Family Therapy or Individual Therapy? Four Concerns to Consider

A couple sits with a therapist as the man looks uninterested.Families are amazingly resilient relationship groups. While many of us have enduring trouble with some aspect of our families, past or present, all of us are part of some form of family all our lives. Most of us organize our lives around the needs, priorities, goals, and problems of our chosen family. Whatever differences and conflicts we may have with other nations and peoples around the world, the human family is the way all of us organize.

Family therapy is a form of psychotherapy that seeks to understand, theorize, and imagine ways to help families function better with more flexibility, healthier communication, and more functional roles, responsibilities, and shared connections. When family relationships are strained beyond the members’ capacity to respond, having a trusted, compassionate, and trained relationship coach or mentor can really make life happier, easier, and healthier for all involved. Licensed marriage and family therapists (LMFT) have specialized education, training, and supervision in helping families increase their ability to function in a positive, enjoyable way—at least, that’s the goal.

As helpful and healing as family therapy can be, there are certain life problems that are so detrimental to individual functioning that they should be addressed in individually therapy before family therapy can begin. These include:

  1. Addiction. Major, active addiction is so distracting and distressing to personal functioning, that the condition must be in treatment and under stable recovery before family therapy can be helpful. Most LMFTs will expect that drug, alcohol, and gambling addictions, and eating disorders get identified and treated before the whole family is under care. Sexual addictions, in my experience, are often only identified when a couple or family is well into therapy, and so may be initially hidden. However, they too are best treated individually if the addiction has been identified in the beginning.
  2. Severe mental health conditions. Major mental health issues such as bipolar, severe depression, anxiety, schizophrenia or other disabling conditions should be under treatment before family treatment is begun.
  3. Family violence. Chronic anger, violence, and abusive behaviors are so threatening to family life that attempting family therapy can actually cause more hurt unless the violence is first prevented, controlled, and stopped.
  4. Affairs. Secret or not, ongoing emotional and sexual affairs unbalance a family so that therapy is not possible unless they are completely stopped. Most family therapists will ask about affairs in their initial phone conversations or meetings with couples and the adults of family groups and will defer family therapy in cases of ongoing affairs.

Even if your family may be in the midst of one of these problems, a family therapist may be a great local resource for finding the help you need. If you are worried about your family, have run out of your own ideas, and energy for making a change is running low, please consider seeking out the professional help you need to get your closest relationships back on track.

© Copyright 2011 by Lynne Silva-Breen, MDiv, MA, LMFT, therapist in Burnsville, Minnesota. All Rights Reserved. Permission to publish granted to

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Stuart Tait

    Stuart Tait

    March 18th, 2011 at 8:00 PM

    It can be very distressing for the entire family even if one family member has a problem or is conflicting with the others.I have to agree that the four things you have mentioned here are of utmost importance and need to be fixed first thing.Also,it is very important that all family members think of fixing the problems for the family’s sake and not be selfish during the therapy.

  • Charlotte


    March 19th, 2011 at 5:31 AM

    For many families these underlying issues often overshadow any chance that they will have at having a strong relationship with one another and making the family ties strong and sound. Of course families are always going to have issues but these are some of the more serious ones that can have horrible ramifications on family healing.

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