Learn / Heal Your Relationships—and Yourself—in Family and Couples Therapy
Heal Your Relationships—and Yourself—in Family and Couples Therapy
Addiction doesn’t happen in a vacuum. A single person’s mental health issues can affect a whole community. And in particular, addiction can wreak havoc on family dynamics, undermining every person’s mental health. This is true for blood relatives, spouses, and chosen family members.
Many rehab programs offer family therapy to people in residential treatment. This process might focus on one person’s addiction, but it can benefit everyone who attends. This is a chance to improve your relationships, and for each person to work on their mental health.
What to Expect From a Family Therapy Session
If you go to family therapy through a rehab program, you’ll probably start by talking about addiction. You may discuss the impact of one person’s behavior, and why they started using drugs in the first place. But these conversations are only the beginning.
Family therapy is an opportunity for everyone to really hear each other, and also feel heard. Each person shares their own perspective, and talks about what’s happening in their own life. You are a part of your family, but also, your family is just one part of you. In these sessions, you can share things you might never have mentioned before. It can even feel like you’re getting to know your loved ones in a brand new way.
“Family” doesn’t have to refer to your biological relatives.1 According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “‘Family’ means a group of two or more people with close and enduring emotional ties.” And in most programs, the patient can choose to invite chosen family to join them in therapy.
Your family will probably be able to get this treatment even if the person in treatment travels to rehab. Most programs offer both remote and in-person sessions.
The therapist will spend the first couple of meetings getting to know everyone in the room. After that, they’ll guide you through exercises designed to help your family work through interpersonal issues.1 For instance, the therapist might ask you to spend a week taking note of the kind things your family members say. Or, they might ask a family member to practice saying “no.”
These activities can teach you to communicate more clearly. They can also help you break out of unhealthy behavioral patterns. And when you process them in your next session, you can build on what you’ve learned.
Types of Family and Couples Therapy
There are many different types of family therapy. If you have a strong preference for one of these options, you can look for a rehab program that offers it. You may also be able to find a private family therapist in your area.
Structural Therapy
The structural method of family therapy2 emphasizes achieving a well-balanced family system. This technique focuses on establishing healthy boundaries between members based on that system. For instance, a parent-child relationship has different boundaries and expectations than one between spouses.
Structural therapy begins with the therapist observing the family’s interaction patterns.3 Once they understand the family dynamic, they’ll suggest changes. The goal is to help everyone build sustainable relationships, and to empower your family as a whole. To achieve this, therapists may combine techniques from structural and strategic family therapy.
Strategic Therapy
During strategic therapy,2 families focus on healing the symptom of a structural problem. If a family member is in rehab, you’ll likely focus on addiction as a symptom of your family’s overarching issues.
Symptoms serve a purpose—that’s why they exist in the first place. For example, a person might develop an addiction to cope with loneliness after a divorce. Even when you fix the symptom, you’re left with its underlying cause. Without expert help, families often get stuck in a cycle. Structural-strategic therapists call this a “symptom-maintaining” sequence. And it can feel like you’re bailing out a ship with a leak.
In this type of treatment, the therapist will guide your family3 toward a more sustainable solution. They’ll suggest practical ways you can support each other, instead of telling you what not to do. This can help you take action, and make lasting changes.
Brief strategic family therapy (BSFT)4 is a shorter version of this treatment, lasting only 12 sessions. This method is specifically designed for families with young people in treatment. The goal is to change the dynamics that encourage younger family members to act out.
Therapy With Teens
Family involvement is extremely important for teens attending rehab. Data shows that family therapy can help youth with mental health issues2 work through behavioral problems. And adults who attended sessions with their teens felt more competent as parents.
Paradigm Teen & Young Adults Treatment offers family therapy for teens and their loved ones. This rehab center involves parents in every step of the recovery process. Family members can attend sessions in person, although remote therapy is also available. Teens also see their own 1:1 therapist, who debriefs parents about their child’s progress.
This rehab center also encourages relatives to connect with their peers. You can connect with other families who have similar experiences in Multi-Family Group Therapy. This lets you connect with people who play the same role as you do, in their own family. You can share mutual support, and gain new insight into your own behavior.
Couples Therapy
In couples therapy, 2 people work on their relationship as a team. It can be eye-opening to discuss your issues with a neutral 3rd party. It can also help you start conversations you’ve been delaying. You’ll learn to communicate respectfully, even when you’re talking about painful things. Therapy can help you define your needs, as individuals and as partners. And once each of you knows what you need, you can look for healthy ways to support each other.
Couples therapy isn’t just for romantic partners. It can also help roommates, best friends, siblings, and more. But no matter how your relationship is structured when you start this treatment, it might soon look very different. If you can, let go of expecting any particular outcome. Therapy isn’t about forcing yourself or your loved ones to achieve a certain goal. Instead, it’s a way of helping each of you define and then start living your best lives.
The Benefits of Family Therapy
Stronger relationships aren’t the only benefit of family therapy. This treatment can also improve the mental health of family members as individuals. And when you’re doing well, you may be able to give your loved ones more time and energy. At its best, family therapy inspires an upward spiral, in which you support each other every step of the way.
Benefits for the Person in Addiction Recovery
Family therapy isn’t only for family members; it’s also helpful for the person in rehab. Your loved ones can provide you and your care team with a fresh perspective. They might even be able to share factual information that you don’t remember, or forgot to mention. And this process isn’t about blame. Your therapist might even shut down any attempts to shame you for your addiction. Instead, family therapy is a chance for you to get to the root of the issue.
Social support is vital during addiction recovery.5 According to research, family therapy minimizes the risk of relapse.1 It can also lower treatment dropout rates. There are a few factors at work here. First, family members who join you in therapy might commit to holding you accountable. Also, knowing you have their support might inspire you to stay focused on recovery.
Benefits for Family Members
If you love someone who has an addiction, you may also need to heal. Family therapy can support your recovery process, too. Treatment can help you understand your own unhealthy patterns. And once you do that, you can start to change them.
Those patterns might be directly related to your loved one’s addiction. For example, many spouses of people in recovery show signs of codependency. While this condition is born out of love, it can interfere with your mental health. If you identify this issue in yourself, you might want to consider getting 1:1 treatment.
Once your loved one enters recovery, you may feel a sense of relief. But rehab is the first step on a much longer journey. And while they continue to heal, it’s important for you to do the same.
Benefits of Ongoing Treatment—Even After Rehab
After residential treatment, it might be helpful to keep seeing a family therapist. In most cases, you’ll have to find a new provider who works outside the rehab program. And if you plan in advance, they can help ease the transition out of rehab.
There’s always an adjustment period when you enter a new phase of recovery. And moving to a new space is difficult even under the best of circumstances. If your family is living together after some apart, it’s all too easy to fall back into unhealthy patterns. Therapy can help everyone navigate this challenging time.
The Limitations of Family Therapy
Family therapy isn’t a good fit for everyone. It might be unhealthy to stay in touch with the people you knew before you started recovery. You might even choose to step away from your closest loved ones. And if someone you love goes to rehab, you might need space from them.
As hard as it can be to set these boundaries, it’s important for each of you to prioritize your own healing process. There are many valid reasons why it might be better not to engage in therapy with family members.
Trauma
If you’re healing from trauma caused by family members, you might need to set strong boundaries with them. That might even mean cutting off all contact. This is a big decision, but it doesn’t have to be a permanent one. If you’re considering this step, it’s best to talk to your therapist before taking action.
This can be a concern for people in rehab, family members, and other loved ones. No matter how much you care about someone, it’s okay to take space. Sometimes it’s even necessary. When you’re further along in your healing journey, you may be able to go back to these relationships. Or, you might find that you don’t want to.
Setting New Boundaries
When a person goes to rehab, it’s a great opportunity to step back from unhealthy relationships. If you’re entering recovery, you might stop talking to people who pressured you to take drugs. Or, you might take a break from a partnership with someone who enabled your addiction. Even people with good intentions can sometimes undermine your healing process.
Family members can set boundaries, too. That doesn’t mean you don’t care about the person in recovery. In fact, it’s often the exact opposite. You can use this time to think about your role in the person’s life, how their addiction affects your mental health. If you’re not in a good place, you can’t effectively support them either. Stepping back from the relationship can give you some much-needed perspective. And then, you can start thinking about what comes next.
Learning to Let Go
In family and couples therapy, each person starts to understand and communicate their own needs and boundaries. And ideally, you’ll all start working toward your personal goals. In time, every one of you can learn to thrive.
That being said, your goals won’t always align with those of your loved ones. You might even find that your values are incompatible. In some situations—as with parents and minors—you’ll need to meet in the middle. But sometimes, the best outcome is for you to part ways. In some cases, ending a relationship is a sign of successful family or couples therapy.
Separating can be an act of love. This is a way of giving each other the space you need to live your best lives. You’ll both be free to put energy into the relationships that fulfill you. Or, you can take some time to yourself while you focus on recovery.
Family Therapy Can Help You Move Forward
Exploring your relationships can help you understand yourself better. And that understanding is an essential part of recovery. Whether you’re in treatment, or you love someone with an addiction, family therapy can help you heal.
Browse our list of rehab centers with family therapy programs to learn more about support groups, housing options, and other types of therapy they offer.
Reviewed by Rajnandini Rathod
- Substance Abuse and Mental Health Services Administration. (2013). Family Therapy Can Help For People in Recovery For Mental Illness or Addiction. https://store.samhsa.gov/sites/default/files/d7/priv/sma13-4784.pdf [↩] [↩] [↩]
- Jiménez, L., Hidalgo, V., Baena, S., León, A., & Lorence, B. (2019). Effectiveness of structural–strategic family therapy in the treatment of adolescents with mental health problems and their families. International Journal of Environmental Research and Public Health, 16(7), 1255. https://doi.org/10.3390/ijerph16071255 [↩] [↩] [↩]
- Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62(Suppl 2), S192–S200. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_770_19 [↩] [↩]
- Szapocznik, J., Schwartz, S. J., Muir, J. A., & Brown, C. H. (2012). Brief strategic family therapy: An intervention to reduce adolescent risk behavior. Couple & Family Psychology, 1(2), 134–145. https://doi.org/10.1037/a0029002 [↩]
- Atadokht, A., Hajloo, N., Karimi, M., & Narimani, M. (2015). The role of family expressed emotion and perceived social support in predicting addiction relapse. International Journal of High Risk Behaviors & Addiction, 4(1), e21250. https://doi.org/10.5812/ijhrba.21250 [↩]
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