Family therapy is defined as a professional and deliberate approach and method used to explore, understand, and address internal family interactions as well as individual disorders and the suffering they cause. The goal of family therapy is to transform the interactional structures that maintain individual mental health issues and prevent developmentally constructive solutions. This is achieved by highlighting positive resources and opportunities within the interactions.
In Finland, family therapy is one form of psychotherapy eligible for reimbursement through the Finnish social insurance institution, Kela, either as part of rehabilitation psychotherapy or as specialized medical rehabilitation. The majority of family therapists in Finland work within the public sector. Family therapy originated in the 1950s, primarily developed for use in child psychiatry and the treatment of psychoses. Over its history, family therapy has incorporated influences from various frameworks, combining solution-focused and narrative approaches with structural, systemic, and strategic frameworks, as well as more recent trends including reflective, dialogical, and resource-oriented approaches.
Family therapy as a treatment method
In particular, dialogical and resource-oriented family therapy employs social constructionism as its theoretical framework. This perspective posits that reality is constructed within the social relationships in which we live. A key concept in this approach is the discursive and contextual nature of problems, meaning that the reality of a problem is constructed through language and is tied to specific contexts. Thus, problems are not viewed as inherent psychological deficiencies within individuals but are understood through the exploration of resources within conversational methods.
American psychologist Harlene Anderson challenged systemic family therapy by asserting that systems do not create problems; rather, problems within the family create specific interactional systems. Family therapy aims to influence these uniquely formed interactional systems.
Family therapy as a treatment method
Family therapy is commonly used to address interactional issues such as divorce crises, severe mental health disorders like schizophrenia, and as a support alongside other therapeutic methods. It can be applied to precisely defined mental health disorders, difficult family conflict situations, interactional disturbances, and normal family crises. Research has shown that incorporating family therapy into treatment has enhanced the effectiveness of basic therapy provided within public healthcare settings.
There is research on the effectiveness of family therapy, although it has not been studied as extensively as other forms of psychotherapy. Research has shown that family therapy is effective for adolescents with behavioral and emotional disorders, substance abuse, and eating disorders. There is also some evidence of its effectiveness in treating depression, self-harm, and chronic somatic illnesses.
For adults, family therapy has been found effective in managing schizophrenia, substance abuse, dementia, and risk factors for cardiovascular diseases. Evidence supports the effectiveness of couple therapy in treating depression, marital conflicts, obesity, and hypertension risk factors.
Studies have also shown that clear communication can protect against the onset of mental illness, even in individuals with a genetic predisposition. Measuring the effectiveness of family therapy presents challenges, particularly regarding what is being measured. Is it changes in symptoms, diagnosis, adaptation mechanisms, family interaction, or client satisfaction with the therapy? Most studies focus on changes in the client’s experienced symptoms.
Although family therapy is considered effective according to research and is also recognized as a form of psychotherapy in Finland, its share of the rehabilitation psychotherapy services covered by Kela is very small compared to individual therapies. On the other hand, most family therapists work in the public sector, so family therapy is not as readily available in the private sector as individual therapy.
This means that high-quality, evidence-based, and effective psychotherapy is available at a lower threshold in public services. In the latest editorial of the Family Therapy Journal, Eija-Liisa Rautiainen highlights network, family, and couple therapy methods in the context of therapy guarantees, which are suitable for supporting short-term psychotherapy and psychosocial support in primary health care.
Since trained family therapists already work in the public sector, utilizing their psychotherapeutic expertise would not incur additional costs. It is important to make use of existing resources so that clients receive the most high-quality and effective help as early as possible.
