What Are Family Therapy & Family Counseling? Definitions
Family therapists recognize that changing a family system (usually) means disrupting existing relationship patterns and interpersonal communications (Metcalf, 2011).
While family therapists adopt many approaches, they are each typically underpinned by the following four principles (Goldenberg, 2017):
Family members are intimately connected, so therapy must focus on the beliefs of every member.
Over time, family members living in close proximity “set up patterns of interacting made up of relatively stable sequences of speech and behavior” (Goldenberg, 2017, p. 26).
The presenting problem’s context typically comprises the “interactions, beliefs, and behaviors that therapists observe and engage with” and can be considered the cause and effect (Goldenberg, 2017, p. 26).
Family problems are often the result of challenges resulting from facing environmental shifts or life changes.
Family therapy and family counseling are closely related terms and often used interchangeably, but with the latter sometimes used as a broader term encompassing various therapeutic approaches and techniques adopted by psychologists, social workers, and other professionals to enhance communication, resolve conflict, and support families facing challenges (American Psychological Association, n.d.; Goldenberg, 2017).
Marriage and family therapy
Marriage and family therapy are forms of psychotherapy that help individuals, couples, and families improve their relationships and resolve conflicts. Their scope involves working with the couple or the entire family rather than one individual (Metcalf, 2011).
Despite differences in how family therapists go about providing opportunities for families to change, all attempt to create a therapeutic environment that (Goldenberg, 2017):
Encourages self-examination in order to reduce discomfort and conflict
Mobilizes family resilience and empowerment
Helps the family members improve their overall functioning
Within marriage therapy, counselors may use various techniques, such as talk therapy, role-play, and homework assignments with the couple (Metcalf, 2011).
Family therapy for mom and son
Family therapy for mothers and sons can be an effective way to address issues that are affecting their relationship and the family as a whole. The therapist will identify communication and behavior patterns within the relationship that contribute to broader problems and suggest approaches to encourage greater understanding and reduce conflict (Metcalf, 2011).
Communication theory and its impact on family therapy
Communication theory involves studying how people exchange information and meaning through verbal and nonverbal messages (Fitzpatrick & Ritchie, 1993).
The impact of communication theory on family therapy and family counseling is significant and can be used to understand how communication patterns within the family structure contribute to or alleviate problems.
Therapists can use communication theory to identify patterns of communication causing conflict or distress within the family and to develop strategies for improving communication and resolving disputes, such as active listening, empathy, and assertiveness.
Types of Family Therapy
Family therapists are strongly influenced by the models they use, and there are many.
As a result, clients may be seen from very different perspectives depending on the type of family therapy adopted (Metcalf, 2011; Goldenberg, 2017).
The following is a list of several of the most influential types, but there are others present in the literature.
Structural and strategic family therapy
Structural family therapy and strategic family therapy approaches “are foundational in the field of systemic family therapy due to their emphasis on systemic process over content and altering family interaction patterns that create, maintain, or exacerbate problems” (Wampler et al., 2020, p. 460).
Developed in the late 1960s by Salvador Minuchin, and along with contributions from Charles Fishman, Maryanne Walters, and others, structural family therapy recognizes the importance of the individual within their social context (Wampler et al., 2020).
As such, individuals do not exist in isolation but in relation (both acting and reacting) to the family, with the “family seen as the vehicle for producing individual change” (Wampler et al., 2020, p. 462).
Consequently, rather than one individual being the “guilty party” or “symptom owner,” problems are distributed and often the result of a dysfunctional hierarchy or poor functioning within subsystems (Wampler et al., 2020).
Strategic family therapy arose out of the work of the Mental Research Institute in California in the mid-1950s. Unlike other therapeutic approaches that assume insight leads to change (changing through knowing), the strategic approach suggests change happens before understanding (knowing through changing; Wampler et al., 2020).
Shifts in perception and understanding the system’s rules and family interactional patterns are required to facilitate lasting change (Wampler et al., 2020).
According to psychodynamic theory, “humans have an unconscious mind that influences a person’s behavior” (Wampler et al., 2020, p. 417). As a result, we are often driven by simple, unconscious desires — such as pleasure — that are self-serving.
As far back as Sigmund Freud in the early 20th century, the impact of family on the individual’s character formation and unconscious mind was clear. Therefore, the psychodynamic approach to family therapy emphasizes the importance of exploring family members’ past experiences and relationships to gain insight and understanding into existing problems (Metcalf, 2011).
The psychoeducational therapeutic approach supports providing education and information to families about mental illness and challenging behavior patterns while developing treatment plans for the whole family (Metcalf, 2011).
Narrative family therapy (contextual)
Narrative therapy is recognized as being at the forefront of today’s family therapy and family counseling, “signifying that our knowledge of reality is organized and maintained through stories we tell about ourselves and the world we inhabit” (Goldenberg, 2017, p. 370).
After all, the stories — or narratives — we tell ourselves are the context of our lives. And yet, families often build and maintain self-defeating and harmful narratives about their members.
Narrative therapy involves “respectful, non blaming conversations in which clients are the experts in their own lives and assumed to have the skills and competencies needed to construct more positive stories about themselves” (Goldenberg, 2017, p. 371).
Narrative therapists support families in reframing problems from an internal deficiency or issue within the individual, couple, or family to an unwelcome narrative dominating their lives. The family is encouraged to unite against the problem as a separate entity — with its own political and social context — to be overcome (Goldenberg, 2017).
Circular questioning is a powerful technique used in narrative therapy. It involves asking questions about interactions and relationships within the family system to explore how family members perceive each other’s behaviors, emotions, and thoughts (Rogers & Cooper, 2020).
Systemic and systematic family therapy
Systematic family therapy (also known as systemic family therapy) focuses on the family as a whole rather than individual members. As such, it recognizes that individual psychological issues and conflicts are often influenced by and embedded within the more extensive family system (Goldenberg, 2017).
Using this approach, therapists and counselors consider the family as an interconnected system with unique communication patterns, roles, and dynamics. The approach requires them to establish an alliance with multiple individuals at once and manage various views of the therapeutic alliance (Goldenberg, 2017).
Ultimately, they aim to identify and address dysfunctional patterns within the family system that contribute to individual problems by challenging mental models, accepting ambiguity, and considering multiple generations (Goldenberg, 2017).
Functional family therapy
Functional family therapy is a well-researched approach to the family that “fosters both cognitive and behavioral changes in individuals and their families” (Goldenberg, 2017, p. 335), integrating learning, systems, and family therapy.
This form of therapy aims to go beyond behavior change, helping clients understand that how they act regulates relationships.
Studies have found functional family therapy to be particularly helpful in treating adolescents with problems with substance abuse, violence, and delinquency (Goldenberg, 2017).
Bowenian family therapy
Murray Bowen was a crucial figure in the development of family therapy and one of the developers of the family systems theory. His approach emphasizes both the significance of past relationships (psychodynamic approach) and the family as a unit (systems approach; Goldenberg, 2017).
According to family systems theory (or Bowenian family therapy), there are eight interlocking concepts (Goldenberg, 2017):
Differentiation of self
Nuclear family emotional system
Family projection process
Multigenerational transmission process
Bowen preferred to think of himself as a coach, helping family members “become objective researchers into their own ways of functioning” (Goldenberg, 2017, p. 214).
Behavioral and cognitive-behavioral family therapy
“Behavioral and cognitive‐behavioral models for understanding and treating problems in couple and family relationships are well supported empirically” (Wampler et al., 2020, p. 493).
Cognitive interventions that encourage clients to identify those aspects of their thinking that contribute to negative emotional and behavioral responses within the family system have proven valuable, along with testing the validity of cognitions and replacing unhelpful thoughts with more helpful ones (Wampler et al., 2020).
EFT “views couples and families in both intrapsychic and interactional terms, helping them gain access to what is emotionally significant for each person” (Goldenberg, 2017, p. 248) while guiding their actions and explorations with the therapeutic relationship.
EFT practitioners focus on what is going on between people rather than what is inherent within each person. They help clients focus on their moment-to-moment inner experiences and relationship events.
Other approaches worthy of note include family constellation therapy and internal family systems therapy. The former focuses on events that have led to family breakdowns to restore balance within the family constellation, and the latter addresses individual healing and growth, recognizing the mind as a system composed of multiple distinct parts (Konkolÿ Thege et al., 2021; Sweezy & Ziskind, 2013).
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Online Marriage & Family Therapy Programs: Do They Work?
With marriage and family therapy and counseling programs increasingly moving online, it is vital that therapists have the necessary digital skills and competencies to support their clients.
In addition, they must consider the impact of remote treatment on the ethical and regulatory codes associated with their work, potentially across multiple borders and states (Blumer et al., 2015).
Equally important is the efficacy of online marriage and family therapy programs.
While the academic literature is limited, research confirms online treatment’s positive value and impact on marriage and family therapy for various issues. Studies have shown remote treatments’ positive effects as equivalent to in-person delivery, benefiting both relational and mental health outcomes (McLean et al., 2021).
Recommended Family Counseling Books
Family counseling is a vital aspect of therapeutic treatment, with many valuable books to support new and existing therapists.
The following books are some of our favorites and help teach the theory, background, and practical steps involved in practicing family therapy and family counseling.
1. It Didn’t Start With You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle – Mark Wolynn
Mark Wolynn shares his deep understanding of inherited trauma in this groundbreaking book and offers new, powerful tools for relieving client suffering.
Wolynn’s extensive experience as a pioneer in inherited family trauma, coupled with his “Core Language Approach,” empowers readers to uncover hidden emotional legacies and provides practical techniques for reconnecting, integrating, and reclaiming life and health.
This engaging and comprehensive book equips therapists and interested readers with the knowledge and skills necessary for competent and effective family therapy.
With its practice-oriented approach, this ninth edition delves into essential viewpoints, intervention techniques, and the goals of family therapy, from evidence-based practice research to addressing issues of diversity, gender, culture, and LGBTQ families.
Identifying Our Expert Companions
This exercise helps clients discover what they need from an expert companion and how to identify them among the variety of people they know.
Connecting With Others by Self-Disclosure
In this exercise, clients learn how to practice self-disclosure to increase their feelings of being understood, accepted, and cared for, boosting relationships and wellbeing.
Other free resources include:
Mind the Gap
Use this exercise to identify the values the client wants to instill in the family and make plans for their implementation.
Meeting Our Family’s Needs
Each family member is given the opportunity to have their needs heard, understood, and ultimately accepted in this helpful activity.
An individual’s social capital is an accumulation of their positive network connections.
Clients can expand their social capital by focusing on their relationship quantity, strength, intensity, and density.
To do so, ask the client to try out the following steps:
Step one – List the most important people in your social network.
Step two – Assess existing connections’ strength, density, and intensity.
Step three – Identify elements of your social capital that require attention.
Examining Rituals of Connection
Rituals of connection are relationship-enhancing behaviors essential in family therapy and family counseling that symbolize intimacy and provide couples with a sense of stability, commitment, and purpose.
Nurturing a shared sense of meaning and maintaining commitment through rituals of connection is integral to a happy, satisfying, stable, and enduring romantic relationship.
Try out the following steps:
Step one – Identify and reflect on your connection rituals with your partner.
Step two – Assess whether the rituals are currently working for you both.
Step three – Identify what you can do to improve or replace those rituals that require attention.
Family therapy and family counseling recognize that families are organized systems and aim to improve relationships and resolve conflicts by working with all family members.
It disrupts existing unhealthy relationship patterns and communication styles and promotes positive change and growth within the family unit.
In doing so, family therapy emphasizes the importance of understanding family members’ beliefs and the sometimes-unhealthy sequences of behavior that can develop along with the contextual shifts and life challenges that contribute to family problems.
Communication theory plays a significant role in family counseling by analyzing how communication patterns within the family structure impact their problems. Therapists use the approach to identify and transform conflict-causing connection patterns and encourage conflict resolution.
There are various types of family therapy and counseling, each offering different perspectives and models for understanding clients. They offer diverse views that guide therapists in providing tailored interventions for families in need.
Ultimately, family therapy is a practical approach to improving relationships and reducing discord within the family system. Through its use, therapists can disrupt existing dynamics and promote positive change by considering all family members’ needs, beliefs, and values.
Working collaboratively with families to understand their relationships and interactions
Identifying and building on strengths
Developing more effective communication and problem-solving skills
What are the main techniques used in family therapy?
There are many different techniques used in family therapy and counseling, such as:
Genograms (visual representation of a family’s relationships and history)
What is the most common type of family therapy?
One of the most commonly used types of family therapy is structural family therapy (SFT).
SFT focuses on the interactions between family members and how these interactions shape the family’s structure.
American Psychological Association. (n.d.). Family counseling. In APA dictionary of psychology. Retrieved July 19, 2023, from https://dictionary.apa.org/family-counseling.
Blumer, M. L. C., Hertlein, K. M., & VandenBosch, M. L. (2015). Towards the development of educational core competencies for couple and family therapy technology practices. Contemporary Family Therapy, 37(2), 113–121.
Fitzpatrick, M. A., & Ritchie, L. D. (1993). Communication theory and the family. In P. Boss, W. J. Doherty, R. LaRossa, W. R. Schumm, & S. K. Steinmetz (Eds.), Sourcebook of family theories and methods (pp. 565–589). Springer.
Goldenberg, I. (2017). Family therapy: An overview. Cengage learning.
Konkolÿ Thege, B., Petroll, C., Rivas, C., & Scholtens, S. (2021). The effectiveness of family constellation therapy in improving mental health: A systematic review. Family Process, 60(2), 409–423.
McLean, S. A., Booth, A. T., Schnabel, A., Wright, B. J., Painter, F. L., & McIntosh, J. E. (2021). Exploring the efficacy of telehealth for family therapy through systematic, meta-analytic, and qualitative evidence. Clinical Child and Family Psychology Review, 24(2), 244–266.
Metcalf, L. (2011). Marriage and family therapy: A practice-oriented approach. Springer.
Rogers, M., & Cooper, J. (2020). Systems theory and an ecological approach. In M. Rogers, D. Whitaker, D. Edmondson, & D. Peach (Eds.), Developing skills and knowledge for social work practice (2nd ed., pp. 259–268). Sage.
Sweezy, M., & Ziskind, E. L. (2013). Internal family systems therapy: New dimensions. Routledge.
Wampler, K. S., Miller, R. B., & Seedall, R. B. (Eds.). (2020). The handbook of systemic family therapy (vol. 1). Wiley Blackwell.
About the author
Jeremy Sutton, Ph.D., is a writer and researcher studying the human capacity to push physical and mental limits. His work always remains true to the science beneath, his real-world background in technology, his role as a husband and parent, and his passion as an ultra-marathoner.