Families are a unique social system with their own personality that substantially affects every member of the family. The family’s ‘personality’ is determined by the parents’ beliefs and values, the individual nature of each family member, and the influence of extended family. Family therapy is based on the idea that a problem with one family member may be a symptom of a larger family problem. Any change in the family affects each member individually. Teens who are displaying behavior problems create stress within their families, but family members who pull together become part of the solution.

A report in the 2005 Journal of the American Academy of Child and Adolescent Psychiatry states that there is “abundant evidence” that family therapy can often make a big difference in six problem areas for teens: conduct disorders, substance abuse, depression, anxiety, eating disorders, and understanding attention problems. The study, conducted by Allan Josephson, evaluated a decade of research on family therapy.

Many times, families who are dealing with a troubled teen want to send the child to therapy and hope it will ‘fix’ them. Troubled teens may realize greater gains in family therapy.

What does a family therapist do?

A family therapist teaches family members how their family functions. They help identify conflicts and develop strategies to resolve them. During therapy sessions, the family’s strengths are used to help them handle their problems. All members are encouraged to take responsibility for problems.

The therapist sets goals with the family and discusses the length of time expected to achieve those goals, which depends on the severity of the problem and the willingness of the members to participate in therapy. Not all members of the family attend each session.

Why does family therapy work?

Family therapy works for a variety of reasons. First, the teen may be reacting to issues within the family. The problem behavior may be quickly eliminated if the root cause is addressed. The root cause could be a change in the family, a communication problem within the family, or some other family dysfunction. Even if the teen’s problem behaviors are not a result of family problems, the family’s response to the teen’s problem can make it worse.

Therapy provides a safe environment where all family members can listen to and talk with each other. Each family member will have concerns to address, such as feelings of guilt, anger, or betrayal. Siblings often resent the increased focus on the teen who’s getting into trouble. The therapist can act as a moderator to ensure that all voices are heard, concerns are acknowledged and emotions are validated. This process can help family members learn and practice more effective methods of communication. During and after a teen’s treatment, the rest of the family usually needs support and guidance.

When the parent signs on for family therapy, that sends a strong signal to the child. The parent demonstrates a strong commitment to the child that may make the teen feel more compelled to actively participate. In individual therapy, a teen can say anything about parents, siblings or life at home. When the family meets together the therapist gets a bigger picture with both sides of the story vetted, and the therapist can deal with a teen’s poor choices and communication immediately in the session.

Family therapy can also be very helpful when the two parents disagree about what is causing the teen’s behavior and/or how to respond. Putting a teen in individual therapy isn’t going to help if the parents are in conflict about what to do. Through therapy, relationships between family members are strengthened, and parents are often empowered to handle other problems that may develop with their teen from the strategies they learn in therapy.

How do we find a good therapist?

It’s always a good idea to get a specific referral to a therapist. You can obtain an informed referral from friends who have participated in family therapy, your doctor, your insurance company, clergy, and employee assistance programs. When you call to make an appointment, ensure that the therapist is either a licensed clinical social worker, a licensed marriage or family therapist, or has specialized training in family therapy. Even if you do all of this, your therapist still needs to be a good fit for your family, make everyone feel comfortable talking openly, and seems helpful. If you don’t feel comfortable, then you need to find another therapist.

What should we expect for the first session?

Families should be prepared to explain the problem, when the troubling behavior started, and any contributing factors. Additionally, you should be able to articulate what you want to change.

Families should also have questions for the therapist. For example, you may want to ask what kind of success rate do they have and what is their approach to working with families. Ask what expectations the therapist has for each of the family members.

Final thoughts…

Studies show that adolescents whose families participate in therapy experience a higher rate of successful treatment, and are less likely to relapse. During family therapy, a counselor educates the family about relationships and communication styles that can impact the family dynamic. Yes, the problem may be with the teen, but the family can contribute to the problem. Working together creates a feeling of acceptance and understanding that cannot always be achieved in individual therapy. Additionally, the family is more prepared to support the teen’s continued recovery after therapy concludes.