The concept of family therapy has been in practice since the mid 1950s from therapists who found value in focusing on the external forces affecting the progress of the individual. This shift was drastic because it challenged popular and contemporary beliefs of treatment being rooted solely in the patient-therapist dynamic.
However, family systems theorists, such as Salvador Minuchin, Virginia Satir and Murray Bowen, perceived the issue experienced by the patient in family therapy to be a product of dysfunctional communication within the client’s family of origin.
Several concepts emerged from this approach, which developed and gained popularity over time. From this perspective, treatment began to focus on the entire family as a unit as well as the contributions of each family member, as opposed to an individual and their internal experience. This approach sets the tone for what to anticipate in sessions with a family therapist.
When treating addiction, it is of the utmost importance to be mindful that addiction affects the entire family and the entire family affects addiction. This phenomenon can be understood as an inverse relationship, meaning that treating the family decreases the potential for relapse and promotes healing. Without family therapy, the potential for relapse increases.
The intention of treatment for the family is to uncover any enabling behaviors, identify emotional cutoff and understand the role everyone plays in the family unit. Remember, awareness is the first step toward making progress.
Depending on the therapist, the family can anticipate different styles of treating the identified problems. If the therapist identifies with Bowen’s perspective, the attention will focus on various aspects of the family, which can be revealed through a map of your family’s communication patterns and relationships. The map will provide a clearer picture of the several dynamics within the family and begins to identify connections, both currently and historically, in the family.
A therapist rooted in Satir’s approach would focus on each member of the family and how their emotions, actions and perceptions relate to and define the family’s structure. Another approach would be through the lens of Minuchin, which seeks to define the invisible rules guiding the family. The concept is to disrupt the dysfunctional aspects of those rules in order to stabilize the family and return them to a healthier level of functioning.
Every therapist will approach working with a family differently, depending on the needs and concerns of the family unit. A therapist might choose to begin treatment with the entire family or, if a client is already being seen in individual treatment, a therapist might continue seeing their client in addition to the family.
Some therapists will be more process orientated, thus dissecting and identifying the structure of the family through understanding different perspectives. Others will provide some homework and other solution-focused assignments to bring awareness to the different rules governing the family structure. Regardless of what therapist is chosen, there is value in each approach.
Typically the structure of the session remains similar to that of an individual session. The family will meet with their therapist once during the week for about 45 minutes. The early stages of therapy are typically spent familiarizing the therapist with the issues present in the family and gaining information about what lead the family to enter treatment.
The work then becomes unpacking everything brought into therapy by the family. The therapist will guide each member as they speak to one another, facilitate open and honest communication and collaboration within the family and offer psychoeducation to help the family understand what forces are at play.
Therapists will utilize different interventions to facilitate the family’s process and bring into awareness the various unseen dynamics at play. A family can expect that many emotions will arise throughout the course of treatment, in addition to uncovering and identifying several perspectives from each member of the family. The focus is on the family unit as an entity, and therapy will refrain from singling out an individual member of the family. The intention is on the dynamics, communication styles and underlying or unspoken messages of the family, which are received both overtly and covertly.
Family therapy can be a wonderful and healing experience for all members because it seeks to identify various traits of the family, frequently revealing unspoken, underlying rules and uncovering dynamics passed down generationally. It is helpful to remember that every family is different and brings a wealth of history affecting the way in which the family operates. Often the result is renewed healing and improved understanding of what makes your family unique.