A Guide to Family Therapy Techniques
What is Family Therapy?
Family therapy sees the symptoms of one family member as pointing to problems in the larger family unit. In this framework, psychological symptoms in one family member are manifestations of a dysfunctional family.
Change in one family member affects the family structure and the other members of the family. Thus the focus of treatment is the family system. For example, a therapist interviews a child with his family to try to understand his behavior.
Family therapists work with couples and families to address a wide range of issues. Their goals might be to:
- improve communication patterns
- solve specific family problems
- address adverse situations in the family such as death or serious physical or mental illness
- enhance family functioning and so improve interactions among family members
Family therapy approaches include structural, strategic, intergenerational, experiential, and solution focused. While some family therapists are associated to one of these models, others incorporate techniques from a variety of approaches in their practice. This guide discusses five techniques originating from various family therapy approaches.
Family Therapy Techniques
Some family psychologists, such as Murray Bowen, assume that multi-generational influences are vital to understand the present nuclear family functioning. A genogram is a pictorial depiction of the patterns across generations which covers at least three generations.
A genogram helps both the therapist and the family to understand the important turning points in the family’s emotional processes, such as births, deaths, marriages, and divorces, and how these influences persist in their own relationships.
The therapist uses the genogram to assess family functioning as well as for interventions in the family system. It identifies problematic intergenerational patterns and also indicates alternative ways of interacting and addressing problems.
The video below explains how a genogram is developed depicting three generations.
Developing a Genogram
Robert Sherman and Norman Fredman, in their book, "Handbook of Structured Techniques in marriage and Family Therapy," describe techniques such as sculpting, the genogram, re-framing and behavior rehearsal. The authors give the rationale for each technique, describe the procedure, and illustrate how it is used which practitioners will find helpful.
One technique used, especially in structural family therapy, is termed enactment. Enactments are role-playing activities to bring the family conflict within the counselling session. The therapist prompts the family to reenact an interaction, for example, a conflict situation.
The therapist encourages the family to act out their dysfunctional interactions instead of talking about them. He or she is able to observe directly instead of relying on family members' accounts. Enactments help the therapist to see how family members behave which might be quite different from how they describe their behavior.
Here, family members demonstrate how they deal with conflicts. The therapist assesses the problematic interactions within the family. This approach helps the therapist to intervene on the spot. Then through further enactments, the therapist, creates intervention procedures to modify interactions to produce structural changes within the family.
Family Therapy Helps to Develop Positive Interactions in Families
Family Therapy Techniques Poll
If you have been in family therapy, which ONE of the following techniques was used?
3. Family Sculpting
Family therapists also use a technique called family sculpting to increase the awareness of members of families on how each person functions within the family or how he or she is viewed by others in the family system.
Sculpting provides a recreation of the family system. This involves setting the scene, choosing role players, and creating and processing the sculpture activities.
The the therapist might give each person an opportunity to sculpt the family as he or she sees it. The person communicates, non-verbally, thoughts and feelings about the family. Through sculpting each family member is able to see how he or she is contributing to problematic situations in the family.
Through the use of this technique, members of the family also get the opportunity to express how they see each other in the family structure. They are also able say how they would like their relationships to be different. This could lead to improvement in their family functioning.
Reframing is used many family therapy approaches including strategic, structural, and experiential. It takes something out of its logical context and places it in another, to help create a different way of looking at the situation or relationship. It is shifting the frame in which the situation is viewed so the meaning is changed.
Much of the problematic behavior in families usually become entrenched and so re-framing reinterprets some problem behaviours. The goal is to give new meaning to behaviors, and in so doing, produce new behaviors that match the new interpretation.
A change in meaning could have a positive impact on relationships in the family. For example, a wife complains that her husband is not spending as much time as he used to with the family because of his work. The therapist could offer this reframe, "Can you think of the situation as your husband loving his family so much that he is ensuring that they are well provided for?"
Consequently, the technique helps the wife and other family members to view problem behaviors in a new light which can lead to solutions. The facilitator in video below uses several other examples to show how. reframing can be used to get a new perspective on situations.
Directives are the cornerstone of the strategic family approach, developed by Jay Haley and Cloe Madanes. This is a family intervention where the therapist gives the clients behavioral tasks to alter negative interaction patterns. These assignments or tasks are aimed at re-organizing the structure or changing the interactions in the family. This interrupts or change the the family's stuck sequence.
Directives can be straightforward or indirect. The goal of straightforward directives is to change the way the family interacts by introducing new action.These directives usually require small changes which are easier to accomplish. Indirect directives are paradoxical and are also called symptom prescriptions, instruct clients to engage in the problem behavior in some way.
Paradoxical interventions may be used with families that are avoiding change. A family might see one member as the problem and so the other members are resistant to change their perspectives for fear of greater discomfort than they are currently experiencing. The therapist might paradoxically encourage the family, for example, to continue to argue so things will get better.
Strategic Directives Can Enhance a Couple's Relationship
The inability to change the way we attempt to solve a problem can prove fatal to a relationship, even to a life.— Cloe Madanes, author of "Relationship Breakthrough"
Summary of Five Family Therapy Techniques
Family Therapy Approach
This a pictorial depiction of family menbers and their relationship to each other across three generations. Information gained is used to identify problematic inter-generational patterns.
These are role-playing activities. The therapist encourages family to act out interactions to assess problematic patterns.
This is a recreation of the family system that helps family members to see how they are contributing to the problem.
This technique shifts the frame in which the family situation is viewed, New meanings could bring change in behaviors.
Strategic, Structural, Experiential
The therapist gives clients tasks aimed at changing the family structure. There are straightforward and indirect directives.
Family therapists agree that changes in one member of the family, cause changes in the other members, and eventually the entire family system. The techniques described in this hub reflect strategies from various approaches to family therapy.
These techniques are aimed at achieving specific objectives, including reducing families' presenting problems and improving relationships. Families learn about what is not working and implement steps to avoid recurrence of the problem or similar ones.
Colapinto, J. (1982). Structural family therapy. Retrieved from http://www.colapinto.com/files/SFT.doc Accessed August 11, 2015.
Gerhart, D. (2013). Mastering Competencies in family therapy: A practical approach to theories and clinical case Conceptualization. Belmont, CA; Brooks/Cole.
Nichols, M. P. & Schwartz, R. C. (2006). Family therapy: Concepts and methods. Boston, MA: Pearson Education, Inc.