Over 30 years ago my partners and I founded the Centers for Family Change. One of our motivations, at that time, was to develop a private practice that emphasized family therapy as the primary modality or approach. It was our belief that the most effective way to address many common childhood and adolescent problems was with family therapy. However, over the years we have found that providing family therapy was more challenging than we first thought.
Family therapy is harder than individual therapy:
- the views of more than one person have to be understood, addressed and balanced.
- patterns of interaction need to be identified and tracked; therapists need to think in terms of how systems work in addition to examining feelings and beliefs.
- conflicts can occur quickly and become quite intense.
- the therapist cannot just empathize with and understand the perspective on only one person; there are multiple perspectives and truths to balance.
Families often do not prefer or event want family therapy:
- teenagers may want the privacy and autonomy offered by individual therapy.
- parents may believe the problem lies completely within their child.
- family members may not want to address difficult and painful family issues.
Logistical Challenges exist:
- it is hard to schedule families, more evening or weekend hours are needed.
- insurance may not want to pay for family therapy.
Despite these challenges, and in some cases because of them, family therapy is often called for. Unaddressed issues, multiple perspectives on problems, unresolved conflicts, and problematic patterns of interaction all may need to be addressed to effectively resolve problems. Failing to fully consider these problems may hinder or prevent individual therapy from succeeding, where family therapy, despite its challenges, can.
In upcoming entries I will expound on the rationale for family therapy; examine and discuss the elegant simplicity and common sense truths of Structural and Strategic family therapy models; and discuss how family therapy fits for many problems of childhood and adolescence including ADHD, anxiety disorders, underachievement and defiant and oppositional behavior.