What is the difference between family therapy and individual therapy?

Individual therapy assumes the difficulty sits inside the person, in their thoughts, history and meaning-making, and works to change something there. Family and systemic therapy assumes the difficulty sits between people, in patterns of interaction, and works to change the pattern. They answer different questions rather than one being more sophisticated.

How do I know if a case needs family therapy?

Common signs include a child who is fine at school and falls apart at home, progress in the room that does not survive the week, the referred person not being the person who needs to change, each family member giving a different but internally coherent account, and the same difficulty appearing in the previous generation.

When is individual therapy the better choice?

When the person needs space that is genuinely their own, when family violence or coercive control would make conjoint sessions unsafe, when trauma processing needs to happen without an audience, when an adult's family are not part of the picture, or when confidentiality would be compromised without consent.

Systemic practice

Family therapy vs individual therapy: how to know which one a case needs

Q: Can you work systemically with only one client?

Yes. You do not need the family in the room to think systemically. A single client carries their family with them, and circular questions or a genogram will bring that family into the session in the client's own words.

By the AkindaCo education team · Adelaide, South Australia

The honest answer is that this is rarely a choice between two treatments. It is a choice about where you locate the difficulty, and that decision shapes everything that follows.

The core difference

Individual therapy works on the assumption that the difficulty sits inside the person in front of you, in their thoughts, their history, their nervous system, their meaning-making. The work is to change something there.

Family and systemic therapy works on the assumption that the difficulty sits between people, in patterns of interaction, in what each person does in response to what the other did. The work is to change the pattern.

Neither is more sophisticated than the other. They are answering different questions.

What actually changes in the room

Who attends. Family therapy may involve parents, siblings, grandparents, sometimes the school or a caseworker. Individual therapy is one person.
What counts as data. Systemically, what happens between two people in front of you is the most useful information in the session. That interaction is the thing being worked on, live.
Who is the client. In systemic work, the relationship is the client. Nobody is the patient.
What a good outcome looks like. Individually, the person feels or copes differently. Systemically, the pattern shifts, and often several people feel differently as a result.

Signs a case needs a systemic lens

These are the ones practitioners describe most often when they arrive at our training:

The child is fine at school and falls apart the moment they get home, or the reverse.
You are making progress in the room and none of it survives the week.
The referred person is not the person who seems to need to change.
One parent engages and the other will not, and you have started to think of that parent as the obstacle.
Everyone in the family gives you a different account and each one is internally coherent.
The same difficulty appears in the previous generation, and nobody has named that out loud.
The professional network around the family is in conflict, and the conflict mirrors the family's.
You have been patient, thorough and kind, and nothing shifts.

That last one is worth sitting with. It usually does not mean you are failing the family. It usually means you are working with one person in a system that has other ideas.

Signs individual work is the right call

The person wants space that is genuinely their own, away from the family, and that need is itself clinically important.
There is family violence or coercive control, and conjoint sessions would be unsafe.
The work is on trauma processing that the person needs to do without an audience.
The person is an adult whose family are not part of the picture and do not want to be.
Confidentiality would be compromised in a way the person has not consented to.

The false choice

Most experienced practitioners end up doing both, often within the same case. Individual sessions with a young person alongside parent sessions. Conjoint work that pauses for a few individual sessions when something needs private space. A systemic formulation guiding work that is delivered one-to-one.

You do not need the family in the room to think systemically. A single client sitting in front of you carries their family with them, and circular questions or a genogram will bring that family into the session in the client's own words.

This is the shift that our family therapy training in Adelaide is built around. Not swapping your modality, but adding a lens you can apply to the caseload you already have.

What about the evidence?

Be careful here, in both directions. Systemic and family approaches have a substantial evidence base across child and adolescent difficulties, and a great deal of it is specific to particular presentations rather than general. If you need to justify a systemic approach for funding or in a report, cite the literature for that presentation rather than the general claim that family therapy works.

Our own team publishes in this space. You can read summaries in published research and conference presentations.

Where to learn systemic practice

AkindaCo runs Family Therapy Foundations, a two-day PACFA-endorsed intensive in North Adelaide for counsellors, psychologists, social workers, occupational therapists and school wellbeing staff. No prior family therapy training is assumed. We also run a one-day course on the therapeutic use of genograms.

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