Goals: Specific & General
Common family therapy goals include exploring patterns and their relation to individual psychopathology, encouraging the family to improve functionality, increasing positive communication, restructuring maladaptive international and relational patterns, and strengthening natural resilience.6
In general, goals of family systems therapy usually fall into two categories: specific goals for individual family needs and general goals that apply to all families. General goals are related to familial interactions and changing maladaptive patterns, while specific goals cater to individual needs such as diagnoses and pathology, substance use disorders, or trauma.7
Reasons to Seek Family Systems Therapy
Common reasons to seek out family systems therapy include suicidal ideation of a family member, suicidal attempt of a family member, and parental substance abuse.
Other common reasons why families seek therapy include:
- Substance use disorder of a family member4
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- Major mental illness of a family member4
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- Issues with overall functioning of the family unit4
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- Conduct disorders/behavioral issues of a child4
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- Chronic illness of a family member4
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- External stressors such as job issues4
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- Communication deficits4
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- Depression and anxiety of members that impact family function4
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After initial safety measures are taken, the clinician will gather more information about the family system, history of behaviors, and interactional patterns placement within the family (genogram). This information allows them to assess and determine underlying causes and considerations for the family dysfunction as well as the individual diagnosis.
Parental Substance Abuse
When working with parental substance abuse it is essential to gauge safety. All therapists have an ethical duty to warn if there is ever concern of imminent harm.5,11,12 In this scenario, they would meet with the family, gather information, conduct assessments, and create a safety plan to ensure that the family is aware of their local resources in the event of a crisis.11,12
During the working phase of therapy, the therapist would work with the family to identify transgenerational patterns, previous traumas, and other influential factors in the development of the substance use disorder. Then, they would work with the family to create goals related to decreasing substance abuse, increasing function through education, and providing support for cessation of enabling patterns.6,11
Cost of Family Systems Therapy
Depending on the state, a typical cost range is $75-200 per hour-long session.4 Family therapy can also be accessed through private insurance; however, most insurance will not cover it unless a family member has a mental health disorder. In these cases, the insurance company looks for an “identified client.” All intake paperwork and subsequent assessments go under that client’s name.
The identified client is usually the individual who showcases a diagnosable mental health concern like depression, conduct issues, substance abuse, or behavioral issues. This means that all clinical notes, goals, and interventions will be geared towards improving that client’s issues in the larger interest of improving family function. The treatment plan will be required to include at least one goal for the client and a separate goal for the family.2,4,9,11
Insurance also dictates credentialing requirements on who can provide the therapy, how it can be conducted, and in some cases, what assessments can be performed. Guidelines are dependent on both the state of residence and insurance of individual members.4
How to Find a Family Therapist
Finding a family therapist can require a referral from a primary care physician or an individual therapist; however, families can also self-refer. Check with your insurance providers to determine whether you need a referral.4,8,11 You could also search through a directory like Choosing Therapy, which enables you to filter therapists by state, specialty, availability, cost, experience, and language.
Key Questions to Ask
To decide whether a potential therapist is an appropriate match, families should always consider asking a few questions upfront like how much experience do they have.
Other key questions to consider asking your family systems therapist include:
- How much experience do you have in dealing with this type of presenting issue (e.g. substance abuse)?
- Do you have adequate cultural competency?
- Do you understand societal/cultural considerations that may be impacting stress and level of function?
- What is your level of experience/expertise in the family systems approach?
- Are there any additional considerations, assessments, or mandates that pertain to the state?
What to Expect at Your First Appointment
During the initial session, the therapist usually gathers information about the family system as a whole, the reason for seeking therapy, the history of certain behaviors, and cultural and socioeconomic information. Then, they work with the family to create specific and general goals like decreasing substance-use and increasing adaptive family communication.7 Generally, family therapy is short in duration and lasts for an average of 12 sessions.4,7,9,10
Is Family Systems Therapy Effective?
The effectiveness of family systems therapy generally depends on the family’s engagement and willingness to grow. In fact, therapists across the board agree that engagement is the number one predictor of success.1,,5,16,17 Some studies show that family therapy interventions are actually the preferred treatment approach for depression, substance abuse, child and adolescent risk behaviors, suicide risk, and relational issues.10
Any family who is able to demonstrate an open mindset and work to improve on systemic deficits will be able to make positive changes. That said, family therapy does not “solve” family problems. Instead, it provides tools for families to use to increase their cohesion.9 Factors that may hinder the effectiveness of family therapy include relapse, medication noncompliance, or certain pathologies related to personality disorders that may negatively impact treatment progress.11
Risks of Family Systems Therapy
One of the risks to consider with family therapy is the competency of the therapist. Certain families may exhibit very intensive needs, so it is important to be sure that those needs match the therapist’s level of competency.8 Additional risks are related to certain mental health and substance-use issues.12 Therapists working with high-risk family members who exhibit suicidal ideations or have made past suicide attempts need to ensure that their plan includes crisis response and preventative measures.11,12
Therapists working with clients who exhibit substance use disorders will also need to explain their duty to report to child protective services if there is a concern.1,8,11 It is encouraged that therapists in this role explain how working with child protective services can be a positive experience that fosters general health and wellness for the family.
Lastly, if family members have conflicting goals that impact individual members’ well-being, it may pose additional risks in trying to create a clinically appropriate goal for the family while also catering to individual needs.18
Criticisms of Family Systems Therapy
Family systems therapy can be very intense and requires a great deal of work and compliance from all members. This can be a difficult task to achieve if the family is not ready, and studies show that families who terminate early have less successful outcomes.11,17 When individual members demonstrate toxic or dangerous traits, it can even become ethically problematic to promote family cohesion.1,17,18
Some argue that family therapy is practiced with little awareness of the external factors that influence behaviors such as school, workplace, or neighborhood.19 From a feminist perspective, family therapy can be seen as promoting a traditional patriarchy that supports a misogynistic conceptualization of problems. This consideration is particularly applicable when working with LGBTQ+ related family problems.19
Final Thoughts on Family Systems Therapy
Family systems therapy is a complex approach utilized to work with an intimate group of individuals who usually reside in the same dwelling. It showcases multiple approaches given the vast nature of familial issues, the multitude of influential factors, and the diagnostic considerations of individual members.
The family unit is one of the strongest relationships you’ll find. However, even the most tight-knit family can experience problems in communication. Sometimes, those problems last a long time, and hurdles seem insurmountable due to the close proximity and familiarity of family members. It may take a professional to get you all back on track to result in more peaceful home life.
That’s where family therapy comes in.
What is Family Therapy?
A form of psychotherapy, family therapy is designed to reduce distress and conflict through the improvement of interactions between family members. Usually, it’s best to have all family members who are affected by the problem in one room; however, this isn’t always feasible. What sets family therapy apart from individual counseling lies in the perspective or framework, not necessarily how many people are present in the session.
Family counseling looks at problems as patterns or systems that need to be adjusted, rather than focusing on one person’s sole role in the problem. This is why it’s often referred to as “strengths-based treatment.” Strong family relationships play a critical in the overall mental health of each family member. This method can be effective in helping family members adjust to another family member’s struggle with an addiction, medical issue or mental health diagnosis, for example. It can also be used to improve communication and reduce conflict.
Common Reasons for Family Therapy
There are many reasons that may prompt you to seek family therapy, including:
- If your child is having a problem with school, substance abuse or an eating disorder.
- If a major trauma or change has impacted the entire family, such as moving, a natural disaster, or incarceration of a sibling or parent.
- The unexpected or traumatic loss of a family member.
- Adjustment to a new family member in the home, such as the birth of a sibling or grandparent moving in.
- Domestic violence
- Divorce
- Parental conflict
Family therapy is a specialized skill set, so if you are in need of this type of therapy, it’s important to choose a mental health professional who has the training and credentials that uniquely qualify them to perform this kind of counseling.
Goals of Family Therapy
Family therapy can be helpful to all family members on many different levels. Family therapy sessions can help:
- Develop and maintain healthy boundaries
- Facilitate cohesion and communication
- Promote problem-solving by a better understanding of family dynamics
- Build empathy and understanding
- Reduce conflict within the family
Contact Comprehensive MedPsych Systems
We offer family therapy services here at Comprehensive MedPsych Systems. A therapist will meet with several members of your family to help you all more thoroughly understand others’ thoughts, motivations, behaviors, and feelings. Therapy is designed to improve communication and increase effective behavior choices, ultimately helping the family unit to function better. To book your appointment, contact us at 941-363-0878 or fill out our online form.
