When we think of someone doing therapy, we usually imagine an individual 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 conflicting aspects between members of the same family are dealt with. In this article we indicate what it is and what it is used for.

What kind of psychological intervention?

Family therapy is understood as that form of therapy that focuses on the family as the object of intervention. The objective is to strengthen and provide resources to the family so that they can act in a collaborative manner thanks to this to resolve disputes and conflicts that they may have among themselves or problems that are specific to a single individual.

The family is understood as the basic element in the development of the human being, since it represents the fundamental element 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 the 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, being the roles and communication the basis 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, with new elements, properties and characteristics being born from their interaction.

For the systemic perspective, the behavior and state of one of the components of the family cannot be understood separately from the system, with 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 therefore affected by the environment.

Changing the dynamics of behaviour

The systemic model is not intended to directly modify problematic behaviour , but to change family dynamics and the pattern that provokes, facilitates or makes it useful or meaningful. A more indirect way is sought to reach the same end, while at the same time provoking an improvement and strengthening of the positive family dynamics and the strengths of both the system and each of its components.

Some of the key aspects of systemic family therapy are the communication processes (in which incongruent communication styles are worked on at an analogical or digital level, the 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 limits 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 family members.

There are many schools and techniques even within the same perspective . The school of Milan, the structuralist school of Minuchin or the school of Palo Alto are examples of different perspectives within the systemic current. In terms of concrete techniques, task prescription, imbalance (temporarily allied with one of the components of the system to change family boundaries), dramatization, redefinition of symptoms in a positive way, paradoxical intention or instigation are used.

The properties of the family system

Within the system there are different properties:

1. Circular Causality

The behaviour of one member of the system is influenced by the behaviour of the others , just as one’s own behaviour influences the rest of the system. If you shout, the rest of the system will react, and the reaction will generate a response in the first one.

2. Totality

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 can become anxious (for example) from different stimulations.

4. Equity

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 balance. This causes deep changes to be necessary in order for them to be maintained over time, or else they could return 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 of therapy. In this sense we can find that, in addition to the systemic perspective, this form of therapy has been worked from among the two that you can see below.

Psychodynamic perspective

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

The existing conflicts make the infant’s emotion look repressed , which on the one hand causes the parent in conflict to remember and relive his lack of developmental resolution and on the other hand, this reflects his conflicts in the treatment of his child. Therapy focuses on visualizing and working with transference and countertransference relationships in order to help the family as a whole to resolve their developmental sequences.

Cognitive-behavioral perspective

From this perspective, therapy focuses on the direct resolution of a particular 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 aim is to modify the behaviour of one of the members. But it can also be used to solve dysfunctional aspects of the family itself.

Applications of this type of therapy

Family therapy has been used since its origins to help solve various types of problems. Among them are the following.

1. Family crises

The existence of intra-family problems that cannot be solved by traditional means has often been a reason for consultation for family therapy. A difficult situation, aspects linked 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. Couples therapy

Couples therapy is one of the subtypes of family therapy. 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 members

Especially when the subject in question is one of the children, it is not uncommon for parents to decide to try to remedy it. In many cases, parents or family members can be employed as co-therapists who can facilitate the maintenance of the 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 of the families (for example, broken homes or couples who continually argue may contribute to causing emotional and behavioural problems).

4. Treatment of addictions and other disorders

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

5. Psychoeducation

Psychoeducation with families can be fundamental in helping a person’s environment understand their situation, what to expect, what they can do to help them, or what steps need to be taken.

6. Parent training

Parenting training is a great advantage for parents who have children with behavioral problems or who do not know how to deal with specific situations that are being experienced throughout their development. It teaches how to cope with maladaptive behaviour through shaping and positive stimulation that allows the child to adapt.

The position of the therapist

Within family therapy, the therapist has a particular role. Although it depends on the perspective from which the family therapy is applied, as a general rule the professional has to remain in an equidistant position between all the members of the family present in the therapy, without taking sides with any of its members. He or she 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 you can establish temporary alliances with some of the members in order to focus the attention of the group on certain aspects, but later you have to return to a neutral position and/or.

In some cases it will need to remain an external and cold element that merely points out the patterns of family functioning, while in other cases it may be necessary for it to represent the role of one more family member in order to introduce a new element into the therapy and help make the different points of view visible.

Bibliographic references:

  • Almond tree, M.T. (2012). Psychotherapies. Manual CEDE de Preparación PIR, 06.
  • Minuchin, S. (1974). Families and family therapy. Gedisa: Mexico.
  • Ochoa, I. (1995). Approaches in systemic family therapy. Herder: Barcelona.