Tarnow Articles

The Long-Term and Comprehensive Benefits of Family Therapy 

In our initial meeting, parents typically discuss a long history of creative behavioral interventions, countless consultations, numerous "calls from the school," and chronic sleepless nights. As I am marveling at the time, energy, and commitment these parents have demonstrated in attaining help for their child, the parents tell me they are overwhelmed with feelings of guilt, inadequacy, confusion, and helplessness. Although it is quickly apparent that these "ineffective" families are in fact, very functional systems, adept at trying new things, seeking help, and applying new knowledge; the families, themselves often feel worn down and hopeless. This article will address ways in which families can be assisted in feeling strong and powerful again--ways in which the families can regain their sense of self-efficacy and confidence.

Typically a family's reported sense of helplessness has centered around an "emotional" issue that one member may be having. For some reason families continue to receive the message that emotional problems are "bad" and should be handled within the family system. Physical problems however, are dealt with promptly by seeking outside assistance (e.g., our daughter was just diagnosed with juvenile diabetes. What do we do?). Perhaps family systems believe there is something wrong with their "family" if one of their members is suffering emotionally. Utilizing family therapy to regain your family's well-being is like seeking a medical consultation and subsequent treatment. There is no shame, just help: This is what is happening to your child. These interventions will be helpful in making him feel better. This is what it will look like when he is healing.

The following article discusses some of the main tasks of family therapy and the different interventions that are utilized to accomplish these tasks.

Tasks One of the first and most important tasks in family therapy is establishing support and understanding for each member of the family system. When family members actually understand each other individually, they stop reacting defensively and are more open to change. Family therapy assists members in finally hearing what is important to the other members and identifies ways of being supportive to each family member.

The second task that often arises in family therapy is healing the relationships in the family system that have been damaged by conflict. Frequently one of the most damaged relationships is the one that exists between the parents. When problems occur in the family system, the two CEO's of the family have much water under the bridge composed of resentment and blame. Addressing the relationships in the family system is critical in establishing effective functioning and lasting changes.

Establishing support and understanding
for each member of the family system

• Family therapy identifies hidden or direct messages to which each family member may be responding in a positive or negative way (e.g., Mom is a powerful lawyer. I can't make good grades. She must consider me a failure. I'm not even going to try anymore).
• Family therapy identifies ineffective communication patterns and teaches family members more effective communication skills.
• Family therapy educates members about the developmental tasks each child and parent may be facing. Awareness of the different developmental stages and the feelings that often accompany these stages, helps families understand each other better and provides assistance in mastering the different developmental tasks.
• Family therapy teaches members to identify and articulate the underlying emotions that accompany many of their behaviors. Identification and articulation of these feelings often prevents them from being "acted out" in negative ways.
• Family therapy assists parents in understanding how their own "childhood issues" may be played out in the family system (e.g., No one was ever there for me when I was a kid, he needs to buck up and learn how to be a man. He's ten now. I was working when I was ten years old). Parents' childhood traumas may also be revisited or reenacted when a child reaches the same age at which his or her parent was traumatized (e.g., My mom died when I was eleven and now that Katie is almost eleven. I can't seem to stop thinking about my mother).

How does family therapy provide support to individual family members?

A family therapist's job is to recognize not only the unique strengths and contributions of each family member, but also the specific stressors each one is facing. Perhaps one member has been diagnosed with Attention Deficit Disorder or Major Depression. Perhaps Mom feels that no one appreciates or understands the emotional stress she is under after having her third child. Helping each member articulate what his life is like at that very moment helps the other members understand that person better and thus how to interact with him more effectively.

Our family has the same fights over and over and we never resolve anything. Can family therapy help with that? Communication patterns: -- How to really hear each other.

The family therapist is closely attentive to communication patterns that are often deeply ingrained, and makes suggestions of different ways to interact (i.e., Ok, when Sally was talking, you began to shake your head again, Dad. Wait a second. Ok, Sally try again. Now, Dad what did Sally say?) When both members feel heard and understood, a compromise or mutual understanding is much more easily accomplished. The purpose of communication is to help the other person understand, not to make yourself heard.

My kids accuse me of always lecturing them. Why won't they understand that I am just trying to help? -- Identifying underlying emotions.

By the time preteens or adolescents reach my office the parents have usually spent months yelling, lecturing, doling out consequences, and trying to get their teen to understand the long term ramifications of their behaviors. Lectures, consequences, and warnings come out chronically, and unfortunately, chronically fall on deaf ears. In the family therapy process parents begin to identify the underlying emotion in their speeches and lectures. Frequently, invariably, the emotion is fear. "I am so afraid for him. He doesn't know what he is doing and I don't know how to make him see what he is doing!" When the child or teen is able to see that the parent is not angry or just trying to be oppressing, but rather has genuine fear and a sense of helplessness regarding their child, it is usually easier for the teen to hear his/her parent's message.

We had no problems until Kristi turned 15. Help!! -- Understanding developmental issues.

Being able to understand the developmental tasks that their child is attempting to master often helps parents understand how to assist their child more effectively. For example, a family's teenager is busily attempting to formulate some type of identity and trying to separate/individuate from her family unit. Parents are often confused or even frightened by some of the identities that their teens may be exploring (e.g., I'm studying Buddism; I don't believe in the institution of marriage). Having parents understand that this developmental process is normal assists them in not reacting too strongly or becoming too invested in shutting down their teen's exploration. Allowing the teen's exploration becomes particularly helpful considering their other developmental task -- separation/individuation. I say this, as I frequently watch teens embrace the very things that most disturb their parents as a way of seeking individuation from them.

Some Final Words on Family Therapy

Remember if there is an emotional problem in your family it does not mean there is something "wrong" with your family. It does not mean you have been a "bad parent" or have a "problem child." Instead, it means that there might be modifications that need to be made in the family system to get things running smoothly again, to re-establish good communication, to laugh again, to regain your feelings of hope and control, to hear the words: This is what is happening to your child. These interventions will be helpful in making him feel better. This is what it will look like when he is healing.