Family relationships are one of the most important things in life—but that doesn’t mean they’re always easy. Sometimes, in order to best protect and nurture these relationships, your family may need help from an outside, objective professional.  A family therapist can help focus on relationships and interactions among members of a family and how they contribute to overall mental and emotional health. 

Depending on your specific needs, there are several types of family therapy approaches you may want to consider. Keep in mind, many family therapists combine two or more of these approaches in the work they do with families. A good family therapist will be able to tell you which models of family therapy they rely on the most. Just ask them when you call to set up an appointment.

10 Types of Family Therapy to Consider

1. Bowenian Therapy
2. Cognitive Behavioral Therapy
3. Intergenerational Family Therapy
4. Milan Therapy
5. Narrative Therapy
6. Solution Focused Therapy
7. Emotionally Focused Therapy
8. Strategic Family Therapy
9. Structural Family Therapy
10. Systemic Family Therapy

A family therapist can help ensure that your family interactions are as healthy as possible for everyone involved. Strained family relationships can come from many different fronts: major changes in family life, parent relationship tension, work stress, trauma, addiction treatment, chronic illness, eating disorders, child and adolescent behavioral issues, financial issues, and so much more. 

The overall goal of family therapy is to help family members appreciate the importance of family by creating and maintaining healthy relationships and mental health. Family therapy also assists family members by teaching them how to better communicate effectively with one another and work cooperatively to solve whatever challenges they face.

Family therapy has many tangible benefits, including the following:

• Improved family communication 
• Healthier personal and behavioral boundaries
• Improved problem-solving
• Increased empathy
• Deeper level of family trust
• Healthier family patterns and dynamics
• Reduced overall family conflict 
• Better anger management skills for the entire family
• Improved mental health for all

Family therapy is usually led by licensed marriage and family therapists, but it could also be facilitated by licensed clinical social workers or other professional counselors if they have received additional training needed for doing effective family therapy.  Such professionals have earned graduate and postgraduate degrees or certifications, and are likely also credentialed through the American Association for Marriage and Family Therapy.

Bowenian Family Therapy

Developed by Murray Bowen in the 1950s, Bowenian therapy explores the mental and emotional tension we all feel between individualism and togetherness. To be our healthiest, we all need independence and companionship in varying doses. The degree to which we’re all able to reconcile these two opposing forces depends on our “differentiation of self,” which Bowen defined as “the capacity to think and reflect and not be reactive to internal or external emotional pressures.” In this type of therapy, the therapist will assume a neutral role, serving as a coach and mentor—and sometimes as “translator” among family members. 

The goals of Bowenian therapy typically include increasing the self-differentiation of family members, reducing emotional reactivity among family members, and helping clients develop new patterns of behavior and mental response for the future. Bowenian therapy is considered by many to be an integration of multiple therapy approaches.

Cognitive Behavioral Therapy

Cognitive behavioral therapy attempts to identify and adjust certain ways of thinking that may be causing internal distress and/or family strife. Cognitive behavioral therapists help people outline alternative thought patterns and behaviors that may be healthier. With this type of behavioral therapy, specific behavior treatment plans may be developed and implemented. Family members often have homework that they need to complete between sessions, including worksheets that help them map out their thoughts, feelings and actions. A mental health professional  may utilize both individual sessions and family sessions that include some or all members of the family.

The overall goal of cognitive behavioral therapy is to help stabilize family behavioral dynamics by identifying patterns of conflict. Once patterns emerge, individuals are better able to identify their role in these patterns. They learn to develop healthier mental responses that help them to adapt and communicate better. Cognitive behavioral therapy helps family members adjust their thoughts and behavioral patterns in ways that benefit the entire family. In other words, the individual focuses on personal growth in order to help the entire family unit.

For this kind of behavioral therapy to be successful, every single person participating must be open and honest—and willing to work through emotional issues. 

Intergenerational Family Therapy

Intergenerational family therapy recognizes that the different generations within a family can influence individual and family behaviors. This type of therapy often helps families identify multigenerational mental and behavior patterns and see how current challenges may be rooted in those of previous generations. 

Often, therapists employ the concept of the genogram, which is a schematic representation that mimics a family tree, but with substantially more information included. A genogram, in addition to mapping family structure, will outline relationships among various family members in order to help identify patterns. Sometimes the simple act of mapping it all and putting thoughts on paper can help identify places where families can work to strengthen relationships and reduce conflict.

Milan Family Therapy

Milan therapy focuses on analyzing belief systems that individual family members or the entire family unit may hold. It often examines family rituals and practices, especially those related to conflict. Milan therapy challenges families to explore their belief systems—including conscious and subconscious systems. This can help dismantle belief systems that perpetuate conflict in family units and replace them with healthier family values and belief frameworks.

Narrative Family Therapy

Whether with individuals or a relationship,  narrative therapy helps each family member to examine the narratives they have formed about themselves and their relationships with family members. More importantly, it invites individuals to let go of old, unhelpful narratives and replace them with new, more helpful--and often more accurate--narratives which better highlight each individual’s positive attributes, gifts, and skills. By doing so, family members begin seeing each other and their relationship differently. Seeing it differently, they begin to think and feel differently, while also choosing to act in new ways. Narrative therapy has many core values, including the belief that our problems mainly exist outside of us, and thus do not define us. Despite this, Narrative therapy asserts that individuals are still very much responsible for how they choose to respond to handle and respond to these “externalized” problems. At its heart, narrative therapy helps clients take mental ownership of their own values, capabilities, competence, and self-worth. 

Solution-Focused Therapy

Solution-focused therapy is considered one of the brief therapy approaches of our day. One of its core principles is that an individual or family does not need to identify the cause of the problem in their different situations  in order to identify the solution. In the approach, the therapist utilizes questions that help the clients think forward about their lives and relationships, considering what they do want versus what they don’t want. The energy and focus is on figuring out how to get to where they want to be versus understanding how they got to where they currently are. 

Many clients find this approach to family therapy to be refreshing. They often find that it helps family members feel more comfortable going to family therapy, knowing that the conversations will not lead to a feeling of defensiveness and blame. Still, staying focused on solutions is not easy, and often requires the therapist to put a lot of energy into helping family members do so. In addition, some clients believe their family problems are too severe for this approach, and therefore don’t believe it will be helpful to them. And based on family therapy research, if they believe that, they should choose a different type of family therapy to participate in. 

Emotionally-Focused Therapy

Emotionally-Focused family therapy (also known as emotion-focused therapy) is founded upon principles of attachment theory, and focuses on helping each individual (usually in a marriage relationship) examine and express their emotions in a safe environment. One core concept in this approach to therapy is that family members have become accustomed to feeling and reacting to their secondary feelings, such as anger, instead of being aware of and discussing their primary feelings, such as hurt or sadness. Consequently, family members come to see each other in ways that do not invite empathy or compassion.

An emotionally-focused therapist works to help the couple not only better understand their feelings, but also helps them have powerful interactions, or “enactments” that lead to changes in how they see each other. These enactments also create new patterns of interacting which are reinforced by the positive outcomes that occur in the therapy sessions. This approach to therapy may feel slower and have less energy, but the impact on relationships can be powerful, as evidenced by the research on this approach. 

Strategic Family Therapy

Strategic family therapy centers on family functions and processes. It explores behavior outside of therapy sessions and may concentrate on processes such as problem-solving and communication. Therapists who use this technique believe that change can be achieved rapidly, without necessarily involving analysis of the problem’s source—which likely means you won’t have to attend as many sessions as with some of the other types of therapy. However, you’ll likely also have outside “homework” to complete in order to get the most out of this approach. 

As the name suggests, this approach focuses is used by family therapists who utilize their insight and understanding of the families old patterns to identify “strategic” methods for interrupting those old patterns in order to open up the possibility for new patterns to begin.  In this approach, it’s helpful if family members can trust the therapist, even if all of the interventions suggested don’t always make sense. 

Structural Family Therapy

Structural family therapy explores the framework of the family by looking at patterns, behaviors, and family relationships as they display during a therapy session. Structural family seeks to establish parents as leaders of the family, and work to ensure that all family members have appropriate personal boundaries.

Therapists may also look at sibling or parental subsystems within the family unit, usually by employing role play, such as reversing roles at a hypothetical family gathering. After observing family structure, the therapist may then create a diagram that depicts the current family structure, which the group can use to define a healthier structure moving forward. With this approach, the therapist is often an active participant with the family, observing, learning, and helping strengthen family relationships. This approach often works well for families with at-risk youth and can help adjust unhealthy family dynamics well into the future. 

Systemic Family Therapy

Systemic family therapy is actually at the heart of all the family therapy approaches described above. Still, it’s worth highlighting to help you understand the foundation of these various approaches. 

Systemic family therapy views the family as a holistic unit and considers the entire family’s emotional tone, attitudes, and feelings. It centers its attention on the dynamics among family systems, rather than on individual issues and personal reflection. This kind of therapy is based on family systems theory (sometimes referred to as just systems theory), which recognizes that a family is more than just the sum of its individual members. The basic premise is that our behaviors within family systems are both inseparable from and informed by our family relationships and other family influences. For example, a parent struggling with alcoholism or mental health issues doesn’t undergo treatment in a vacuum – his or her disorder also has ramifications for the spouse and children. A family systems approach concentrates on how the issue affects the whole family rather than just the individual, and, in turn, how the family dynamics affect the issue

Systemic therapy also considers the spoken and unspoken communication within the family, as well as the meaning family members give to family interactions. With this approach, the therapist remains allows the family members to take the lead on developing their own solutions. That said, the therapist remains an active role in assisting the family in creating solutions when they are stuck.

Interventions may include encouraging family members to develop new ways to solve disputes and issues. With this kind of therapy, it becomes a shared family experience since the entire family system attends together.

Types of Family Therapy

Family counseling can help strengthen and improve family relationships and mental health. It can provide your family with an opportunity to solve problems and express thoughts and emotions in a manner that’s good for everyone. Family therapy also presents an opportunity to explore family roles, structures, and behaviors in order to identify the source of conflict. For many families, family counseling helps identify their strengths and weaknesses, such as caring for one another or having difficulty trusting each other. 

If family therapy sounds like something that could benefit you and your family, it may be helpful to find a licensed marriage and family therapist with whom you can build a strong, trust-based relationship. Seeking a referral from another trusted professional, such as your family doctor, is often a good place to start. On the other hand, you may have a friend or associate who has a good family therapist they might recommend. 

A therapist can work with your family to address the challenges you are facing. There is no one right way to approach family therapy. As you gain understanding of the various types of family therapy available, you can choose the path that best matches your family’s needs.