Essential family therapy interventions

Ask any family therapist about the core components of implementing family therapy interventions and they will likely mention systemic thinking. This article will discuss this concept, as well as others, to help inform you of family therapy techniques you can use in your next session.

Systems thinking, as a broad concept, can be applied to many industries and fields.

When applied to family therapy techniques, systemic thinking can be best understood as viewing a family as a system in and of itself, but also as one that exists within larger societal systems—where family members are directly influenced by the actions, experiences, and feelings of others and the world around them.

Implementing systemic family therapy techniques ensures that family therapy interventions  benefit everyone in the family.

With systemic thinking, family therapists don’t see individuals without seeing them in the context of their identities and relationship with others.

Problems that involve one family member are seen in the larger scope of the family as a whole. As such, conducting family therapy and delivering effective family therapy techniques prioritizes the family as the client, instead of each member.

Compared to individual therapy, where an individual’s symptoms guide treatment, family therapists rely on interpersonal dynamics, patterns, boundaries, and communication to fully assess the course for family therapy interventions. Because of this holistic approach to therapy, family therapy can be a place for deep and meaningful change.

What is family therapy?

Family therapy is a form of psychotherapy that focuses on treating issues among multiple members of a family group.

To conduct family therapy, you need at least two members, but can work with as many as necessary to support the overall family need.

Many clinical providers of family therapy have open and fluid definitions of what constitutes a family.

Essentially, a family is a group of people that care about one another and are interconnected in each other’s lives. So, a family session could involve parents, grandparents, siblings, friends, spouses, other partners, in-laws, and more.

Below are some family therapy examples that can help demonstrate the wide ranging contexts and relationships that could be treated with family therapy interventions:

• A child and their adoptive parents
• A family with a parent who has been diagnosed with a severe mental health condition
• A brother and sister who have recently lost a parent due to a medical illness
• Friends who are reconciling after many years of estrangement
• Three members of a polyamorous relationship who are looking to develop clearer expectations and boundaries for their relationship agreement
• A couple who are trying to navigate the complexities of infertility
• A mother, son, and stepfather adjusting to a new family structure
• Queer-identified partners who need support with embracing pivotal aspects of their identity
• Queer-identified chosen family members, who may not bear genetic relation or custodial responsibility, but hold deep familial bonds

Similar to individual therapy, family therapy interventions include diverse approaches depending on the situation as well as the clinical expertise and interest of the provider.

There are many types of family therapies that are available to clients, however, some of the most common include emotionally focused family therapy, play therapy, narrative family therapy, Bowenian family therapy, strategic family therapy, structural family therapy, and solutions-focused brief family therapy.

What can family therapy interventions treat?

According to the American Association for Marriage and Family Therapy (AAMFT), family therapy can be an appropriate treatment for a variety of clinical concerns.

For example, family therapy interventions may be appropriate for issues of “depression, marital problems, anxiety, individual psychological problems, and child-parent problems.”

Moreover, it has become common with certain mental health issues to recommend family therapy methods as the gold standard for care, including issues with eating disorders, grief and loss, psychosis, and substance use.

The goal of any family therapy method, in any instance, is to improve relational bonds, communication patterns, and to reduce dysfunction that may exist in a family system.

Through education, in-session processing, and supporting increased connection, family therapists have the crucial task of decreasing conflict and helping relationships build a deeper sense of resilience.

Examples of systemic family therapy techniques

Applications of family therapy techniques using a systemic approach are critical to strengthening the family system.

Some of the most common family therapy techniques follow the general course and phases of care: information gathering, joining, assessment, and delivery of family therapy interventions.

Here’s more on each of these phases:

Information gathering     

The first stage of family therapy involves gaining enough information so that the clinician (and family) can better contextualize and understand the problem.

Family therapists will survey the perspectives of each person in the family by using self-reported data as well as observing interactions between members in session.

Circular causality

One way to gather this information is through circular causality.

Circular causality is the principle that in any interaction, a circular cause and effect pattern triggers and reinforces behaviors, feelings, thoughts, or emotions in a family dynamic.

For example, the action from person A impacts person B, who then engages in an action that reinforces actions from person A, and so on and so forth.

When asking questions, clinicians can try to define this pattern to see how relational problems get stuck.

Genogram

One of the most useful family therapy interventions is the genogram.

A genogram is defined as a “visual representation” of the family’s patterns, structure, relationships, and history.

When used at the beginning of treatment, clinicians will map out valuable demographic information like age, place of birth, substance use history, occupation, medical history, and more. All of this information can be represented through symbols so that a total diagram can provide information all at once.

Genograms help families identify the presence of triangles in the family system. Triangles are structures within families that enable two people to stabilize their relationship through a third influence, whether another person, issue, job, or other factor.

Emotional triangles are considered the “smallest stable relationship system” and the identification of triangles within a family can help the clinician see how the family functions and deals with emotional tension.

Joining

Family therapy techniques are designed so that the clinician is always focused on building an alliance with the family. In addition to building a strong therapist-client relationship, family therapists are often concerned with ways to “join” the family.

Joining means that the therapist is working toward understanding the perspective of all members and becoming a part of the family so that they can help facilitate change.

Some family therapists are highly focused on the structure of the family system, believing that they can effect change at the structural level, by modeling ways of strengthening family techniques, appropriate behavior, and emotional awareness and self-regulation.

Mimesis

One family therapy technique that can be used in this phase of treatment is called mimesis.

Mimesis is the process of emulating or imitating the communication patterns of the family.

An example of this family therapy intervention would be using the same tone or pace of speech as the family or by utilizing humor for a family that jokes frequently.

Assessment

Assessment is happening at all phases of family therapy. However, once the clinician has joined with the family system and is able to understand the experience of being within the family, deeper assessment can be conducted.

Power mapping

One of the most in-depth assessment tools in family therapy is called power mapping.

Power mapping in family therapy is another visual tool that showcases the “who, what, where, when, and why” of power within a family.

Power mapping in family therapy can be a supplementary tool to the genogram or be used singularly.

By power mapping, not only do you understand how the family functions, but you gain a sense of who has the most power within the family.

Typically, family therapists focus on the source of power within the family, as this leads to the highest probability for change.

Employing family therapy interventions

At this point in the therapeutic process, the actual family therapy interventions are applied.

The types of family therapy interventions can differ depending on the orientation of the clinician, however, when working systemically, this part of family therapy will focus on shifting established interactional patterns within the family.

Feedback loops

Using family therapy techniques like feedback loops, role playing, and boundary setting, families at this stage of therapy will practice what they have learned to improve communication and relationships with one another. 

Building positive feedback loops are the goal of feedback loop exercises. These are patterns of interactions that move the family towards increased connection through new ways of engaging with one another.

Feedback loops are an essential aspect of systemic family therapy because they focus on how behaviors and interactions from one person to the other impact the entire way the family exists.

Therapists can help clients identify this pattern by helping break down the cycle into various parts (actions, behaviors, thoughts, emotions) and then identifying how these impact other members of the family. Visuals are often used to support this learning process.

Role playing

Role playing is another common family therapy intervention that supports restructuring family interactions.

Role playing involves supporting family members to enact scenarios or experiences that the family has had.

By doing this in a supportive and facilitative environment, family members can learn about how each person experiences family dynamics and ways in which new communication methods can help bring about better outcomes for all.

Boundary setting

Boundary setting is a family therapy method that supports family members to effectively identify, set, and communicate their boundaries with one another.

Families that have been enmeshed or codependent tend to greatly benefit from this intervention, as they learn to have increased differentiation while maintaining a strong connection with one another.

Therapists can coach family members on how to set these expectations and even utilize role playing to practice how boundary setting can look within a given family.

Maintaining a systemic view in family therapy 

Thinking and providing family therapy interventions systemically is a practice that requires time, commitment, and a shift in problem-solving.

Systemic healing is challenging for therapists and clients alike, as facing resistance in family therapy is common. Family therapy techniques confront existing patterns and present clients with new ways of processing their own experiences contextually, which can take some getting used to.

As you prioritize seeing the family in the context of their relationships, you begin to see how family therapy itself exists as another manifestation of systemic thinking, and family therapy techniques can be used to navigate the systems at play.

As clinicians, we are part of the system that can help families grow and heal, which can make our relationships and communities even stronger.

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