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Family counseling, or family therapy, aims to address psychological, behavioral, and emotional issues that cause family problems. Family members will work with a therapist or counselor to develop and maintain a healthy relationship.
Family counseling, or family therapy, is a method to develop and maintain healthy and functional family relationships.
The goal is to identify and address problems in the family. These issues could be emotional, psychological, or behavioral.
Many approaches to family therapy stem from family systems theory. This suggests that families work in systems rather than groups of people who function independently of each other.
According to family systems theory, changes in one family member will influence changes in other parts of the family.
What is the difference between family therapy and family counseling?
The terms “family therapy” and “family counseling” are often interchangeable. Both usually involve talking to help individuals and families work through conflicts, barriers, or mental health issues.
However, a therapist may have different credentials than a counselor. Usually, a counselor requires only a bachelor’s degree and may provide general support to a client. A therapist requires a master’s degree and a license to practice.
Counselors typically work with people who have substance use disorders, for example. In most cases, a clinician doing family counseling will be a therapist.
Asking is the best way to know what kind of services a family mental health professional provides and their qualifications. During a meet and greet, families can ask about the specific counseling or psychological approach they take.
Therapists and counselors should also provide information about their education and license to practice.
Some family counselors offer home visits or online sessions. These could provide families with more comfort than office-based meetings. However, other families may prefer counseling outside of the home environment.
There are several types of family counseling:
Functional family therapy
This typically focuses on families with a child or an adolescent with complex emotional or behavioral problems.
The child and their parents or caregivers may attend 8–30 weekly sessions together. The sessions will help families learn strategies to deal with the child’s behavior and improve family functioning.
Multisystemic therapy
This aims to address any behavioral and emotional problems of children and adolescents.
Multisystemic therapy also focuses on broader issues with the child’s behavior. For example, it could aim to improve their interaction with social systems, such as schools or neighborhoods.
Transgenerational therapy
This involves a therapist examining interactions across generations, such as between parents or caregivers and children. The aim is to understand how past responses to challenges influence the family’s current interactions or problems.
Transgenerational therapy is useful when issues and behavior patterns persist across generations. Also, it may help predict how problems might develop in the future since past behavior is a good predictor of future behavior.
Brief strategic family therapy
This therapy aims to change the patterns of interaction between family members.
It is a time-limited intervention that targets family problems leading to problematic symptoms showing in youths. Most brief strategic family therapies will last 12–16 sessions.
Research reports that this form of therapy has long-term benefits. The researchers found that brief strategic family therapy was more effective than treatment as usual, such as group therapy and parent training groups, at reducing arrests and incarceration in the short and long term.
Structural therapy
Structural therapy manages problems that arise due to the family structure. It aims to achieve a functioning and balanced family hierarchy with appropriate boundaries between members.
The key difference with structural therapies is the focus on structure rather than specific behaviors that cause problems.
The benefits of counseling vary from family to family but can include:
- developing healthy boundaries
- improving communication
- defining someone’s role within the family
- improving family dynamics and relationships
- providing strength and coping tools for family members
- addressing dysfunctional interactions
- improving the family’s problem-solving abilities
Research from 2019 suggests that family therapy effectively addresses issues with children, including:
Family therapy can help reduce the risk of some mental health conditions in adolescents.
According to a 2020 study, families might find therapy useful to address the following:
- difficulty communicating or expressing emotions
- conflicts between siblings
- inconsistent parenting
- marital problems
- developing a functional and healthy relationship following a divorce
- adapting to a major change
- dealing with a chronic illness or death in the family
Finding the right counselor is important for family therapy to work. Personal comfort matters in the choice of a therapist.
People can follow some general tips when searching for a family therapist. These approaches may help find a therapist who might be a suitable fit for the family:
- Ask friends or extended family for a referral.
- Speak with a family doctor.
- Inquire at a place of worship.
A therapist may also agree to an initial phone call or introductory session, during which the family can decide whether this is the right counselor for them.
In addition to personal feelings, the family should consider:
- the therapist’s treatment style and approach
- how often the therapist recommends attending therapy, and for how long
- whether insurance covers services and whether low cost options are available
Since participation is an important part of family therapy, one might want to reconsider a counselor who makes any family member significantly uncomfortable.
During a family therapy session, therapists may talk with the family as a group, as individuals, or as a combination of the two.
A typical therapy session is around 50 minutes once per week. People may find it difficult to discuss concerns initially, and it is important that the family finds a therapist it feels comfortable with. Families may try several therapists before finding one that meets their needs.
The American Association for Marriage and Family Therapy (AAMFT) states that family therapists provide the following services:
- diagnosis and treatment of mental health and emotional conditions
- treatment planning
- psychotherapy for individuals, couples, and children
- couple, group, and family therapy
The number of family counseling sessions depends on various factors, such as why a family is seeking help and whether family members participate during therapy.
There is evidence that family therapy is an effective form of counseling.
A 2019 literature review notes that family counseling and other family-based approaches, such as parent training and programs, are effective in a variety of situations, including:
- sleep, feeding, and attachment problems in infancy
- recovery from child abuse and child neglect
- behavioral conditions
- disordered eating
Additionally, research indicates that family therapy is effective for adolescents with mental health conditions, regardless of gender. The authors note that the adolescents in this study reported fewer internal and external problems after therapy.
Also, parents reported that they learned more effective parenting methods and felt the family was closer. However, the study notes that female parents were more likely to find family counseling helpful than male parents.
Some family therapists participate in insurance plans, while some are private pay.
It is important for people to check the services an insurer will cover. Before attending sessions, a person should also check that therapists accept particular insurance plans.
For example, Medicare covers family counseling sessions that focus on mental health treatment.
Some therapists might also participate in employee assistance plans. It is worth checking with an employer whether these schemes are available.
Prices will depend on the type of therapy, the counselor’s qualifications, location, and therapy duration.
Some organizations and companies may offer family counseling at a discount or for free. Below is a nonexhaustive list of places that provide lower-cost therapy.
Learn more about the best free or low cost therapy.
Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.
Medical News Today follows a strict product selection and vetting process. Learn more.
Best for first responders: Therapy Aid Coalition
- Price: offers four sessions for no more than $100 per session
- Certifications: clinical psychotherapists licensed and insured in their home state
- Ratings: no ratings on Trustpilot or Better Business Bureau (BBB)
- Reviews: no reviews for the company, although individual therapist reviews may be available
Therapy Aid Coalition is a volunteer-based platform that works with licensed and insured therapists. The company offers low cost therapy to certain people and groups in the United States.
The groups and individuals the organization serves may change regularly. At the time of publishing, Therapy Aid Coalition offers its services to:
- healthcare professionals
- first responders
- people affected by Hurrican Ian in Southwest Florida
People need to complete an online questionnaire to use this service. Questions include which state a person resides in and how much they can pay for sessions.
Best for sliding scale fees: Youth & Family Counseling
- Price: $30–160 per session, depending on income and family size
- Certifications: licensed counselors and therapists that cannot prescribe medication
- Ratings: no ratings on Trustpilot or BBB
- Reviews: no client reviews
Youth & Family Counseling is a nonprofit organization that provides therapy services to families, children, couples, and adults of all ages.
This organization works with various insurance providers, such as Cigna, Aetna, and Medicare. It also offers fee subsidies if a person does not have an insurance plan or needs financial support.
Youth & Family Counseling bases its fees on household income and family size. People can choose to see a therapist in person or opt for video conferencing, which is compliant with the Health Insurance Portability and Accountability Act.
Best for communication options: BetterHelp
- Price: $60–90per week, billed monthly
- Certifications: licensed, credentialed, and state board certified therapists
- Ratings: 4.6 out of 5 stars on Trustpilot, based on over 5,900 reviews
- Reviews: mostly positive on Trustpilot and BBB
BetterHelp is an online telehealth counseling service that offers family therapy, among other types of counseling.
While this company does not offer free services, its weekly subscription is on the lower end of therapy costs. Individuals will need to pay between $60 and $90 per week, which the company bills monthly.
People can exchange messages, live chat, video conference, or speak with their therapist via telephone. BetterHelp aims to match a person with a suitable therapist by asking potential clients to complete a questionnaire.
Review of BetterHelp.
Below are answers to some common questions about family therapy.
What are the goals of family therapy?
The goals of family therapy are often similar to those of individual psychotherapy.
Family therapy can help address mental health conditions, substance use disorders, and conduct disorders, among others. Moreover, with family therapy, the focus is on the family structure and relationships between members, not on individuals.
Is family therapy for everyone?
Family therapy may not be for everyone. It may be suitable for those who want to improve family relationships or treat mental health conditions from a family system’s perspective.
Often, in family therapy, several members participate. It may not be an appropriate therapy if family members object to or do not want to take part in the process.
What questions should I ask my family therapist?
Some common questions for a family therapist include:
- What is your treatment approach?
- What do you expect from me and members of my family?
- Do all members of the family have to attend sessions?
- How many sessions do you anticipate?
- What is your educational background?
- Are you licensed?
- Do you take insurance?
Everyone who considers family therapy should feel comfortable asking a potential counselor the questions that are important to them and their family.
Family counseling aims to address underlying problems that cause family issues. There are several forms of family therapy. Different family problems may require specific types of counseling.
When people research potential therapists, they should check that they accept their insurance plan, if they have one. A person should also ensure their policy covers the particular service needed.
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