What Is Family Systems Therapy?

family therapy

FatCamera / Getty Images

What Is Family Systems Therapy?

Family Systems Therapy

Family systems therapy is a form of psychotherapy that focuses on the family as a whole unit. A central tenet of this approach is that a family is an emotional unit and individual behavior must be considered from the context of the family. People are influenced by their family but each person also influences their entire family.

This approach also suggests that the family is more than the sum of its parts. When something affects one member of the group, it can have a resounding impact on every other member of the family. For that same reason, the strength and stability of the family unit can provide balance and support when one family member is experiencing problems.

In addition to taking into account the family system as a unit, this approach to therapy also considers how generational, social, community, and cultural factors influence individuals and families. 

This article discusses how family systems therapy works, what it can help with, and some of the key techniques that may be used. It also discusses the effectiveness of this type of therapy and things you should consider before trying family systems therapy.

Key Concepts in Family Systems Therapy

Family systems therapy is based on the work of Murray Bowen, a psychoanalyst who developed family systems theory. According to Bowen, family systems theory is rooted in eight interlocking concepts. These eight concepts are:

  1. Triangles: A three-person relationship system that acts as a building block for other emotional systems.
  2. Differentiation of the self: This refers to the ability to maintain individuality. People with high levels of differentiation are able to independently pursue goals while those with poor differentiation rely more on getting validation from other people.
  3. Nuclear family emotional process: This refers to how the family operates in their emotional interactions. These patterns can include marital conflict, dysfunction in a spouse, impairment of one or more children, and emotional distance.
  4. Family projection process: Parents can also transmit their problems and anxieties onto their children. This can affect how kids develop and can create emotional problems for other members of the family.
  5. Multigenerational transmission process: This describes how people choose partners who have similar levels of differentiation as themselves. Subsequent generations each have progressively lower levels of differentiation.
  6. Emotional cutoff: In order to manage conflicts within a family, some members may distance or cut themselves off from other members of the group. Cutting off old relationships without resolving the conflict can add pressure and stress to future relationships.
  7. Sibling position: Bowen believed that birth order had an impact on family dynamics including in areas such as parental expectations, sibling relationships, and parental discipline patterns.
  8. Societal emotional process: This concept suggests that many of the things that impact families also affect societies as well. Societal attitudes, cultural shifts, and conflicts can often play a part in affecting families.

Recap

Understanding the eight principles can help families better establish healthy boundaries, create more positive relationships, change negative patterns of communication, and improve the functioning of both individuals and the entire family.

Techniques of Family Systems Therapy

Family system theory suggests that individuals are inextricably interconnected to their relationship networks. Bowen believed that understanding these networks and the patterns of communication and conflict that occur within them was essential in order to address individual problems.  

Types of therapy utilizing this theory may employ a number of different techniques that are designed to help both individuals and the entire family unit. Some of the different types of techniques that may be used depending on the needs of the family include:

  • Couples therapy: When a couple is having issues, it can affect the entire family. Couples therapy may be used to help people in a relationship resolve conflict and improve communication.
  • Intergenerational family therapy: This technique focuses on understanding how generational influences have affected both individual behavior and how the family unit functions. It helps families understand how patterns acquired from previous generations are affecting the family and learn new ways of interacting. 
  • Narrative therapy: This is an approach in which people develop a story of their life that helps them better understand their experiences, behaviors, and roles. 
  • Psychoeducation: This involves teaching members of the family about different aspects of mental health and treatment. This can be helpful when one family member is dealing with a mental health condition. By educating family members, the individual's support system can respond more effectively and empathetically to their needs.
  • Structural family therapy: SFT focuses on helping people identify and understand how the family is structured. The goal is to help people improve this organization as needed and learn how to communicate with one another more effectively.
  • Strategic family therapy: This technique focuses on identifying interventions to address specific problems. Each problem requires a novel approach that is specifically designed to address the unique issue the family is facing. 

Recap

Family systems therapy may draw on aspects of other types of therapy as needed. Techniques that may be used include couples counseling, psychological education, and other family-based interventions.

What Family Systems Therapy Can Help With

Therapy approaches that are focused on families can be helpful for a number of different issues that affect family members. Some conditions and problems that it may be used to treat include:

  • Addiction and substance abuse problems
  • Anger management problems
  • Anxiety
  • Bipolar disorder
  • Challenges caused by things such as divorce, job loss, or financial difficulties
  • Depression
  • Dysfunctional relationships
  • Eating disorders
  • Infidelity and divorce
  • Parenting issues and conflicts
  • Personality disorders
  • Stress and trauma

It can also be helpful for addressing conflict within families, whether these center on problems in relationships between siblings or between parents and children. It can also be helpful for families dealing with life challenges or with chronic health conditions that may affect one or more family members.

When it comes to treating individual mental health problems, family systems therapy often looks at how factors within the family may contribute to the onset or maintenance of such conditions. If one person has a substance use disorder, for example, this type of therapy would help members of the family understand how things like codependent relationships allow the addiction to continue.

Once people have a better understanding of factors that might contribute to the problem, members can then work to change their roles, communication styles, and behaviors in order to support one another more effectively.

Benefits of Family Systems Therapy

This type of therapy has been shown to be helpful for a diverse range of problems. By improving behavioral, emotional, and psychological functioning, family systems therapy can address a wide range of symptoms or difficulties that affect individuals and families. Some key benefits:

  • Better functioning families: One of the key benefits of family systems therapy is that it can improve how the family unit functions. It also benefits individual family members in a variety of ways. First, it can be helpful for treating different types of mental health issues. And by improving their family support system, this type of therapy ensures that family members also have the empathy and support they need going forward.
  • Stronger connections: Another benefit of family systems therapy is that it promotes openness, empathy, and honesty in families. This can strengthen relationships and improve communication, which can address current problems and prevent future issues.
  • More cohesiveness: Family systems therapy characterizes families as a team. During treatment, each person works individually and collaboratively to come up with solutions that will make the team stronger and healthier.
  • Healthier communication: Family systems therapy can help identify communication problems, power imbalances, and dysfunctional patterns that affect the well-being of each family member as well as the functioning of the entire family unit.
  • Cost-effective: Systematic family therapy can also be a cost-effective approach to treatment. A 2013 study comparing services provided by marriage and family therapists compared to individual therapy found that family therapy services were the least expensive option.

According to one report, family systems therapy helps prevent long-term problems by supporting families during challenges and changes. Other important benefits include strengthening relationships, improving communication patterns, increasing resilience, and encouraging supportive family networks.

Effectiveness

Research suggests that family systems therapy can be an effective treatment for a number of different conditions including substance use disorders, depression, child and adolescent behavior problems, and relationship issues.

Family systems therapy can be effective on its own or when used as part of a multimodal treatment program for both children and adults. Some conditions it has been shown to benefit include attachment problems in children, eating disorders in adolescents, and relationship distress in adults.

Research has also shown that this approach to therapy can also be useful for strengthening family support when individuals are facing serious health issues.

Studies also suggest that family systems therapy can be helpful when used alongside other treatments for substance abuse in teens and adults.

Recap

Research supports the efficacy of family-based interventions for a number of different mental health concerns including depression, substance use, relationship problems, and other mental disorders in both children and adults.

Things to Consider

Because family systems therapy focuses on the relationships between family members, it is important for the entire family to work together during therapy. This can be challenging in situations where one or more family members are reluctant, ambivalent, or resistant to treatment.

Research supporting the use of family systems therapy remains limited. However, studies are ongoing and the available evidence shows promise in the use of this treatment for a variety of purposes.

It is important to note that family systems therapists remain neutral throughout the treatment process. This can be challenging for family members who want the therapist to provide feedback or challenge problematic behavior. From the perspective of some family members, this neutrality can sometimes seem like an implied approval of certain behaviors.

How to Get Started

If you think family systems therapy might be helpful, start by looking for a licensed and experienced therapist with a background in this type of therapy. You might begin your search by looking at an online therapist directory or by asking your primary care physician for a referral. Online therapy may also be an option in some cases.

Ask a potential therapist about their training and credentials. Also be sure to inquire about their specific experience working in the areas that you want to address, such as substance abuse or parent-child conflict. 

During your first session, you can expect your therapist to gather information about your family, the problems you are facing, and your goals. The therapist may ask questions about your history, your relationships, how you communicate, and what you hope to achieve during therapy.

While it may vary depending on your needs, family therapy is typically time-limited, lasting for an average of 12 sessions.

Was this page helpful?
13 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. The Bowen Center for the Study of the Family. Learn about Bowen theory.

  2. The Bowen Center for the Study of the Family. Social emotional process.

  3. Miklowitz DJ, Chung B. Family-focused therapy for bipolar disorder: reflections on 30 years of researchFam Process. 2016;55(3):483-499. doi:10.1111/famp.12237

  4. Cluxton-Keller F, Bruce ML. Clinical effectiveness of family therapeutic interventions in the prevention and treatment of perinatal depression: A systematic review and meta-analysisPLoS One. 2018;13(6):e0198730. doi:10.1371/journal.pone.0198730

  5. Varghese M, Kirpekar V, Loganathan S. Family interventions: basic principles and techniquesIndian J Psychiatry. 2020;62(Suppl 2):S192-S200. doi:10.4103/psychiatry.IndianJPsychiatry_770_19

  6. Distelberg B, Williams-Reade J, Tapanes D, Montgomery S, Pandit M. Evaluation of a family systems intervention for managing pediatric chronic illness: Mastering Each New Direction (MEND)Fam Process. 2014;53(2):194-213. doi:10.1111/famp.12066

  7. (Crane DR, Christenson JD, Dobbs SM, Schaalje GB, Moore AM, Pedal FF, Ballard J, Marshall ES. Costs of treating depression with individual versus family therapy. J Marital Fam Ther. 2013;39(4):457-69. doi:10.1111/j.1752-0606.2012.00326.x

  8. About Families. Systemic therapy: what difference does systemic therapy make to the outcomes for children and families?

  9. Carr A. Evidence for the efficacy and effectiveness of systemic family therapy. In: Wampler KS, McWey LM, eds. The Handbook of Systemic Family Therapy. 1st ed. Wiley; 2020:119-146. doi:10.1002/9781119438519.ch6

  10. Milberg A, Liljeroos M, Wåhlberg R, Krevers B. Sense of support within the family: a cross-sectional study of family members in palliative home care. BMC Palliat Care. 2020;19(1):120. doi:10.1186/s12904-020-00623-z

  11. Rowe CL. Family therapy for drug abuse: review and updates 2003-2010. J Marital Fam Ther. 2012;38(1):59-81. doi:10.1111/j.1752-0606.2011.00280.x

  12. Slesnick N, Zhang J. Family systems therapy for substance-using mothers and their 8- to 16-year-old children. Psychol Addict Behav. 2016;30(6):619-629. doi:10.1037/adb0000199

  13. American Association for Marriage and Family Therapy. Marriage and family therapist: the family-friendly mental health professionals.