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Family Systems Approach

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Regardless of age, education, income, cultural background, or sexual orientation, every person faces challenges in life to one degree or another. When problems are especially hard to overcome or arise repeatedly, there’s a good chance the issues stem from your family of origin.

While many forms of therapy encourage clients to explore family dynamics as part of the healing process, family systems therapy actually engages the whole family in treatment. Since what happens to one member of a family affects everyone in the family, healing the microcosm of the individual calls for the healing the macrocosm of the family.

What Is the Family Systems Approach?

Psychiatrist Murray Bowen developed the family systems approach, also known as family systems therapy, in the 1950s. The underlying theme of the family systems approach is that families are an emotional unit. They are an interconnected system of interdependent individuals. Moreover, they influence one another, and their psychology cannot be understood in isolation from the system as a whole.

The Bowen theory posts that family members respond to each other in habitual ways, according to their roles within the family and their unspoken relationship agreements. And he understood that these behavior patterns can create balance but also may produce dysfunction. With this understanding in mind, the family systems approach helps people resolve issues in the context of the family unit. Bowen’s family systems theory fosters insight into the family group dynamic, working with it to promote overall health.

Eight Principles of Family Systems Theory

The eight principles of family systems theory highlight the interconnectedness of family members, shifting the focus from the “patient” to variables and circumstances affecting the family system. The eight interlocking concepts in Dr. Bowen’s family systems theory include: 

  1. Triangles: a relationship system comprised of three people. Triangles usually have one side in conflict and two sides in harmony, contributing to the development of clinical problems.
  2. Differentiation of Self: having a sense of one’s individuality separate from the family unit. Highly differentiated people are more likely to pursue goals independently while those with a less developed sense of self may seek validation from other people and experience co-dependency.
  3. Nuclear Family Emotional Process: how the family operates in emotional interactions. Bowen believed the nuclear family experienced issues in four main areas: marital conflict (or intimate partner conflict), dysfunction in a spouse or partner, emotional distance, and impairment of one or more children, leading to arguments, criticism, under-performance, over-performance, and/or distancing behavior.
  4. Family Projection Process: the transmission of the parents’ anxiety, emotional concerns, and/or relationship problems onto the child, who may develop emotional issues as a result. Rather than address their own problems, parents try to fix perceived problems in their children that remind them of their own. They treat their children as if something is wrong with them. This shapes their development such that the children grow to embody their parents’ fears and perceptions. 
  5. Multigenerational Transmission Process: Bowen believed the roots of the most serious human problems are generations deep. The multigenerational transmission process determines the levels of “self” people develop. It also impacts the way they interact with others, affecting the selection of a spouse or intimate partner. People choose partners with similar levels of differentiation. Small differences in levels of differentiation between parents and offspring lead to significant ranges of differentiation among individual family members over generations.
  6. Emotional Cutoff: distancing from the family or cutting off all contact to reduce stress or avoid conflict without resolving the issues at hand. In so doing, distancing family members may place too much importance on present and future relationships, causing undo strain and stress.
  7. Sibling Position: the tendency of the oldest, middle, and youngest children to assume specific roles within the family relationship system. This is typically due to differences in parental expectations and parental discipline. For example, an executive who’s an oldest child may work well with an assistant who’s a youngest child. Likewise, people whose sibling rank positions are complementary may be less likely to divorce than if their positions are at odds.
  8. Societal Emotional Process: Bowen treated parents in the criminal justice system and saw how external influences could affect the family system. Thus, this principle of family systems theory suggests that social and cultural forces can influence family relationships. As people experience greater anxiety during periods of societal regression, ramifications occur within the emotional systems of family units.

The History of Family Systems Therapy

Murray Bowen served as a general medical officer in the United States Army during World War II. While working with soldiers, his focus changed from surgery to psychiatry. After leaving the Army, he conducted research into family interactions at the Menninger Clinic and at the National Institute of Mental Health. There he continued to develop his theory that the family functioned as an emotional unit.

Bowen researched the family patterns of people with schizophrenia who were receiving treatment and the patterns of his own family of origin. Finally, he introduced family systems theory in the late 1960s. Traditional individual therapy commonly explores an individual’s inner psyche to spark positive change. But family systems therapy focuses

on the structure and behavior of the family’s relationship system. Bowen believed this was instrumental in the formation of character. Changes in the behavior of one family member, Bowen posited, would likely influence the way the family functions over time.

What Family Systems Therapy Can Help With

Many psychological problems stem from relationships within an individual’s family of origin. That’s true even if the problems arise later in life. Individuals, couples, and families can benefit from the family systems approach.

Bowen’s family systems theory can be helpful in addressing conditions such as:

  • Depression
  • Anxiety
  • Grief
  • Anger management
  • Substance use disorder
  • Alcohol use disorder
  • Bipolar disorder
  • Eating disorders
  • Personality disorders
  • Parenting issues
  • Stress and trauma
  • Coping with physical disabilities
  • Coping with chronic health conditions

Family systems therapy can also address conflict within the family unit—between siblings, between parents, or between parents and children. When treating adolescent mental health problems, the family systems approach explores how factors within the family may contribute to the onset or maintenance of such conditions. If a teen suffers from alcohol use disorder, for example, family systems therapy would help the family understand how codependent relationships enable the addiction and allow it to continue.

How Family Systems Therapy Works in Practice 

As in almost all therapy, family systems therapists usually spend one or two sessions gathering information about the family system. That includes the history of their family dynamics and why the family is seeking therapy. The therapist offers all family members an opportunity to express their thoughts and feelings. Subsequently, they work with the family to create general and specific goals like decreasing substance use and increasing family communication.

Family members explore their roles within the family and experiment with switching roles when necessary. And they learn to support each other with the goal of fostering a healthy family system.

Activities in sessions vary widely. A family systems therapist may help families identify their underlying structures and patterns and come up with ideas for initiating positive change. They may lead them in role-playing activities or communication exercises to encourage greater understanding of how each family member feels. Some family systems therapists assign written or behavioral homework between sessions. All family systems therapists advocate equally for family members. They help to guide the family unit to reach its own conclusions about the best courses of action.

Family systems therapy is generally brief and results oriented. On average, it lasts for 12 sessions. However, more sessions may be required to help everyone feel secure in their ability to make healthy choices and maintain healthy relationships.

Family Systems Therapy: Three Main Approaches

Family systems therapy is comprised of three main approaches:

  • Structural family therapy: This approach focuses on interactions, patterns, and behaviors among family members. To minimize dysfunction, the family therapist aims to help restructure the way the family system works. Restructuring can include working on family boundaries, hierarchies of power, and reactions by family members to major life changes.
  • Strategic family therapy: In this approach, therapists address family behaviors and interactions that contribute to problem behavior. They help families function better so they can overcome their most pressing problems. Interventions might include having family members act out behavioral patterns without verbalizing them. Or they might seat family members in different configurations than they habitually choose. Practicing new communication patterns is another intervention. This includes having family members talk directly to each other rather than about each other in sessions.
  • Intergenerational family therapy: This approach acknowledges that patterns of behavior are passed down from generation to generation, influencing family dynamics and the behavior of individual members. Therapists help the family identify and relate to the problems of their predecessors. Looking back can assist them in managing their own issues in the present. An important part of intergenerational family therapy is the creation of a genogram.

The Genogram

Bowen believed that putting together a family genogram is one of the best ways to understand how a family’s emotional system operates. A genogram is a pictorial representation of a family’s medical history and interpersonal relationships. Family systems therapists may use genograms to highlight hereditary traits, psychological factors, and other significant issues or past events that may affect an individual’s or family’s collective well-being.

To create the genogram, the therapist asks each family member a series of questions. The therapist gathers enough information to create a detailed family history stretching back at least three generations. In the process, families study their patterns of behavior and acknowledge echoes within the family line. Ideally, they discover more effective ways to solve problems and change their responses to the roles they’re expected to play.

Adolescent Treatment and Family Systems Therapy

Family systems therapy, informed by family systems theory, has been shown to be effective in the treatment of teens and families. Consequently, mental health conditions like teen depression, teen substance use disorder, teen anxiety, and teen eating disorders often respond well to the family systems approach. When the whole family is invested in the healing process, teens have a greater chance of success.

A 2019 study showed that regardless of gender, adolescents who participated in structural-strategic family therapy exhibited fewer internalizing and externalizing problems after treatment. As well, parents participating in the same study reported greater family cohesion, parental satisfaction, and perceived parental efficacy.

Family Therapy at Newport

At Newport, we recognize the importance of looking closely at the family system and involving the entire family in treatment, not just the adolescent. Our foundational approach is Attachment-Based Family Therapy (ABFT).

ABFT is based around the notion that humans are social creatures with an inherent need for connection. According to attachment theory, when parents are sensitive to their children’s needs and consistently available, children move into adolescence with secure attachment. Secure attachment has a positive effect on teenagers’ feelings of self-confidence, self-worth, and their ability to regulate emotions.

ABFT is designed to increase the security of the attachment between parent and child. This provides a supportive foundation to protect against depression and suicide.

Other Modalities in Newport Treatment

At Newport, we complement family therapy with a wide range of other modalities. We use approaches that help adolescents reduce anxiety, mitigate insecurities, combat substance abuse, enhance focus, build relationship skills, improve body image, heal trauma, and more. Some of our modalities include Eye Movement Desensitization and Reprocessing (EMDR), psychoeducation, cognitive behavioral therapy, acceptance and commitment therapy, nutritional therapy, relationship trauma repair, and more.

When teens are struggling, the whole family feels it, not just the adolescent. Thus, treatment can benefit the entire family unit, not just the struggling teen. If you think your teen is suffering from issues beyond your understanding or ability to help, reach out to our team at Newport Academy. We’re here 24/7 to help you find the best form of treatment for your family.

Key Takeaways

  • Family systems therapy is based on the premise that individuals cannot be understood or healed in a vacuum because they’re part of a larger context, the emotional unit of their family of origin. With this understanding, family systems therapy helps people resolve any number of issues by working with the family dynamic.
  • There are eight interlocking principles in family systems theory. One of them is the Differentiation of Self, having an identity that’s separate from the family unit. This is important because highly differentiated people are more capable of carving out their own lives and are less dependent on validation from others.
  • Another of the eight principles in family systems theory is sibling position, which centers around the tendency to assume specific roles within the family based on birth order and the differences in parenting they typically engender.
  • Family systems therapy can be helpful with any number of issues including depression, anxiety, substance use disorder, eating disorders, conflict within the family, and more.

Frequently Asked Questions About Family Systems Therapy

What is family systems therapy for?
Family systems therapy is for families in conflict or pain due to issues with one or more family members. This form of therapy involves the entire family in the healing process. Family systems therapy is based on the notion that the family is an emotional unit of interdependent individuals who affect each other and must be understood within the context of the family system.

What are the eight principles of family systems theory?
The eight principles of family system theory are: triangles, differentiation of self, nuclear family emotional process, family projection process, multigenerational transmission process, emotional cutoff, sibling position, and societal emotional process.

What are the different types of family systems therapy?
A number of different approaches may be used in family systems therapy depending on the family’s needs. Some of these include structural family therapy, strategic family therapy, and intergenerational family therapy.


Int J Environ Res Public Health. 2019 Apr; 16(7): 1255.

Updated December 19, 2022