Marriage and Family Therapy

IMAGE Think about the last time you felt angry, sad, or blissful. Chances are, your mental state had something to do with an interaction with another person—a sister, a boyfriend, a co-worker, a parent.

Marriage and family therapists believe interpersonal relationships have a profound impact on people, and that most mental health issues can be understood and treated by considering a person's system of relationships. Therefore, families, spouses, and partners are all part of marriage and family therapy (MFT).

"Work and school productivity, health, and well-being all stem from having decent family relationships," says Gregory Brock, PhD, LMFT (licensed marriage and family therapist), director of the University of Kentucky Family Center. If you have personal problems, Dr. Brock says, changing patterns in your interpersonal life can help fix them.

"Families really contribute to issues with individuals," agrees Maureen Davey, PhD, LMFT. "All individual problems must be considered in context." MFT seeks to examine the context of problems within a family and find a way for everyone in the family to deal with those problems.

Not Just for "Typical" Families

Being married or having a typical family unit (if there is such a thing) is not a prerequisite for MFT. While families and married couples are often seen in MFT, extended families, work groups, and groups of close friends are all MFT candidates. And Dr. Brock strongly recommends a few sessions for couples contemplating marriage.

"No relationship works perfectly," Dr. Brock says. "[MFT] can help you to understand what is working well and what needs work."

Dr. Davey agrees. "Being aware of the things you will struggle with as a couple can help you deal with hot points when they come up," she explains. This helps prevent those hot points from becoming destructive.

Solutions and Goals

If you want years of open-ended therapy, MFT might not be the answer. In MFT, "You get in, do the work, and get on with your life," explains Dr. Brock.

MFT issues might be anything from a child acting out to a substance-abusing teenager to a bickering couple. Therapists treat terribly destructive families as well as families that work well but need minor adjustments. Therapists will try to learn what you hope to achieve in therapy and work with you to determine an efficient course of treatment to reach those goals.

If there is a solution, you will not need years to find it. Many courses of treatment last anywhere from 10-20 sessions. "That is it," Dr. Brock says. "After that, families and couples may come in every now and then for preventative maintenance," he adds.

Session Expectations

A first MFT session will generally involve a lot of questions. The therapist needs to assess the situation and understand the dynamics of the system before getting into appropriate therapy.

"I ask questions about family roles, overt and covert rules, and try to understand how this system of relationships works," Dr. Davey says. Therapists also need a complete picture of each individual's social structure. If a child has a problem, for example, the therapist might ask questions about the parents, siblings, extended family, school system, and peers.

A thorough understanding requires additional questions about culture, race, and economics. Cultural competency training helps therapists deal with families from diverse backgrounds. "Therapists need to consider what is healthy for the family they are treating, not what would be healthy for the therapist's family," Dr. Davey explains.

After the initial assessment, a therapist will try to determine what tools and methods will work effectively to change the problematic patterns in the relationships. Sessions could include role-playing, using dramatic action (psychodrama), playing games, restructuring of attachments, discussing relationship strengths and weaknesses, and more.

"We did role playing and spent time interacting with the therapist as an intermediary," says Jen Tester, who participated in MFT with her husband. "The therapist could help explain what we were trying to say when we were having a hard time expressing it." Every session may be different; the therapist should work to find the tools that help you.

Check to see if your health insurance will pay for therapy. If not, some offices offer a sliding scale system that depends on your income.

The Right Therapist

To practice marriage and family therapy, a therapist must be a trained mental health professional and licensed to practice marriage and family therapy. All LMFT have gone through extensive training and supervision. Ask questions about background, education, and licenses to make sure your therapist is qualified.

Word-of-mouth is one good way to find a qualified therapist, but what worked for someone else might not work for you. Therapist style can vary dramatically. It is okay to meet with several therapists until you find one that you like.

"It is so important to trust your therapist," Tester advises, so "shop around." A good place to start is the American Association of Marriage and Family Therapy's therapist locator tool .

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