Family therapy is a different form of therapy than just one-to-one therapy.
The format and the approach are all very varied from traditional therapy.
Within therapy too, there are many schools of therapy. Although family therapy is conducted with all or most members of the family, it can even be conducted with one person.
Family therapy started as a reaction to the diagnosis of schizophrenia and other psychotic disorders where the person himself or herself was blamed as the reasons for the symptoms.
Family therapy research suggested that children from families that gave mixed signals when communication tend to be much likely to develop such disorders later in life.
Of course, this was a very extreme position to take and they did mellow it down later, but they had made a case for the role of dysfunctional family patterns.
Family therapy contends that the fault is systemic although there may be only one ‘identified patient’.
However, if the identified patient has to truly get better, then the whole system needs to change. They may have one or more faulty communication patterns which may lead to faulty subsystems and inefficient boundaries, which eventually lead to mental health disorders in one or more people.
The family therapist tends to talk to the whole family, and encourages them to talk to each other as well, and identifies the communication gaps and issues in them.
Once noticed, they correct the pattern there in the session itself, and slowly these changes are implemented later outside the therapy room as well. Boundaries are to the level which one subsystem is differentiated from the other.
Parents are one subsystem, children are another subsystem and so on. If the parents are overly involved in the child’s life, it is called an enmeshed boundary, whereas if their involvement is haphazard, it is called a diffused boundary.
Once these boundaries are known to be unhealthy, they are gradually improved by commenting and practicing alternate behaviours, in the therapy room and slowly later in life too.
When the whole family is not able to come, then the remaining members are asked about the patterns in the family, and asked to change their response in the patterns so that these effect the other person and in return, the whole system becomes healthy.
Family therapy is found to be especially effective in relationship issues like divorce cases, or when there are special children in the family.
When there is recurrent drug abuse of psychopathology that relapses too often, it is believed that the person is not able to give up the old behaviour because of the family, and in that case too, family therapy is attempted.
Family therapists require special training in order to understand family systems and successfully observe faulty patterns.
The family is a much more difficult clientele than a single person as fights can and do erupt within the therapy room itself and therefore the therapist needs to be very skilled to be able to control such situations.