Types of Family Therapy & How to Choose The Best One
Nearly 90% of family therapy clients report improvement in their overall emotional health. When children are involved, their behavior significantly improves more than 70% of the time. Understanding the types of family therapy and how to choose the right therapist can help you be successful.
Despite staggering statistics, family work remains one of the lesser-understood therapy approaches. This article offers a brief yet nuanced explanation of what family therapy is and guidance for how you might go about choosing a family therapist.
What is family therapy?
Family therapy theories explain how, why, and to what degree individuals are impacted by their families and how families are impacted by their members. This bidirectional impact is a significant focus point throughout the family therapy process.
Therefore, family therapy is a type of psychotherapy sometimes used to improve individual(s) mental health issues and also to improve family relationships.
Family therapy honors the scientific evidence that mental health conditions exist and function within the context of one’s family system.
Types of Family Therapy
Although many mental health professionals practice family therapy, not all are trained as family therapists. If you’re considering family therapy, I usually recommend choosing a mental health professional who is specifically trained in scholarly theory and professional practice of family therapy.
Below are five popular family therapy approaches that inform how many family therapists practice today. Note: while family therapy is traditionally used to support two or more members of the same family, it can also be effective with just one person.
Psychodynamic Family Therapy
Psychodynamic family therapy is a form of talk therapy and practice that integrates both psychodynamic and family systems theories.
While there’s an extensive list of psychodynamic theorists, a few that specifically oriented themselves toward understanding mental health conditions within the context of the family system include:
Sigmund Freud, an Austrian neurologist, significantly advanced our understanding of conscious and unconscious thoughts and behaviors in relationships.
D.W. Winnicott, an English pediatrician, taught us about the profound impact of the parent/infant relationship.
Melanie Klein, an Austrian-British psychoanalyst, underscored early parental attachment as undoubtedly linked to the quality of a person’s later relationships.
Given the psychodynamic emphasis on healthy relationships, a signature technique of psychodynamic family therapy is to regard the family/therapist relationship as paramount to the success of the work. A psychodynamic family therapist effectively attends and attunes to their relationship with each individual family member, and the family system as a whole.
Multigenerational Family Therapy
Murray Bowen, an American psychiatrist, developed a family therapy approach based on the impact of previous family generations on the current generation. Bowen taught us that our ancestors’ communication of their thoughts and feelings creates inherited patterns impacting how we communicate our thoughts and feelings today.
Multigenerational family therapy analyzes intergenerational family relationships to assess how well differentiated their members are. Differentiation can be explained as the degree to which we functionally balance our autonomy with interdependence in significant relationships.
Multigenerational Family Therapy, or Bowenian Theory, makes strong use of a genogram. A visual representation of multiple generations of members of our family, the genogram can procure specific, nuanced details to help explain differentiation, emotional patterns, and more.
Structural Family Therapy
Structural Family Therapy (SFT) was developed by Argentinian-born family therapist Salvador Minuchin. Originally applied to an understanding of juveniles in delinquency of the law, Minuchin recognized that these youth were in a dynamic, systemic interaction with the legal system, not too dissimilar to their family dynamics.
Structural family therapy evolved to emphasize the need for a strong and supportive family structure with functional communication. SFT is a here-and-now therapy approach that improves parents' ability to recognize opportunities for their own empowerment within the family hierarchy. SFT is not a deep dive into the past.
A popular structural family therapy technique is reducing the amount of detouring (e.g., going around one parent to get to another parent, going through your child to get to your co-parent, etc.) that families participate in. This is also known as de-triangulating.
Brief or Solution-Focused Family Therapy
Solution-focused family therapy is a here-and-now therapy approach that works to develop clear and concrete goals for a well-articulated, mutually agreed-upon family problem.
It’s not a long, depth-focused family therapy, and it won’t undo mental health issues that have historically been treatment-resistant. Solution-focused family therapy will help you solve present-day problems that truly have pragmatic solutions.
Solution-focused family therapy techniques often depend on the uniqueness of the problem(s). However, family therapists often make use of the miracle question, which can be any question that gets the family thinking about their mental health issues in a new way.
Some miracle questions might be, “When was this problem not a problem? If this problem were to disappear tomorrow, how would your life be different?” The answers to the questions are used to work through the problem further.
The miracle question encourages families to creatively reconsider their problem(s) to expand opportunities for understanding, improvement, and change.
Contextual Family Therapy
Contextual Family Therapy (CFT) is truly a blend of most family therapy approaches.
Developed by Dr. Ivan Boszormenyi-Nagy in the 1970s, CFT honors the existence and interaction of:
Facts that influence the lives of the family (e.g., social, political, genetic, etc.)
Unique, nuanced individual psychologies of each member
Dynamic, nuanced interactions between members
Code of relational ethics used by members
Family therapy techniques with CFT include:
Acknowledging and crediting members for their contributions to the health and struggle of the family system
Working up and down the family generations to develop and expand empathy for the unique suffering of others
Assessing and developing family recognition of relationships to loyalty and fairness
How to Choose the Right Therapy Approach
Most excellent family therapists will likely incorporate multiple approaches in their work with you. Therapists legitimately trained in family therapy should be familiar with the types of family therapy approaches listed above, and many more.
Most often, the best approach for you is the one that integrates everything you and your family need to actually achieve your goals. Simply asking a family therapist about this upfront can help you choose the right therapist and approach for you.
Here are seven points to consider when hiring a family therapist:
Do you want to attend in-person or online therapy?
Are you and your family all in the same state, or do you need a family therapist licensed in more than one state?
What is your and your family’s availability to meet with a therapist?
How much education and training is important to you in a clinician? (e.g., a master’s degree? A doctorate? How about a coach with no formal academic training?)
What is your budget for family therapy? Are you using insurance or paying out of pocket? How are you sharing the cost?
Does the mental health professional have experience working with whatever mental health issues you are presenting with? Do they feel confident they can help you?
Does the demographics of the therapist matter to you? (i.e., race, age, class, gender, religion, etc.)
What Family Therapy Can Help You With
There are many possible goals of family therapy. You might go to therapy to overcome a specific situation or discuss multiple issues.
Family therapy can help you with the following:
Types of Family Therapy: FAQs
Below, I’ll answer some common questions about family therapy techniques and practice to help you better understand what option might be best for you.
What is the most common type of family therapy?
In my experience, there is no most common type of family therapy. Most outstanding family therapists pull from various theories depending on how you and your family present and what you want and need.
What is the best therapy for families?
The best therapy for families is the option they can afford and where they can be seen when, where, and how they want. It's also important to have a genuine trust and confidence in the therapist you've hired to help you.
What is the difference between family counseling and family therapy?
Both counseling and therapy are guides for the present and future. While counseling is typically associated with a wellness model of therapy that's future-oriented, therapy helps you extinguish past pain points that keep you stuck from getting a better place in a legitimate and sustainable way.
Is family therapy effective?
Family therapy can be extremely effective. In fact, statistics consistently show that family therapy is as effective as, if not more than, individual therapy.
Family therapy is usually most effective when all parties want to attend and work towards goals together. Understanding the best types of family therapy for your needs and preferences can also help you choose a therapist you can have success with.
How to Get Started With Family Therapy
There are many ways to get started with family therapy, but first, you’ll want to ensure you’ve talked about it with the members you want to join with.
Once your family has agreed, you can begin searching for a therapist. It’s typical to use online search engines like the Therapist Directory on Psychology Today or ask friends, physicians, or even your individual therapist for a referral.
If one or more of you are in individual therapy, you might consider hiring a family therapist who is willing to collaborate with the other mental health professionals serving you. Consultation and collaboration ensure best practices and aligned goals among therapy approaches.
If you’d like to learn more about online family therapy with me, let’s schedule your free 15-minute consultation. I may be able to help if each family member participating in therapy lives in any one of these 40+ states.
