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Marriage and Family Therapy

Reviewed by Psychology Today Staff

Marriage and family therapy is a form of psychotherapy that addresses the behaviors of all family members and the way these behaviors affect not only individual family members but also relationships between members and the family unit as a whole. Family therapy was developed by physician Salvador Minuchin in the 1960s and '70s. Treatment is usually divided between time spent on individual therapy and time spent on couple therapy, family therapy, or both, if necessary. MFT may also be referred to as couple and family therapy, couple counseling, marriage counseling, or family counseling. This type of therapy focuses on communication, coping skills, constructive problem-solving, as well as ways to build trust and strengthen healthy relationships in a family system. According to the U.S. Bureau of Labor Statistics, the occupation of marriage and family therapists may grow 14 percent from 2021 to 2031.

When It's Used

The range of physical and psychological problems treated by MFT include marital and couple conflict including separation or divorce, parent and child conflict, alcohol and drug abuse, sexual dysfunction, financial difficulties, grief, distress, eating disorders and weight difficulties, behavior problems in children such as self-harm, life transitions such as job loss, and difficulties with eldercare such as coping with a parent’s or grandparent’s dementia. Marriage and family therapy practitioners also work with mental-health matters such as a family member’s depression, anxiety, or schizophrenia, and they address the effect these concerns have on the rest of the family.

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What to Expect

Marriage and family therapy is normally short-term and consists of an average of 12 solution-focused sessions. More sessions may be required, however, depending on the nature and severity of the problem(s). In couple or marriage counseling, the therapist will begin by meeting with both partners; after which, time is spent with each individual. In family therapy, the therapist will also begin by meeting with the entire family and then, if appropriate, meet separately with individual family members. The first session is generally for information gathering, so the therapist can learn about the problem that brought you to therapy, get the thoughts of everyone involved, and observe couple-family dynamics. You may need to log formal assessments, self-reports, or personal observations in this process.

At the same time, you should be able to get a clear sense of the therapist’s role and competency, the goals of treatment, and any rules to be observed in and out of sessions, such as who should attend which sessions and confidentiality of any information shared between and among partners or family members and the therapist. Over time, you will identify individual family roles and behaviors that contribute to conflicts, identify specific challenges, and explore ways to actively resolve concerns.

How It Works

While traditional therapy focuses more on the individual, marriage and family therapy examines how an individual’s behavior affects both the individual and their relationship as part of a couple or family. The theory behind this therapy: Regardless of whether a problem appears to be within an individual or within a family, getting other family members involved in the therapeutic process will result in more effective solutions. This therapy is goal-oriented and works toward an established end result. In recent years, MFT practitioners and groups have called for expanded approaches to traditional marriage and family training that incorporate more real-world practices to integrate other therapies and become more inclusive of non-heterosexual couples and families.

What to Look for in a Marriage and Family Therapist

A licensed marriage and family therapist is a mental health practitioner with a master’s degree or doctoral degree as well as specialized training that includes at least two years or 3,000 clinical hours of experience supervised by a marriage and family therapist. Upon completion of supervised hours, a therapist must also pass a state licensing exam or the Association of Marital and Family Therapy Regulatory Board’s national MFT exam, which is used in most states.

The marriage and family therapist can be found in health clinics, private practice, family services, and other settings and institutions. In addition to finding a qualified licensed marriage and family practitioner, it is important to work with someone you and your family members trust and feel comfortable working with in a counseling environment.

Screen your potential therapist either in person or over video or phone. During this initial introduction, ask the therapist:

  • How they may help with your particular concerns
  • If they dealt with this type of problem before
  • What their process is
  • The timeline for treatment
References
Journal of Marital and Family Therapy. Qualitative Research in Family Therapy. 2021
Association of Marital and Family Therapy Regulatory Boards
Karam EA, Blow AJ, Sprenkle DH, Davis SD. Strengthening the systemic ties that bind: Integrating common factors into marriage and family therapy curricula. Journal of Marital and Family Therapy. April 2015
Hudak J and Giammattei SV. Doing family: Decentering heteronormativity in “marriage” and “family” therapy. Critical Topics in Family Therapy. 20 March 2014.