Family therapy: types and forms of application

When we think of someone doing therapy, we usually imagine a one-on-one session in which a person interacts with the psychologist. We may also conceive the possibility of a group session, with different people with the same type of problem.

But there is also a type of therapy that is applied to a family group, the so-called family therapy, in which conflictive aspects between members of the same family are dealt with. In this article we tell you what it is and what it is used for.

What is this type of psychological intervention?

Family therapy is understood to be that modality of therapy focused on the family as the object of intervention. The objective is to strengthen and provide resources to the family so that they can act collaboratively thanks to it. settle disputes and conflicts that may have between them or problems of a single individual.

The family is understood as a basic element in the development of the human being, as the element fundamental that allows the infant to acquire a model regarding how to see, act, relate and communicate with the world. It is an essential element when learning emotional and relational aspects, with great influence on development.

That is why in this type of treatment an attempt is made to involve two or more members of the same family in order to observe and, if necessary, modify, the interaction patterns between family members.

It is conceived that the internal problem of an individual is preceded by the presence of interpersonal conflicts, which when internalized can cause symptoms. The pathological is linked to the non-acceptance of new roles in one of the individuals, with roles and communication at the base of the existence of numerous mental and social problems.

Family therapy and the systemic perspective

One of the main currents and the one that is most linked to this type of therapy is the systemic current. From this perspective, the family is conceived as a system, a set of elements whose sum generates a result greater than the simple addition of each one of them, emerging from their interaction new elements, properties and features.

For the systemic perspective, the behavior and state of one of the components of the family cannot be understood separately from the system, the system influencing each individual and vice versa. The family would be an open system, receiving information from the environment, being affected by the environment and exchanging information with it in order to adapt and survive. Each of the members is thus affected by the environment.

• Related article: "Systemic therapy: what is it and on what principles is it based?"

Change behavior dynamics

From the systemic model it is not intended to directly modify the problem behavior, but rather to change family dynamics and the pattern that causes it, facilitates it, or gives it usefulness or meaning. A more indirect way is sought to reach the same end, while causing an improvement and empowerment positive family dynamics and strengths of both the system and each of its components.

Some of the key aspects of systemic family therapy are communication processes (in which incongruous communicative styles are worked on at an analog or digital level, affectivity and emotion expressed or the presence of rigidity), the assignment of roles and the need to change them, the clear or diffuse structure of the family and the boundaries between people that can allow or inhibit the process of creating an own and autonomous identity, the negotiation in conflicts or the establishment of power relations between the members of the family.

exist multitude of schools and techniques even within the same perspective. The Milan school, the Minuchin structuralist school or the Palo Alto school are examples of different perspectives within the systemic current. Regarding specific techniques, the prescription of tasks is used, the imbalance (temporarily allying with one of the components of the system to change family boundaries), dramatization, redefining symptoms in a positive way, paradoxical intention or instigation.

The properties of the family system

Within the system there are different properties:

1. Circular causality

The behavior of one member of the system is influenced by that of the others, just as it influences the rest of the system. If one shouts the rest will have a reaction, while the reaction will generate a response in the first.

2. Whole

The system generates its own responses due to the interaction, being more than the mere sum of its parts.

3. Equifinality

Different people can get to the same point through different paths. In this way two people they can arouse anxiety (for example) from different stimulations.

4. Equicausality

The opposite of equifinality. The same starting point can lead to different conclusions. Thus, an event will be experienced differently by different people.

5. Homeostasis

The system tends to try to find a state of equilibrium. This causes profound changes to be necessary in order to keep them in time, or else it could be returned to the original state. On the other hand, if a consistent change is achieved that is integrated into the system, it can be maintained over time.

Family therapy from other perspectives

When we talk about family therapy, we are generally associating it with a type of treatment linked to the systemic current. However, and despite the fact that the development of family therapy is closely linked to this current of thought, throughout history there have been multiple theoretical perspectives that have worked with this type therapy. In this sense we can find that, in addition to the systemic perspective, this form of therapy has been, among others, worked from the two that you can see below.

Psychodynamic perspective

Some currents of psychoanalysis have also applied aspects of family therapy, especially those who follow the theory of object relations. From this perspective, a patient's symptom is seen as indicative of failure to resolve the developmental sequence of one or both parents.

Existing conflicts make the infant's emotion suppressed, which on the one hand causes the father in conflict to remember and relive the lack of resolution of his development and on the other hand that this reflects his conflicts in the treatment of his son. Therapy focuses on visualizing and working with transference and countertransference relationships in order to help the family as a whole to resolve its developmental sequences.

• Related article: "The 9 types of Psychoanalysis (theories and main authors)"

Cognitive-behavioral perspective

From this perspective, therapy focuses on the direct resolution of a specific problem presented by the family or one of its members, the objective being quite specific.

Couples therapy, parenting training, or psychoeducation are some modalities that have been treated from this perspective. In some cases, the family may be employed as a co-therapist, if the objective is to modify the behavior of one of the members. But it can also serve to solve dysfunctional aspects of the family itself.

• You may be interested: "Cognitive Behavioral Therapy: what is it and on what principles is it based?"

Applications of this type of therapy

Family therapy has been used since its inception to help solve various types of problems. Among them can be found the following.

1. Family crisis

The existence of intra-family problems that cannot be solved by traditional means have frequently been reasons for consultation for family therapy. A difficult situation, aspects related to the life cycle such as the birth of children or the arrival of their emancipation, a death whose mourning has not been elaborated or some latent conflict between its members are valid examples.

2. Couple therapy

Couples therapy is one of the subtypes of family therapy out there. Overcoming problems in the couple such as lack of communication, exhaustion, infidelity or incompatibility in some aspects of life are some of the most frequent reasons for consultation.

3. Behavioral problems or mental disorders in one of the limbs

Especially when the subject in question is one of the children, it is not surprising that the parents decide to try to remedy it. In many cases, parents or family members can be used as co-therapists who can facilitate the maintenance of changes and the follow-up of programs established by the therapist.

Likewise, in other cases the problems presented may be strongly influenced by the communication patterns families (for example, broken homes or couples who argue continuously can contribute to emotional and behavioral problems).

4. Treatment of addictions and other disorders

In the treatment of various addictions and even other psychological disorders it can be very useful integrate the closest family members, so that they can help the subject to stay away from stimuli that elicit the consumption response. They can also participate in making the subject see the need to continue with the treatment and the advantages of stopping consuming, as well as reinforcing the behaviors that favor their recovery.

5. Psychoeducation

Psychoeducation with families can be essential in order to help understand the environment of a your situation, what to expect, what they can do to help you, or what steps you need to take from.

6. Parent training

Parent training is a great advantage for parents who have children with impaired behavior or who do not know how to deal with specific situations that are being experienced throughout their growth. How to deal with maladaptive behaviors is taught through molding and positive stimulation that allows the minor to adapt.

The therapist's position

Within family therapy, the therapist has a particular role. Although it depends on the perspective from which family therapy is applied, as a general rule the professional has to stay in an equidistant position among all the members of the family present in therapy, without taking sides with any of its members. It must ensure that all members can give their opinion and that it is heard and valued by the other participants.

Depending on the case and the modality of family therapy, occasionally if you can establish temporary alliances with one of the members in order to focus the group's attention on certain aspects, but later on it has to return to a neutral position me.

In some cases it will have to remain as an external and cold element that is limited to pointing out the patterns of family functioning, while in other cases it may be necessary to represent the role of another family member in order to introduce a new element in therapy and help to show the different points of sight.

Bibliographic references:

• Almendro, M.T. (2012). Psychotherapies. CEDE PIR Preparation Manual, 06. CEDE: Madrid.

• Minuchin, S. (1974). Families and family therapy. Gedisa: Mexico.

• Ochoa, I. (1995). Approaches to systemic family therapy. Herder: Barcelona.