This paper examines and compares four major therapeutic models: psychoanalytic family therapy, experiential family therapy, cognitive behavioral therapy (CBT), and strategic family therapy. Each approach is defined, its core techniques and goals outlined, and its relative focus on the individual versus the family system explored. The paper then compares the models across key dimensions — historical versus present focus, active versus verbal techniques, and individual versus family orientation. Finally, it considers how these therapy models can be applied to address poverty and intergenerational trauma, arguing that family-based therapies offer a broader lens for identifying and resolving deep-rooted pathogenic patterns.
Psychoanalytic therapy is an in-depth conversational therapy whose objective is to bring deep and unconscious feelings and thoughts into a person's conscious mind (Altman, 2012, pp. 39–86). The aim is to ensure that repressed emotions and experiences — often associated with childhood — are highlighted and evaluated. The client, alongside their therapist, works to understand how early repressed memories affect the client's behavior, relationships, and thinking in adulthood (Psychology Today, 2019, p. 1).
Psychoanalytic family therapy is founded on the reasoning that any group of people who consider themselves a family, in any culture, has some level of interdependence existing between the individual units that make up that family. This is based on the generational hierarchy and role distribution within that hierarchy (Gale, 2005, p. 1). The family also has a degree of subjective interdependence within it. The motivation behind the introduction of psychoanalytic family therapy was the difficulties therapists encountered when treating certain patients. Therapists became interested in the families from which these individuals came. The families were considered pathogenic. The therapist examined the mental patient and the family as a unit and highlighted their specific functioning modes (Gale, 2005, p. 1).
Experiential family therapy was defined by Kempler (1965) as the psychotherapeutic method of treating emotionally disturbed patients within the family context (Kempler, 1965, p. 57). Experiential therapy is concerned with exploring the how and what of "thou and I" in the here and now. The fundamental concept of this approach is accepting the crucial relevance of the present, the immediate, and the whole — not as an excluding perspective, but as the central point from which all perspectives are readily related (Kempler, 1965, p. 57).
The family context in therapy has been explicitly and implicitly identified as an important component of treatment, just as the broader context of a client's economic, social, national, and ethnic status is significant. Many therapists previously assumed that therapeutic treatment could only continue beneficially if the patient temporarily separated themselves from their familial environment during therapeutic interviews (Kempler, 1965, p. 57). Individual therapy has always had subjective advantages, but in many cases these advantages are exceeded in importance by the benefits that come from an approach that unites the therapist with the family. Therapy sessions are often artificial in atmosphere and arrangement; an individual therapy session grants the patient a sense of importance, accentuated through the therapist's undivided attention (Kempler, 1965, p. 57). The client is removed, for a moment, from the everyday counteractions and ordinary routines of daily life.
According to Tuttle (1998), experiential therapy is a form of therapy that uses intuitive methods employing multisensory and active techniques (Tuttle, 1998, p. 167). These techniques may include drawings, role playing, guided imagery, props, and other active experiences. They help surface new information (Tuttle, 1998, p. 167). The increase of new information stimulates growth and change within the family system. These techniques are especially useful when more verbal and tradition-based communication is assessed as ineffective (Tuttle, 1998, p. 167).
Kingdon and Mander (2015) define CBT (cognitive behavioral therapy) as a type of psychotherapy focused on the here and now (Kingdon & Mander, 2015, pp. 30–32). It is founded on assumed interactions between a patient's cognitions, emotions, and behaviors — encompassing mental events such as images, memories, and thoughts. The objective of CBT is to encourage change by helping individuals understand and then alter the way they think and behave, thereby leading to indirect changes in their feelings (Kingdon & Mander, 2015, pp. 30–32).
The NHS (2017) defines CBT as a talking therapy that may assist patients in managing their problems by changing their behavior and thinking. CBT is commonly used in the treatment of depression and anxiety, although it can be used for a range of physical and mental health conditions as well (NHS, 2017, p. 1). CBT is founded on the understanding that a person's feelings, thoughts, actions, and physical sensations are interconnected, and that negative feelings and thoughts are likely to trap the patient in a vicious cycle (NHS, 2017, p. 1). The objective of CBT is to assist the patient in handling overwhelming problems in a more positive manner by breaking them down into small, manageable parts (NHS, 2017, p. 1).
The therapist trains the patient on how to change negative patterns in order to improve how they feel. Unlike other talking therapies such as psychoanalytic family therapy and experiential family therapy, CBT is concerned with current problems rather than issues linked to the past (NHS, 2017, p. 1). CBT seeks practical avenues for enhancing the patient's state of mind each day. It is applicable in the treatment of various mental health conditions, including anxiety disorders and depression, and also helps people who have panic disorder, phobias, PTSD, OCD (obsessive-compulsive disorder), sleeping problems, alcohol misuse, and eating disorders such as bulimia and anorexia (NHS, 2017, p. 1).
"Brief, problem-solving family hierarchy model"
"Similarities and differences across all four models"
"Using therapies to address generational poverty and trauma"
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