16 Jan Integrating Family Systems and Cognitive Behavioral Treatment Models
Ever-changing challenges in this modern era, such as post-pandemic reintegration into work and school and the battle over technology, place many more challenges on families. The American Association for Marriage and Family Therapy (AAMFT) reports that the need for family therapy continues to rise, with a 50-fold increase in family therapists since 1970. This growth is reflective of the improved public awareness of the value of therapy and the quality of family life. There is concern about the increased need for support due to the stress on families.
This concern calls on psychologists to explore how best to meet the needs of their clients and families. Cognitive behavioral family therapy (CBFT) is one treatment modality gaining attention for efficacy in integrating family systems and CBT. Similar to Cognitive Behavioral Therapy, CBFT focuses on assisting clients with changing irrational beliefs to help invoke changes in mood and behavior. With CBFT, however, the assumption exists that there is a mutual influence between family members related to cognitions, behaviors, and emotions. CBFT demonstrates promising alternatives in treatment, integrating and applying behavioral and cognitive components to family systems. CBFT is versatile and can promote progress in various individual treatment needs and alter family interaction patterns.
CBFT provides the fundamental principles and techniques in empirically supported interventions and programs. The utilization of CBFT in the population of very young children in need of behavioral health interventions demonstrates considerable promise. Very young children cannot developmentally implement techniques to manage symptoms; the interventions rely on the parents. A 2017 Journal of Affective Disorders study examined the efficacy of CBFT compared to Parent Training (PT). Results demonstrated that the introduction of CBFT was superior to the PT condition in reducing externalizing problems in the participants.
Like CBFT, Child- and family-focused cognitive-behavioral therapy (CFF-CBT) is an intensive family-based treatment model. CFF-CBT is a manual-based intervention consisting of 12 sessions for youth aged seven to thirteen diagnosed with Bipolar Disorder. This approach directs services both for the youth and their family. Traditional CBT techniques are combined with psychoeducation, mindfulness, and positive psychology. This model aims to treat not only the symptomatology of Bipolar but the psychosocial impairments accompanying the disorder.
Research conducted in 2022 on the psychosocial functioning of individuals with Bipolar Disorder concluded that treatment for Bipolar should include family strategies with interventions geared around enhancing social support, resilience, and psychoeducation. The researchers made these conclusions based on evidence that individuals with Bipolar had significant family and psychosocial dysfunction, reduced social support and resilience, and a higher level of suicidal ideation than people without this diagnosis. Such evidence supports the continued need to develop family-focused treatment modalities for young people.
A 2014 study reported in the Journal of the American Academy of Child & Adolescent Psychiatry on the efficacy of CFF-CBT compared to traditional psychotherapy for mood symptom severity and global functioning in children diagnosed with Bipolar Disorder. The study concluded that families participating in a CFF-CBT model were more engaged, evidenced by more consistent attendance, and less likely to drop out of services. Families also reported greater satisfaction with treatment. The researchers reported some limitations related to posttreatment global functioning. However, they reported evidence of the model’s efficacy in reducing acute mood symptoms and improving long-term psychosocial functioning.
CBFT and CFF-CBT offer promising results in treating psychiatric disorders in young people and address the need for the inclusion of the family system in treatment interventions. Considerable work remains in the development and research of family-focused models of care.