Often the reason is fairly clear. If we think of families as living organisms the parts of which work together to deal with the outside world, then there simply are times that new stressors appear and have to be dealt with. Sometimes the pain and challenge of those new events are just too difficult to cope with if there isn’t some outside assistance available.
Some of the obvious stressors that cause families to seek help are the death of a loved one, the loss of a pregnancy or the death of a newborn, divorce, remarriage, the need to blend families together, the birth of a child, the loss of a job, or the necessity to move to a new home or even to a new section of the country. Life is difficult and sometimes an added stress can just overwhelm. One goal of family counseling is to help families deal with those stressors.
While family counseling can help deal with such stressors, working with families has another important function, one that is not so obvious. It is an effective method for dealing with many emotional and behavioral problems that appear to be rooted in individuals. It can be an effective alternative or adjunct to more traditional individual psychotherapies.
What are some of the indications that family therapy might be a good choice? First is the rapid onset of the problem behavior, particularly if the person whose behavior has changed was previously functioning well and there is no obvious trauma that might have set things awry. An example might be a child who had been doing fine suddenly refusing to attend school. Even if the behavior of this “patient of record,” which is what we call the problem individual, seems so bizarre as to be labeled crazy or in the usual diagnostic terms psychotic, family treatment can often accomplish a lot. In fact, one of the advantages of family therapy is the removal of the stigma of being the “patient” and replacing it with the idea that this is a shared problem.
A second indicator for family counseling is the unwillingness of some members of the household to take part in solving the problem, of helping that “patient of record” to get better. Since the assumption that makes families work is that the members love one another, there should be a willingness of everybody to help with this problematic situation. If somebody is “too busy,” “can’t see the point of meeting as a family” or offers similar resistance, that’s a good indication that there is in fact a family problem.
A third indication is that the person whose problem is difficult tries to make their behavior seem quite natural and normal. For example, they might try to make the problem seem like a medical issue rather than a behavioral one or they might say they are working on the solution or they may try to deny that the problem behavior exists; such denial is frequently found with substance abuse and eating disorders.
That “normalization” of behavior is often belied by the individual’s finding ways to come into conflict with others about it. For example, an anorexic will do battle with everybody about what family meals and menus should be instead of the much less conflictful reduction of serving sizes and possibly avoiding meals by being so busy.