One of the questions that should be addressed when a couple or family approach me for marriage/family therapy is what type of therapy will be most useful for each family and each unique situation.
Family therapy with older children and teenagers occurs through the use of conversation in a neutral, calm setting where the emphasis is on open, respectful communication and interventions by the therapist which point outpatterns in the way members of a family communicate, how the past may be repeating itself in the present, and how our personal childhood histories influence how we choose and interact with our children and spouse.
Likewise, marriage therapy, or marital therapy, also focuses on taking turns talking about feelings and problems in an open and respectful way, and the marriage/family therapist listens empathically and provides helpful comments and generally provides direction to the conversation. The family/marriage therapist may point out aspects of a communication and repeated patterns from the past that are unconscious and unseen by a couple. Exploration of trauma or difficulty in the individual lives of a married couple may also be an important aspect of marriage/family therapy, since it is assumed in psychodynamic therapy that the developmental history of an individual is critical to hold the present unfolds. Importantly, this “unfolding” may be mostly unconscious, and it is the marriage/family therapist’s role to recognize these patterns and make these explicit in a tactful way.
Therapy often becomes a type of “container” for a family to speak about difficult thingsin a controlled, safe setting where feelings and actions are not given free reign but are stopped by the therapist at critical moments in order to reflect and understand what is occurring in that moment.
Family therapy can also occur with younger children: this therapy is known as parent-child, dyadic or attachment-based therapy.
My approach is to custom-make a treatment plan for each family, couple or individual that I encounter. After an assessment period of 6-8 weeks, I make a recommendation on what I think will be most helpful to you. One option that has been useful is to combine marriage therapy and family therapy: for some sessions the family attends, and other sessions just the couple attends sessions. Recommendations may be made for one or more of the family members to receive individual therapy in addition to marriage/family therapy.
