family.

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When to go to family therapy?

Family problems can affect all areas of each member’s life. Difficulties may arise at work, school, or in daily interactions with other people.

When family problems seem too big to handle and do not improve, and other areas of life have been affected, it may be time to see a family therapist.

Family therapy may be helpful when:

  • There is a conflict between family members
  • There are different communication problems.
  • Substance abuse or addiction.
  • Mental disorders of a family member.
  • Financial problems or disagreements about money.
  • School problems (dyslexia, dyscalculia, behavioral, ADHD).
  • Difficulties between siblings.
  • Behavior problems in children.
  • Caring for a family member with special needs.
  • Problems with the extended family.
  • Illness or death in the family.
  • Infidelity
  • Conflicting separation or divorce and planning for shared custody.

How can family therapy help?

Family therapy can help:

  • Find ways to resolve conflicts and reduce them.
  • Promote empathy and collaboration.
  • Encourage communication
  • Understand each members’ role in family dynamics and promote healthy behavior patterns and dynamics.
  • Assist in emotional management.
  • The family union
  • Promote sincerity and trust among members.
  • Develop a supportive family environment.
  • Reduce sources of stress and tension within the family.
  • Forgiveness.
  • Integrate isolated family members.

Before going to family therapy:

  • Think about what you want to change.
  • Set realistic goals.
  • Don’t focus on how the other one has to change.
  • Think about how you can change and commit to it.
  • Take some of the responsibility for the problem.
  • Don’t blame the other members of the family
  • Don’t expect rapid changes. Therapy is a long process, it’s not easy, but it’s worth it.
  • Don’t expect the therapist to tell you what to do, or who is right and who is wrong. A good therapist will remain neutral.
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Family therapy: What to do if a family member doesn’t want to go?

If there is a family member who doesn’t want to come to therapy we can’t force them because the motivation to go to therapy has to come from themselves. Family therapy can never be imposed because if it is it is likely to be ineffective.

We can try to convince them and that it will be good for the family. That family therapy can improve the relationship, without blaming or attacking them. We can suggest that the person assists once and check it and if they don’t like it then not come back.

Therefore, if there is a family member who does not want to come, therapy can be done without them, and hopefully, the changes made by the rest of the family can positively influence them.  The therapist can also give indications about how to treat this reluctant member.

How does family therapy work?

Family therapy examines how a person’s behavior can affect the relationship with other family members and family dynamics. Even if only one member shows the “problem”, therapy is considered more effective if other family members are involved in the therapeutic process. Family therapy is about discovering and working out what role each member plays in the family, how they influence each other and creating healthy patterns of behavior.

The therapeutic process will depend on the orientation of the therapist and on what is considered appropriate in each case. But it is usual to have a session with the whole family first, where the problem and the objective will be explained. This way you can also see what the family interaction is like. Afterwards, each member of the family will be interviewed separately to find out how each one of them lives the situation.

Most sessions will be with all the family members unless the therapist considers it appropriate to have a separate session. The family will work towards their therapeutic objectives.

Like couples therapy, family therapy is not about blaming anyone or agreeing with anyone. On the contrary, it is about creating a space where empathy and understanding are encouraged to improve communication, solve problems and find ways to work together. Many times family therapy will not eliminate all the problems, but it provides family members with strategies and skills to overcome difficulties together in a healthy way.

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5 family therapy techniques

If therapy seems like a treatment that will benefit you and your loved ones, it is best to find a reputable professional with whom to rebuild and heal family relationships and develop problem-solving skills. However,  if you don’t think you’re ready for it yet, there are some exercises that can help you.

These 5 exercises and techniques are intended for therapeutic use, however, they may also be useful for those who want to explore the possibilities of family therapy before committing to long-term treatment with a therapist. If you are a therapist or other mental health professional, these exercises might help.

1. The miracle question

This technique is used in all kinds of therapy. It is intended to help the person explore the type of future they would like to build. We all suffer sometimes, but sometimes, the suffering is greater because we do not know what our goals are.

The miracle question serves to explore one’s own dreams and desires and also to know the milestones of recovery in the therapeutic setting. It allows the user to see a positive future, where their problems have been alleviated and the therapist to see how best to help them.

“Suppose tonight, while you slept, a miracle occurred. When you awake tomorrow, what would be some of the things you would notice that would tell you life had suddenly gotten better?”

Even if the user answers something that is impossible to achieve, the answer can still be useful. And you can explore it further with the question “How would that make a difference?”

2. Colored candy

This exercise is a fun and creative way to introduce yourself to family therapy, especially if there are young children.

For this exercise, you need a pack of Skittles, M&M, or any other small colored candies. You can make a healthy version with pieces of different fruits (that are different colors). Distribute seven units to each family member and have them color-code them. Remind them they can’t eat them yet.

Then ask each member to choose a color and say how many they have. For each color, they have to give as many answers as there are units of candy. The issues they have to answer are:

  • Green: Words to describe your family.
  • Purple: Ways your family has fun.
  • Orange: Things you think could get better in your family.
  • Red: Things that worry you.
  • Yellow: Your best memories with your family.

When the first member of the family has given their answers, have them choose someone else to answer the above questions based on the color and number of items. Once everyone has answered all the questions, they can eat the candy.

When everyone has responded, a discussion based on the responses begins. The following questions may help the discussion:

  • What have you learned?
  • What is it that surprised you most about it?
  • How will you work to make changes or improvements?

3. The ball of emotion

This exercise requires a large ball (like a beach ball) and a marker. This exercise is useful for helping emotional expression, especially with children and adolescents.

Write on the ball several emotions, such as “happy“, “sad“, “angry”, “disappointed”, “proud”.

Place family members in a circle and have them throw the ball at each other. When you catch the ball you have to describe a moment when you felt that emotion in front of you.

The intention of this activity is to discuss emotions with the family, practice empathic listening and express emotions.

4. The Genogram

A genogram is a graphical or schematic representation of an individual’s family tree. However, unlike a typical family tree, the genogram provides more information about the relationships between family members.

A genogram could look like this:

Genogram- Family Therapy

Genogram- Family Therapy

Genograms have two levels of information:
  • Basic information: name, sex, date of birth and death (if any).
  • Other information: education, occupation, major life events, chronic illness, family relationships, romantic, social, mental health issues, etc.

By including this additional information, the therapist and family can work together to identify patterns in family history that may influence the current emotions and behaviors of family members. Sometimes the simple act of mapping and observing this information can be very helpful.

Information on emotional relationships may include abuse, divorce or separation, whether a relationship is characterized by love or indifference, whether a relationship can be considered “normal” or dysfunctional may also be crucial.

This work can be done individually but is much more powerful within the therapeutic context.

5. The box of compliments

This exercise is great for increasing positive interactions between family members.

It consists of putting a box with a slot in the lid and next to it post-its (each color is assigned for one person) and a pen. The exercise consists of, each time someone in the family sees someone else doing something they like, they will write it down on a post-it and put it in the box: “I really liked that you woke up happy”. At the end of the day, the box is opened and the notes are read aloud with the whole family together. It is important to try to make at least one positive note for each person.

This activity should not be used to demand, fight, or reprimand.

Family Therapy

Family Therapy

Types of family therapy

Strategic therapy

This type of therapy has evolved from a combination of psychotherapeutic practices and consists of 5 parts: the social stage, the problem stage, the interaction stage, the goal therapy and the tasks stage.

Systemic therapy

Systemic therapy sees the family as a whole, where the interactions of the members influence each other (this is called circular causality). It emphasizes the emotions of the whole family and seeks to identify problems within the family dynamics, as well as the ideas and attitudes of family members to understand what is happening to the family as a whole. Once identified, the therapist will attempt to modify attitudes and relationships towards more beneficial, less harmful or more realistic ones.

According to this theory, if the family is in homeostasis, in a certain internal balance, the system remains constant. Every family seeks its own balance, and if something tries to break it, corrective forces arise. This balance can be healthy or harmful.

Structural therapy

Among the systemic therapies is structural therapy, which was developed by Salvador Minuchin. This therapy focuses on specific objectives:

  • Interactions within the family
  • The family structure based on social interactions.
  • The good functioning of the family, based on how the family responds and develops according to the family’s needs.
  • The position of the family therapist is to help the family overcome unhealthy behavior patterns and develop a stronger entity.

Narrative therapy

Narrative therapy focuses on how each one tells their life story and that the origin of many of the problems lies in the way we tell each other our experiences, how we interpret them. Sometimes that way of interpreting our life can hurt us, and that’s where narrative therapy comes in.

Transgenerational therapy

This therapy focuses on examining interactions between family members across multiple generations. The therapist’s observations and analysis of family interactions help you identify nuclear problems within the family. In addition to current problems, the therapist can prevent future conflicts or stressful situations. This type of therapy is often used in conjunction with other therapies.

Cognitive-behavioral therapy

Cognitive-behavioral therapy focuses on modifying the irrational thoughts that are causing the problems through cognitive restructuring and modification of problem behaviors. Assertive communication is also promoted.

Have you ever tried family therapy? Please leave us a comment below.

This article is originally in Spanish written by Andrea García Cerdán and translated by Alejandra Salazar.

Psicóloga General Sanitaria y sexóloga. Deseosa de mejorar la calidad de vida de las personas mediante la práctica clínica y la comunicación a través de la red.