By: Dr. Elizabeth Justine Devlin
Family therapy is often utilized as a therapeutic approach to a diverse array of presenting concerns amongst family members including family conflict, communication difficulties, conflict amongst siblings, and therapy after a trauma to the family such as divorce, infidelity, or loss. In addition, learning how to support a family member who has a mental illness and/or physical illness is an important aspect of Family therapy. Family dysfunction can cause a significant impact on family and overall wellness. When tension and/or conflict arises within the home, it can cause issues with individual wellness leading to higher stress levels for parents/guardians and children. Family therapy emphasizes the utilization of these fundamental relationships in interpersonal and individual growth.
Listed below are 6 concerns addressed by Family Therapy:
- Coping with loss/grief: When a loss occurs in a family, emotions may be at an all time high, and with various members of the family mourning this loss, some family members may feel misunderstood or isolated in their grief. Family members may cope with loss differently which can sometimes lead to anger, confusion and disconnection. Family therapy assists in learning how to support one another, being more compassionate and understanding in one another’s approach to various types of attempts at coping. Family therapy also focuses on restoring connection within the family and addressing family dynamics that may be changing following the loss. Family therapy also allows space for each family member to feel supported in their grief and learning how to communicate and express their emotions following a loss.
- Family trauma, addiction, infidelity and divorce: Trauma within the family may be defined as any significant event that directly impacts the family dynamic and leads to conflict or disconnection among the family as a whole. One trauma that impacts each individual in the family and it’s functioning as a whole is Substance use disorders and other addictions may lead to dysfunction in the family and conflict in terms of how each member responds to the addiction. For instance, some members may enable the addiction due to difficulty saying no and complex emotions that may impede their ability to set boundaries. Other members may want no communication with the person struggling with addiction that creates conflict amongst family members. Family therapy emphasizes learning how to connect, restore balance, and coping skills on how to address and communicate amongst one another about the family member with addiction in a more compassionate way while also setting boundaries to protect the functioning of the family and how to support the person with the addiction as a united front. Psycho education on addiction, and addictive behaviors would also be addressed to better understand the addictive behavior and behavioral responses. Infidelity and divorce: Divorce and infidelity are amongst the most common issues in which couples seek psychotherapy. However, the couples themselves are not the only members of the family affected. In terms of infidelity, this can impact trust amongst the couple, but also amongst the entire family and children. Children may feel the need to take sides with one parent or the other when infidelity or divorce occurs. In addition, increased tension, arguments, and poor communication amongst the couple may have a negative impact on children or adult children who are exposed to these stressors. The trauma of divorce and infidelity may throw off the entire dynamic of the family and cause emotional trauma during the divorce process. Family therapy assists in providing an opportunity for safe communication and emotional expression for each individual family member so they feel supported during this difficult time. In addition, psycho education on the impact of triangulation (siding with one parent or the other), on the families ability to function in a healthy more constructive way.
- Mental illness and Physical Health issues: When one or more members of the family struggle with mental health or physical health issues, the entire family can be impacted. If there is emotional instability, difficulty with emotional regulation and mood swings, or issues with distress tolerance, the likelihood that the rest of the family is also affected is significant. If a parent is struggling with depression, children may internalize the lack of motivation and excessive sleep as that parent being disconnected or unwilling to engage with them. This can cause emotional distress amongst all family members. In addition, if a child is struggling with mental illness, and the rest of the family is unsure of how to support or communicate with them, family therapy will assist with understanding mental health issues and to have a voice and process ways to support this person and needs of each individual family member. Like mental health issues, if a parent or child is struggling with significant medical conditions or physical health issues including chronic illness, chronic pain, cancer, autoimmune diseases and other conditions, the entire family can be impacted as well. Other family members may feel helpless in their ability to support the person with a medical condition or feel resentment/guilt if the medical condition changes the dynamic of the family. Family therapy may be utilized as a therapeutic tool to address how the person with the condition is experiencing the family, and address how the physical health condition has impacted the family as a whole and skills to learn how to communicate about their emotions, express them in ways they can be heard and understood, as well as ways to support one another and enhance connectivity as a team. For example if a parent or child is unable to engage in certain family activities or has differences in mobility due to illness, this can become distressing for all. Learning how to grow together, be flexible, and find new activities to enjoy may be beneficial to discuss in family therapy.
- Sibling conflict: Most families experience some variation of sibling conflict such as competitive sibling relationships. However, if the sibling conflict occurs frequently and emotional instability amongst the siblings occurs, seeking family therapy could be helpful. In addition, if the sibling conflict is causing issues with their parents/guardians, and the parents are unsure of how to address the issues without the siblings feeling as though the parent is choosing a side, the conflict may be exacerbated. Family therapy will assist in identifying and understanding the core of the conflict, and assisting the entire family in supporting the siblings, their differences, and assisting them in learning how to get their needs met and communicate their emotions/needs more effectively. Therapy provides a safe space for the siblings to have their voice heard with the guidance of a therapist to assist the siblings in understanding how the conflict impacts the family as a whole and how to better cope with emotions that may lead to conflict with their siblings. Parents will also learn how to cope and skills to utilize to assist the siblings in connection.
- Co-Parenting: Co-parenting after a divorce or separation can be particularly challenging. Other than the significant change in the dynamic of the family, challenges with communicating effectively due to emotions related to the separation can cause disruption and difficulty engaging with the other parent about the children. However, it is of importance to create a balance and structure for the children during this time, as well as support. Family therapy can be utilized to assist parents in setting up expectations in their homes and agreeing to a schedule to ensure a smoother process in transitioning from home to home. In addition, if the parents talk negatively about the other parent and overhear arguments while attempting to co-parent, children may act out or internalize blame for their parent’s arguments. Family therapy would include giving the children a place to express these concerns and emotions, as well as helping parents better communicate for the children’s sake. Having a good co-parenting relationship reduces stress for all parties involved.
- Blended Families: As blending families becomes more common, it is important to recognize that some challenges may arise during this time. Children may be use to a certain way of life or having their parent’s attention full time and may have difficulties getting use to other children or their parents partner. Family therapy may be utilized at the outset of blending families; therefore, before the blending begins or moving in. Seeking counseling prior to can contribute to a more successful integration. This includes discussing worries, concerns, and discussing potential issues that could arise beforehand may minimize the anxiety of blending families and have skills to use once the blending occurs. In addition, family therapy may be sought after the blending occurs if dysfunction begins including emotions such as confusion, anger, sadness, and feeling isolated or competitive for their biological parents attention. Blending families can be very challenging for all parties, seeking therapy will assist in learning how to communicate, set boundaries, structure and standards for the whole family to provide comfort and consistency.
In conclusion, family therapy covers a variety of concerns, worries and challenges families may endure. From needing assistance with learning how to communicate more effectively with one another, to loss and trauma that impacts families and ways to cope, connect, and support one another during these difficult life events. Below is a brief overview of the types of family therapies that exist for a variety of issues.
What are some of the modalities of Family therapy?
- Structural Family Therapy: This is one of the most common or popular forms of family therapies that focus on viewing the family as a singular unit with multiple functioning pieces. Works on identifying family conflict and integrating family roles.
- Milan Family Therapy: Similarly to structural family therapy, the family is viewed as a unit or single system. Unlike structural therapy, Milan focuses and emphasizes natural behaviors within a family unit and focuses on reactions and feedback.
- Strategic Family Therapy: Strategic Family Therapy focuses primarily on patterns within families. Focuses more on a hands-on approach to conflict resolution. The therapy emphasizes highlighting these patterns and creating changes that are better fit for the family.
- Narrative Family Therapy: This modality of family therapy is most individualistic in comparison to other models. Focuses on supporting and encouraging each individual member of the family. Focuses on conflict resolution being a symptom of needing to enhance self-perception and self-esteem.
- Trans Generational Family Therapy: This modality focuses on conflicts among different generations within the family by enhancing communication and breaking down barriers to communication by enhancing compassion and understanding.
- Gottman Family Therapy: The theories and goals of Gottman therapy emphasizes disarming conflicting communication, and to increase intimacy, respect and affection by removing barriers in addition to enhancing compassion and empathy.
References
- About marriage and family therapists. American Association for Marriage and Family Therapy. https://www.aamft.org/About_AAMFT/About_Marriage_and_Family_Therapists.aspx. Accessed May 4, 2021.
- Family therapy can help: For people in recovery from mental illness or addiction. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/product/Family-Therapy-Can-Help-For-People-in-Recovery-From-Mental-Illness-or-Addiction/SMA15-4784. Accessed May 4, 2021.