For clinicians · Family therapy guide
Family therapy — a clinician's guide to systemic family work
Family therapy treats the family as the unit of change. This guide covers the major systemic models — Bowenian, structural, strategic, experiential — and the printable family therapy worksheets clinicians use for assessment (genograms, roles, rules) and intervention (boundaries, communication, rituals, repair).
Major systemic models
Bowenian (Murray Bowen)
Differentiation of self, triangulation, multigenerational transmission, emotional cutoff, family projection process. Long view — three generations, patterns repeating.
Structural (Salvador Minuchin)
Subsystems, boundaries (rigid, clear, diffuse), hierarchy, alignments, enactments. Maps the family structure and uses in-session moves to shift it.
Strategic (Jay Haley, Cloé Madanes)
Directive, problem-focused, brief. Reframes, paradoxical prescriptions, ordeal therapy. Assumes symptoms serve a function in the system.
Experiential (Virginia Satir, Carl Whitaker)
Growth-oriented, emotion-focused. Family sculpting, communication stances (placater, blamer, computer, distracter, leveler), congruence.
Narrative (Michael White, David Epston)
Externalizes the problem, uncovers unique outcomes, re-authors the family story. 'The person is not the problem — the problem is the problem.'
Core family therapy worksheets
Three-generation family map with relationships, cutoffs, alliances, triangulations, deaths, illnesses, and repeating patterns.
Open worksheet →Identify the roles each member carries — hero, scapegoat, mascot, lost child, caretaker — and where they came from.
Open worksheet →Surface the spoken and unspoken rules — what gets talked about, what doesn't, who gets to feel what.
Open worksheet →Map rigid, clear, and diffuse boundaries across subsystems — parental, sibling, extended family.
Open worksheet →Track the family's communication cycle — who speaks, who's silenced, where it breaks down.
Open worksheet →Structured protocol for repairing a specific recurring conflict — issue, positions, underlying needs, agreement.
Open worksheet →A weekly family meeting template — check-in, appreciations, logistics, one repair, one shared decision.
Open worksheet →Rupture, impact, ownership, repair action, prevention — the family version of the anatomy of an apology.
Open worksheet →Screen for enmeshment vs disengagement across subsystems — the structural family therapy diagnostic.
Open worksheet →Bowenian cutoff work — costs, protective function, first move toward re-engagement without merger.
Open worksheet →Frequently asked questions
- What is family therapy?
- Family therapy is a systemic approach that treats the family — not the individual — as the unit of change. Symptoms are understood as a function of family patterns: alignments, boundaries, roles, communication rules, and multigenerational legacies. Major models include Bowenian (Murray Bowen), structural (Salvador Minuchin), strategic (Jay Haley), experiential (Virginia Satir), and narrative (Michael White).
- What is a genogram?
- A genogram is a multigenerational family map — usually three generations — showing relationships, cutoffs, alliances, triangulations, deaths, illnesses, substance use, and repeating patterns. It's the foundational assessment tool in Bowenian and most systemic work.
- What are structural family therapy's core concepts?
- Minuchin's structural model works with subsystems (parental, sibling, marital), boundaries (rigid, clear, diffuse), hierarchy, alignments, and coalitions. The therapist maps the family structure, identifies the enactments that maintain the presenting problem, and uses in-session moves to shift the structure.
- How does family therapy handle the identified patient?
- Systemic therapies reframe the identified patient — the family member 'holding' the symptom — as the entry point rather than the problem. The symptom often serves a function in the family system (stabilizing a conflicted couple, distracting from a loss, maintaining a role). Treatment addresses the system, not just the symptomatic member.
- Are your family therapy worksheets aligned with major systemic models?
- Yes. Our family worksheets draw from Bowenian, structural, strategic, and experiential traditions — genograms, family roles, boundaries, communication cycles, rituals, secrets, and repair. See the family therapy library at /resources/family-therapy.
The full family therapy worksheet library
Genograms, roles, rules, boundaries, communication, rituals, secrets, repair, blended and adoptive family work, life-cycle transitions — printable worksheets for the full systemic toolkit.
Related guides
Continue with another modality — same clinician-facing format.
Beck's cognitive model, thought records, behavioral activation, exposure.
The four modules — mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness.
Managers, firefighters, exiles, and Self-energy — the internal family systems model.
IFS, Ego State Therapy, Voice Dialogue, Schema Modes — a model-agnostic protocol.
Polyvagal-informed practice, window of tolerance, bottom-up stabilization.