Filial therapy provides caregivers (typically parents) with training in basic play therapy techniques so they can use these techniques with their own children. This modality originated as a group family program and was one of the first systemic family therapy interventions.
Founded on the belief parents can learn the necessary skills to become therapeutic agents in their children’s lives, filial therapy incorporates family members as the main agents of change, offering a unique outlook on the therapy process. Trained professionals educate primary caregivers in the method and then provide supervision and guidance as families begin to navigate and resolve challenges.
Filial therapy was developed by Bernard and Louise Guerney in the 1960s when they became aware of the limited number of treatment providers trained to work with children. This innovative approach to play therapy attempted to address that lack by training parents in relevant techniques and giving them the ability to practice these techniques with their children, expanding the reach of play therapy in the process.
In the original Guerney model of filial therapy, parents attended training for an average of 12 months while simultaneously conducting weekly play therapy sessions with their children. Since the late 1980s, Garry Landreth has helped to expand the use of filial therapy by adapting the original model to account for time constraints and limited resources. In his model, parents attend 10 training sessions while also conducting (and videotaping) weekly play sessions with their children at home. There are currently various formats of filial therapy available, with lengths ranging from 10 to 24 weeks.
Filial therapy draws from psychodynamic, family systems, developmental, and behavioral theories, among others. The method is a psychoeducational intervention designed to teach skills to parents. Therapists specifically trained in play therapy educate parents in the method and supervise sessions, but their role in this modality is more educational than therapeutic. Parents do not become play therapists in the process; rather, they learn skills to help children overcome difficulties and/or improve parenting practices.
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This type of therapy does not focus on either parent or child as the person seeking treatment. Instead, the relationship between parent and child is the focus of the therapy. Issues arising in families are often related to the family dynamic—a child’s issue is typically not solely attributable to the child, and concerns experienced by one member of the family are likely to affect the entire family.
Therapists underscore the necessity of empathy and acceptance as part of the therapy process, listening and accepting parental feelings on as deep a level as possible and recognizing and reflecting the feelings of the child as expressed through the child's play. Empathic listening is considered essential in this process. Filial therapy also involves the entire family, when it is possible to do so, and emphasizes the importance of the therapy work truly being a collaborative effort.
Filial therapy involves several stages. A therapist will generally first conduct an assessment of the family and will likely take some time to observe family interactions. Then, the therapist will demonstrate a play therapy session and train parents in basic techniques over the course of a few sessions. After that, the therapist provides direct supervision as parents conduct sessions with their children. The parent-led sessions typically begin in the clinical setting but eventually transition to the home. For the duration of the therapy, the therapist provides ongoing support and addresses any challenges families may encounter, thus preparing families for the completion of the therapy. This type of therapy does not focus on either parent or child as the person seeking treatment. Instead, the relationship between parent and child is the focus of the therapy.
Filial therapy is most often conducted in a group setting so parents can receive emotional support in addition to didactic training. In a group setting, parents also have the ability to experience a variety of parenting styles. Filial therapy has also been adapted for use with couples and individual parents and can be used to train teachers, mentors, and other caregivers. The techniques in filial therapy are non-directive and child-centered, meaning children are free to play as they wish, without a lot of instruction or direction from the parents.
Four basic techniques are taught in filial therapy:
- Structuring: Parents structure the play session by creating a specific play area and telling the child any of the toys provided in the space can be played with, in any way the child desires (with a few safety-based restrictions).
- Empathic listening: Parents can develop skills to reflect a child’s behavior and emotions during play and use these skills to provide reflective commentary on what the child is doing and what the child may be feeling or experiencing.
- Child-centered imaginary play: The parent simply watches and follows as the child engages in imaginary play.
- Limit setting: Although rules are kept to a minimum, parents provide limits to ensure safety and respect for property. Some aggression is permitted, but parents intervene if the child attempts to destroy toys or engage in dangerous behavior.
The goal of therapy is for the child to feel more accepted and to be able to express feelings in safe and appropriate ways.
Filial therapy was initially designed to treat children experiencing social, emotional, or behavioral concerns and is used today to treat a wide range of childhood issues, such as:
- Concerns related to adoption or foster care
- Chronic illness or disability
- Inattention and hyperactivity
- Oppositional behaviors
- Attachment issues
Filial therapy aims to both empower parents and improve the relationship between parent and child. Over the course of filial therapy, the parent has the opportunity to learn a variety of methods for engaging the child while still maintaining limits.
Filial therapy is a well-studied, evidence-based treatment. Research shows it can benefit both parents and children by facilitating improved relationships and often leading to marked improvement when children face behavioral and psychosocial challenges. Filial therapy may also be effective in the prevention of future difficulties, as it addresses problems within the family system and gives parents tools they can use to more effectively respond to their children. Filial therapy may even be more beneficial than traditional play therapy, as it is often possible to see positive results in fewer sessions.
Filial therapy may not be effective for all children or family situations, but a majority of research shows filial therapy to be effective for a diverse range of children and families. It is considered to be a culturally sensitive intervention, but in some cases, the skills taught by the therapist may conflict with certain cultural beliefs. Additional research on incorporating cultural beliefs and identity into filial therapy may be beneficial.
Another potential concern may arise out of filial therapy's reliance on self-reporting. In some studies, parental reports did not agree with the reports obtained from other sources, such as teachers or the other parent. Also noted was the tendency of some parents to underreport their own distress, which could potentially impact therapy outcomes.
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- VanFleet, R. (2011). Filial therapy: Strengthening family relationships with the power of play. In C.E. Schaefer (Ed.), Foundations of play therapy. Hoboken, NJ: John Wiley & Sons, Inc.
- VanFleet, R. (2012). An overview of filial therapy. Retrieved from http://www.lianalowenstein.com/articleFilialTherapy.pdf