What Is Family Therapy?

Family therapy is a form of treatment that involves looking at and treating family dynamics and behaviors so that the family as a whole can recover from problems, including addiction and other mental health disorders.¹

Family therapy views the family as a system of related parts that can be affected by changes in other parts.

When a family member is misusing drugs or alcohol, other family members tend to organize their behavior around the person’s substance use.² This can involve getting angry at, blaming, or shutting down the person who is using substances, lying to and for each other, keeping secrets, or developing other unhealthy ways of coping.

In this way, addiction, or substance use disorder (SUD), is sometimes seen as a family disease.²Family therapy can help families address unhealthy coping patterns, improve the health and functioning of the family, and positively support the recovery of the family member with an SUD.²

How Does Family Therapy Work?

Family counseling is a broad term that includes different family-based treatment approaches.² It generally focuses on family dynamics and their unique strengths to promote change in different areas, including SUDs.² According to the Substance Abuse and Mental Health Services Administration (SAMHSA), families should be involved in SUD treatment to give people the best chance at lasting recovery.²

While family therapy can begin at any point, family therapy for addiction treatment generally works best when the person in treatment is committed to recovery and has made some progress in treatment.¹ Family therapy works by involving all members of a family.¹ “Family” in this case includes anyone who is important to the person, whether or not they’re related by blood or live together.

Family therapy recognizes that most family systems try to maintain balance no matter what. Many families try their best when a family member has a SUD, but they might not always know how to function, adapt, or support the person in recovery.²Family therapy offers the person in treatment valuable support at all stages of recovery, and can also improve the health and well-being of the whole family, not just the person in treatment.²Together with a trained therapist, families can identify changes they would like to make, learn to make these changes, and improve how they support each other.²

Types of Family Therapy

Family addiction therapy services can include different approaches depending on the needs of each family. Some common family therapy approaches for addiction include:²

Behavioral couples therapy (BCT). This approach is geared toward couples or partners where one person is struggling with a substance use disorder. Partners learn ways of promoting recovery, such as rewarding abstinence (not using drugs or alcohol) or other recovery efforts in the person with an SUD.
Behavioral family therapy (BFT). Since family often plays a role in reinforcing or maintaining a family member’s substance misuse, this approach uses contingency management (CM) strategies to increase positive behaviors and reduce behaviors that might reinforce substance use.
Brief strategic family therapy (BSFT). This is a form of family counseling in addiction treatment for adolescents with SUDs; it works to change dysfunctional family dynamics that may have influenced substance misuse.
Functional family therapy. This family-based therapeutic approach has three treatment phases that involve changing dysfunctional family interactions that reinforce substance use.
Solution-focused brief therapy. This family therapy method focuses mainly on helping family members find their own solutions to problems, rather than pinpointing specific problems with family dynamics.
Multisystemic family therapy (MST). This goal-oriented, strengths-focused approach treats adolescents with severe SUDS and their families through an intensive family counseling treatment program.
Multidimensional family therapy (MDFT). This approach combines individual counseling and multisystem methods to treat adolescents struggling with multiple problems, including substance abuse and conduct-related behaviors. MDFT typically involves adolescents, their parents, family members, and any other involved parties.
Family support groups. These are groups specifically designed to support family members of people in recovery from SUDs.

What to Expect During Family Therapy

Family therapy usually means that you meet on a regular basis with a trained therapist. In this case, “therapist” can mean a licensed family therapist, social worker, psychiatrist, psychologist, counselor, clergy member, or any professional specially trained as a family therapist.¹Common things you can expect in family therapy include:^1,2

Most sessions will last around an hour and take place at a clinic, treatment center, or the therapist’s office. In rare cases, they can take place at the family’s home.
Sometimes families meet together and other times each family member may meet with the therapist on their own.
Your therapist may ask each family member to sign a contract agreeing to certain rules, such as not interrupting each other or not telling others about what was said during therapy.
During each session, the therapist will ask questions, or listen while others talk. The therapist may focus a session on teaching certain skills, such as how to communicate better. Or a session may focus on feelings or a problem the family would like to solve.
The ultimate goals of family therapy substance use treatment are to give support to the person in treatment so that they can maintain recovery, and to strengthen the family unit and its functioning.
The person in recovery should decide who attends family therapy sessions. Sometimes, certain family members should not be involved, such as in cases of domestic violence or child abuse.
The family can be involved in different ways and to different extents, depending on the levels of care and settings; the level of care and treatment setting can evolve and change over time depending on the needs of the person in treatment.

Benefits of Family Therapy for Addiction

If it is an option for you, treatment that involves family may work better than treatment that does not include the family.¹The benefits of family therapy for addiction recovery can include:^1,2

Better treatment engagement. Family therapy might encourage a person to begin a treatment program and be engaged in the process.
Reduced risk of dropping out of treatment. Family therapy may also motivate a person to remain in treatment.
Lower costs. When compared to individual therapy or mixed therapy (meaning therapy that is not solely family or individually based), family-based therapy is often less expensive. It has also been associated with lower costs to society as a whole, such as reduced healthcare spending and juvenile criminal justice costs.
Better treatment outcomes. While most of the studies in this area have focused on adolescents with SUDs, these showed improved outcomes in many areas, including reduced substance use, increased levels of abstinence, and improved family functioning.
Better family functioning. Studies have shown that family therapy can improve family functioning and communication, as well as reduce family conflict.
Enhanced relapse prevention. Research shows that support from family members who don’t use drugs or alcohol can help prevent a return to substance abuse.

How to Find Family Therapy for Substance Use

Many rehab programs incorporate family therapy as a part of the addiction recovery process. If you’re ready to find treatment, a good first step is to reach out to your doctor, who can assess your medical needs and refer you to an appropriate treatment center. They can also help you determine the treatment format, intensity, and modality best suited to your situation.

You can also use our search tool to find rehabs near you that offer care for addiction. Filter your results by location, services, and more to find the program that fits your needs and supports your recovery journey.

Family Therapy for Addiction Treatment