Counselling vs Therapy vs Psychotherapy: What’s the Difference?
Counselling, therapy and psychotherapy overlap, but they are not identical. What each involves, who provides it in the UK and how to choose what suits you.
Family Therapy Explained: How It Works and When It Helps
What family therapy is, how systemic therapists work, who attends, what sessions involve, when NICE recommends it and how to find family therapy in the UK.
Key takeaways
- Family therapy helps family members understand each other and change patterns together, rather than focusing on one person.
- NICE recommends family intervention for psychosis and suggests family therapy for eating disorders in children and young people.
- In the UK, look for a systemic family psychotherapist registered with UKCP, often through the Association for Family Therapy.
On this page
Family therapy is a type of talking therapy that works with family members together to understand and change the patterns between them. Rather than seeing one person as “the problem”, it looks at how relationships, communication and life events affect everyone. It can help with conflict, big transitions and the strain of living with illness, and NICE guidance includes family-based approaches for some conditions, including psychosis and eating disorders in children and young people. In the UK, it’s available through some NHS services and privately.
How family therapy works
Most family therapists in the UK use a systemic approach. This means seeing the family as a system in which each person’s behaviour affects the others. The therapist helps everyone:
- hear each other’s perspectives
- notice patterns, such as how arguments start and escalate
- understand the influence of history, culture and life events
- try new ways of communicating and solving problems
The therapist doesn’t take sides or decide who’s right. Their job is to make it safe for everyone to speak and to help the family find its own solutions.
Who counts as family?
Whoever matters. Family therapy can include parents and children, couples, siblings, grandparents, step-families, foster and adoptive families, and close friends who play a family role. Not everyone has to attend every session, and sometimes therapists meet individuals or smaller groups too.
What sessions are like
- Length: often about an hour to 90 minutes.
- Frequency: sessions are often spaced every two to four weeks, giving time to try changes at home.
- Number: from a handful to many sessions, depending on the situation.
- Format: usually in person, sometimes online.
Some services use a reflecting team: colleagues observe the session and then share their thoughts with the family, who can respond. The family is always told about this in advance and agrees to it.
When family therapy can help
| Situation | How it can help |
|---|---|
| Frequent conflict or breakdown in communication | Understanding the patterns and finding calmer ways to talk |
| A child or teenager’s emotional or behavioural difficulties | Supporting the whole family, not just the young person |
| Eating disorders in children and young people | NICE advises considering eating-disorder-focused family therapy for children and young people with anorexia or bulimia |
| Psychosis or schizophrenia | NICE recommends offering family intervention to families of people with psychosis |
| Separation, divorce or blended families | Helping everyone adjust to new arrangements |
| Illness, disability or caring roles | Sharing the load and talking about difficult feelings |
| Bereavement | Supporting family members who grieve differently; see grief counselling |
| Substance use in the family | Understanding its impact and supporting change |
Family therapy compared with couples and individual therapy
| Family therapy | Couples counselling | Individual therapy | |
|---|---|---|---|
| Who attends | Several family members | Two partners | One person |
| Focus | Patterns across the family | The couple’s relationship | Your own experience |
| Useful when | The difficulty affects everyone | Relationship problems are central | You want personal space to talk |
If the main difficulties are between two partners, couples counselling may be a better fit. Many people also use individual counselling alongside family work.
Safety first
Family therapy isn’t suitable when someone in the family is being abused or controlled and joint sessions could put them at risk. A good therapist will check for this and may recommend individual support instead. If you’re experiencing domestic abuse, the National Domestic Abuse Helpline (England) offers free, confidential support 24 hours a day on 0808 2000 247.
Finding family therapy in the UK
- NHS: family therapy is often offered through child and adolescent mental health services (CAMHS), eating disorder services and some adult mental health teams, usually by referral.
- Social care and charities: some local authorities and charities offer family support services.
- Privately: look for a systemic and family psychotherapist registered with UKCP. The Association for Family Therapy and Systemic Practice (AFT) has a directory of qualified practitioners.
Our guides to finding a counsellor and counselling costs in the UK explain how to check registration and compare fees.
Getting the most from family therapy
- Agree shared goals at the start, even if they’re simple.
- Expect discomfort. Hearing others’ views can be hard, and that’s often where change starts.
- Try things between sessions and bring back what happened.
- Keep going through bumpy patches, and tell the therapist if something isn’t working.
If you need help now
If you or someone in your family feels unable to stay safe, call 999 or go to A&E. You can call Samaritans free on 116 123, any time, or text SHOUT to 85258. In England, call NHS 111 and choose the mental health option.
Frequently asked questions
What if one family member refuses to attend?
Therapy can still go ahead with those who want to come. Change in part of a family often influences the whole, and the door can stay open for others to join later.
Is what I say in family therapy confidential?
What’s said in sessions is usually shared among those present, and therapists keep it confidential from outsiders, with the usual safety exceptions. Our guide to confidentiality in counselling explains the limits.
Do children take part in family therapy?
Often, yes. Therapists adapt sessions so children can take part in ways that suit their age, such as through drawing or play.
Sources
Every article is edited by a human and checked against our editorial policy. Spotted a mistake? Tell us.
Keep reading
CBT Explained: What to Expect From Cognitive Behavioural Therapy
Cognitive behavioural therapy explained: how CBT works, what sessions involve, homework and techniques, what it helps with, how long it takes and its limits.
Couples Counselling: When and How It Helps
What couples counselling involves, signs it could help, what happens in sessions, common approaches, how to find a counsellor in the UK and what it costs.