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How Does Family Therapy Work?

During a one on one therapy session, the patient and therapist go back and forth discussing certain concerns. Depending on the approach being used, the therapist may ask specific questions or encourage a patient to speak more about a certain topic. Nevertheless, one on one sessions are simply an exchange between two people. 

But, what happens when an entire family is working with a therapist? It is no longer a simple conversation between two people. With family therapy, there are multiple feelings, voices, and viewpoints that must be considered. So, how exactly, does family therapy work?

For starters, family therapy includes the entire family and emphasizes the benefits of overcoming obstacles as a family. Its main aim is to find a solution, rather than to assign blame and it is therefore used to treat both “individual” and “family” problems. There are various different approaches a family therapist may use. The most common are: 

Family therapy session with mom, dad, and daughter


The structural approach to family therapy stresses five key ideas developed by Salvador Minuchin:

  1. Attention must be paid to familial interactions, rather than individuals.
  2. One’s identity is based on their interactions with the family.
  3. The entire structure of the family is composed of social interactions.
  4. Define a well-functioning family as one that can respond appropriately to family needs.
  5. The therapist plays an active role to help identify and work through patterns that prevent the family from growing together. 


The strategic approach to family therapy implements various psychotherapy techniques that have proven to be effective. This approach has five key stages: social, problem, interactional, goal-setting, and task-setting. It is considered to be a brief approach to family therapy that used homework assignments to change the family dynamics. With this approach, the therapist maintains a more powerful role to encourage those who lack power in the family structure to speak out. 


The Bowenian approach to family therapy stresses the differentiation of family members, little anxiety regarding the family, and maintaining healthy emotional contact between family members. This approach advocates for a balance between individuality and togetherness, as well as stressing these eight interlocking concepts. 

Parents relaxing on the couch and watching their children play on the floor


The systematic approach to family therapy is centered on unconscious meanings behind the way the family acts and communicates. With this approach, the family therapist plays a less-active role in order to observe how the family handles their issues. 


The intergenerational approach to family therapy acknowledges the role of past generations in the current family system. This approach identifies multigenerational patterns of behavior to help families understand how their issues developed. It also focuses less on assigning blame and more on “I” statements when communicating with one another. 

As you can see, family therapy can work in a variety of ways depending on the approach used. Although there are different approaches to family therapy, the overall purpose is to help strengthen the family bond, improve communication skills, and teach the family how to combat problems together. Whether the family is struggling with an individual or family problem, family therapy can prove to be beneficial for the entire family. 

Dr. Miller is trained in Adult, Child and Adolescent Psychiatry. She is also trained in Anesthesia and Pain Management. Because of her broad experience, Dr. Miller is uniquely qualified to treat psychological trauma, depression, and anxiety that can occur as a result of injury or disability.  For more information, schedule a consultation at NJ Family Psychiatry & Therapy.            

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Helene A. Miller / And Other Providers
Family Psychiatry and Therapy brings compassion, understanding, and skilled care to patients throughout New Jersey. Our team of mental health professionals focuses on providing a positive and uplifting experience that aids our patients in facing life’s toughest challenges.