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Harvard Commentaries
35320
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Couples, Family And Group Therapy


March 05, 2010

Depression
8596
What Kind Of Treatment Is Available?
Couples, Family And Group Therapy
Couples, Family And Group Therapy
htmGroupTherapy
Your depression may have roots in the way you interact with family members, in an intimate relationship, or with friends or co-workers. Therapy is available to take direct aim at the problem.
363092
InteliHealth
2010-03-05
t
InteliHealth/Harvard Medical Content
2012-03-05

Reviewed by the Faculty of Harvard Medical School

Couples, Family And Group Therapy
Your depression may be caused or aggravated by your relationships with family members, intimates, friends or co-workers. Therapy is available to take direct aim at the problem.
 
Just like individual therapists, couples, family and group therapists use a variety of theories and different methods. Often, flexible use of a combination of methods is best. Regardless of the approach used, a therapist may do one or more of the following:
  • Teach you about general human interactions (sometimes called psychoeducation)
  • Help you understand how you developed your interpersonal style
  • Help you recognize what you are thinking when you face conflict in a relationship
  • Help you appreciate another person's point of view
  • Facilitate clearer, more direct communication
  • Encourage behavior change that will lead to more satisfying or productive relationships
Couples, family or group therapy can be combined with individual psychotherapy, drug treatment or both.
 
Couples Therapy
 
Many people are unhappy in their primary relationship. Depression can be one cause of relationship problems, and relationship problems can cause depression, creating a cycle that can be difficult to break. If one or both members of a couple are depressed, each partner's depression may require treatment. However, focusing on the relationship can be an important part of feeling better.
 
Conflict occurs in any intimate relationship. Couples therapy teaches people how to manage that distress. Learning about your partner’s viewpoint can help you to avoid blaming. Insight into both the other person’s desires and motivations goes hand in hand with achieving goals as a couple.
 
Every relationship involves negotiation. Thus a couples therapist may teach you how to compromise and make trade offs, which may include taking more responsibility for your feelings and actions.
 
Some therapists give homework. They may focus primarily on helping you change your behavior.
 
Although working things out may be an explicit goal of couples therapy, partners may ultimately decide to dissolve the relationship. In such cases, a therapist can help the two negotiate their separation, especially if residual hostility makes it more difficult to settle any disputes.

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Family Therapy
 
Beyond biology and inheritance, your family has great influence on your temperament and your vulnerability to depression. Treatments that take your family into account can be help address depression. Particularly if you still live with family members, you may find it helpful to look closely at the way family interactions affect you.
 
In family therapy, two or more family members meet with a therapist to understand problems in how the family functions (rather than discussing the problems of one individual in the family).
 
As with all forms of psychotherapy, a variety of approaches can be used. The approaches used in family therapy are similar to those used in couples therapy.

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Group Therapy
 
Group therapy provides a peer group and a therapist who acts as the leader. As relationships in the group develop, you have a chance to learn how you interact with people. Are you competitive with other group members? Are you easily hurt by others? Do you have trouble with the authority represented by the group leader? These questions can become a topic for group discussion. This process is not easy, but the experience begins to feel safer as group members get to know one another. By getting this sort of feedback, you learn new skills, correct misimpressions and misunderstandings on the spot, and get support for making important changes.
 
Some groups, such as self-help groups, rely more on mutual support. For example, members may talk about common experiences to decrease their feelings of isolation. There may be a group leader, or the group may be organized and led by peers. The goal may be to provide information about depression, its causes and its treatment.
 
The group may provide a way for members to trade information about resources in the local community. For example, the Depression and Bipolar Support Alliance is devoted to providing information about mood disorders. It has numerous local chapters and sponsors more than 800 peer support groups.
 
Note: If you are interesting in joining group therapy but want to ensure that the leader is certified, contact the American Group Psychotherapy Association.

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