Family Therapy

Most children in the Looked After system are offered sessions with the Child and Adolescent Mental Health Service [CAMHS]. SureCare’s Chartered Psychologist, Cheryl Massey, is a trained Systemic Family Therapist with 6 years experience in CAMHS as a specialist in the Looked After Children team. Therefore all the young people who sometimes find it difficult to access CAMHS can find equally good support via SureCare’s own therapeutic resources. This includes the availability of Family Therapy where this is appropriate, and this facility has already been very productive for some of the young people in SureCare.

Definition

Family therapy is a form of psychotherapy that involves all the members of a nuclear or extended family. Although some forms of family therapy are based on behavioral or psychodynamic principles, the most widespread form is based on family systems theory. This approach regards the family, as a whole, as the unit of treatment, and emphasizes such factors as relationships and communication patterns rather than traits or symptoms in individual members.

History of Family Therapy

Family therapy is a relatively recent development in psychotherapy. It began shortly after World War II, when doctors, who were treating schizophrenic patients, noticed that the patients' families communicated in disturbed ways. The doctors also found that the patients' symptoms rose or fell according to the level of tension between their parents. These observations led to considering a family as an organism or system with its own internal rules, patterns of functioning, and tendency to resist change. The therapists started to treat the families of patients as whole units rather than focusing on the hospitalized member. They found that in many cases the family member improved when the "patient" was the family system. This approach of involving the entire family in the treatment plan and therapy was then applied to families with problems other than the presence of any symptoms.

Family therapy is becoming an increasingly common form of treatment as changes in society are reflected in family structures.

Purpose

Family therapy is often recommended in the following situations:

  • Families with problems across generational boundaries. These would include problems caused by parents sharing housing with grandparents, or children being reared by grandparents.

  • Families that deviate from social norms (commonlaw relationships, gay couples rearing children, etc.). These families may not have internal problems but may be troubled by outsiders' judgmental attitudes.

  • Families with members from a mixture of racial, cultural, or religious backgrounds.

  • Families who are scapegoating a member or undermining the treatment of a member in individual therapy.

  • Families where the identified patient's problems seem inextricably tied to problems with other family members.

  • Blended families with adjustment difficulties.

Description

Family therapy tends to be short-term treatment, usually several months in length, with a focus on resolving specific problems such as eating disorders, difficulties with school, or adjustments to relational issues.

In family therapy sessions, all members of the family and the therapist is present at most sessions. The therapists seek to analyze the process of family interaction and communication as a whole; they do not take sides with specific members. They may make occasional comments or remarks intended to help family members become more conscious of patterns or structures that had been previously taken for granted. Family therapists, who work as a team, also model new behaviors for the family through their interactions with each other during sessions.

Family therapy is based on family systems theory, which understands the family to be a living organism that is more than the sum of its individual members. Family therapy uses "systems" theory to evaluate family members in terms of their position or role within the system as a whole. Problems are treated by changing the way the system works rather than trying to "fix" a specific member. Family systems theory is based on several major concepts:

The identified patient [IP] is generally the Looked After Child
The IP is the family member with the symptom that has brought the family into treatment. The concept of the IP is used by family therapists to keep the family from scapegoating the IP or using him or her as a way of avoiding problems in the rest of the system.

Homeostasis (balance)

The concept of homeostasis means that the family system seeks to maintain its customary organization and functioning over time. It tends to resist change. The family therapist can use the concept of homeostasis to explain why a certain family symptom has surfaced at a given time, why a specific member has become the IP, and what is likely to happen when the family begins to change.

The extended family field

The extended family field refers to the nuclear family, plus the network of grandparents and other members of the extended family. This concept is used to explain the intergenerational transmission of attitudes, problems, behaviors, and other issues.

Summary

These details explain Family Therapy but perhaps do not really come close to explaining how important this approach may be, especially to families with dysfunctional relational styles. It is always helpful to families who have endured trauma and, especially, inter-generational trauma. This, unfortunately, is often the historical profile of the families of our Looked After Children. It is therefore essential that this approach is something that SureCare can readily offer, without resorting to external referrals and relying solely on meeting the criteria of NHS agencies.