Family Therapy: Definition, Activities, & Techniques

By Charlie Huntington, M. A., Ph. D. Candidate
​Reviewed by Tchiki Davis, M.A., Ph.D.
Family therapy changes how a family interacts to promote better psychological well-being for the family members. This article describes key techniques and sample activities from family therapy.
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As a counselor at a sleepaway camp for boys, I worked with boys of all ages and from a variety of different backgrounds. It was fascinating to watch them adjust to life at camp, where the rules were so different from their own homes. Some boys pushed the envelope from the start, wanting to find the limits of the rules (and the limits of their counselors). Other boys seemed very shy at first and deathly afraid to break the rules or ask for help. It warmed my heart to watch this second group of boys relax into the freedom of camp, learn to take risks, and be seen and celebrated by the camp community. When their parents came to pick them up at the end of the month, I wondered if the home they were going back to was a supportive and nurturing place.
I thought of these boys when I began working as a therapist, because some of my clients were children from chaotic and unsafe home environments. Just with like my summer campers, who got just one month away from their families, these children and teenagers could get support and validation from me for an hour at a time, but what good was that if they had to spend almost all their time in a home that felt unsafe?

When therapists encounter a client whose family dynamics seem to be a powerful factor in their struggles, we often start to consider whether family therapy might be the right response to the situation. So, how do you treat an entire family at once? This article will shed light on the nature of family therapy and leave you with plenty of examples of family therapy in action.
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What Is Family Therapy? (A Definition)

Family therapy is any kind of therapy that focuses on changing how family members interact with each other, with the purpose of improving the well-being of the whole family or certain members in the family (Lebow & Gurman, 1995). This can be accomplished with just one person in the room, such as a parent, but it usually involves multiple family members coming to the therapy session, or even the therapist going to the family’s house to work with them there (Lebow & Gurman, 1995).
 
As I will discuss more below, family therapy is typically aimed at addressing behaviors that impact the whole family. While family therapy can be used to help with a child’s depression, for example, it is more likely that a family in which an adolescent is regularly abusing substances will come to family therapy, because the substance abuse is likely to be highly disruptive to the whole family.

Goals of Family Therapy

The primary goals of family therapy are to increase positive interactions and structure in the family and to reduce conflict among family members (Diamond et al., 2021). Sometimes, just accomplishing these goals is the full purpose of family therapy. At other times, achieving these goals is seen as an intervention that will improve something else in the family. For example, the entire family of a teenage girl with an eating disorder might come to family therapy because it has become clear to the girl’s therapist that certain ways the family members interact are motivating or exacerbating her eating disorder.
 
To achieve these goals, the therapist must build and maintain a positive connection, or alliance, with each family member (Friedlander et al., 2006). It is the therapist’s task to help each family member state their goals for the family and see how their involvement in family therapy will contribute to those goals. Balancing these goals and perspectives is one of the toughest tasks for a family therapist.
 
At the same time, the therapist’s strong alliance with one family member may impact their alliance with another family member (Friedlander et al., 2006). To build on our previous example, if the adolescent girl with an eating disorder perceives the therapist to be supportive of her father’s desire to police her weight, she may resist engaging with the therapist. This makes it important to have a sense of purpose for therapy that is shared by the entire family.

Family Therapy Theories

The most important theoretical perspective of family therapy is that it sees mental health challenges and psychiatric disorders from a systemic perspective (Carr, 2019). This means that even if there is just one person in the family who has a diagnosis, treatment is focused on how the whole family – the family system – interacts around that diagnosis. For example, family therapy to support a child with social anxiety disorder would pay just as much attention to how each family member may enable the child to avoid social contact as it would focus on helping the child overcome their anxiety. For many issues, seeking systemic solutions seems to yield better outcomes than trying to address the problem through individual therapy (Carr, 2019).
 
This systemic perspective was gradually widened to consider how the family members themselves interact with other systems, such as schools, workplaces, and neighbors (Imber-Black, 1988). Taking an even wider focus can help the therapist and the family avoid blaming the family members for things that may not be in their control. For example, the family of a child with attention-deficit hyperactivity disorder may face additional challenges if the school system resists providing much-needed accommodations for the child.
 
Another helpful theoretical perspective for family therapy is the idea of the “family life cycle” (Dallos & Draper, 2015). This perspective says that all families are continually faced with adjusting to new realities in the family system as life transitions occur. For example, almost all families with children will go through a transition when the children move out of the house. At the same time, the reaction of each family system to this change will be unique to the family system, reflecting its particular traits and history (Dallos & Draper, 2015). This perspective helps to normalize the constant change that families face.

Benefits of Family Therapy

It is clear from reviews of the psychotherapy research that family therapy can be a highly effective treatment (Lebow & Gurman, 1995). Family systems that for many years have struggled with ineffective communication and negative emotions can and do learn how to have positive experiences together. Family members become more adept at expressing their needs effectively and meeting each other’s needs. In the process of family therapy, many families come to identify shared goals and move toward them for the first time.

Approaches to Family Therapy

Among the most commonly used approaches to family therapy are structural family therapy, functional family therapy, and strategic family therapy (Hogue et al., 2019). These approaches are typically used to help families where substance use and/or disruptive behaviors are impacting the family system.
 
Structural family therapy
Structural family therapy (Minuchin, 1974) has been shown to be effective in many research studies (Colapinto, 1991). As you might be able to guess, structural family therapy focuses on how the family system is organized. It takes the view that the key to better individual and family functioning lies in changing the structures in the family, and the therapist’s role is to help the family reach a new stage in their relationships with each other.
 
Functional family therapy
Functional family therapy is an approach that has been particularly effective in helping families with children and teenagers engaged in delinquent, violent, or substance-abusing behaviors (Weisman & Montgomery, 2019). In parallel with structural family therapy, as its name suggests, the goal of functional family therapy is to make family interactions more functional and less dysfunctional. A family therapist using this approach will help the family identify which communication patterns are ineffective, learn how to be more effective in communicating, and practice establishing boundaries and rules for how each family member functions and interacts with other family members.
 
Strategic family therapy
The third common approach is called strategic family therapy, and it focuses on how all behaviors in the family system, especially those that are considered maladaptive, have a strategic function (Szapocznik & Williams, 2000). In fact, at one point in time, each strategy worked well, but at present, some are no longer effective, and the family is stuck in a pattern where each individual’s strategic responses may actually make things worse. The therapist’s role is thus to help the family members identify and implement more strategic behaviors.
 
While there are many other family therapies, including some that focus on the family system as a cluster of different attachment relationships (Diamond et al., 2021), these approaches are most characteristic of how family therapy typically operates. I should add that while family therapy is mostly used for what we therapists call “externalizing behaviors” – actions that negatively impact the environment or other people – it can also be used to address diagnoses such as depression, sometimes even more effectively than traditional treatments for depression (Waraan et al., 2022).

Family Therapy Activities

In family therapy, activities are used to get family members opening up and interacting with each other. For example, the therapist might ask each family member to create a family genogram, putting each family member into a family tree and writing about a particular characteristic they have, such as their religious faith (Frame, 2000). Then, each family member shares with the rest of the family what they have written.

Another activity, called the emotions ball, consists of the family tossing around a ball that has emotions written on it and practicing naming a time they have felt one of the emotions. As these activities happen, the therapist can help family members respond to each more effectively. In these moments, when family members learn to show care and appreciation for each other more effectively, much of the pain of previous negative interactions can be healed (Tsvieli et al., 2022).

For another example of family therapy activities, I recommend watching the following video:

Video: Family Play Therapy Activity: Improving Communication

Family Therapy Techniques

Family therapy uses four main categories of techniques to create positive change: 
  • changing how family members interact with each other
  • changing how they see their relationships
  • getting adolescents in the family more engaged with the family, and 
  • making healthy connections within the family more of a priority for each member (Hogue et al., 2019). 

​To accomplish these goals, more specific techniques such as reframing negative behaviors, minimizing blame for negative behaviors, and stopping unhelpful interactions between family members to replay the scene all seem to help (Hogue et al., 2019).

The therapist may first “join” with each family member to help them feel emotionally validated and then ask them to try relating to another family member in a different way. For example, when a parent is angry, the therapist may work with the parent to identify the source of the anger, then practice bringing the underlying need or vulnerability to the surface so that others can understand it better: “When I have to leave work to pick you up from school after you get in trouble, I get worried that my boss will eventually fire me. I yell at you because I want you to understand how seriously these situations affect our family’s well-being, but I can see what the therapist is saying about how my yelling just makes you more ashamed.”

Family Therapy Online

At the moment, there is very limited research on family therapy done online, but it seems that meeting online may be more agreeable to children and adolescents, and it can make it much easier for the whole family to participate (Levy et al., 2021).

Articles Related to Family Therapy

​Want to learn more? Check out these articles:

Books Related to Family Therapy

If you’d like to keep learning more, here are a few books that you might be interested in.

Final Thoughts on Family Therapy

It is common for families to experience family therapy as initially very difficult, but ultimately very rewarding and relieving (Friedlander et al., 2006). It is really helpful to have a referee and coach jumping into the middle of your arguments to help sort them out! As well as working with children and adolescents, family therapists work with family systems where everybody is grown up, too. If you think there is an issue that affects your whole family and you’d like help figuring it out, I encourage you to use this article and other resources to consider whether a family therapist could be helpful for you.

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