Marriage and Family Therapy can be described as a family’s structure and behavior within that system that influences and forms the individual. Family, whether they are physically present or not in sessions, will be a part of the therapeutic process with the client becoming aware of patterns, adaptations, behavior modifications, communication, boundaries while exploring the aspects of their family history and experiences.
This type of self-exploration through family dynamics often sheds light on “why we do what we do” and can identify patterns in order to change disruptive, negative, or destructive behavior.
Marriage and Family Therapy if often solution-focused with attainable goals that have a frame for completion, and does not draw on too long for each focus and goal.
Marriage and Family Therapy can utilize several different styles and interventions; some being role play, psychodynamic, family structural, systems approach, and behavioral techniques. Research that has been conducted and published for the viability of marriage and family therapy and has proven it’s effectiveness and reliability for mental health benefit. Areas in which marriage and family therapy assist both individuals and families, including children, may include: marriage issues, parent/child, eating disorders, mental disorders, conduct disorders, personality disorders, the effect of medical issues, depression, inter-systems conflicts, communication, and substance abuse.
What are Marriage and Family Sessions Like?
Marriage and family therapy is generally 45-60 minute sessions. In treatment, the Marriage and Family Therapist (MFT) will schedule 1-2 sessions per week or more if needed. They will conduct an initial assessment which usually takes longer to determine which goals and areas of treatment the client wants to focus on and they will help prioritize goals. Outside of treatment centers. MFT’s can complete goals within 20 -50 sessions, or 6 months to one year. Couples sessions including marital therapy last at an average of 12 sessions, or three months, and family therapy average 9-12 sessions.
In treatment, you will expect to have therapy at least once a week for individual treatment, and there will be an opportunity to meet with family members If your family cannot attend in person, teletherapy will be arranged. Confidentiality applies to teletherapy the same as it does in person. Family members and clients in recovery benefit from family therapy as a way to educate family members on the disease of substance abuse and what role they have played in the development of the client’s issue. It can also provide insight into further support of their loved one.
Marriage and family therapists observe and examine how individuals behave within the family, identify relationship problems and are able to develop a treatment plan that can benefit all.
What if I’m not Married or I am Estranged from My Family?
You do not have to be married or involved in a family during treatment. People who have a significant other or not can work on relationship issues. Some of these involve wanting to have a partner and not understanding why there isn’t one. Exploration of self, learning not to personalize, creating healthy boundaries, raising self-esteem, can be a focus in therapy if so desired. If a person does not wish or cannot involve themselves with family members they can still benefit from family therapy with the help of the therapist. People often explore childhood issues with an MFT, write letters on what they want to say and work through it with the therapist, and can role play if necessary in order to find a voice in areas previously incapable of, or establish closure.
What type of People Practice Marriage and Family Therapy?
Marriage and Family Therapists (MFTs) are mental health professionals who are licensed to practice in the state the treatment center is located in. Each state has their own set of criteria for MFT’s. The therapists concentrate on family structure and systems and psychotherapy and have the education necessary to treat people with mental and emotional disorders. They also can diagnose mental illness and refer to specialists. They are not medical doctors and will only treat physical illness if it has a pertinence to psychological stressors for individuals and families.
The education that MFT’s go through is extensive; including graduate and postgraduate programs in order to obtain a Masters or Doctorate degree. MFT’s can come from an educational focus in social work, psychology, psychiatry, sociology, medical, philosophy, education and begin their clinical studies in addition to their formal education. MFT’s can also attend college in to focus solely on Marriage and Family Therapy. While in a Master’s program, the therapist in training will be assigned field work to get hours towards working in the industry under a supervisor’s care. While in treatment, you may have a clinician who is an MFTi, meaning that they are interning at the treatment center to acquire the needed hours prior to testing for their clinical exam. While MFTi’s may not have the same experience as MFT’s, they do have adequate training and a supervisor to assist if necessary at the treatment center.
Upon completing approximately 3000 hours (this may vary by state) of individual and group sessions, the MFTi will be able to apply for National Testing in order to obtain a license. Upon receiving their license, they may enter into private practice.
MFT’s are integral to the mental health field as are psychiatrists, social workers and psychologists and are recognized by the government to be legitimate and core to mental health practice. In the last 50 years, MFT’s have doubled in practices, and treat nearly 2 million people in the US. Every state in the US has Marriage and Family therapists practicing as licensed by their state. They are regulated by a national and state board and have to complete a certain number of continuing education units (CEU’s) every year.
Studies Prove True with Marriage and Family Therapy
Studies show that clients, including those in treatment centers, are very satisfied with their Marriage and Family Therapists. In several different measurements, clients have reported improvement with co-worker relationships, markedly improved family relationships, improvement in significant other relationships, overall better emotional and mental health, passion for living, being of service to others has improved, individual accomplishments, feelings of betterment, and involvement in social and communal activities has heightened.
Most clients in therapy have reported that they would recommend MFT’s over other health care professionals to friends and that nearly 90% of clients have stated that their sessions have been a positive experience.
Marriage and Family Therapy practice are wonderful for children. Performance in school, anxiety, coping skills, relationships, and behavior improve with an average of 9012 sessions at a rate of 74% according to statistics. Because of the family-centered approach, children who naturally internalize all family problems i.e.: divorce, can begin to untangle where their responsibility of family dynamics are, while the therapist uses age-appropriate techniques.
Some differences of MFT’s and other mental health clinicians are: psychologists will focus on the individual and not family structure, social workers will also include a larger profile of the surroundings and may use family therapy but will include other external factors, psychiatrists will determine mental illness and prescribe medications, whereas MFT’s have a specific focus on the individual and how they relate to the family. Every type of clinician can be beneficial to substance abuse clients, and it is at the treatment facility to have a specific program where they feel what is best for the client base.
How Marriage and Family Therapy Works
Most therapy will focus on the individual, while marriage and family therapy examine how the individual client’s behavior is integrated into their family or relationships. It is goal-oriented, short-term and looks for solutions. It has shown proven results for cultural diversity and non-traditional family systems, such as blended families, grandparent involvement, LGBTQ, and single-parent households.
A typical session, during the mid-area of treatment may look like this:
Therapist: You said you felt comfortable with your drug dealer and that is one of the reasons you keep returning to him. Does he remind you of someone else?
Client: Yeah, a little bit. He’s like my brother.
Therapist: Tell me more about your brother.
Client: He was laid back, easy-going. He was my friend.
Therapist: You’re talking about him in the past tense. Is your brother not here anymore?
Client: He died from an O.D. Somehow I feel responsible even though I wasn’t there at the time.
Therapist: Do you feel an obligation to keep seeing your dealer because it’s making up for you not being there for your brother?
Client: Yeah, somewhat. I never thought about it like that……
When the MFT asks questions to present behaviors and actions that reveal issues of relating to others, it gives a client insight of the “why” behavior continues. So many times, the behavior is either subconscious or unconscious, and with the help of the therapist, it can be brought to the forefront of consciousness. After a client has a conscious awareness of the situation, then they can become mindful. If the client in the scenario above is having a hard time kicking their habit because their dealer reminds them of their deceased brother, they will have to first explore their feelings of guilt within the family or it will be nearly impossible to stop the habitual actions.
If for instance, when a person is involved with domestic violence, it becomes almost impossible to change out of the cycle unless underlying issues are dealt with and the victims perspective changes, not the abusers. It is most prominent that the victims of domestic violence seek help from marriage and family therapy, or they come in for couple’s therapy, but the abuser cannot see his or her part in it. An MFT will help the client develop a safety plan and is careful not to suggest that the victim leaves the relationship, but established a plan of action if the violence escalates. If there is a danger to children, however, as if the abuser is also striking physical or verbally attacking their kids, then the MFT is required by law to call the proper authorities determined by the state such as Child Protective Services.
Marriage and Family Therapists will also see senior clients and the elderly. As people are living longer now, there are many issues that come up about taking care of older family members. Sometimes the older member will need someone in the family to be the point person and decision maker, but often the elder client will be fully aware of what their needs are. Determining this can be helpful if the family sees and MFT for a short period of time and develop a plan of care.
Marriage and Family Therapy During Treatment
An addict in recovery and their family can receive highly beneficial treatment while in residency and in aftercare.
The disease of alcoholism and addiction does not start and end with the client, on the contrary- this is defined as a “family disease.” Treatment of the family can be helpful in:
- Better communication
- Education with the disease
- How to move forward
- Tools for the enabler
- How to support effectively
- Determining each family member’s role
- Creating a relationship “contract”
- Establishing new family rules and guidelines
- Additional addictive behaviors within the family
- Exploring how culture and ethnicity has to do with the disease
- Identifying barriers
- Creating healthy boundaries
- Working together as a united front
The non-identified clients (those not in treatment) can learn how to be most effective by staying open-minded, changeable, and with a readiness to accept the approach of how to best help their loved one. In addition, therapy can assist with the de-escalation of fears and stressors surrounding the disease, predominantly with the constant fear that their loved one will be taken away from them either by jail, institution or death. These are real, ongoing concerns that the family lives with while the addict suffers, and Marriage and Family Therapy helps with these issues.
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