The Benefits of Family Therapy as a Part of Residential Treatment

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Inpatient treatment provides structured, intensive treatment for behavioral and mental health disorders. You’re never alone but in a new environment with strangers. Though you may grow close to fellow patients and receive the care you need, what happens when your time at the facility ends?

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We’re creatures who depend on others from time to time, whether for support, resources, or simply companionship. This sentiment is especially true for those undergoing inpatient treatment and is where family therapy steps in.

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It is essential to make the client and their inner circle feel safe and optimistic moving forward. At Sequoia Behavioral Health, at least once a week during your stay, you and your chosen loved ones will do a talk therapy session together. These are the people you will spend time with and rely on once you leave our facility.

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Why Family Therapy Sessions?

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Family Therapy isn’t just for the person in treatment; it can benefit the whole family. It is an advantage for the individual and helps the family function better as a unit.

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Family dynamics are not only capable of contributing to various disorders but are also deeply affected by them. Family therapy can address past, present, and future family systems for the benefit of all.

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Resolve Childhood Trauma

Often, childhood trauma is due to the actions of a parent or guardian. While abuse, neglect, and manipulation certainly cause it, so does emotional distance.

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Not all trauma occurs from something physically harmful or outright vicious. Attachment trauma can develop from a parent not soothing a distressed child, not attending the child’s activities, or critically commenting on the child’s choices.

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While individual therapy sessions will help a client resolve this trauma, group sessions will help address it with the family. Therapy won’t allow you to go back in time, but it can rebuild trust and create understanding between the family and the client.

Discuss Issues of Enablement and Codependency

Enabling and codependency used to be thought of exclusively regarding alcohol use disorder. But it can happen in any relationship with unhealthy behaviors caused by personality, behavioral, and mental health disorders.

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Codependency is often considered an addiction to relationships. It causes people to stay in one regardless of how healthy it is for either party. Enabling is consciously or unconsciously supporting a person’s unhealthy habits.

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Typically, the family or closest loved ones of a person seeking treatment are the ones who engage in enabling and codependency. They probably didn’t intend harm but just wanted to keep that person around and happy.

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Family therapy can help them identify these patterns and learn how to disengage from them to give their loved one receiving care a chance to continue healing once they’re home.

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The National Library of Medicine states that even the support system needs recovery support. Many things change during and after a loved one undergoes treatment. The support system needs to adjust to their loved one’s behavioral changes, reconciling their own behavioral patterns alongside those changes.

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Teach Your Support System How to Help

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Family Therapy isn’t just for the person in treatment; it can benefit the whole family.

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Coming out of residential treatment can be as much of an adjustment as going in. Each unique individual comes with unique challenges and treatment plans. The same is true for their lives in treatment and after.

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Family therapy can help the family learn what adjustments to make for their loved one’s sake. They can understand the treatment’s “how and why” through psychoeducation. They also learn about effective communication and how they can best be supportive.

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The conditions and disorders that bring someone to a residential treatment facility are complicated. Improving how the family works as a unit can have positive effects that last a lifetime.

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Who is Involved in Family Therapy?

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At Sequoia, family therapy centers around the person currently in treatment. They have a say in the family that joins them for these sessions, whether it’s parents, grandparents, or siblings. Sometimes, clients choose to invite extended family that they are close with.

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However, many people aren’t close with members of their family. Through abuse, disownment, or other difficult situations, a client can have powerful feelings about not having certain people around. These people might actively work against them in treatment and are not welcome in family therapy sessions, though we may address them in the context of healing trauma.

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You may have heard the phrase, “the blood of the covenant is thicker than the water of the womb.” Family isn’t always determined by blood but by love.

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If someone chooses that their family is their closest friend circle, then that is who will participate in family therapy with them. If they are a supportive group that will be heavily involved, helpful, and supportive in the client’s life, then it is beneficial to involve them in family therapy sessions.

Does Family Therapy Work?

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Family therapy is effective at mending bonds between people, but how practical is it regarding a person’s treatment?

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The Substance Abuse and Mental Health Services Administration (SAMHSA) found that family therapy does improve the treatment efficacy of a person with a substance use disorder. Their review of family therapy found that it can contribute to the following:

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• Lower relapse rates
• Increase adherence to treatment
• Changed family patterns regarding substance use
• Preventing others in the family from using or abusing substances

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SAMHSA’s literature acknowledges that family therapy can prevent substance use before a person enters treatment. But they also present significant evidence that supplementing substance use disorder treatment with family therapy has countless positive outcomes.

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They also stated that family therapy as part of substance abuse treatment could improve the family’s overall functioning. Working through issues as a group addresses the ethos of the family.

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Approaches to Family Therapy

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Just like individual therapies, family therapy can have different approaches and goals. It’s up to the therapist to determine which course will work best for the client and their family. Often, they use a combination of several techniques throughout the treatment.

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Experiential

Experiential therapy helps people heal through experiences and includes things like recreational therapy. Family therapy usually involves some acting. One technique is called psychodrama, which involves clients and their loved ones reenacting certain situations.

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Experiential therapy provides a safe environment for situations that might not feel safe.

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Here, family members recreate a conflict scenario, and the therapist guides them through healthier ways to react and resolve the issue. Sometimes the therapist will do this with puppets to give those involved the perception of someone else talking, which often feels safer.

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Experiential therapy provides a safe environment for situations that might not feel safe. The therapist, client, and trusted support system can “hash out” problematic behaviors that may have caused stress or trauma in the past without anyone getting hurt. If similar problems arise in the future, they now have the tools to turn these situations into positive experiences.

Contextual

Hungarian psychiatrist Dr. Ivan Boszormenyi-Nagy developed contextual family therapy. He observed that much trauma and behaviors repeated themselves in each subsequent generation. These behaviors affected each individual in the family system. Therefore the individual could address their needs only within the context of their family.

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Dr. Boszormenyi-Nagy developed four principles of contextual therapy:

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• People are products of their environment—how we act and perceive the world is based on our experiences. Contextual therapy aids clients in understanding exactly how their therapy dynamic has affected them.
• Contextual therapy is client-centered—while we can use it in a family setting, the focus is still on the individual in residential treatment.
• Contextual therapy is goal-oriented—rather than aiming to “feel better,” contextual therapy offers achievable, tangible goals.
• Contextual therapy is collaborative—trust between the therapist and client is a vital bond. The therapist guides clients toward understanding their circumstances and works alongside them to define and achieve goals.

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Contextual family therapy considers the entire family dynamic when treating one person, though everyone participating can benefit from the knowledge it provides. Because the client and therapist will also outline real goals, the family can support them and help keep them accountable.

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Emotionally Focused

Often, attachment trauma can resonate throughout a person’s life. Emotionally focused family therapy helps clients and their families mend bonds and create secure attachments. Like contextual therapy, it acknowledges dysfunctional family systems across generations and learned patterns.

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It can be focused on partnerships but is more common in caregiver-child relationships. We don’t blame the caregivers but compel them to understand how their actions may have created attachment trauma in their children. They might even realize things about their past that lead to these behaviors, allowing them space and resources to resolve these issues.

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Structural Family Therapy

Like contextual therapy, structural family therapy looks at the family as a unit, but dives deeper into the individual parts of that unit. It addresses the interactions between family members and how these interactions affect the individuals and the structure of the family unit. The goal is to change the dysfunctional system of the family and re-structure it to be healthier for everyone.

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The techniques used in structural family therapy help every member understand how their actions contribute to the mental health of another person in the family.

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In this type of therapy, the counselor will observe the family, identify family hierarchy, rules, communication styles, and patterns in each individual relationship. This is called "family mapping" and can happen in the counselors office and at the family home.

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Once the counselor establishes the patterns of the interactions, they'll begin to work with the family to address the dysfunction they observe. The most common techniques of structural family therapy are: 

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• Creating boundaries—everyone in the family will discuss, re-evaluate, and create healthy boundaries with each other.
• Role-playing—like experiential therapy, this involves family members acting in certain situations as other family members to identify dysfunctional interactions and practice healthier ones.
• Unbalancing—the counselor or therapist will challenge one family member's communication style, behaviors, or perception of others in order to contextualize the dysfunction.
• Reframing—every family member will work to think about their family structure or the role within it differently.

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A huge component to adjusting the structural framework of a family is empathy. The techniques used in this type of interention help every member understand how their actions contribute to the mental health of another person in the family. Structural family therapy helps individuals by creating a more cohesive and healthy family structure.

Family Therapy Sessions at Sequoia Behavioral Health

We can’t do it all on our own. Especially when something brings you into residential treatment, finding a healthy, happy way forward with those who love and support you is crucial.

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Our team will ensure that you have the tools for life after treatment and that your closest family and friends do, too. Family therapy at Sequoia only happens once or twice a week and is individualized to each client and their unique situation.

Please schedule a consultation with us today, and learn what residential treatment looks like at Sequoia.

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