Family therapy and individual therapy are two of the most used modalities of therapy today. Both have a role in psychotherapy and both can be helpful at the appropriate juncture in assisting individuals to grapple with their issues and strengthen their communication.
What is family therapy?
Family therapy, or family counseling or systemic therapy is a form of psychotherapy that addresses “psychological distress in relation to the family rather than just the individual”.
It does so from a systemic perspective, building on the concept that mental health struggles are influenced by and are influencing of our relationships. Families are all interconnected, and the behavior or feelings of each individual can affect the entire unit.
While therapy with an individual only addresses individual symptoms, family therapy attempts to change the patterns, interactions and narratives that maintain problems as well as help each individual harness their own strength to develop more adaptive ways of functioning.
Common approaches in family therapy
Your family’s needs will determine whether the family therapist works within one or integrates several of the following models:
- Family-based therapy: The gold standard of treatment for adolescents with eating disorders. Parents are given the ability to take control of their child’s recovery and the tools to and resources necessary to aid their child in regaining weight, normalizing eating behaviors, and developing healthfully.
- Functional family therapy: A short-term treatment for youth aged 11-18 with serious behavioral problems including violence and/or substance abuse. It instills trust, teaches parenting skills, and connects families with resources to keep progress.
- Multisystemic therapy: An intensive treatment for children and adolescents with chronic antisocial behavior. Therapists engage all the systems in which the child is involved (e.g., family, school, peers) and work in close partnership with parents in order to intensify effective parenting, strengthen communication, remain involved in school, develop networks of support, and minimize contact with delinquent peers.
- Structural family therapy (SFT): Aims to restructure the family’s organization by creating clear boundaries and restoring appropriate hierarchies. It empowers the parent, establishes appropriate and flexible boundaries, and modifies relationships according to the needs of the growing child.
- Narrative family therapy: Assists families in reframing unhealthy family dynamics through deconstruction of problem stories, separating problems from people, and constructing new empowering narratives.
What is individual therapy?
Individual therapy, or psychotherapy and “talk therapy”, is a process that occurs between an individual client and a trained and licensed mental health professional. The focus is on developing self-understanding and changing behavior to reduce suffering, function better in life, and improve the quality of one’s life.
Central to it is a one-on-one collaborative relationship that offers a safe, confidential environment for the individual to reflect, explore, and develop while working through issues as quickly or slowly as they wish.
Common approaches in individual therapy
Several evidence-based approaches are utilized in individual therapy, based on the needs and goals of the individual:
- Cognitive behavioral therapy (CBT): Is concerned with the connection between thoughts, feelings, and behaviors. People learn to recognize these detrimental patterns and create coping mechanisms which form the basis for healthier habits.
- Dialectical behavioral therapy (DBT): Incorporates CBT but also adds in mindfulness and acceptance strategies. DBT also combines acceptance and change, focuses on teaching distress tolerance and emotional regulation while developing new coping skills.
- Psychodynamic therapy: Investigates the influence of unconscious thinking and childhood experience on present behavior. Therapists assist their clients in developing awareness and insight to help long lasting change and growth.
- Person-centered therapy: Assumes “that people have an innate drive toward growth and are the experts of their own lives”. The role of the therapist is supportive, non-directive and allows the individual room to grow and find their own solutions.
Benefits of family therapy vs individual therapy
Similarly, family therapy and individual therapy each have their own unique benefits for children and adolescents. The choice between the two depends on your requirements and objectives.
Benefits of family therapy
How it can help your family:
- Better communication: Developing skills such as active listening and empathy to foster understanding, enhance cohesion and improve conflict resolution.
- Strengthen support network: Developing a new found parenting/caring experience to be supportive in their healing, Building supports, Accessing community resources.
- Define roles and set boundaries: Define healthy boundaries within the family and change roles as children get older.
Benefits of individual therapy
Individual therapy has the benefits of a more private and focused space:
- Self-development: Use the exploration of thoughts, feelings, and history to gain self-awareness and develop new patterns of behavior.
- Confidentiality: The private nature of your sessions creates a safe environment for exploration, particularly in cases of trauma, shame issues and family secrets.
- Individualized treatment: Treatment is personalized to you, and therefore as you move forward the therapist can shift their approach to be more concentrated and impactful.
- Development of skills: Studies show that the individual modality develops lasting psychological resources, such as coping skills and stress management, more effectively.
Downsides and contraindications
There are challenges to both that can limit their effectiveness, but both are effective:
Challenges of family therapy
- Scheduling and logistics: It takes longer to organize multiple members.
- Refuseniks: Those who do not want to participate can lead to key participants refusing to come, or resisting the change within the session which can lead to session stagnation, or further entrenched conflict.
- Power differentials: If not facilitated carefully, one person feels ganged up on, or not listened to.
- Privacy issues: Sharing may be inhibited due to decreased confidentiality.
Situations in which family therapy is not advised include the following:
- Abuse or domestic violence is occurring
- Stabilization is needed first for someone (e.g. they are actively using substance, in an acute mental health crisis)
- High chances of safety risks, intimidation and threats.
- External stresses (such as litigation, financially) play a large role and necessitate a specialized form of treatment
Challenges of individual therapy
- The problem has a systemic cause: When a family member is struggling with conflict, addiction or behavior problems, it generally requires family engagement to deal with the reasons behind, rather than asking only one individual to change.
- You need social practice: There is no substitute for the social practice of being in a session with your family, there is no equivalent to the experiences that you share with other people or the opportunity to work in the moment on relationships that therapy can provide.
- Crisis or severe mental illness: Safety issues, acute psychosis or other emergencies that require coordinated care or crisis intervention. Individual sessions alone are insufficient.
- Time/cost barriers: Long-term therapy may be cost prohibitive or not possible to continue for chronic conditions.
Evidence and effectiveness
It is well established that individual and family therapy all provide a meaningful impact on the mental health of children and adolescents.
- Meta-analyses show that 75% of youth in therapy experience benefit.
- Youth who received at least one session of family therapy averaged two weeks longer in treatment than youth who did not receive any family therapy.
- The combination of family therapy in conjunction with either individual therapy or group therapy has been associated with 50% of the suicide attempts as either type of therapy alone.
- A meta-analysis indicated that 60% of youth treated with cognitive behavioral therapy for anxiety disorders are recovered and show significant reductions in symptoms.
- DBT, across studies, decreased the prevalence of self-harm among adolescents.
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