Family Systems Therapy

  • Jialu Li Master of Science in Language Sciences (Neuroscience) UCL

Family systems therapy is a therapeutic approach that concentrates on treating the entire family as a cohesive unit. A fundamental principle of this method is the recognition that a family operates as an emotional entity and individual behaviour must be understood within the context of the family dynamic. Individuals are both shaped by their family environment and contribute to the overall dynamics of the family. This type of therapy emphasizes that a family transcends the mere sum of its individual members. Any event affecting one family member can reverberate and impact every other member profoundly. Consequently, the resilience and solidity of the family unit can offer a stabilizing influence and support when a particular family member is grappling with challenges.

This article explores the workings of family systems therapy, and its potential applications, and highlights some of the essential techniques employed. Additionally, it delves into the efficacy of this therapeutic approach and provides considerations before opting for family systems therapy.

Key concepts

Family systems therapy, rooted in the teachings of psychoanalyst Murray Bowen and his development of family systems theory, is rooted in eight interconnected concepts:1

  • Triangles: These represent three-person relationship systems that serve as foundational elements for other emotional systems.
  • Differentiation of the self: This pertains to the ability to maintain individuality. Individuals with high differentiation can autonomously pursue goals, while those with lower differentiation depend more on external validation.
  • Nuclear family emotional process: This refers to the emotional interactions within the family, encompassing patterns such as marital conflict, spousal dysfunction, impairment of children, and emotional distance.
  • Family projection process: Parents can transmit their problems and anxieties to their children, impacting their development and potentially causing emotional issues for other family members.
  • Multigenerational transmission process: Describing how individuals tend to choose partners with similar levels of differentiation, leading to progressively lower differentiation levels in subsequent generations.
  • Emotional cutoff: Some family members may distance themselves or cut off ties with others to manage conflicts. Unresolved conflicts left behind can create stress in future relationships.
  • Sibling position: Bowen proposed that birth order influences family dynamics, affecting parental expectations, sibling relationships, and patterns of parental discipline.
  • Societal emotional process: This concept suggests that societal factors, such as attitudes, cultural shifts, and conflicts, can impact both families and societies at large.1

When is it used?

Family Systems Therapy proves to be beneficial in addressing a variety of issues that impact family members.

This therapeutic approach is commonly employed to treat conditions such as:

  • Addiction and substance abuse problems
  • Anger management issues
  • Anxiety
  • Bipolar disorder 2
  • Challenges arising from events like divorce, job loss, or financial difficulties
  • Depression
  • Dysfunctional relationships
  • Eating disorders
  • Infidelity and divorce
  • Parenting problems and conflicts
  • Personality disorders 3
  • Stress and trauma

Additionally, Family Systems Therapy is valuable for addressing intra-family conflicts, whether they involve issues between siblings or between parents and children. It also proves helpful for families coping with life challenges or chronic health conditions affecting one or more members.4

What are the benefits of a family systems approach?

Family Systems Therapy offers a range of benefits by enhancing behavioural, emotional, and psychological functioning, effectively addressing various symptoms and difficulties affecting both individuals and families. Some notable advantages include:

  • Enhanced family functioning: Family Systems Therapy plays a pivotal role in improving the overall functioning of the family unit. It not only aids in treating various mental health issues but also ensures that individual family members receive the necessary empathy and support by strengthening the family support system.
  • Improved connections: This therapeutic approach fosters openness, empathy, and honesty within families, leading to stronger relationships and improved communication. Such improvements not only address current problems but also contribute to preventing future issues.
  • Increased cohesiveness: Family Systems Therapy views families as cohesive teams. Throughout the treatment process, individuals work both individually and collaboratively to devise solutions that enhance the overall strength and health of the family unit.
  • Healthier communication: The therapy identifies and addresses communication problems, power imbalances, and dysfunctional patterns that impact the well-being of each family member and the overall functioning of the family.
  • Cost-effectiveness: Family Systems Therapy proves to be a cost-effective treatment option. A 2013 study comparing services provided by marriage and family therapists to individual therapy found that family therapy services were the least expensive option.5

According to reports, Family Systems Therapy not only supports families during challenges and changes but also helps prevent long-term problems. Additional key benefits include the strengthening of relationships, improvement in communication patterns, increased resilience, and the promotion of supportive family networks.

Effectiveness

The effectiveness of Family Systems Therapy is largely contingent on the active involvement and willingness of the family to undergo growth. The consensus among therapists is that engagement is a pivotal factor, universally recognized as the primary indicator of success.6 Several studies affirm that family therapy interventions are the preferred approach for addressing conditions such as depression, substance abuse, child and adolescent risk behaviours, suicide risk, and relational issues.7

Families displaying an open mindset and a commitment to addressing systemic deficiencies are well-positioned to experience positive changes through family therapy. It's crucial to understand that family therapy doesn't serve as a definitive resolution to family problems; instead, it equips families with tools to enhance their cohesion. Factors that could impede the effectiveness of family therapy include issues like relapse, noncompliance with medication, or specific pathologies associated with personality disorders that might negatively influence treatment progress.

Summary 

In summary, Family Systems Therapy, rooted in Murray Bowen's theories, places the family at the centre as an interwoven emotional unit. It serves as an effective intervention for a diverse array of issues, bringing about enhanced family functioning, strengthened connections, heightened cohesiveness, and improved communication dynamics. Its versatility extends to addressing conditions like depression, substance abuse, and relational challenges. The success of Family Systems Therapy is intricately linked to the family's active engagement and openness to preventive measures. Noteworthy for its cost-effectiveness, this therapeutic approach equips families with essential tools, even though it doesn't offer a definitive resolution to complex familial issues. It is crucial to recognize that the therapy's effectiveness may be influenced by various factors, including the family's willingness, the presence of relapse, adherence to medication, and specific pathologies such as personality disorders. Despite not providing a conclusive solution, Family Systems Therapy plays a vital role in enhancing family dynamics and fostering resilience in the face of challenges.

References

  1. The Bowen Center for the Study of the Family [Internet]. [cited 2024 Feb 1]. Dr. Bowen. Available from: https://www.thebowencenter.org/dr-bowen
  2. Miklowitz DJ, Chung B. Family‐focused therapy for bipolar disorder: reflections on 30 years of research. Family Process [Internet]. 2016 Sep [cited 2024 Feb 1];55(3):483–99. Available from: https://onlinelibrary.wiley.com/doi/10.1111/famp.12237
  3. Varghese M, Kirpekar V, Loganathan S. Family interventions: basic principles and techniques. Indian Journal of Psychiatry [Internet]. 2020 Jan [cited 2024 Feb 1];62(Suppl 2):S192. Available from: https://journals.lww.com/indianjpsychiatry/fulltext/2020/62002/family_interventions__basic_principles_and.8.aspx
  4. 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 Proc [Internet]. 2014 Jun [cited 2024 Feb 1];53(2):194–213. Available from: https://onlinelibrary.wiley.com/doi/10.1111/famp.12066
  5. Crane DR, Christenson JD, Dobbs SM, Schaalje GB, Moore AM, Pedal FFC, et al. Costs of treating depression with individual versus family therapy. J Marital Family Therapy [Internet]. 2013 Oct [cited 2024 Feb 1];39(4):457–69. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1752-0606.2012.00326.x
  6. Thompson SJ, Bender K, Windsor LC, Flynn PM. Research note keeping families engaged: the effects of home-based family therapy enhanced with experiential activities. Social Work Research [Internet]. 2009 Jun 1 [cited 2024 Feb 1];33(2):121–6. Available from: https://academic.oup.com/swr/article-lookup/doi/10.1093/swr/33.2.121
  7. Marriage and family therapists [Internet]. [cited 2024 Feb 1]. Available from: https://www.aamft.org/Consumer_Updates/MFT.aspx
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Styliani Tsolka

MSc, Health Psychology, University of Surrey, UK
BSc, Psychology, University of Surrey, UK

Stella is dedicated to promoting Mental Health Awareness, among people of all backgrounds and knowledgeable in applying theoretical concepts with real-life scenarios. In the future, Stella aspires to qualify as a Counselling Psychologist, focusing on individualized holistic care.

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