From improving communication to increasing mutual understanding and providing valuable tools for coping with life changes, the benefits of family therapy — a form of psychotherapy with a focus on interpersonal familial relationships in which you, your kids and your partner (or other members of your family) work as a group with a mental health care provider — are vast. But it can often be difficult to convince a loved one to go, let alone getting multiple family members to attend. Therapy can bring painful and uncomfortable situations to the surface and be emotionally draining.
At the same time, therapy can cause people to feel as though their situation is getting worse before it gets better, according to Whitney Goodman, licensed marriage and family therapist, founder of Calling Home and author of “Toxic Positivity.” “Some members of the family may struggle with denial, acceptance or sharing their feelings,” she explains. “They may feel judged or scrutinized. When this happens, the person in therapy may feel even more isolated from the family.”
But putting in the work can lead to heartening results for everyone involved. Here, what you need to know about family therapy, how to know if it is right for you, its benefits, types of family therapy and more, according to experts and people who’ve done the work alongside their loved ones.
What is family therapy?
Family therapy is “as a form of psychotherapy that aims to reduce distress and conflict by improving interaction among family members,” says Ilene S. Cohen, a therapist who holds her doctorate in marriage and family therapy. In family therapy, a mental health care provider works with family members to boost self-awareness around each person’s individual challenges and to understand how they affect the connections within a family unit.
What actual family therapy sessions will look like depends heavily on the individuals, their situation and their therapist. However, a first visit will likely involve getting an overview of what the family is struggling with and identifying goals for therapy, says Cohen. For example, the goal for “a family looking to map out household roles might be to clearly define and understand each member’s responsibilities within the home,” she adds. “For co-parenting improvement, a goal might be to develop effective communication strategies or establish consistent parenting techniques across households.”
Beyond that, the therapist may use different techniques, such as mapping family trees, which can “help identify recurring behaviors or issues, like addiction or mental health conditions” over generations, says Cohen.
Role-playing is another common practice, allowing “family members to understand and empathize with each other’s perspectives by stepping into each other’s shoes,” she adds.
How do you know if family therapy is right for you?
People may attend family therapy for a number of reasons, but the core idea is to improve or resolve issues within familial relationships. They may be striving to address a temporary hardship that affects the whole family (such as moving away from a childhood home) or attempting to resolve a longstanding conflict (like disagreements between partners on parenting choices). Cohen, for instance, primarily sees clients dealing with relationship difficulties, major life changes and managing mental health issues within their family.
According to a study written by Lucia Jimenez, et al. on the effectiveness of family therapy in the International Journal of Environmental Research and Public Health, “a common objective in structural family therapy, regardless of clients’ needs, consists of empowering and strengthening the family as a system.”
For example, a mom in Houston, Minnesota sought family therapy to cope with the medical challenges her three children were facing, including a cancer diagnosis and resulting limb amputation. Family therapy was a way for Katie Nelson to “find ways to cope with [their] emotions and struggles in a safe and controlled environment.”
How to be ‘successful’ in family therapy
What success looks like in family therapy will largely depend on the individual family unit and specific situation, but therapists and parents agree on the following ways to ensure you achieve your desired outcome.
Acknowledge that you may not be able to get everyone to attend
Family therapy, despite its name, does not always equal an entire family being present in therapy. In some cases, the entire family attends, and for others, the therapist works with one family member or, perhaps, just the parents on specific issues like how to communicate more effectively with each other.
Family members may be reluctant to attend therapy “due to a variety of reasons such as fear, skepticism or misunderstanding about the therapy process,” explains Cohen. When this happens, Cohen encourages the attending members to continue participating, even when other loved ones struggle to show up.
In these situations, Goodman encourages family members who have shown up to a session to remember that they can’t control their relative’s actions, even if they were to attend. She will also ask the family members in attendance, “How can we work on you, and how this is impacting you, and how you’re going to handle yourself within this relationship?”
Cohen adds that even when a family member doesn’t attend, “the client who is present can still make significant progress by learning new skills and strategies to improve their interactions with the rest of the family.”
Discuss the desired outcome
Everyone’s endgame in therapy will be different, but it can help to “agree on a common goal as a family,” says Goodman. After all, it’s easier to work toward something that everyone has a stake in.
Daniel Levitch, a university career counselor in Santa Clarita, California began attending family therapy with his wife and two kids during the COVID-19 pandemic to address an adversarial communication pattern they had found themselves in. “We all had to be onboard and invested to be able to make this work, and that alone helped put us on the same page,” says Levitch.
Try to keep an open mind
While having a goal can give you something to strive toward, try to leave some room for the unexpected, and “be prepared to do some personal digging in a safe and guided environment,” says Levitch. Behavior you view as problematic in your children or other family members may result from reasons and feelings they finally feel comfortable sharing.
“Don’t go in with an agenda,” adds Levitch. “For example, ‘If the kids would just learn to listen and clean their room, everything would be fine.’” Family therapy goes a lot deeper than that and explores these expectations and communication misfires (like kids not listening) within the family structure, and the “why” behind it may not be what you think.
Weigh the pros and cons of telehealth
Virtual therapy has made care accessible for countless people, but there are pros as well as cons. When exploring virtual versus in-person therapy, the experts we talked to recommend considering the follow thoughts:
- With the perceived distance of online care, some family members may feel more comfortable attending and being open and honest.
- It can make scheduling easier.
- If more than two people will attend, ask yourself if the WiFi connection is potentially lagging and people talking over each other (intentionally or unintentionally) will cause more stress and tension.
Family therapy benefits
Because everyone attends therapy for different reasons, the results will also vary from family to family. However, here are some of the benefits you might see.
Improved communication
One of the aspects of family therapy is having a professional there to guide family members through difficult topics and conversations and to help them “understand one another and make sure that they can solve problems amongst themselves without [the therapist there] when therapy has ended,” says Goodman.
For Levitch and his family that meant working on improving their communication in therapy. “[It] gave us a common language to reference and employ,” says Levitch. In his family’s sessions, they “discussed communication styles and tailoring our approach to increase the clarity of our message and build trust in the process,” he explains.
More equitable parenting
A natural result of improving communication is hopefully a better understanding of others’ feelings and struggles. And with that can come “higher levels of respect and consideration,” says Goodman.
If you’re attending with your spouse and you have children, this may result in a better balance in your relationship when it comes to child-centered tasks. In the International Journal of Environmental Research and Public Health study, researchers note, “Participant mothers reported feeling more support from fathers in child rearing” as a result of attending family therapy.
A better understanding and acceptance of who your family members truly are
One of the biggest indicators of success in family therapy is going into it with an unassuming attitude. For Levitch, one of the most surprising outcomes of family therapy was how much his children contributed and how much he and his wife, as parents, learned about their children through the process. Levitch says his children took the sessions very seriously and even helped him and his partner utilize techniques later.
Likewise, Nelson said participating in family therapy helped her “see each of [her] kids in a different perspective.” Before therapy, it was easy to view them as just young kids without any real problems, but the sessions helped her realize “that you can have struggles and hurt, [regardless of] age,” she added.
Improved mental health and well-being
While this may seem obvious, the quality of a person’s relationships with their family members can have a huge impact on their overall quality of life. “When we work to improve communication, understanding and dynamics within [the family] system,it can lead to a reduction in stress, conflict and emotional distress, hence promoting mental health and overall well-being,” says Cohen.
Types of family therapy
While there are numerous modalities of family therapy, here’s a brief rundown of the more common types. While it’s important to familiarize yourself with the basics when choosing a therapist, Goodman says that a lot of family therapists may draw on three or four different styles of family therapy — what’s most important is finding a therapist who specializes in, or has experience with, the issue that is affecting the family, Goodman adds, whether that is coping with with a medical diagnosis, or navigating parenting disagreements between partners.
A good place to start is their website, if they have one, and then schedule a consultation to discuss your goals for therapy and the therapist’s approach to determine if it’s a good fit.
Family systems therapy
This form of therapy considers the family as an interconnected complex system, according to Goodman. “In this system, each member plays a role and has a unique function in maintaining the current system. Therapists who use family systems theory may work with individuals, parts of the family or entire families, and they believe that a person is best understood as a part of the system rather than an isolated individual,” says Goodman.
Structural family therapy
Similar to family systems therapy, structural family therapy “focuses on adjusting and strengthening the family system to ensure each member can interact effectively. It involves identifying and reorganizing the family’s structures, roles and rules,” says Cohen.
Strategic family therapy
In strategic family therapy, the goal is to target specific issues and is more action-oriented, according to Cohen. She adds that therapists may assign homework to families to “help alter the dynamics and change problematic behaviors.”
Bowen family systems therapy
According to Cohen, who specializes in this type of therapy, Bowen family systems therapy “focuses on the family as an emotional unit and uses systems thinking to understand complex family interactions.” She adds that it has an emphasis on the interdependence of family members and the importance of individuals maintaining a sense of self.
How to find a family therapist
With all of this information under your belt, you’re now ready to start your search for a family therapist.
If you have insurance, start there
You may find that your insurance won’t cover family therapy, says Goodman. However, a quick call to your insurance provider or a visit to their website should clear up any questions of coverage. And if your plan does cover it, here are a few things to look for, according to the experts we spoke to:
- A licensed marriage and family therapist (LMFT)
- Someone who is licensed in your state (even if you’re doing telehealth)
- An individual with experience or specialization in the issue that is challenging your family
If you don’t have insurance . . .
Not having insurance, or your insurance not covering family therapy, does not have to mean family therapy is out of reach. Following are some options that may provide low-cost (and/or free) care.
- When searching for a therapist, don’t be afraid to ask if they have any sliding scale spots open.
- Universities with family therapy programs may have openings for the public for the purpose of training students. This can be a great outlet, says Goodman, because those training therapists are being supervised by people with significant experience, resulting in comprehensive care.
- For a small fee, you can join the Open Path Collective, which provides low-cost therapy.
- Research nonprofits in your area, as they may have low-cost or free therapy options.
Be upfront with your concerns
When you’re searching for a therapist, ask for a consultation. In that meeting, be clear on what you’re looking for. And be wary of anyone who makes it seem like they can help with any issue, which is “a big red flag,” according to Goodman. “You’re in good hands when someone is very clear and direct about what they do not do, as well as what they do,” she notes.
The bottom line on family therapy
Therapy is never going to be easy, but from improved mental health to a better functioning home environment, the return on that investment of time can be immeasurable. Regardless of the situation or issue at hand, whether it be trauma-, communication- or illness-based (just to name a few), improving communication and learning coping skills under the guidance of a qualified professional has the potential to be life-changing for you and your loved ones. For instance, Nelson says family therapy taught them “how to function better as a family and how to support each other when challenges arise.”
Ultimately, as Cohen concludes, “It takes courage to address family issues and strive for a healthier, happier family life.”
