PublishedJun 24th, 2026•7 min read
Family Therapy: How to Decide If It's Right for Your Family
Author
Alisa Trout
LMFT
Families seek therapy for many different reasons. Sometimes, it’s persistent conflict and communication breakdown that leads them there. At other times, it’s a response to a major life change or when a family member is struggling through a mental health challenge.
If you’re considering family therapy, it’s understandable that you might feel hesitant. Many families wonder if their problems are “serious enough” for therapy, or are concerned because not every family member will participate. The fact that you’re asking the question means that you want things to improve.
This article is not a clinical overview of family therapy. Rather, it is a guide to help you in deciding whether or not family therapy fits your family’s situation.
Key question | Is family therapy the right next step for my family? |
|---|---|
Short answer | Family therapy is most helpful when relationship patterns, not just individual issues, are driving the problem. If communication has broken down or family members are stuck in repeated cycles of conflict, a family therapist can help. |
Who it's for | Families experiencing ongoing conflict, communication breakdown, adjustment to major changes, or the impact of one member's mental health on the household |
Format | In-person, virtual, or hybrid sessions with a licensed family therapist |
Typical duration | Average of 9 sessions (AAMFT); varies by complexity |
At Octave | Fully licensed therapists with 10+ years of experience on average; matching based on your family's specific needs and concerns |
Is family therapy right for your family?
Family therapy is a form of psychotherapy where a trained, licensed clinician works with multiple family members to improve communication, resolve conflicts, and strengthen how the family functions as a unit. It is evidence-based and widely endorsed for treating family dysfunction, with research from the AAMFT finding that 90% of participants report improved emotional health.
If your family is struggling with conflict or dysfunction, you may be considering family therapy as a way to find collective and individual wellbeing. It can be an excellent way to achieve your goals as a family and to begin the process of healing.
While family therapy helps many people, it is not always the right first step. The family may not require therapy yet or other family members may not be willing to attend. In instances like these, there are alternative approaches you can take to try to resolve issues in the family.
Let’s take a closer look at whether family therapy is right for your family.
Family therapy may be a good fit for your family if…
Family therapy can be especially helpful if your family feels stuck in perpetual conflict, communication breakdowns, or is adjusting to major changes.
- There are persistent conflict patterns that play out over a lengthy period of time.
- Communication breakdowns are common, with family members struggling to speak openly and honestly.
- A family member is dealing with a mental or behavioral health issue and it is affecting everyone.
- The family is adjusting to a major change, such as divorce, a blended family, relocation, or loss.
- A teen or child is acting out or withdrawing.
- Family members feel emotionally distant or disconnected.
- There is unresolved tension between adult family members.
When family therapy may not be the best first step
It’s important to consider alternative options when there is an active crisis, especially when domestic violence or abuse is present.
- There is an active crisis that requires immediate intervention.
- Domestic violence or abuse is ongoing, in which case the first step is to plan for the individual safety of the family members.
- The issue is isolated to a single family member and does not involve relational dynamics.
- All other family members are unwilling to participate…
- Although it should be noted that therapy can still work with a subset of the family, and individual therapy can address family-of-origin issues even without other family members present.
When to seek immediate support first
- There are one or more incidents of domestic violence.
- A family member is experiencing suicidal ideation.
- A family member is going through an active substance use crisis.
- There are concerns about child safety.
- The family does not feel safe with a specific family member.
Stabilization and safety always come first. It is when everyone is in a safe and stable place that family therapy can be part of a long-term healing plan.
If you or your family requires immediate support, the following resources can help:
- National Domestic Violence Hotline
- 988 Suicide & Crisis Lifeline: Call or text 988.
- SAMHSA National Helpline: Call 1-800-662-4357.
- Crisis Text Line: Text HOME to 741741.
When there is immediate danger, call 911 or visit your local emergency services.
Find experienced family therapists
How family therapy helps families work through conflict
Family therapy treats the family system rather than individual issues, helping family members understand the patterns leading to conflict.
Family problems therapy works differently than individual therapy, with different mechanisms and points of focus. Whereas individual therapy delves into the ways a person interacts with themselves and the world, therapy for family problems focuses on systems. Every family is a self-contained system consisting of multiple relationship dynamics, each affecting the others.
There are different types of family therapy. These include:
- Systemic family therapy, which focuses on adjusting the patterns shaping the family system.
- Structural family therapy, which focuses on the roles, boundaries, and hierarchies around which the family is organized.
- Strategic family therapy, which focuses on solving specific current problems.
- Bowenian family therapy, which looks at the family system across generations.
- narrative family therapy, which helps families reframe the stories they tell about themselves and each other.
The role of the therapist is to help the family understand the system and each person’s place in it, as well as to provide tools for better communication skills.
Unlike individual therapy, which may focus on growth and continue indefinitely, family counseling is often structured around specific goals and is short term. According to the American Association for Marriage and Family Therapy (AAMFT), family therapy lasts, on average, nine sessions.
Family therapy, or family problems therapy, is evidence based. Research from the AAMFT found that almost 90% of individuals report an improvement in their emotional health and around 73% of parents report improvement in their child’s behavior. A study in the International Journal of Environmental Research and Family Health on the effectiveness of family therapy for children and adolescents found strong evidence that it helps with emotional and behavioral problems, recovery from abuse and neglect, and improves family cohesion.
What good family therapy looks like
Good therapy for family problems should be goal-focused and structured and each family member should feel heard.
In effective family therapy, sessions are not used for open-ended venting but rather are structured around pre-defined goals. The therapist explains their approach towards the beginning, along with why it is a good fit for your family.
The therapist actively manages the dynamics so that one individual dominates the session, no matter their place in the family hierarchy. Everyone leaves feeling heard. Although difficult emotions can and should surface, the therapist ensures the process is contained and feels safe.
There is always the possibility that one or more family members will feel reluctant to speak. In these cases, the therapist does not ignore that person but rather addresses their resistance directly.
Signs of quality family therapy
- The therapist explains their approach to family counseling and how it works.
- The therapist works with the family to define goals in the first sessions.
- Every member of the family feels heard.
- The space feels safe even when difficult emotions surface.
- The therapist seeks to engage with family members reluctant to speak.
- Each family member begins to better understand the family system and their role in it.
Red flags in family therapy
- Sessions feel aimless with no defined goals.
- The therapist consistently aligns with one family member over the others.
- One family member dominates sessions and the therapist does not intervene.
- The therapist pushes premature reconciliation having only addressed surface issues.
- The therapist dismisses or minimizes a family member’s experience.
One difficult session doesn’t mean the therapist isn’t right for your family. But if you notice a pattern of these signals, it is worth taking seriously.
How to choose a family therapist
Questions to ask a family therapist before starting
Before starting family counseling, asking questions can help ensure a particular family therapist is right for your family.
- What training and experience do you have working with families?
- Which therapeutic approach do you use and how does it work?
- Have you had experience with our family’s specific situation?
- How do you handle it when a family member is reluctant to participate?
- Do you see family members individually in addition to the group sessions?
What matters beyond credentials when choosing a family therapist
The credentials of a family therapist should specifically relate to family therapy. A licensed marriage and family therapist (LMFT) has been specifically trained in family and couples counseling approaches. Also, it is useful to find out if they are a member of the American Association for Marriage and Family Therapy (AAMFT), the professional organization that maintains standards and ethics, as well as keeping therapists abreast of developments in the field.
In addition to their credentials, the therapist’s specific experience can make a difference. Look for a therapist who has experience with the type of situation your family is going through, such as a teen with behavioral issues, conflict between adult siblings, dealing with grief, or other issues.
Another crucial factor is how comfortable they are with your family’s structure and identity. While a therapist must treat all families equally, they may not have the same understanding of what your family is going through. This can make a difference when you have a blended family, have LGBTQ+ members, or are from a different culture to the therapist. This is not to say that they need to come from the same background, but rather that they understand the nuances that affect you.
Finally, it’s important that the therapist names and explains their specific approach and why it is a good choice for your family. You should feel comfortable with their approach and their transparency regarding it.
How family therapy compares to individual therapy and other approaches
Family therapy is focused on the relational system, in contrast to individual therapy which focuses on one person’s experience within it.
Dimension | Family Therapy | Individual Therapy | Family Mediation |
|---|---|---|---|
Focus | The relational system, including communication styles, roles, and interpersonal dynamics. | One person’s internal experience, including thoughts, emotions, and behaviors, within the context of their history. | Resolving a specific, often legal, dispute such as custody or estates. |
Who participates | Two or more family members. | One person, with the option to ask a family member to join on occasions when the therapist considers it useful. | The parties involved in the dispute, along with a mediator. |
Best suited for | Recurring conflict, communication breakdowns, parenting challenges, the impact of a family member’s mental health struggles, or major life transitions. | Personal mental health struggles, such as depression, anxiety, and trauma. | Practical disputes which require a negotiated resolution, often involving legal or financial conflicts. |
Typical duration | 8 to 20 sessions, depending on goals and complexity. | Varies according to the approach. Some modalities are short-term, lasting from 6 to 12 sessions, while others can continue indefinitely. | 2 to 6 sessions, or as long as it takes to reach an agreement. |
Evidence base | Strong evidence base for multiple approaches to family therapy, with positive outcomes for individuals and families. | Extensive evidence base for multiple approaches across a wide range of conditions and scenarios. | N/A |
Addresses relationship patterns | Yes. | Yes. | No. |
Many people combine approaches, participating in family therapy with their families while engaging in their own individual therapy. Couples who are in couples therapy, which focuses on the romantic partnership, add family sessions when children or other family members are affected.
Who is family therapy right for?
Family counseling is helpful to any family experiencing problems that affect some or all of the members.
- Parents struggling with a child or teen whose behavior has shifted noticeably, from acting out and defiance to withdrawal and isolation.
- Families navigating a major transition such as divorce, remarriage, blending households, relocating, or the loss of a family member.
- Adult family members experiencing estrangement or persistent tension who want to repair or redefine the relationship.
- Families where one member’s mental health (depression, anxiety, substance use, eating disorder) is affecting the household dynamic.
- Families with a member facing a chronic illness or disability who need to adjust roles, expectations, and communication patterns.
- Blended or non-traditional families working to establish new dynamics, boundaries, and connection across family structures.
- Families who feel stuck in repetitive cycles of conflict, miscommunication, or emotional distance despite individual efforts to change.
Why consider Octave for family therapy
Octave can be a strong fit if you want help finding a licensed family therapist, using insurance, and getting started without a long search on your own.
Experienced, fully licensed therapists
- All therapists are fully licensed. Octave does not work with trainees or pre-licensed associates.
- Therapists average 10+ years of practice experience.
- Providers are continuously trained and supported.
Matching based on your family’s needs
- You can browse family therapists directly or connect with Octave’s team for help finding the right fit.
- 89% of clients report a strong therapeutic alliance with their therapist.
- Most providers can be seen within 1–3 business days.
Affordable and accessible care
- Clients pay an average of $28/session through insurance.
- Over 95% of clients pay less than $45/session through insurance.
- 40 million Americans are in-network with Octave.
- FSA and HSA accepted; no subscription model.
- Virtual and in-person therapy are available in select locations.
Exact costs vary by plan and are always confirmed with clients before care begins.
Cultural and linguistic reach
- Therapy is available in 40+ languages.
- Nearly 1 in 3 therapists can provide therapy in a second language.
- 50%+ of therapists identify as BIPOC.
When Octave may not be the best fit
- You need intensive or residential care.
- You are seeking a specific out-of-network therapist.
- You are currently unsafe and need crisis intervention.
- You prefer self-directed approaches without therapist involvement.
Next steps: starting family therapy with Octave
If you have decided that family therapy is right for your family, getting started is easy. With Octave, there are two pathways available when you reach out.
The first is to find a therapist yourself using the online form. You can filter by location, insurance, specialization, and experience with family therapy. Then, you can review the relevant profiles and book directly with the therapist of your choice.
Alternatively, you can get matched by the Care Navigation team. This process begins with a conversation (with a real person) to discuss your family’s situation, dynamics, and goals. The team will provide you with personalized recommendations based on your discussion. They will help you schedule your first session – usually within one to eight days.
Both paths lead to the same experienced, fully licensed family therapists. The choice is about how much guidance you want.
What to expect in the first family therapy session
In the first family therapy session, your therapist will discuss your family history, getting an understanding of the context. They will give every family member a chance to share their perspective, as well as what they hope to gain from therapy.
The therapist will explain their approach and work with you to set some ground rules to ensure everyone feels safe enough to participate. They will help you agree to the collective goals you’ll work towards.
The first session is for laying the groundwork and building rapport with the therapist. It can give you a sense of what to expect in therapy and build optimism, but processing and deeper work will typically begin in the next session.
Common questions about getting started
How long does family therapy typically take?
Family therapy typically takes around 9 sessions according to the AAMFT. However, the length of therapy depends on the family and its specific context and needs.
Will insurance cover family therapy?
Many insurance plans cover family therapy. Coverage varies depending on plan and provider. Octave will help you understand what you can expect your insurance to cover.
What if not everyone in the family is willing to come?
Family therapy can be effective even if not every member attends. The therapist will work with those willing to participate, helping them understand their role in the system. Often, even a change in one person’s approach impacts the entire family.
Does my family need to be in crisis for therapy to help?
Families do not need to be in crisis for therapy to help. In fact, the best time to start therapy is when problems are only starting to arise. Furthermore, it can be difficult for some families to recognize they are in crisis, especially if they have an intergenerational history of dysfunction.
Reaching out on behalf of your family takes courage. It’s not a decision you need to make immediately, and doing the research is an important first step.
Frequently asked questions about family therapy
Family therapy is a form of counseling that focuses on the family system. A family therapist works to help the members of the family understand their various roles and the issues that are causing distress. Common goals include improving communication, resolving conflicts, and strengthening the family as a unit. In contrast, individual therapy focuses on one person, with introspection and processing of themself on an internal and external level.
Your family does not need to be in crisis to go to family therapy. Since you’re considering family counseling, there’s almost certainly some discomfort. Therapy can help you build a stronger, healthier family. That’s a worthy goal in itself, and not one reserved for families in crisis.
Yes. Family therapy is about addressing the system. As long as two or more members attend, it is possible to understand and work on the issues at the heart of that system. In many cases, the changes to those who attend make a difference to the whole family. At other times, it gives those participating the scaffolding necessary to maintain their own wellbeing in a difficult family situation.
There is no age limit for family therapy. However, it is important to take into consideration what you want to get out of therapy. Discussions about some topics which affect adolescents and adults can become impossible when a young child is present. Consider involving young children only when they are directly connected to the issues and they are old enough to understand the process.
Family therapy takes, on average, 9 sessions, according to the AAMFT. Your family’s circumstances and needs will impact the length, meaning you may require fewer or more sessions.
Different types of family therapy use different approaches, some of which may be better suited to your family. Your choice should take your family’s situation and preferences into account. Common types of family therapy include:
- Systemic family therapy, which focuses on adjusting the patterns shaping the family system.
- Structural family therapy, which focuses on the roles, boundaries, and hierarchies around which the family is organized.
- Strategic family therapy, which focuses on solving specific current problems.
- Bowenian family therapy, which looks at the family system across generations.
- Narrative family therapy, which helps families reframe the stories they tell about themselves and each other.
Family therapy through Octave costs an average of $28 per session with insurance. The exact amount depends on your insurance provider and plan. Use Octave’s insurance finder to see what you are covered for.
Family therapy can be done online. For many modern families, this is the most practical way to organize the logistics. Getting everyone together in a room at the same time, especially when multiple adult members work, can be extremely difficult. Virtual options make family therapy accessible to many more people.
Family estrangement therapy can bring estranged family members together to work through their difficulties. Estrangement is difficult not just for those who are estranged from each other, but for the other family members as well. This is not to say that all family estrangements can be resolved or that there are never legitimate reasons to maintain the status quo. In cases where there has been abuse in particular, estrangement may be the safest option.
Individual and family therapy each serve different purposes. Individual therapy helps one person manage their internal and external realities, dealing with day-to-day and long-term problems. Family therapy helps heal relational problems within the family system. If you are already in individual therapy, you can do family therapy as well in order to resolve family issues.
Yes, there is a strong evidence base for the effectiveness of family therapy. The various types of family problem therapy use structured approaches to achieve measurable results. Research from the AAMFT found that nearly 90% of people in family therapy reported improved emotional health, and around 73% of parents reported improvement in their child's behaviour.
It is helpful if your therapist holds an LMFT designation, as this indicates specialised training and experience in family and couples counselling. That said, other licensed clinicians with relevant family therapy training and experience may also be well-qualified to carry out family therapy. Membership in the American Association for Marriage and Family Therapy (AAMFT) is not required but makes it easier to check their credentials and indicates accountability to a professional body with established ethics standards.
About the Author
Alisa Trout
LMFT
I work with women navigating identity shifts in motherhood who may think, “I don’t recognize myself,” or “I love my child, but I feel lost.” I’m passionate about women’s mental healthcare and supporting this transition. As a marriage and family therapist, I consider how relationships, family history, and societal expectations shape your mood, confidence, and sense of agency. Using a narrative and systemic approach, we’ll make sense of what you’re carrying, strengthen self-advocacy, and create a new story that fits who you’re becoming.
Sources
American Association for Marriage and Family Therapy, California Interest Network. About Marriage and Family Therapy. Retrieved from https://networks.aamft.org/california/about-us/new-item2
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. Int J Environ Res Public Health. 16(7):1255. https://doi.org/10.3390/ijerph16071255
