Therapy Games Behavioral Health
Family therapy techniques
Family therapy techniques are ways to address family conflict by improving the communication and interaction of family members. There are numerous family therapy techniques, but four main models dominate the spectrum. This blog reviews the main therapy family techniques: structural, Bowenian, strategic and systematic.
Have you ever heard someone describe your child’s behavior and it appears contradictory to what you experience at home? You may wonder why someone would act one way around their family and differently when they are with other people. There is a term for that. It is called family dynamics.
Family has a powerful influence over our behavior and mental state, for better or worse. They are the source of both joy and heartache. At times they give us support and other moments they contribute to our problems. Sometimes we just don’t get along. Let’s take a look at what family therapy is and ways it can help resolve problems.
What is Family Therapy?
Family therapy is used to address family conflict by improving the communication and interaction of its members. It examines how a person’s behavior affects both the individual and their relationship as part of a couple or family. It usually involves multiple family members.
Does family therapy have to involve the whole family?
Most of the time, family therapy will involve more than one family member. Depending on the particular model, however, family therapy does not have to involve the whole family. For example, in Bowenian family therapy, a therapist may work with an individual while maintaining a family therapy perspective. Additionally, a therapist may choose which family members attend each particular session. During the first session, for instance, all members of a family may come in for assessment purposes. But a therapist may then determine that they only need to work with a few people. In fact, each session may include a slightly different variation of the family, including seeing a family member alone.
Family resistance
It is not uncommon for certain family members to be resistant to family therapy. Families often come to an intake session with the belief that one person is the identified client and that person is the only one who should be involved with therapy. For example, much of the time, a child’s problems facilitate a trip to the therapist’s office. Parents and other family members may be surprised to find that a therapist wants to discuss their behavior, as well as what the child is doing. It may take some finessing to convince family members to become regular participants in the therapy process.
Can a non-family member be part of family therapy?
The definition of a family has changed substantially in the last 50 years. Families now come in all sorts of variations. For example, let’s say that a friend lives in your house and is a regular part of daily family interactions. Strictly speaking, she is not a family member but she does have an essential role in establishing family dynamics. Or, a divorced woman’s partner has moved into the house. They are not yet married but he acts very much like a stepfather. In these cases, the non-family members have great influence over the family’s behavior. It may be critical for them to take part in family therapy if you are going to make a significant positive change.
Family Therapy Techniques
There are numerous variations of family therapy techniques but four main models seem to dominate the spectrum:
Structural
Created by Salvador Minuchin, structural family therapy theorizes that the family structure is responsible for its problems. More specifically, Minuchin believed a family needed to maintain a certain hierarchy and boundaries to remain healthy. In structural family therapy, the therapist directs the family toward change within the session. For example, the therapist might direct parents to take a more active role and display a united front to their children. Minuchin believed that families would often employ triangulation, a process where a third person is used to cover up issues between two family members. One of the essential tools of the structural family therapy technique is the completion of a structural map, where the boundaries and hierarchies of a family are illustrated.
Bowenian (intergenerational family therapy)
Murray Bowen developed one of the first comprehensive theories of family therapy. He believed that the goal of therapy was self-differentiation, or the ability to separate thoughts from feelings. He posited that self-differentiation decreased anxiety and symptomatology within the family. Because self-differentiation is an individual process, he would be willing to work with single family members instead of requiring multiple family members to take part. He believed that dynamics within a family often resided in triads (triangles) and the role of the therapist was to point out dynamics as a neutral coach and educator. Genograms are used as an essential tool to identify intergenerational family dynamics.
Strategic
Milton Erickson and Jay Haley popularized the use of strategic family therapy. They believed that the family maintains problems through repeated responses to family interactions. The therapist’s job is to motivate the family to change behavior patterns through second-order change (i.e., creating new responses to behavioral problems). Unlike structural family therapy, most of the work is done outside the therapy session. The therapist will give the family homework and ask them to experiment with fresh responses to recurring problems. A therapist uses paradoxical intention as one of the main techniques. For example, a therapist may “prescribe the symptom” and ask a family to keep doing what they have been doing in the hope they will rebel and try something different.
Systemic (Milan Model)
In systemic family therapy, it is believed that a family member develops symptoms in an effort to cope with the behavior of other members of the family. It is thought that by changing one person’s actions, the entire system can be altered because everyone is interconnected. The therapist is seen as a neutral figure whose primary goal is to have family members question their knowledge of the family system (i.e., epistemology), which in turn will lead them to change their behavior.
The primary systemic family therapy technique is called circular questioning. Circular questions aim to make someone think about the connections between family members. They introduce a person to other people’s perceptions and the differences in how family members view situations. This allows people to gain a different perspective on the problem and can spur a shift in actions. For example, a therapist might ask each family member, “who cares about you the most in the family?” Each person’s perspective is then vocalized for everyone to process, hopefully causing an eventual change in behavior.
What a therapist does in family therapy will differ depending on the theoretical framework. What is common to all family therapy, however, is a recognition that a family is a system with many interconnected parts. Family dynamics must be addressed for the system to become adaptive and healthy.
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More resources
- Therapy resources and worksheets
- Therapy private practice courses
- Ultimate teletherapy ebook
- The Ultimate Insurance Billing Guide for Therapists
- The Ultimate Guide to Starting a Private Therapy Practice
