Mental health challenges among children and teens are on the rise, with anxiety, depression, and behavioral issues becoming more prevalent in recent years. While these issues can be treated in a variety of ways, marriage and family therapists (MFTs) bring a unique perspective: they see the family not as a background element but as a central factor in a young person’s mental and emotional health. MFTs approach therapy systemically, addressing not just the individual but the relationships and dynamics that surround them. This approach has profound implications for treating children and adolescents.
Children and adolescents are deeply influenced by the dynamics of their family systems. When emotional, behavioral, or relational problems emerge in young people, they are rarely isolated to the individual. This is where MFTs play a critical role. Unlike therapists who focus solely on the individual, MFTs are trained to assess and treat psychological concerns within the broader context of family relationships, offering unique and effective support for children and teens.
This article explores the critical role of marriage and family therapists in supporting children and teens. We will cover the challenges youth face today, how MFTs address these challenges, the therapeutic models they use, and evidence of their effectiveness. We also delve into case examples and collaborative strategies with parents, schools, and communities.
The Unique Role of Marriage and Family Therapists
Marriage and family therapists are trained mental health professionals who specialize in treating emotional, behavioral, and relational problems within the context of family systems. Unlike therapists who focus solely on the individual, MFTs assess how familial relationships and communication patterns contribute to psychological symptoms.
For children and teens, MFTs may work one-on-one, with the entire family, or in combinations (e.g., child and parent, siblings, or caregiver dyads). They create a supportive, structured environment to help young clients express themselves, build coping skills, and improve their relationships.
See Also The Complete Guide to Marriage and Family Therapy: What It Is, How It Works, and Who It Helps
Training and Qualifications: Specialized Training for Youth Issues
MFTs typically hold a master’s or doctoral degree in marriage and family therapy or a closely related field. Their education includes specialized coursework in child and adolescent development, systemic theory, trauma, and evidence-based practices. In most jurisdictions, MFTs are licensed clinicians who complete rigorous clinical training, including supervised practice.
Many MFTs undergo specialized training in child and adolescent development, trauma, play therapy, expressive arts, and behavioral interventions. They are also educated in attachment theory, neurodevelopmental models, and evidence-based practices for youth mental health.
Common Issues in Children and Teens Addressed by MFTs
MFTs frequently address a wide range of issues in children and teens, including behavioral problems, emotional difficulties like anxiety and depression, and the impact of trauma or challenging life events. MFTs also focus on family dynamics, communication, and conflict resolution within the family system. Children and adolescents present with a wide range of concerns. MFTs are equipped to work with youth experiencing the following issues.
Family Conflict and Divorce
Divorce, separation, and high-conflict relationships between parents can significantly impact a child’s emotional well-being. MFTs help children cope with these transitions while guiding parents in managing conflict, maintaining consistency, and supporting the child’s adjustment.
Parental separation or high-conflict households can destabilize a child’s emotional world. MFTs help children navigate these changes while working with parents to co-parent more effectively. They often provide a safe space for children to express feelings of guilt, confusion, anger, or sadness related to family disruptions.
Divorce and family conflict are among the most stressful events a child can experience. The emotional upheaval that accompanies the restructuring of the family unit can lead to confusion, anxiety, sadness, and behavioral changes. Marriage and Family Therapists play a crucial role in supporting children through these transitions, helping them process their emotions, develop coping strategies, and maintain a sense of security and stability.
Understanding the Impact of Divorce on Children
Children often experience divorce differently than adults. Their cognitive and emotional development stages influence how they perceive and react to family conflict. Young children may struggle with feelings of abandonment or believe they are to blame, while adolescents might internalize their distress or express it through rebellion or withdrawal (Amato, 2000).
Research has shown that children of divorced parents are at higher risk for a variety of psychological issues, including depression, anxiety, academic problems, and difficulties in forming future relationships (Lansford, 2009). However, these risks can be mitigated when children have access to therapeutic support during and after a divorce.
Goals of Therapy for Children in Family Conflict
Therapists work with children of divorcing or conflicted families with several key goals in mind:
Emotional Expression and Validation
Children may not have the vocabulary or maturity to articulate complex emotions. Therapists use age-appropriate methods like play therapy, drawing, or storytelling to help them express their feelings in a safe, supportive environment.
Clarifying Misunderstandings
It’s common for children to misconstrue the causes of divorce, often blaming themselves. Therapists help correct these misconceptions, providing reassurance and age-appropriate explanations of the situation.
Coping Skills Development
Therapy equips children with tools to manage stress, anxiety, and change. Techniques might include mindfulness, journaling, or identifying supportive adults and activities that provide comfort.
Improving Communication
Children in conflicted families often feel caught in the middle. Therapists teach them how to communicate their needs and feelings to parents without fear of judgment or reprisal.
Strengthening Resilience
By focusing on a child’s strengths and sources of support, therapists foster resilience—the ability to adapt positively despite adversity.
Common Therapeutic Approaches
Play Therapy
Especially effective with younger children, play therapy allows therapists to observe and interpret children’s thoughts and emotions through their play. This non-threatening approach helps children communicate indirectly, which is often easier than verbal expression for early developmental stages (Landreth, 2012).
Cognitive Behavioral Therapy (CBT)
CBT helps children recognize and reframe negative thought patterns that arise from family conflict or divorce. For instance, a child who believes, “It’s my fault Mom and Dad are fighting,” can learn to identify this thought as inaccurate and replace it with a more realistic interpretation (Friedberg & McClure, 2002).
Family Therapy as an Intervention
In some cases, therapists involve parents or other family members in the child’s therapy sessions. This approach can improve co-parenting communication, reduce conflict, and promote consistency in parenting strategies—all of which benefit the child’s adjustment (Lebow et al., 2012).
Narrative Therapy
Narrative therapy helps children re-author their life stories in empowering ways. A child may be guided to see themselves not as a victim of divorce, but as someone who has navigated a tough experience and come out stronger (White & Epston, 1990).
Trauma-Informed Therapy
When family conflict involves abuse or high-conflict divorce, therapists may use trauma-informed approaches such as Eye Movement Desensitization and Reprocessing (EMDR) or Trauma-Focused CBT. These help children process traumatic memories and reduce symptoms of PTSD (Cohen, Mannarino, & Deblinger, 2017).
Supporting Children Through the Stages of Divorce
Before the divorce, therapists can prepare children for impending separation by:
- Helping parents find age-appropriate ways to disclose the news.
- Creating a safe space for children to express fears and questions.
- Teaching families how to co-parent respectfully to minimize conflict.
During the divorce, therapists can prepare children for impending separation by:
- This stage often involves logistical changes like moving homes or custody arrangements.
- Support children in adapting to new routines.
- Help them manage loyalty conflicts between parents.
- Monitor for signs of emotional or behavioral distress.
After the divorce, therapists can prepare children for impending separation by:
- Post-divorce, therapy focuses on long-term adjustment
- Processing lingering emotions like grief or anger.
- Encouraging stable relationships with both parents (when safe).
- Supporting developmental tasks like school performance and peer relationships.
See also Helping Kids Cope with Divorce: What MFTs Want Parents to Know
The Role of Parents in the Therapeutic Process
While therapy centers on the child, parental involvement is key to successful outcomes. Therapists often work with parents to:
- Encourage healthy communication and reduce conflict in the home.
- Provide consistent routines and discipline across households.
- Avoid behaviors like “parental alienation” or using the child as a messenger or spy.
When both parents support the therapeutic process, children are more likely to feel secure and recover more quickly from the stress of divorce.
When to Seek Help
Parents should consider therapy for their child if they observe:
- Withdrawal from friends or activities.
- Sleep disturbances or nightmares.
- Academic problems.
- Aggression or defiance.
- Physical symptoms like headaches or stomachaches with no medical cause.
- Expressions of hopelessness or thoughts of self-harm.
Early intervention can prevent more serious emotional problems from developing later.
Behavioral Disorders
Issues such as oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and conduct disorders often present in school or at home. MFTs work not just with the child but with the entire family to identify relational patterns that reinforce these behaviors and create plans to modify them.
Externalizing behaviors such as aggression, defiance, and hyperactivity can strain family relationships. MFTs assess the relational context in which behaviors occur and collaborate with families to modify patterns that reinforce the issues.
Emotional and Mood Disorders
MFTs treat depression, anxiety, panic disorders, and mood dysregulation in young people. They consider both the internal world of the child and the external dynamics of their environment, including parenting style, attachment, and family stressors.
MFTs work with individuals, families, and even groups to improve communication, strengthen relationships, and develop healthy coping mechanisms. MFTs also collaborate with schools and other professionals to provide comprehensive support for young people.
Trauma and Abuse
Children and adolescents who have experienced trauma benefit from relational healing. MFTs incorporate trauma-informed care, helping both the child and family members understand and recover from adverse experiences, such as abuse, neglect, or community violence. MFTs help the child process the trauma while involving safe caregivers in healing the attachment bond and restoring security.
See also Adolescent Anxiety and Depression: Role of the Family Therapist
Grief and Loss
Children and teens facing the loss of a loved one, pet, or family stability (e.g., due to incarceration or military deployment) often struggle with grief. MFTs support healthy grieving processes and maintain open, developmentally appropriate communication within families.
Academic and Social Challenges
School refusal, bullying, poor academic performance, and peer relationship difficulties can reflect emotional distress. MFTs collaborate with families and schools to address these problems holistically.
Identity and Developmental Concerns
As children grow, they grapple with questions about their identity, including cultural identity, sexual orientation, and gender identity. MFTs support affirming environments and help families navigate these transitions with sensitivity and respect.
Neurodevelopmental Disorders
Children with autism spectrum disorder (ASD), sensory processing disorders, or learning disabilities often require family-centered approaches. MFTs help families adapt their routines and expectations to better support these children.
Key Theoretical Models Used by MFTs with Youth
Structural Family Therapy
Developed by Salvador Minuchin, this approach views family problems as rooted in the structure of relationships. MFTs identify enmeshed or disengaged relationships and work to restructure boundaries and hierarchies to promote healthier functioning.
This model views family issues through the lens of structure, hierarchy, and roles. MFTs using this approach help reorganize family subsystems (e.g., parent-child relationships) to improve boundaries and authority, especially helpful with behaviorally challenging children.
Bowen Family Systems Theory
Murray Bowen emphasized multigenerational patterns and emotional functioning. MFTs use genograms and emotional process techniques to help family members increase differentiation and reduce anxiety-driven reactivity.
MFTs trained in Bowen theory focus on multigenerational patterns and emotional reactivity. They aim to increase differentiation of self in family members and reduce anxiety-driven patterns that affect child development.
Attachment-Based Family Therapy (ABFT)
This model focuses on rebuilding trust between adolescents and caregivers, particularly in cases of depression or suicide risk. ABFT aims to create secure attachments through emotionally focused dialogues.
Attachment theory underpins much of child-focused family therapy. MFTs help strengthen secure attachments between children and caregivers, essential for emotional regulation, resilience, and social functioning.
Narrative Therapy
Narrative therapists help children and families re-author the stories they tell about themselves, shifting from problem-saturated narratives to those of resilience, growth, and capability.
Children often respond well to narrative approaches, which allow them to externalize problems and re-author their stories. MFTs help youth view themselves as capable and resourceful, rather than as defined by a diagnosis or behavior.
Emotionally Focused Family Therapy (EFFT)
EFFT focuses on improving emotional communication within families, helping children and parents develop secure bonds and more attuned responses to each other’s needs.
Though originally developed for couples, EFT has been adapted for families. It helps create secure emotional bonds between parents and children, especially in families with high emotional disconnection or conflict.
Play Therapy and Creative Techniques
MFTs use play, art, storytelling, and sandtray therapy to engage children, who often express thoughts and feelings more easily through creative mediums than through verbal communication.
Play and expressive arts therapies, often incorporated by Marriage and Family Therapists (MFTs), provide children and teens with non-verbal ways to process emotions, communicate, and develop coping skills. These therapies utilize creative arts like play, art, music, movement, and drama to help young people express and understand challenging experiences. MFTs trained in these modalities can help children and teens address a range of issues, including trauma, anxiety, depression, and social-emotional development.
See also Using Play Therapy in Family Counseling for Younger Children
Therapeutic Techniques and Interventions
Family Sessions
Including all family members in sessions allows the Marriage and Family Therapist to observe dynamics firsthand. Through guided interactions, they facilitate empathy, role clarification, and problem-solving.
A cornerstone of MFT practice with children and teens is systemic engagement. Rather than treating the child as the “identified patient,” MFTs include parents, siblings, and other caregivers to create a more supportive and sustainable change.
Individual Sessions with Children
Marriage and Family Therapists provide children a safe, supportive space to explore their feelings and experiences. Techniques often include games, therapeutic stories, and art.
Sometimes parents and children benefit from having separate sessions before or alongside family therapy. This approach allows for individualized processing while maintaining a focus on relational goals.
Parent Training and Coaching
Marriage and Family Therapists coach parents on effective strategies for discipline, communication, and emotional responsiveness. They may introduce routines, charts, or conflict-resolution scripts.
Marriage and Family Therapists provide parents with tools for effective communication, consistent discipline, and emotional attunement. They help parents understand their own emotional triggers and how these influence parenting styles.
Psychoeducation
Families learn about child development, mental health diagnoses, and how their actions impact their child’s well-being. This knowledge empowers families to make positive changes.
Collaboration with Schools and Communities
School Interventions
Marriage and Family Therapists often liaise with school counselors, psychologists, and teachers. They may help develop behavior intervention plans (BIPs), Individualized Education Programs (IEPs), or classroom accommodations.
Community Referrals
When appropriate, Marriage and Family Therapists refer families to additional services such as speech therapy, occupational therapy, pediatric care, or legal assistance.
Multidisciplinary Teamwork
In cases involving child protective services, juvenile justice, or hospitalization, Marriage and Family Therapists work as part of a broader care team, ensuring continuity and coordination of care.
Cultural Competency in Family Therapy
Effective Marriage and Family Therapists are culturally sensitive and trauma-informed. They recognize how race, ethnicity, gender identity, immigration status, religion, and socioeconomic status shape a child’s development and a family’s coping mechanisms. Marriage and Family Therapists seek to affirm diverse identities and challenge harmful generational cycles or systemic oppression that may impact family life.
Effectiveness of Marriage and Family Therapy
Research evidence and multiple studies support the efficacy of MFT for treating children and adolescents:
- Multisystemic Therapy (MST) has demonstrated success in reducing criminal behavior and improving school attendance among youth (Henggeler et al., 2009).
- Functional Family Therapy (FFT) shows positive outcomes for adolescents with conduct problems and substance abuse (Alexander & Parsons, 1982).
- Attachment-Based Family Therapy (ABFT) is effective for treating depressed and suicidal adolescents (Diamond et al., 2016).
- Family-based approaches have also shown effectiveness in treating eating disorders (Lock & Le Grange, 2013).
Comparative Advantage
Compared to individual therapy, family therapy often yields faster results and longer-lasting improvements, especially when problems are relationally rooted. Children treated within a family context are more likely to maintain gains, improve communication, and strengthen emotional resilience.
Case Examples
Case 1: Rebuilding After Divorce
A 9-year-old girl struggled with separation anxiety and regressive behaviors after her parents’ divorce. The Marriage and Family Therapist worked with both parents to create consistent routines and communicate with less hostility. Through family play sessions, the child expressed her fears, and the parents learned to co-parent with empathy. Symptoms reduced significantly after 10 sessions.
Case 2: Teen Depression and Disconnection
A 15-year-old boy was withdrawn, irritable, and failing classes. The Marriage and Family Therapist identified a breakdown in communication between him and his parents, partly due to unrealistic academic expectations. Using emotionally focused techniques, the therapist facilitated dialogues that increased mutual understanding. The boy began to re-engage at school and express himself more openly.
Case 3: Trauma Recovery in a Foster Placement
A 12-year-old girl in foster care exhibited nightmares and aggression. The MFT worked with the foster parents to create a trauma-informed, consistent environment. Using narrative therapy and art, the girl gradually shared her story. Over time, trust developed, behaviors improved, and the foster placement stabilized.
Conclusion
Marriage and fmily therapists provide essential, transformative support for children and teens. By focusing on relationships and systemic patterns, they uncover the root causes of emotional and behavioral issues, rather than merely treating symptoms. Their work not only alleviates distress in young people but strengthens families, schools, and communities.
As awareness grows about the benefits of family therapy, MFTs are poised to play an even greater role in supporting the next generation’s mental health. Their expertise in fostering secure attachments, healthy communication, and resilient coping strategies makes them invaluable allies in the lives of children and adolescents.
Dr. Randi Fredricks, Ph.D.
Author Bio
Dr. Randi Fredricks is a leading expert in the field of mental health counseling and psychotherapy, with over three decades of experience in both research and practice. She holds a PhD from The Institute of Transpersonal Psychology and has published ground-breaking research on communication, mental health, and complementary and alternative medicine. Dr. Fredricks is a best-selling author of books on the treatment of mental health conditions with complementary and alternative medicine. Her work has been featured in leading academic journals and is recognized worldwide. She currently is actively involved in developing innovative solutions for treating mental health. To learn more about Dr. Fredricks’ work, visit her website: https://drrandifredricks.com
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