Family TherapyWhat It Is and When to Consider It

What is family therapy?

Family therapy is a form of group psychotherapy that focuses on helping families in difficulty by reducing distress, managing conflict, and improving relationships and coping skills. A family unit can consist of any group of loved ones, not necessarily blood relatives or those living in the same household—from guardians, foster parents, and same-sex partners to step-siblings, grandparents, aunts, uncles, and ex-spouses.

Family therapy is perhaps most commonly associated with addressing conflict at home, whether that’s between spouses, siblings, or children and parents. However, family therapy can be an effective way of improving family dynamics in other ways, too. Having the input of a skilled therapist can help improve communication between you and your loved ones and build stronger, healthier relationships. It can help you adjust to changing circumstances as a family, whether that’s moving to a new area, coming to terms with a divorce or bereavement, or living in a newly blended family. A family therapist can also help you navigate mental and physical health issues faced by one person that impact the family as a whole.

Some people are reluctant to consider family therapy, expecting it to be intrusive or painfully embarrassing. You or your family members may have misgivings about letting a stranger into the private world of your home life, or be concerned about “airing your dirty laundry” in front of an outsider. But those who take the plunge are often pleasantly surprised to discover that family therapy isn’t all about assigning blame or rehashing old resentments. Rather, it’s about fostering understanding and resolving issues together. Many people find it can be easier to address topics that may be “off-limits” or difficult to bring up at home. Others find family therapy provides a safe space where you can air your thoughts and opinions without the spiral into conflict.

Of course, family therapy isn’t right for everyone. The more you understand about how it works and the type of problems it can help with, the better you’ll be able to decide if it’s right for you and your family—and how you can get any reluctant family members on board.

What issues can family therapy help with?

All families struggle from time to time. Family therapy can help with any mental, emotional, or behavioral issues that are impacting family life. It can also provide you and your loved ones with the tools for growth, enabling you to deal with future issues in a way that strengthens rather than damages your closest ties.

Chronic conflict. Conflict is a natural part of every relationship, but when it’s not handled positively and respectfully it can be extremely damaging. Whatever your family conflict looks like—kids cowering in fear while parents hurl insults (or worse), siblings relentlessly bickering, or parent-child clashes that turn family time into a war zone—mismanaged conflict can sow discord and division. Family therapy can help you learn how to improve your communication skills and resolve disagreements constructively. It can also help you deal with old, unresolved family conflicts.

Grief or loss. The pain of losing a loved one, a family pet, or a home, for example, can often cause family members to withdraw from each other and isolate. But learning to share the loss with each other can make the burden of grief easier to bear, and eventually help you all to move forward with your lives.

Mental health problems. When one family member is dealing with a mental health issue such as addiction, depression, or anxiety, it often impacts every member of the family. Crucially, family support can also play a major role in someone’s recovery. Even when a family member is facing a serious mental health condition, such as bipolar disorder, schizophrenia, or Alzheimer’s disease, support from those closest to them can make a huge difference in their ability to maintain a fulfilling life.

Behavior problems with children or teens. Parenting is never easy, especially when you’re dealing with a troubled teen or child who’s moody, rebellious, self-harming, abusing substances, or facing other developmental or behavioral issues. Seeking professional input can help you and your child find ways to connect, reduce stress at home, and address any underlying issues

Divorce, remarriage, or blended family issues. Divorce can trigger a great deal of pain, disruption, and uncertainty for both you and your children. And while you, as a parent, may see remarriage and blending a family with a new partner as a period of joy and optimism, it can also involve a lot of challenges. Overcoming children’s worries and resistance to change can often require a whole new set of parenting and communication skills.

Life transitions. Major life challenges or transitions such as moving home, changing schools, having a grandparent move in, losing a job (and income), or having a family member deal with a serious illness or injury can disrupt family life. Family members may deal with these challenges in different ways, but talking together about what you’re experiencing and finding support from each other can help you deal with stress, adapt to changes, and look forward to better days ahead.

Trauma, abuse, or family secrets. Abuse and other types of trauma can have a ripple effect throughout families and generations, impacting family members who didn’t directly experience the events as well those who did. Even family secrets can drive a wedge between family members. Family trauma therapy can help families work through the pain caused by shared or individual traumatic experiences, develop healthier coping strategies, and heal the emotional wounds.

Types of family therapy approaches

There are several different types of family therapy approaches. While some family therapists specialize in a particular type of therapy, many will use a combination of approaches and family therapy techniques depending on your family’s makeup and the issues you’re facing.

Some of the most common types of family therapy include:

Structural family therapy

Developed in the 1950s and ‘60s, structural family therapy is now one of the most widely practiced approaches to family therapy. It focuses on how the “structure” of a family unit—the different roles members fulfill, the hierarchies, and the relationships between each of you—can contribute to stress and unhealthy, dysfunctional patterns of behavior.

A family therapist may use structural family therapy to improve how your family members communicate with each other, set healthier boundaries or limits, encourage joint problem-solving and decision-making, and improve the way your family functions. This could help parents develop a unified approach to dealing with a rebellious child, for example, and diffuse conflict by reestablishing the parental hierarchy and setting firmer boundaries.

Strategic family therapy

This is a short-term, goal-oriented form of therapy used to treat a family member’s specific behavioral issue, such as a teen’s substance abuse, violence, or risky sexual activity. Since changes in one family member’s behavior can impact the whole family unit and vice-versa, strategic family therapy focuses on adjusting those family behaviors that may be contributing to the family member’s problems. It offers practical ways to enact change, rather than diving deep into issues.

If a teen’s problematic behavior usually results in family conflict, for example, a therapist may suggest new ways for parents to react. By improving communication and creating healthier relationships, strategic family therapy can help your family break repetitive cycles of negative behavior.

Bowenian family therapy

Developed by psychiatrist Murray Bowen, this approach to family therapy explores how problematic patterns of behavior can be passed down through generations. If a parent adopts the same parenting techniques they experienced as a child, for example, any unhealthy behavioral traits can be passed down from one generation to the next. Once these patterns have been identified, Bowenian therapy helps individual family members differentiate themselves within the family, break any toxic behavior patterns, and heal.

Transgenerational therapy also stems from Bowen’s theories, but focuses on the impact of traumatic events experienced by earlier generations.

Narrative therapy

Many of us fall into the habit of defining ourselves by the problems we face or the negative ways in which we sometimes behave. “I am an anxious person,” for example, or “I am not a good parent.” Narrative therapy focuses on separating your identity from these problems or negative behavior traits in order to take a more objective view of yourself and your family. A skilled family therapist can help you and your family examine the shared narratives you hold, and rewrite those that may be contributing to your problems.

This form of therapy can encourage non-judgmental conversations between family members and empower you to challenge your existing views and see yourselves in a more positive light.

Systemic family therapy

Systemic family therapy focuses on how the issues you’re facing as a family can stem from the interactions, behavior patterns, and life choices of individual family members. Rather than addressing a single, specific issue in the way of structural family therapy, systemic therapy focuses more broadly on the family’s ingrained behaviors and beliefs.

Since a family is interconnected, this type of therapy examines both how the family behaves as a single unit as well as the impact of individual family members on that unit. If a child is experiencing symptoms of an anxiety disorder, for example, a family therapist may examine how stress between the parents or a sibling’s rebellious behavior could be triggering or exacerbating their anxiety.

Family psychoeducation

While not a type of family therapy, psychoeducation is often included as part of family therapy when one or more members are dealing with a mental health issue. If someone is suffering from a mood disorder, addiction, or other mental health issue, support from their family can be crucial in their recovery. Family psychoeducation is a structured intervention that provides family members with information about their loved one’s condition, along with tools and coping skills to help provide more effective support.

When to consider family therapy

Families today can look and work very differently from each other. Cultural mixes, blended families, and same-sex partnerships, as well as divorced couples, adult children, and grandparents often living under the same roof means that there’s no such thing as a “normal” family. And just as different families have different strengths and weaknesses, they can also have different reasons for considering family therapy.

Your family doesn’t have to be in crisis to benefit from therapy. If some aspect of family life isn’t working as well as it once did or your family makeup, circumstances, or stress levels have recently changed, family therapy could help get you all back on track.

Other signs that therapy could help include:

Ongoing tension, resentment, or emotional distance. Minor conflicts between family members are usually nothing to worry about. But when every meal time results in heated arguments and misunderstandings, family members can’t stand to be around each other, or they actively ignore one another, it can take a toll on everyone’s health and well-being. Research suggests that exposure to domestic arguments can increase a child’s risk of developing mental and physical health problems later in life. Early intervention can be crucial for improving family relations and reducing the negative long-term effects of family conflict.

Constant miscommunication or shutdowns. When family members are talking but not hearing each other, it can create tension and emotional distance. If you’re unable to address certain topics as a family, or poor communication skills, overwhelming stress, or emotional detachment are straining relationships and putting up walls between you, it may be time to seek help.

One family member’s issues are affecting the household. When one family member has a physical or mental health problem, their needs can often trump those of other family members, creating an unhealthy imbalance. Having an autistic sibling who requires extra attention, for example, can leave your other children feeling jealous or neglected. Looking after an aging parent with dementia can leave you feeling overwhelmed and short-tempered with other family members.

Parents feeling stuck or out of sync. As every parent knows, raising children can be tough. It’s easy to feel so exhausted or overwhelmed that you stop making time for your partner. Or you may feel trapped in the daily grind or so overloaded by home and work responsibilities that you feel unable to cope with your parenting duties.

Kids acting out or withdrawing. Your child has become defiant, disobedient, or aggressive. Your teen greets everything you say with a roll of the eyes or the slam of a door. Any kind of extreme behavior, from tantrums and outbursts to a child withdrawing or isolating, can be a reason to consult a family therapist, especially when noticeable changes in your child’s behavior occur suddenly.

How long does family therapy typically take?

When deciding if therapy is right for your family, it can help to know that family therapy doesn’t have to be a long-term commitment. On average, family therapy lasts for nine sessions, according to the American Association for Marriage and Family Therapy.

Of course, the duration and success of family therapy can hinge on a number of different factors. Firstly, the complexity of the issues being addressed can impact the number of sessions needed. Dealing with trauma or abuse within a family, for example, may take longer to address than improving communication.

Seeking intervention early can be another important consideration. Addressing problems soon after they arise can prevent them from escalating into more serious, long-term issues. It may also be easier for family members to change negative behaviors that haven’t been ingrained over time.

If any members of your family are extremely reluctant or outwardly hostile about the therapy process, though, it could potentially make family tensions and conflict even worse. For family therapy to be most effective, it requires each family member to commit to making positive changes, being open and honest about what they’re experiencing, and following through on the lessons learned.

What to expect in a family therapy session

It’s natural to feel a little apprehensive about starting family therapy. Knowing what to expect in your sessions can help ease any anxiety you or your family members might be feeling.

Each therapist has their own style and how they structure their sessions may vary. Typically, though, in a first session a family therapist will strive to establish a safe environment where each member of the family can openly and honestly express their thoughts and feelings. They’ll also want to gain an understanding of the family dynamics—how you communicate with each other, the challenges you’re facing, and any unresolved issues from the past.

In the first session, a therapist may:

• Explain how family therapy works, adding some details about their background and their particular philosophy.
• Have each family member introduce themselves, with the aim of understanding what you hope to gain from family therapy—both as a group and individually.
• Establish any ground rules. These are usually to ensure that each person is allowed to talk uninterrupted without fear of judgment or conflict.
• Ask questions about your family’s history, the relationship dynamics, and the issues that brought you to therapy.
• Set goals together—what you hope to achieve in specific and measurable terms. “Have the children participate in a weekly family activity without arguments,” for example.
• Encourage participation from everyone. For family therapy to be effective, the therapist will want everyone to participate equally and not have sessions dominated by just one member at the expense of quieter members.
• Teach communication skills, such as active listening, where you learn to focus not just on the words someone uses but on the real meaning behind their words.
• Assign homework, such as practicing stress-relieving exercises or new communication skills before the next session.

In subsequent sessions, a therapist may:

• Start each session by reviewing how each person is feeling.
• Set an agenda with you all for the session, including addressing any issues that have arisen since the previous session.
• Review goals—what’s been achieved and what needs work.
• Guide a discussion addressing the specific issues.
• Teach communication skills and use family therapy techniques, such as role-playing exercises, tailored to address your family’s needs.
• At the end of the session, summarize the takeaway points, review progress, and set homework.

How to get the most out of family therapy

As with any type of therapy, the first step to getting the most out of family therapy is to find the right therapist for your family. Choosing a well-qualified therapist with a similar cultural background and experience dealing with the issues your family is facing can be important considerations. But the key is often to find one who resonates on a personal level with you and your family. A good therapist is someone who makes each family member feel supported, understood, and comfortable about opening up.

Once you’ve found a therapist who’s a good fit, it can also help to:

Keep an open mind. Spending an hour examining family ties, working on your communication skills, talking about your feelings, or picking at old wounds may feel like a daunting or even distressing prospect. And it’s true that family therapy can bring up uncomfortable and painful emotions. However, by keeping an open mind and giving the process a chance, family therapy can be a healing rather than stressful or embarrassing experience. It can also help strengthen your bonds with the most important people in your life.

Be honest. Don’t expect your therapist to be a mind reader. Many of us find it difficult to open up about our innermost thoughts and feelings, especially in front of family members. But the more honest you and your family can be with a therapist, the more you’ll get out of therapy. And if you hit on a topic that is too painful or too embarrassing for you to open up about, let the therapist know. It may help them better understand your family’s dynamics, and could be something they’re able to help you with as therapy progresses.

Prepare for sessions in advance. If you’re having family therapy sessions once a week, you might think of a question you want to ask or a point you want to raise during the week and then forget about it on the day of the session. Try to get in the habit of writing down these thoughts when they occur to you—and encourage other family members to do the same. Then go over your notes before each session so you remember exactly what you want to talk about. Keeping a journal can help.

Try to remain calm and respectful during sessions. It can be tough to hear a family member make statements that you vehemently disagree with. But it’s important to respect their views and allow them to express their views without interrupting or arguing—just as they should allow you to do the same. There’s nothing wrong with conflict as long as it remains respectful and productive. Remember that even when you have different views, you have the same goals: not to win an argument, but to resolve the family issues and heal.

Put what you learn into practice—both individually and as a family. It’s only by incorporating what you learn in family therapy sessions into real life situations that you can make lasting changes. Whether it’s using “I” statements when telling family members how you feel, actively listening when your loved ones talk, or adjusting your parenting style to find common ground with your child, the more you practice what you learn, the more instinctive it will become.

Look for additional ways to improve your emotional health. Whether it’s signing up for individual therapy or making healthy lifestyle changes, there are plenty of other ways to support your work in family therapy and improve how you think and feel. Adopting self-care tips such as being more active, eating a healthy diet, improving how well you sleep, and practicing relaxation techniques can improve your overall well-being and help you get more out of therapy.

Finding a qualified family therapist

In the United States, family therapy is often provided by a therapist who is a Licensed Marriage and Family Therapist (LMFT). However, other types of licensed therapists—such as a psychologist, clinical social worker, and clinical or mental health counselors—may also be experienced in family therapy.

Family therapy can be done in-person or online. While in-person sessions require all family members to visit the therapist’s office, online therapy can offer more flexibility, allowing you to all connect remotely from different places. This can be especially useful if you all have busy schedules or are living or working a distance apart.

Whether you’re looking for family therapy in-person or online, there are a number of ways to find a qualified family therapist.

• You can seek recommendations from friends, relatives, or a local family or mental health center.
• The American Association for Marriage and Family Therapy (AAMFT) offers a Therapist Locator, a database of marriage and family therapists in the U.S., Canada, and some other countries.
• Family therapy is often covered by insurance, so you can contact your health insurance provider to find the family therapists who are in-network with your plan. Family therapy may also be covered by Medicare Part B.
• You can find a family therapist online. Some therapists offer online family therapy via their private practices. Or you can sign up to an online therapy platform that offers couples or family therapy.

Last updated or reviewed on September 2, 2025