Family Therapy Types

Published by Latrina Walden

  • January 21, 2025
  • 22:36

Latrina Walden

Founder & CEO of LWES | MSN, MHA, FNP-C, FNP-BC, PMHNP

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Meet The Author

Latrina Walden

Latrina is the Founder & CEO of Latrina Walden Exam Solutions (LWES). Her background is in creating a NP Academy that supports and educates current and future nurses through an Academy.
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Table of Contents

    Family therapy encompasses various approaches designed to improve communication, resolve conflicts, and strengthen relationships within a family unit.

    Each type of family therapy offers unique techniques tailored to address specific issues, whether they stem from communication breakdowns, behavioral problems, or emotional distress.

    In addition to well-known methods like Structural and Systemic Family Therapy, psychodynamic and psychoanalytic therapy can also be used to explore deeper emotional and relational patterns, often focusing on unconscious dynamics within the family.

    Family therapy techniques

    Primary

    Circular questioning is the primary technique used in systemic family therapy, helping family members explore connections by encouraging them to consider different perspectives. This technique shares similarities with group therapy, where open dialogue and multiple viewpoints also foster a deeper understanding of relational patterns and dynamics.

    Pretend

    Developed by Cloe Madanes in 1980, the pretend technique involves asking family members to act as though a specific issue is resolved. This creative approach helps shift family dynamics, reducing individual symptoms and transforming problematic interactions into healthier patterns.

    Role Playing

    Role-playing in family therapy involves acting out potential family scenarios to explore different reactions and solutions. This technique helps family members practice communication skills and resolve conflicts by applying concepts learned in therapy to real-life situations.

    Structural Family Therapy

    Structural Family Therapy (SFT) is a type of psychotherapy that focuses on improving communication and relationships within a family by examining and adjusting the family’s organizational structure.

    It assumes that psychological problems are influenced by family dynamics and aims to identify and modify the subsystems, authority levels, and boundaries within the family to promote healthier interactions and resolve conflicts.

    Techniques

    Structural family therapy techniques include:

    • Assessment: Evaluating family dynamics and relationships to understand the underlying issues.
    • Structural Mapping: Visualizing and analyzing the family structure to identify roles, boundaries, and hierarchies.
    • Joining: Building rapport with the family by engaging with them in a non-judgmental way.
    • Enactment: Encouraging family members to act out specific situations to gain perspective and facilitate understanding.
    • Role-Playing: Having family members switch roles to help them understand each other’s experiences and emotions.
    • Reframing: Offering a new perspective on a family member's behavior to change how it’s perceived and understood.
    • Boundary-Setting: Helping family members establish clear and healthy boundaries between subsystems and individuals.
    • Subsystem Analysis: Identifying and addressing the different subsystems within the family, such as parental or sibling groups.
    • Identifying Coalitions: Observing and addressing alliances or power struggles between family members that may contribute to dysfunction.
    • Goal-Focused Interventions: Setting specific, measurable goals to guide the therapeutic process and bring about meaningful change.

    Concepts

    The core concepts of structural family therapy includes: family structure, sub systems, power and hierarchies, boundaries, enmeshment, disengagement, triangulation and parentified children.

    Steps

    The four steps of structural family therapy (SFT) are:

    Assessment

    In the assessment phase, the therapist works with the family to evaluate the family’s structure and dynamics. This includes identifying patterns of communication, understanding the roles and boundaries within the family, and recognizing how current issues impact family members.

    Goal setting

    The therapist collaborates with the family to define clear, specific goals for therapy. These goals often focus on improving communication, resolving conflicts, enhancing family cohesion, and addressing any dysfunctional patterns of behavior.

    Restructuring

    In this phase, the therapist helps the family modify their interactions and relationships to foster healthier dynamics. This may involve changing family roles, adjusting boundaries, or introducing new rules that encourage more supportive and balanced connections.

    Intervention

    The therapist employs a variety of techniques to facilitate progress toward the family’s goals. These interventions may include reframing behaviors, prescribing specific actions, or using paradoxical techniques to challenge unproductive patterns and create lasting change.

    Boundaries

    In Structural Family Therapy (SFT), boundaries refer to the rules that dictate how family members interact and relate to one another. SFT therapists assess family dynamics based on the flexibility and clarity of these boundaries.

    In functional families, boundaries are clear but adaptable, allowing members to respond effectively to stressors. The therapist’s role is to help families identify, explore, and establish healthy boundaries that foster better communication and stronger relationships.

    3 Types of boundaries

    • Clear Boundaries: These are healthy, well-defined boundaries that allow family members to maintain their individuality while fostering closeness and mutual respect.
    • Diffuse Boundaries: These boundaries are too loose, leading to excessive closeness and a lack of individual autonomy. This can cause enmeshment and confusion in roles.
    • Rigid Boundaries: These boundaries are overly strict, creating emotional distance between family members and preventing the development of close, supportive relationships.

    Benefits of clear boundaries

    • Encourages Open Communication: Clear boundaries create a safe space where family members feel comfortable expressing their thoughts, feelings, and concerns.
    • Promotes Empathy: Defined boundaries help individuals better understand each other’s perspectives, fostering empathy and emotional connection.
    • Enhances Relationship Quality: Healthy boundaries facilitate more effective communication and reduce stress, leading to healthier, more balanced relationships.

    How SFT therapists work with boundaries

    • Establish Trust and Empathy: Therapists create a trusting and empathetic environment, where each family member feels heard and understood.
    • Identify and Define Boundaries: Through dialogue, therapists guide the family in identifying, exploring, and redefining boundaries to strengthen relationships.
    • Encourage Positive Change: SFT therapists promote proactive and healthy changes within the family system, helping members implement healthier boundary dynamics.

    Difference between Structural and Systemic family therapy

    The main difference between Structural and Systemic Family Therapy is that Structural Family Therapy focuses on reorganizing the family’s structure by establishing clear boundaries and improving communication, while Systemic Family Therapy focuses on understanding and changing the patterns of relationships and interactions within the family, encouraging the family to solve problems together as a unit.

    What is the most common type of family therapy?

    One of the most commonly practiced types of family therapy is Structural Family Therapy (SFT), which focuses on improving family dynamics by addressing boundaries, communication, and family roles.

    What are the three models of family therapy?

    Models of intervention at a family level are described as preventive, crisis intervention or rehabilitative.

    1. Preventive: Aimed at reducing the likelihood of future family issues.
    2. Crisis Intervention: Focused on addressing immediate family crises or challenges.
    3. Rehabilitative: Designed to help families recover and heal after difficult situations or dysfunctions.

    What is the best therapy for family therapy?

    The best therapy for family therapy depends on the family's unique needs and challenges.

    Strategic Family Therapy (SFT) is considered to be one of the most effective options.

    It helps families improve communication, identify and break destructive patterns, and create healthier dynamics. Through targeted interventions, SFT encourages family members to change unproductive behaviors and adopt more positive ways of interacting.

    This therapy also addresses specific issues within family roles, boundaries, and problem-solving strategies, making it highly effective for resolving conflicts and improving family relationships.

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