The concept of family therapy has been in practice since the mid 1950’s from therapists who found value in focusing on the external forces affecting the progress of the individual. This shift was drastic in the sense that in 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 identified patient in family therapy to be a product of dysfunctional communication within the client’s family of origin. Several concepts emerged from this approach in therapy, which began to develop and gain popularity over time. From this perspective, treatment began to focus on the entire family as a unit and 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 session with a family therapist.
When treating addiction, it is of the utmost importance to be mindful that addiction effects the entire family and the entire family effects addiction. We can understand this phenomenon as an inverse relationship. Meaning that treating the family decreases the potential for relapse and promotes healing or vice versa- without family therapy, the potential for relapse increases and a lack of healing. 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 family therapist chosen to work with, the family can anticipate different styles of treating the identified problems. If the therapist identifies with Bowen’s perspective, the attention will be focused on various aspects of the family, which can be made visible through use of a genogram or map of your family’s communication patterns. The genogram 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 perspective. Others with provide some homework and other solution focused assignments to bring awareness to the different rules governing the families structure. However, regardless of what therapist is chosen, there is value to be had 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 to 50 minutes. The early stages of therapy are typically spent familiarizing the therapist with the issues present in the family and the therapist gaining information about what lead the family to enter treatment. The work then becomes unpacking everything brought into session by the family while guiding each member as they speak to one another, facilitating open and honest communication, collaborating with the family, and offering 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 anticipate many emotions will arise throughout the course of treatment in addition to uncovering and identifying several perspectives from each member of the family. It is important to remember that the focus of treatment is on the family unit as an entity and will refrain from singling out an individual member of the family. Remember, the intention is on the dynamics, communication styles, and often underlying or unspoken messages of the family, received both overtly and covertly, which seek to thwart their healthy progression.
Family therapy can be a wonderful and healing experience for all members in the family 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 every family is different and brings a wealth of history effecting the way in which your family operates. Often the end result is that of renewed healing and improved understanding of what makes your family unique.