About Family Therapy
What is Family Therapy?
“Family and systemic psychotherapy – also known as family therapy – can help those in close relationships to better understand and support each other. It enables family members to express and explore difficult thoughts and emotions safely, understand each other’s experiences and views, appreciate each other’s needs, build on family strengths, and work together to make useful changes in their relationships and their lives.
Family therapists can see children and adults on their own, or with other family members. Sometimes they offer a mixture of individual and family appointments, if they think that will be useful. Family therapists can also work with couples.” AFT’s leaflet “What is Family Therapy”
For more information on Family Therapy please refer to the Association of Family Therapy & Systemic Practice website.
Systemic Approaches and Practice
Systemic approaches draw from communication and relational theories to develop an understanding of patterns of interactions and how systems work. A system can be any group of people that are interconnected such as families, working teams, members of a community, school, etc. Professionals trained as systemic and family psychotherapists are able to work in many different contexts. They often work in therapy services but are also skilled in working with groups, teams and with management structures in organisations.
A systemic approach considers that individuals cannot be understood in isolation from the contexts in which they are part of. As such, the approach pays particular attention to significant relationships, culture and the belief systems that give meaning to a person’s actions. It is a thought-provoking approach and has a focus on building strengths to facilitate helpful changes. Above all, it is a respectful, nurturing and appreciative approach.
Family therapy interventions are usually informed by systemic approaches and theories. It is important to note that the title of “family therapist” is not protected in the UK. As such, some therapists trained in other therapeutic approaches (e.g. psychodynamic, behavioural, person-centred, etc.) might do family sessions and call themselves “family therapists”. Therefore, when looking for a family therapist, it is important that you find out more about the therapist’s training and qualifications, as well as their professional registrations to ensure that you are clear what approach inform their practice.
Training to become a Family Therapist
As “Family Therapist” is currently not a protected title in the UK, some therapists may provide family sessions and call themselves family therapist, even though they do not have full training and experience in theories related to family therapy and the associated professional registration.
To qualify as a Systemic and Family Psychotherapist, it is necessary for an individual to undertake a four-year training in Foundation, Intermediate and Qualifying Masters level. “The four-year training is designed to qualify students to work with families, couples, individuals, other systems and relationship networks and includes training relevant to work with children and adolescents.”[i] It is a requirement that students entering this training already have a qualification in a relevant profession e.g. social work, nursing, clinical psychology or psychiatry.
Upon completion of the intermediate level of this training, professionals can call themselves “systemic practitioners” and they can apply systemic concepts into their existing professional practice. It is only after qualification in the Masters level that professionals can call themselves a “Systemic and Family Psychotherapist”, become an accredited member of the AFT (Association for Family Therapy and Systemic Practice in the UK) and register with the UKCP (UK Council for Psychotherapy). There are a wide range of competencies expected from a qualified Systemic and Family Psychotherapist. For a summary of Competency Benchmarks, please refer to this topic on the Frequently Asked Questions Section (FAQ).
To become a certified Systemic Supervisor, Systemic and Family Psychotherapists have to complete a further one-year training at Masters Level. The course combines teaching in advanced systemic family therapy and supervision theories, alongside the practice of retrospective individual and live group supervisions. The course covers aspects related to the training and evaluation of Systemic Family Psychotherapists, as well as consultation to teams and organisations.
Systemic and Family Psychotherapists and Supervisors adhere to standards and ethical guidelines devised by the UKCP and AFT, including a requirement to comply with Continuing Professional Development (CPD) in order to renew their annual memberships.
For more information on training, the profession and registration please refer to the Association of Family Therapy & Systemic Practice website.
Research and Evidence-Based Practice
Due to the very complex nature of mental health problems, it is not always possible to know accurately what the best treatment for each condition is. Psychological approaches that are not systematically structured are less suitable to be evidenced through empirical research. Despite these constraints, the field of systemic and family therapy continuously reviews and contributes to Evidence-Based Practice (EBP). EBP[ii] refers to the process of clinical decision-making that integrates three main areas:
(1) The best available research on the most effective treatment for each condition;
(2) Clinical expertise (judgment and experience of the clinician to consider each client/patient’s particular health state and needs) and
(3) The client/patient’s preferences and values.
In the UK, there is a Non-Departmental Public Body responsible for providing national guidance and advice to improve health and social care across the public sector based on research and EBP; it is known as The National Institute for Health and Care Excellence – NICE.
Systemic Family Therapy is recommended in NICE guidelines for the treatment of several child-focused, adult-focused and couple related problems[iii]. Examples of the emotional and mental health problems for which it is recommend include anxiety disorders, depression, grief following parental bereavement, psychosis, bipolar disorder, eating disorders, addictions and self-harm. Some of these conditions might require a multi-modal approach with clinicians from other professional backgrounds such as psychiatry and nursing, as well as additional interventions such as cognitive behavioural therapy (CBT).
It is not, however, only people experiencing serious mental health problems that can benefit from professional support. Everyone, at some point in life, has difficulties in their relationships; they may struggle to lead their lives according to their values and goals or they may get stuck in unhelpful or unhealthy patterns of behaviour. Systemic family therapy can also help these individuals, couples and families to reflect on their patterns of behaviour and relationships, to improve communication; to realign themselves with their goals and values in life; and to develop strategies and coping skills to help move their lives in the direction that is most meaningful to them.
[i] The Blue Book. Training Standards and Course Accreditation (2015) 4th edition, AFT
[ii] Sackett, D. et al (1996) Evidence-based medicine: what it is and what it isn’t. British Medical Journal, 312, 71-72
[iii] Journal of Family Therapy (2014) Vol 36 (2)