Does Adult Family Therapy Work?

Scheduling a family therapy session might seem like trying to plan your aunt Carol’s surprise 65th birthday all over again, but every week. There are a lot of moving pieces: people to wrangle, Google calendar invites to send, tango classes to schedule around, parking lots to scout, chronically late brothers to lie to about start times, sisters who want to know whether their dog is welcome (the answer may surprise you). 

Compared to individual therapy, family therapy involves many more elements out of your control, particularly if you’re dealing with other adults. And you might be wondering whether it’s worth it—can you tell how effective family therapy will be before you even have your first session? 

The short answer: probably more than you think. Andrew Triska, director of Triska Psychotherapy, says it depends on your family members’ willingness to change. 

“Family therapy isn’t a magic bullet,” says Triska. “A therapist can help your family communicate about what’s bothering you in a way the other family members are more likely to accept. We can help you figure out what behavior needs to change, and we can help you figure out alternatives. But that hinges on every member of the family being motivated to do it.”

While you can’t always know for sure whether your relatives are willing to change, here are some signs that can help you decide whether it’s worth it to pursue family therapy. 

What to Know About Family Therapy

To state the obvious, family therapy, at its core, can help address problems within a family unit. 

You may decide to go to family therapy to improve communication, move through a transition—like a divorce, trauma, or loss—improve relationships, or simply function better as a group. Family therapy can also be helpful for everyone if an individual family member is struggling with something, like an illness, and you want support as a group.

Beyond those goals and potential benefits, family therapy isn’t a type of therapy the way CBT or ACT are. The type of therapy will depend on the therapist’s chosen modality and style. 

Signs Family Therapy Is a Good Idea

In general, family therapy can be helpful if the people you’re going with—whether it’s your siblings, parents, stepparents, grandma, or your brother’s friend who lives in the basement for some reason no one remembers—seem willing to change and to accept that there are problems you need to work through together. It’s an even better sign if they can acknowledge their responsibility for these issues.

But how do you know? Your dad is unlikely to interrupt Sunday dinner to say, “Yanno, I’m willing to acknowledge my role in creating some of the longstanding communication issues this family suffers from. Let’s talk about how I told you to stop crying when Teen Titans was canceled back in ‘05. It’s harmful when a child opens up to you about a feeling and you respond with anger.” 

Still, there are some ways to assess this. You can tell based on how they treat your feelings now. Are they curious about them? Do they want to know more about why you feel the way you do, even if it doesn’t align with how they think you should feel? Have they acknowledged that your feelings are important and that you might have a different perspective on situations or actions? What you’re getting at with these questions is whether they care more about their actual relationship with you than preserving an idea of it in their head.

“They don’t have to go into family therapy having done all the work beforehand,” Triska says. “But it helps a lot when both parties acknowledge that the relationship has to change.”

How they react to negativity can also be a helpful indicator. If you're dealing with someone who can’t acknowledge negative aspects of your relationship (spoiler: all relationships have negatives), or who denies basic facts (we never did x when they absolutely did), that’s a sign they’re not ready to make progress. 

Whether someone is willing to change may become clearer after one or two sessions. If there’s a behavioral difference—a relative has taken feedback and made efforts to change the way they act—this is progress. It can be an indicator that they’re willing to change more. And, maybe they will address how they acted after Teen Titans was canceled.

Signs Family Therapy Won’t Work

If family therapy working hinges on whether your relatives are willing to change, the top sign it won’t work is, you guessed it—they’re not willing to change.

Again, your mom is unlikely to call you, ask whether the shoe rack she sent arrived (there’s a photo in your shared Amazon account of you in a robe receiving a box labeled “shoes rank”), and then pivot to how, although it may have hurt you, she literally never wants to talk about the time she loaded all your Care Bears into her car and went to live with grandma for a month. 

But, if you bring up negative feelings or past experiences, and she doesn't engage with or acknowledge them—or her role in creating them—that can be a sign that family therapy won’t work. 

“One possible response is deflection,” Triska says. “You might hear something like, ‘We don’t need to rehash all that stuff’ or ‘You never complained about that before.’ What that means is, ‘I know you’re hurting, but acknowledging that it’s affecting our relationship would be way too uncomfortable for me.’”

Another indicator is a family member’s willingness to feel difficult emotions in the name of progress. Family therapy can be ultimately freeing and rewarding, but it can also sometimes be a painful process. As family members acknowledge past failings, that can mean having emotions like shame, rejection, or guilt. Some family members start therapy hoping not to experience anything painful. Others enter therapy because they want everyone else to change.

Sometimes, it can be hard to tell whether a family member is willing to feel negative emotions to improve their relationships. They might talk the talk—they may reference things like “healing,” “moving forward,” or “working together as a family”—but won’t necessarily change their behavior. If this is the case, it might take going to family therapy to understand why it won’t work. If, after a few sessions, they seem unwilling to take responsibility for their actions and change, it may not be the right time for family therapy. 

“When we talk about ‘willingness’ to go to family therapy, we’re not just talking about wanting to do it,” Triska says. “A lot of people want their families to be happier in theory, but dig in their heels once it actually starts happening. Therapists can work with resistance, but we can’t force someone to realize they’re contributing to the problem.”

Finally, if you are in a situation where abusive or previously abusive relatives have power over you (for example, if you are living with an abusive parent), it is not a good idea to start family therapy. 

“It could destabilize things that are important to you, like your living situation or school,” Triska says. “Family therapy works on the premise that everyone is contributing in some way to the problem, even if not in the same amount. It assumes that people can work toward solving a problem together, and that is simply not the case with abuse. You can’t do therapy with a threat looming over you.”

Choosing Whether to Go to Family Therapy

Ultimately, whether family therapy will work depends on whether you and others are ready to change, experience negative emotions in the name of a better family unit, and take responsibility for past actions. Sometimes it’s clear whether this is the case beforehand, and sometimes it takes a few sessions.

“In the first couple of months, I’m keeping an eye out for the language people use about the family’s problems,” says Triska. “Sometimes you’ve got one family member getting really specific—like, ‘I need Mom to stop coming to family events drunk and making a scene’—but other family members aren’t willing to talk about problems in a concrete way, even when they’re asked direct questions. Instead, they’ll describe it as ‘a disagreement you had with Mom.’ That often means it’s going to be hard to get them to a place where they can acknowledge a problem exists, let alone help solve it.”

Triska adds that even if change does happen in family therapy, it may not happen on a timeline that works for you. “You have to ask yourself how long you can live with the relationship the way it is.’”

That doesn’t necessarily mean cutting off family members who don’t change as quickly as you want them to, but it might mean setting a boundary. “You don’t have to end the relationship to say, ‘I can’t be as close to you as I want to be,’” says Triska. “You can make the decision to protect yourself, but leave the door open for when they’re ready to change.”

Consider Individual Therapy

If you think your relatives aren’t ready for family therapy, there are still ways to move forward on your own. If you’re ready to work through your feelings, change, and start moving toward the life you want, consider individual therapy. Remember—you don’t need the people around you to decide to change to start making progress.

“A lot of people say, ‘If I can’t get my family members to respect my boundaries, what good is individual therapy?’” Triska says. “But boundaries aren’t just requests you throw out to other people and hope they decide to respect them.” Boundaries, Triska explains, are rules you set for yourself about things you have power over, like “if Mom gets drunk at the reunion, I’ll leave” or “I won’t lend my brother any more money.” Therapy can help you set and stick to these boundaries.

 Interested in finding out more about individual or family therapy? Learn more about our therapists and schedule a free consultation.