Family/Group Therapy


What is Family Therapy?

Family therapy, also known as family systems therapy, is an evidence-based psychotherapy in which a therapist works with the family’s members to alleviate distress and resolve conflicts between them. It also helps families set goals and explore ways to achieve them for their family’s betterment.

Family therapy is a solution-focused, family-based therapy with demonstrated effectiveness. It operates on the principle that a positive change in one family member causes reciprocal changes in most, if not all, the other members of the family.

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Who can Benefit from Family Therapy?

Family therapy is helpful for families of persons with conditions, such as:

  • Schizophrenia
  • Mood disorders: depression and anxiety
  • Substance use disorder
  • Disruptive behavior disorders in children, including oppositional defiant disorder and conduct disorder
  • Eating disorders, such as anorexia nervosa and bulimia nervosa
  • Childhood autism
  • Chronic physical ailments
  • Marital conflicts
  • Separation or divorce
  • Financial crisis within the family
  • Conflicts between siblings

What is the Purpose of Family Therapy?

The primary goals of family therapy (FT) are:

  • Evaluating the interaction of each family member with the other
  • Facilitating effective communication between family members
  • Learning the roles and behaviors of family members
  • Figuring out the family’s most pressing needs
  • Determining and addressing the core family issues
  • Resolving family conflicts by teaching effective coping skills
  • Promoting healthy boundaries
  • Trying to create a friendly home environment
  • Exploring the family’s strength(s) and working to foster them
  • Tweaking the maladaptive communicative behaviors between family members

What is the Usual Duration of Treatment?

The number of family therapy sessions will vary depending on your family’s circumstances and the therapist’s recommendation. However, family therapy is generally a short-term therapy with 12 sessions on average. The duration of family therapy is usually shorter than the regular individual psychotherapy sessions.

How Long Does Each Family Therapy Session Last?

Each session typically lasts for about 45 minutes to an hour and are spaced at intervals of two to three weeks.

What Happens During a Family Therapy Session?

All family therapists have their unique way of approaching. A typical FT session, however, entails filling out some paperwork, usually in advance of the first session.

During the initial stages, a family therapist listens to the concerns of all the family members that made them seek therapy in the first place. While asking questions, the therapist observes the family’s interactions with one another. The therapist will try to get all the family members to sit together for at least the initial part of the session.

The initial stages of family therapy also involve understanding the hierarchies within a family, including:

  • the roles and responsibilities of every member
  • the person(s) having the authority of decision-making in the family

Then comes the communication stage, in which every family member will be inquired about specifics of their lives and recent stressor(s). The therapist will ask about what triggered the conflict and how the family has been trying to handle the situation so far. Each family member can express what they think and how they feel because of the unresolved conflict. All individual stressors are viewed in the context of the larger unit: the family.

Next, the family therapist sets goals during the goal-setting stage, to resolve the major conflict, identified by both the family and the therapist together. The therapist works separately as well as mutually with all members to help resolve a conflict that has been impacting their relationships.

The last stage of a family therapy session is the homework-assigning stage. Finally, a therapist will work out a treatment plan and assign outside-session homework. Doing such exercises will slowly help you learn ways to cope with the problem(s) without the assistance of a therapist.

Additional therapy sessions are scheduled for further delving into the family’s problems and dynamics as well as track the progress.

How does a Therapist Respond to Arguments During Therapy?

Arguments/disagreements may often arise during the interview session. In a controlled environment, where therapists can notice the dynamics right away, arguments and interruptions serve as helpful tools.

Some counselors allow these arguments to take their own course to better understand the core issue. However, if your therapist sees the conversation drifting into personal attacks, he or she will have to intrude, take control of the session, and set certain boundaries to restore peace without taking sides.

Your therapist will then try steering the conversation in the direction that maximizes the odds of resolving the disagreements.

What are the Different Forms of Family Therapy?

There are various types of family therapy. The most common ones include:

Strategic Family Therapy
Strategic family therapy seeks to explore concerns that can be strategically tackled in a shorter period. It is briefer and more direct than other therapy modalities.

Strategic family therapy involves assigning homework to family members with the intention of modifying the way family members interact with one another. Strategic behavioral therapy is a solution-focused therapy that aims to detect solvable issues, then set goals, and finally devise strategies to achieve them. With this type of family therapy, a therapist steers family members towards thinking strategically and figuring out ways to cope with them.

Structural Family Therapy
Structural family therapy entails learning the family structure and strengthening the family’s bond by enhancing interactions among family members. The goal is to set healthy boundaries while constructively restructuring the family.

Bowenian Family Therapy
This form of family therapy is appropriate for individuals who cannot or do not want to involve other family members in the therapy.

Bowenian therapy is built on eight concepts, of which the two core concepts are:

  • Triangulation — Venting in a relationship by talking to a third party to gain distance and provide stability with the one involved in a direct relationship.
  • Differentiation of self — The ability to separate feelings from thoughts in a relationship while still being able to stay emotionally connected to your relationships. It helps members to be less emotionally reactive during times of stress.

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What is Group Therapy?

Group therapy is a form of psychotherapy in which one or more mental health therapists or counselors work with a group of few patients. Therapists conduct group therapy in several settings, including private practices, community centers, and hospitals.

People selected in specific group therapy are usually the ones facing similar problems, for instance, relationship issues or substance abuse. This form of psychotherapy is usually merged with medications and other forms of psychotherapies based on the underlying challenges addressed. Nonetheless, it can be used as a stand-alone treatment for certain conditions.

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What are the Goals of Group Therapy?

Group therapy helps its members to acknowledge their own as well as other participants’ problems. It helps raise self-awareness in individuals and makes them realize that they are not the only ones facing those problems. This comprehension, in turn, helps members of the group to support each other and share their ways of coping with a particular issue.

By helping to gain insight into the feelings and response of other members to similar situations, group therapy aims at instilling positive behaviors and developing more effective problem-solving skills. It also works to mitigate unwanted symptoms such as negative behavior, lack of motivation, and poor adjustment skills.

Group counseling sessions facilitate effective communication between the group members. They aim to educate them on how to converse about the challenges they face while gracefully handling constructive criticism from others. Group conversations, therefore, serve as a conduit for revamping social and interpersonal relationship skills. The idea behind stimulating this attunement is to assist people in their relationships outside the group. Moreover, they help undo bad attitudes that may underlie social barriers.

What Happens During Group Therapy?

Ideally, the group therapist will have individual sessions with each member prior to the start of therapy.

During a group therapy session, about eight (ideally less than twelve) participants typically meet up for an hour or two each week in the presence of at least two professional therapists. These members sit down together, introduce themselves to one another, and share their reason or core problem to join the group therapy. The members in a group are encouraged to openly express their feelings and personal problems to one another in a high trust environment.

Each member will need to respect the group’s rules and procedures. Though constructive criticism may be allowed, none of the members are allowed to humiliate or belittle another in any way.

What is the Job of a Therapist in Group Therapy?

A group therapist employs a broad set of skills to lead the group for optimal growth and change. Some of the therapy skills that form the basis of an effective group discussion include:

  • Active listening – The therapist needs to be attentive and present throughout discussion to avoid missing minute details communicated by group members.
  • Facilitating – The therapist will attempt to facilitate effective communication between group members, so that they can openly express their feelings. The therapist will work to build an atmosphere of safety, acceptance, and trust.
  • Clarifying – The therapist will focus on core underlying problems and help group members gain clear insight into their thoughts and feelings.
  • Reflecting – The therapist will evaluate the feelings and emotions of group members by observing their way of communication and their body language — and express (or reflect) those feelings back to the group members.
  • Empathizing – The therapist will regard and respect the member’s feelings even though the therapist’s experiences and thoughts may differ from that of the members. This also includes the ability to discern subtle nonverbal messages.
  • Interpreting – The therapist will explain behaviors or symptoms of one group member to another. Members are also allowed to interpret their own behavior.
  • Questioning – The therapist will ask both open-and-closed-ended questions regarding the matter of concern either to a group member or the entire group.
  • Linking – The therapist will interlink those members who share common experiences or concerns, so they can work as a team to sort out their issues.
  • Confronting – The therapist confronts members to acknowledge their conflicts in thoughts, feelings, and behaviors. Group members will be asked to decipher their own behaviors.
  • Supporting – The therapist will instill positive reinforcement to promote change.
  • Blocking – The therapist will intervene to block behaviors in a group if any member is found to disrespect another member, break confidentiality, or violate other ground rules. Members will be reminded about being respectful and following the ground rules.
  • Summarizing – The therapist will summarize and provide a recap of the key points deduced from the discussion. Members will also get to know about the direction towards which the discussion is headed.

How Long is a Group Therapy Session?

The preferred duration for group sessions that are done more than once a week is around 45 minutes. Those conducted once a week may last for up to 2 hours. Group therapy may continue for six months at the most, depending on the purpose and goals of the group.

When is Group Therapy Used?

Group discussions are effective at addressing a variety of issues, including but not limited to:

  • Depression
  • Anxiety and panic disorders
  • Substance abuse
  • Eating disorders
  • Anger-controlling problems
  • Personality disorders
  • Shyness
  • Excessive arguments
  • Trust issues

How Effective is Group Therapy?

Research reveals that group counseling has equivalent effects to one-on-one therapy in terms of effectiveness. It works for a number of issues, including depression and anxiety. A study conducted on individuals with depression showed a 44% improvement in symptoms following group behavioral therapy.

Group counseling enables participants to openly express their concerns and discover effective strategies to cope with them. Members also develop altruism and compassion through group sessions. It also instills hope in individuals as they notice an improvement in others.

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