Family therapy for moderate to severe depression

Some evidence – there is enough evidence to indicate that this can be a helpful treatment option.

Family therapy is a talking therapy that involves the whole family. There are different types of family therapy and family therapy is used as a treatment for a range of different mental health conditions. The type of family therapy your professional suggests will depend on how old you are and your specific difficulties. For moderate to severe depression family therapy usually takes place over about 3 months.  

Family focused treatment for childhood depression (FFTCD) 

If youre 5-11 years old, your professional will probably suggest family focused treatment for childhood depression (FFTCD). This treatment takes place over 12-16 sessions and will usually start with your therapist seeing you for one session and then a session with your parent or carer on their own. After these individual sessions, your next sessions will be together with your parent or carer 

FFTCD includes help with understanding depression, getting used to talking together as a family about problems, learning about how what we do affects how we feel and problem solving 

Sessions usually involve 

  1. your therapist meeting briefly with you to talk about your symptoms 
  2. your parent or carer joining the session to talk about any recent important events  
  3. your therapist presenting a new concept or skill and helping you to use the concept or skill within your family relationships  
  4. your therapist guiding you and your parent or carer to practice and apply what they’ve learned through role plays, games, discussions, and problem-solving exercises 
  5. your therapist setting you ‘homework’ to practice these skills at home and encouraging you to see how these skills work in your everyday life 


Systemic family therapy 

Systemic family therapy is based on the idea that families are a system where the actions of one person or what happens to one person can affect how the other people in the family feel and behave. It will also try to help with problems that can happen when family members get stuck in ways of communicating or behaving towards each other that are unhelpful.  

Together, families can come up with solutions or ways of solving problems by changing the way they communicate or behave towards each other. Family therapists will aim to build on your family’s existing strengths without taking sides, blaming anyone, or providing simple one size fits all’ answers. They will help your family members to talk to each other about their worries, feelings and experiences and find solutions that work for them. Systemic family therapy doesnt usually follow a set programme. Sessions tend to be about 60 minutes each week, but this can change if a different way of working would suit you and your family better.  

All family therapists will adapt their ways of working according to your age, needs and preferences. Sessions involving younger children, for example, often include play and drawing. Some people may wish to talk together from the start of therapy sessions, while others may prefer some individual time with their family therapist before deciding whether to share their thoughts and feelings with others and how best to do that. Your family therapist will discuss with you how you would like to work together. 

Some family therapists work individually. Others work in pairs or with a team of colleaguesSometimes these colleagues sit behind a one-way mirror or screen to watch your therapist and family talk together and then share their thoughts and ideas with the family therapist and familyMany families say they find this ’team’ approach to complex difficulties very helpful. 

Treatments outlined on these webpages may not be available in every local area. It’s important that you discuss with your GP or mental health professional the treatment options available to you. You can also search for services near you on our Youth Wellbeing Directory and find out more about referral processes here.

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