When you seek mental health treatment, it’s quite likely that your practitioner will recommend family therapy sessions as well. During these sessions, your therapist will focus on the relationship between family members. And the goal is to improve functionality within the family and help each member understand their role. But where did family therapy begin? And how did it reach its current stage? Let’s discuss what family therapy is, how it developed, and the different practices it adopted.
What is Family Therapy?
It’s known by different names, like family systems therapy, and it’s a form of psychotherapy that involves working with families to bring about positive change. As a discipline, family therapy views relationships between family members in terms of interaction.
It also considers family relationships to be a crucial factor in determining psychological health. Consequently, it views family problems as the result of systemic interactions and can’t be blamed on specific members.
How Family Therapy Works
In family therapy, your family is much more than the sum of its parts, i.e., the individual members. This model is based on the systems approach, and it’s meant to help the entire family return to health.
And it’s done in a way that each member feels emotionally connected to the family, accepted as a fully functioning member, and differentiated as a separate individual who can achieve personal goals. Moreover, family therapy by United Recovery Behavioral Health focuses on helping families overcome the challenges of having a mental disorder and living with someone who does.
Origins of Family Therapy
Before family therapy, psychologists followed the Freudian tradition, which was centered on the patient-doctor relationship. The origins of family therapy can be traced back to the 1950s, and before that, psychopathology was widely considered to stem from within the individual.
Then, in the 1950s, researchers released new insights into studies involving the families of schizophrenic patients. Since then, the paradigm shifted away from the dyadic patient-doctor relationship to one involving the relationships between family members.
Shifting Paradigm
The major shift in the paradigm started with the work of Murray Bowen, who considered the Freudian theory to be too narrow. According to him, the basic unit of emotional functioning wasn’t an individual but the nuclear family. He called this new way of looking at family interactions the ‘systems thinking’ method.
He viewed families as open natural systems, the members of which enter and exit over time, changing the boundaries of the family. Murray Bowen is now considered one of the pioneers of family therapy and understood families from an intergenerational perspective of repetitive, reciprocal, and interlocking relationships. His early clinical work on schizophrenia led him to conclude that problems resulting from unresolved family issues of the past generations have an emotional impact on future generations.
Different Practices
Having gone through the origins and development of family therapy, let’s look at the evolution of its different practices. These are divided into first-generation practice models and second-generation or post-modern therapies.
Psychodynamic
Among the first-generation practices, the earliest is the psychodynamic family therapy by Nathan Ackerman. He theorized that family disturbances reflected an individual’s psyche and environmental issues. However, the psychoanalytic orientation of his approach prevented him from seeing beyond a single individual in the family. He also theorized that interpersonal conflicts are a manifestation of unconscious elements operating in the family system.
Group Family Therapy
Psychologist John Bell was one of the first clinicians to assess families as a whole. Consequently, he integrated group psychotherapy and group dynamics as the conceptual foundation of family therapy. He described families as groups and focused on the roles within families that allow them to tackle intrafamilial issues.
Structural Family Therapy
Salvador Minuchin adopted a structural model which incorporates a generational view to focus on balancing the family structure. It uses a current, here-and-now approach to solving problems. Overall, the structural/functionalist practice model is highly committed to the systems approach and emphasizes an organized family unit.
Minuchin emphasizes that when the family unit is exposed to stressful, extrafamilial forces, it leads to role confusion and power conflict. Therefore, the spousal, sibling, and parental subsystems within the family require restructuring to sustain health boundaries.
Humanistic Therapy
The second branch of first-generational practice models emphasizes the communicative process occurring between members. Among these models, Virginia Satir’s humanistic family therapy is a systems-oriented approach. It focuses on interaction patterns in families, and she assumed that troubled families have a unique pattern of communication.
She also theorized a correlation between family communication and self-esteem, so her approach was to improve family members’ self-esteem, enhance communication, and build problem-solving skills. Ultimately, the therapeutic goal of her approach was to facilitate honest and direct communication among members.
Strategic Family Therapy
Jay Haley was the founder of strategic family therapy, a short-term treatment that involves observing and changing the interactional sequences where the family problem arises. The therapist designs an intervention allowing the family to replicate interactions. This way, they can address issues relating to the family structure and bring about behavioral change.
Solution-Focused Therapy
This is a short-term, goal-focused, and evidence-based therapy that facilitates change in the family by coming up with solutions rather than focusing on problems. It involves a collaboration between the therapist and family, who discuss previously attempted solutions. By focusing on times when the problem is not present, the therapist can develop an intervention around the exception.
Narrative Therapy
Developed by White and Epston, the narrative approach focuses on how language shapes the way families define and perceive problems. Since the aim is to separate the family members from the problem, family members must form a narrative of their experiences around the problem. The therapist helps members acknowledge their ability to change the narrative surrounding their experiences.
Conclusion
From the 1950s to the present day, family therapy has gone through various phases of change. Today, therapists don’t use one specific practice but rather techniques stemming from multiple areas, depending on the client. It has become the most commonly used evidence-based practice to help people recover from mental disorders and maintain healthy relationships with their families.