4 Family Therapy Activities for Anxiety
Relationship conflict within families and intimate partners is significantly higher when one or more of the individuals struggles with an anxiety disorder (Chambless, 2012).
There are numerous activities that can help families and relationships deal with an anxiety disorder.
1. Thought record
Family members can create a thought record of negative and anxious thoughts when they come up. This can be done in a journal or notebook and brought to family therapy sessions. In session, family members will share their anxious thoughts, and other family members can help the client come up with thought replacements.
2. Exposure therapy
Exposure therapy involves gradually exposing an individual to something that causes fear or anxiety (Cleveland Clinic, n.d.).
Exposure therapy activities in family therapy might involve identifying something that one member is avoiding due to fear. This might be anything from a type of animal to social settings.
Family members can create an “exposure hierarchy” with the anxious member. This hierarchy starts with the most terrifying experience (holding a spider) and ends with something less scary (such as looking at a picture of the spider). Family members can work with the individual to move through the hierarchy gradually and provide a safe space of comfort so that the anxious client can overcome their fear.
3. Behavioral activation
Behavioral activation is a technique that helps individuals understand and experience how behavior affects emotions (Carr, 2012). Behavioral activation activities can be introduced and applied in family therapy settings to help one or more members with anxiety.
Behavioral activation activities for anxiety can include deep-breathing exercises (such as square breathing, three-part breathing, or mindful breathing), exercising, scheduling positive activities to reduce avoidance, and identifying goals and values.
Family members can review the most effective activities and implement them in their daily and weekly lives.
4. Feel-good file
Family members will create a manila folder and label it the “Feel-Good File.” It can be decorated and designed by individuals.
Family members will write down one positive strength for another family member on an index card. These index cards are compiled into the client’s file so each member eventually has a folder full of their own strength cards.
Family members can use these folders and refer back to their personal strengths during times of stress and anxiety.
3 Family Therapy Interventions for Depression
Depression is the most common mind-brain illness and affects tens of millions of Americans (Dietz, 2020).
These effects can dramatically impact relationships and families for generations. There are several effective family therapy interventions that can minimize the negative impact depression has.
1. Cognitive-Behavioral Therapy
Although Cognitive-Behavioral Therapy (CBT) is often used for individuals, CBT techniques can be effectively applied to family therapy (Yulia et al., 2016).
The goal of CBT is to help family members identify faulty thinking patterns and change them, which results in positive emotional and behavioral outcomes (Yulia et al., 2016). It teaches family members that they cannot always change circumstances, situations, or other people, but they can change their perception and response.
2. Interpersonal psychotherapy
Interpersonal psychotherapy is a structured, short-term form of therapy that focuses on relationships, communication, and here-and-now problems (Dietz, 2020).
It can be a helpful treatment for depression by addressing specific issues within the family system and working on collaborative problem-solving skills to reduce negative thoughts and feelings.
3. Psychoeducation
Psychoeducation on depression, depressive symptoms, and underlying causes can be helpful for families. Psychoeducation involves educating individuals and family members about the brain, chemical imbalances, symptoms, and treatment of depression (Suijit et al., 2020).
It can provide insight about the disorder, identify effective problem-solving techniques, prevent relapse, and improve relationships.
3 Family Therapy Strategies for Dealing With Addiction
According to the National Institute on Drug Abuse (2023), treating addiction is most successful when the needs of the whole person are addressed.
Addiction is a complex issue and is typically thought about in three phases: treating withdrawal, treating the root causes of addiction, and preventing relapse. Several family therapy strategies are useful in treating addiction. These include contingency management, 12-step facilitation, and brief strategic family therapy.
1. Twelve-step facilitation
Twelve-step facilitation is much like the 12-step process of Alcoholics Anonymous and is not necessarily a medical treatment for addiction, but a complementary addition to support treatment (National Institute on Drug Abuse, 2023).
As the name implies, it is a strategy that involves 12 weeks following the themes of acceptance, surrender, and active involvement in recovery.
2. Contingency management
Contingency management is a therapeutic strategy that uses positive reinforcement to encourage sobriety and recovery (National Institute on Drug Abuse, 2023).
Rewards and privileges are given when clients attend counseling sessions or meetings, attain drug-free milestones, or take medication as prescribed.
3. Brief Strategic Family Therapy (BSFT)
BSFT is an intervention that focuses on practical, problem-focused, and planned strategies (Szapocznik et al., 2013). Some of these strategies include:
- Practical strategies may include behavioral contracts, where clients sign a contract agreeing to do or not do certain things related to the addiction
- Problem-focused strategies focus on maladaptive family interactions as they relate directly to the addiction. Implementing clear rules, increasing parental involvement, creating guidelines and routine communication are examples of this.
- Tracking is another strategy used as a method of systematically identifying family interactions to address strengths and weaknesses (Szapocznik et al., 2013). These interactions are recorded and linked back to addictive behaviors to create an effective treatment plan for both the individual and the family involved.
3 Family Therapy Exercises for Trauma
When a crisis or trauma occurs, it impacts all members of the family. Individuals react and respond to trauma and major life events differently. Family therapy exercises can help members support and collaborate to heal from the trauma.
1. Genogram creation
Constructing a genogram allows clients to visually map out family relationships, history, and dynamics. It can reveal patterns of trauma transmission across generations, which leads to understanding and discussion among family members.
2. Narrative therapy
Narrative therapy encourages each family member to share their story related to a specific trauma. This can help in understanding differing perspectives, validating experiences, and creating empathy among family members.
3. Family sculpting or role-play
Role-play activities and family sculpting explore family relationships, dynamics, and the meaning of the trauma. This can help family members understand various perspectives and lead to healthy healing.
3 Family Therapy Approaches for Anger Management
Anger is a natural emotion. Experiencing anger when feeling threatened or attacked is a survival technique that has helped humans survive since the beginning of evolution (Williams, 1993).
However, anger can cause a lot of distress and conflict in relationships when it is not managed appropriately.
1. Play therapy
Play therapy can be an effective technique to help children in families deal with anger (Nelson et al., 2012). Anger in children can be a sign of social, school, or environmental factors within their lives.
Play therapy techniques such as drawing to express feelings, role-play with dress-up, and age-appropriate games can be helpful teaching tools for children struggling with anger management (Nelson et al., 2012).
2. Emotional regulation training
Regulating emotions is not about suppressing them. As mentioned, anger can serve a purpose as a powerful emotion. Learning to regulate emotions is about training clients to identify and feel the emotions but not respond irrationally to them.
Things like naming and identifying anger, meditation, mindfulness, physical activity, and learning to pause before responding are all pieces of emotional regulation training.
The Anger Exit and Re-Entry Routines worksheet can be used as a helpful tool in family therapy to work on emotional regulation skills within relationships.
3. Anger management training
Anger management training involves identifying specific triggers and responses, learning strategies to diffuse or avoid, and changing thoughts and attitudes about anger (Williams, 1993).
Clients will record specific incidents where they felt angry and identify a theme that triggers the emotion. Clients are also taught to become more aware of individual responses to these situations and work to find alternate responses.
CBT is often included in anger management training as a way to identify specific thoughts (such as rumination) that lead to increased levels and prolonged duration of anger.
3 Family Therapy Techniques for Grief
Grief is a very individual experience, and it’s difficult to navigate within a family unit or in a relationship.
There are many types of grief, but ultimately, it is the emotional suffering experienced when something or someone is taken away (Lichtenthal & Breibart, 2015).
Kubler-Ross famously established the five stages of grief in 1969. These stages can emerge in any order, at any time, and include denial, anger, bargaining, depression, and acceptance (Simon et al., 2011).
Various family therapy techniques can be used to help families and family members move through the grief process.
1. Making sense of loss
This is also known as “positive reframing,” which can be cognitive, focusing on thoughts, or emotional, focusing on feelings (Lichtenthal & Breibart, 2015).
It is hard to see positives in grief and loss, and clients may only be open to this technique during certain stages of the grief process. Making sense of loss or positive reframing is not discarding the negative aspects of it, but focusing on positive memories, lessons learned, or things that still connect the client with the person lost.
2. Creating new traditions
It is often helpful to create new routines, rituals, and traditions after the loss of a loved one or major life change. In family therapy sessions, members can discuss and brainstorm ideas of things they want to try, experience, or continue for holidays, vacations, milestones/major dates, etc.
The establishment of new traditions can help family members process grief and move on to enjoy a “new normal” (Lichtenthal & Breibart, 2015).
3. Find identity and purpose
Individuals can experience grief for many reasons. These include more than losing someone important. It can be the loss of health, the loss of a career, or any major life transition that involves change and loss.
Helping family members find a new identity and purpose after the change and loss can bring healing and hope to both the individual and the family unit (Simon et al., 2011).
Helpful Resources From PositivePsychology.com
PositivePsychology.com has a wealth of resources that can be used in family therapy.
For a start, you might want to peruse our article, How to Practice Family Constellation Therapy or the worksheets offered in the article Internal Family Systems Therapy.
The Interpersonal Skills Acronyms worksheet is based on the DEARMAN, GIVE, and FAST concepts found in Dialectical Behavior Therapy. It can help couples and family members communicate, interact, and respect one another during times of conflict or disagreement.
Codependency is a common problem in relationships and generally begins with maladaptive behaviors found in the family unit. This worksheet — Codependent Relationships: Beliefs, Attributes, and Outcomes — outlines the difference between codependent and healthy relationships and can be a helpful guide for clients.
If you’re looking for more science-based ways to help others build healthy relationships, check out this collection of 17 validated positive relationships tools for practitioners. Use them to help others form healthier, more nurturing, and life-enriching relationships.
A Take-Home Message
Relationships and families can be complex, dynamic, and multifaceted. Family therapy is based on the idea that the family is a system of different parts.
When one member of the family struggles with mental health issues, it affects the entire family system. Family members often adapt to mental health issues by getting stuck in unhealthy behavior patterns.
This article has outlined a few of the mental health issues, family therapy techniques, and activities that can be addressed through therapy. Family therapy can help all members make positive changes and work toward individual and collective healing.
We hope you enjoyed reading this article. Don’t forget to download our three Positive Relationships Exercises for free.
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