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| |    Family Therapy by Robert Needlman, M.D., F.A.A.P. reviewed and revised by Robert Needlman, M.D., F.A.A.P. Family therapy began in the U.S. about 50 years ago. The basic idea is that often an individual's emotional, behavioral, and even physical problems are best solved by working with her whole family. This makes sense because the behavior of any one member of a family affects every other member. When one has a symptom--headaches, for example, or hyperactivity--how the other family members respond is often one of the key factors that either helps resolve the problem or keeps it going. Who are family therapists? Family therapists have training in a variety of fields-psychology, psychiatry, social work, and pastoral care (that is, trained members of the clergy). Most states have licensing requirements that include at least a master's degree, two years of family therapy practice under close supervision (much of it through a one-way mirror), and a standardized exam. What family therapists do The job of the therapist is to help a family stuck in a destructive pattern of interactions to change. Change comes about as family members learn to see their behaviors from a new angle and respond in new ways. Often when one member of a family begins to change her behavior, other family members respond by counteracting that change. The therapist helps families to recognize and overcome this sort of resistance. I like to think of therapists as acting like a coach, helping families to use their positive energies in the most effective manner, just as a coach helps an athlete develop his or her key skills. How family therapists work Most family therapists work with the whole family all at once, as well as with the parents as a couple or with selected children. The therapist observes the family in action. Rather than listening to them describe how things go at home, this lets the therapist watch the family's interactions occur in real time and step in at strategic moments to offer guidance. Family therapy tends to be problem-based, meaning that it focuses on a particular problem--say, a child's disobedience or a parent's feeling of depression. Usually, the therapist with sit down with the family after the first session and agree on a goal, setting a number of sessions in which to reach that goal. About half the time, therapy lasts for 12 sessions or less. This is brief compared to more traditional insight-oriented therapy. Setting a limit ahead of time allows many families to feel more relaxed, because they know that they are not committing themselves to costly therapy with no end in sight. How to find a family therapist Pediatricians and family doctors often have particular family therapists they trust, and to whom they usually refer. Even if you are seeking family therapy on your own, you may want to talk with your child's doctor or nurse practitioner. The American Association of Marriage and Family Therapy has an on-line directory that can help you find members of that organization in your area, as well as a very helpful consumer's guide to family therapy. You may want to interview several therapists to find one who seems to be a good fit for you. Reputable therapists will not be offended by direct questions about where they got their professional degrees, whether their degree is in family therapy or a related discipline, who supervised their first clinical years, and how long they have been in practice. Ask about their experience treating your specific problem. Ask, too, about the therapist's philosophical approach. There are different schools within family therapy, and you want to know how the therapist you are choosing looks at families, and what sorts of strategies he or she uses.
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