Family therapy is supposed to be very effective treatment for problems within families such as disturbed communication, criticism, parent-child relational problem, partner related issues, lack of bonding between members, stagnant relationships, interpersonal problems, problems between subsystems of joint or extended families or any kind of problems our families are facing in today’s life. Different types of family therapies are proposed by renowned theorists such as Bowen, Virginia Satir, and Milton Erickson. A practicing family therapist considers all aspects of these theories and designs an eclectic approach to fit family problems. Specific strategies are then formulated to treat their problems in direct or indirect manner.
There are three phases of family therapy. The first is family assessment, secondly, members are prepared for the treatment, and in the third phase, strategies are implemented by the members and their problems are resolved. A family therapist considers the following aspects at the time of family assessment
1. Family Structure (Nuclear, Joint, Step Family system, Single parent-led Family or Remarried family)
2. Family Developmental Stage (Married couples, child bearing, pre-school children, school children, teenagers, launching children, middle-aged parents or aging family)
3. Family Systems (Systems: individual, marital, or dyadic; Interconnected systems: extended family, schools, industry, religious systems)
4. Family Environment (Interpersonal relationships: cohesion, expressiveness, conflict; Personal growth: independence, achievement orientation, intellectual-cultural orientation, active recreational orientation, moral-religious emphasis; System maintenance: organization, control)
5. Family Attachment and Cohesion (Attachment: trust, communication, and alienation within members; Cohesion: emotional bonding members have with each other)
6. Family Adaptability (Morphogenesis: how far family permits change; Morphostasis: how far it is characterized by stability)
7. Family Functioning (current functioning level, views, beliefs, and concerns of family)
8. Family Problem Solving (Instrumental: daily life management of food, clothing, and housing; Affective: handling of emotions such as anger or depression)
9. Family Task Accomplishment (Basic tasks: provision of food, shelter, clothing, and health care; Developmental tasks: members’ needs and adjustment in family developmental stage; Hazardous tasks: dealing with unusual or unexpected events and crisis such as death, illness, job loss, natural disasters etc.)
10. Family Communication (verbal and nonverbal messages; Effective, instrumental or simple expression of opinions; clear vs. masked and direct vs. indirect communication)
11. Family Roles (roles related to Provision of resources; Nurturance and support; Adult sexual gratification/partner satisfaction; Personal development: social and life skills related to school or career; Maintenance and management: decision making, boundary, behavior control, finance and health-related functions; Role allocation and Accountability)
12. Family Affective Responsiveness (manner in which members convey feelings; cultural influence of family responses; quality, quantity, and appropriateness of effective response)
13. Family Affective Involvement (Uninvolved, interest devoid of feelings, narcissistic involvement, empathic involvement, over-involvement, symbiotic involvement)
14. Family Behavior Control (standards and rules for family members: in physically dangerous situations, meeting psychobiological needs, socialization behaviors within and outside family; parental control styles: flexible, Rigid, Laissez-faire or Chaotic)
15. Family Values and Norms (expression of values; judgment of appropriate or inappropriate behaviors; ethnic and cultural value system of family; family myths or secrets)
16. Family Rules and Boundaries (Descriptive, prescriptive, meta-rules; Open, close system boundaries)
17. Family Transnational Patterns (Functional, Dysfunctional patterns; marital schism, skew, pseudo-mutuality and hostility, mystification; Double-bind or Meta-communication; Placator, Blamer, Super-reasonable, irrelevant stance)
18. Family Issues (distressed family: referred for treatment; non-distressed family: with no history of treatment and/ or satisfactory relationships)
During the initial interview, a family therapist assesses the above-mentioned problem areas and clinically observes the behaviors of family members during the interview. Family members may be open, secretive, anxious, relaxed, withdrawn, cooperative, timid, aggressive, compliant, or oppositional, which gives the idea about their family patterns and what things need to be changed in the family to make the members fully functioning. The therapist also considers the strengths of the whole family such as the degree of insight regarding problems, the intellectual level of members, mitigating circumstances of the family, self-differentiated individual(s), and other talents or resources of the family which can help them thrive during the treatment.
After the assessment is done, members are introduced to the effective strategies they can use to handle their problems. Various strategies are used by family therapists such as effective communication patterns, role plays, sculpturing, family stories, metaphors, contracts, and other direct or indirect methods of behavior change.
When a therapist observes that family members are skilled in effective communication and problem solving, various tasks are assigned to them regarding their roles in family and community. At this stage, the confidence of family members is enhanced and they are encouraged to solve their problem on their own so that little facilitation is provided by the therapist. In the end, the family becomes equipped with all the necessary tools and strategies to resolve their daily life issues.
When the family is able to handle life problems without the support of a family therapist, it is a stage where therapy is bilaterally terminated with the consent of therapist and all the family members.
Hence, it is ensured that family therapy proves to be effective for struggling families who want support and help. Get help from our expert therapists if you have one of those families struggling hard in life.
Mehwish Mursaleen (Ph.D., Clinical Psychology)
Online Psychotherapist (Consult-a-psychologist.com & iCliniq.com)