A fundamental principle of Functional Family Therapy (FFT) is respect. It’s why I’m in my 22nd year practicing this deeply human, richly clinical model of family therapy. For those unfamiliar with FFT, it's an evidence-based family intervention model that focuses on changing problematic patterns of interaction within families while respecting and building upon each family's unique strengths and values/morals, disseminated by FFT LLC
Respect is a process in constant motion, but is often spoken of like a destination or desired “outcome.” This perspective, in my early years, limited my expression of respect in family therapy to a few warm phrases, understanding nods, genuine empathy, and a smile. It also included a real concerted effort not to be judgmental. But, in those early days, I also thought that meant one must just BE non-judgmental versus one recognizing and actively challenging blind spots. Back in the day, I just felt ashamed if judgment showed up and tried to run from it emotionally. That does not breed respect because I am not dealing with the issue. I was just pretending it does not exist and therefore, limited my ability to clearly observe and assess because I was almost working with one eye clenched shut. The fear of not being the perfect therapist, or even human, actually inhibited my ability to be present and truly respect the client fully. Luckily, one matures and works on oneself and gets better at it all! This personal growth was supported and accelerated through FFT's collaborative approach to learning.
Getting a little help from my friends. FFT group dynamic supports respect. In the model, there is more on the FFT therapist to DO the hard work, as it should be. Being in a supportive work-group, which FFT requires, gave me the space with trusted peers to see beyond my own understanding of things. In learning FFT, I learned what respect in therapy (as a verb) really can and needs to look like, along with how to get there. I am not saying I did not know how to respect people. My family raised me well! But FFT work deepened my sense of it and how I embodied it in therapy. I also do a lot of my own personal and professional growth around assumptions and showing up for people from all walks of life.
Respect in FFT: Who are you really? Can I see and speak to the dignity in all you have experienced and how you survived? And then, when it comes time to do the work - can I make it fit you? Not the “you” that society wants or the “you” I might want based on my own values or beliefs. No, FFT is talking about respecting the “you” that is true (and, PS, also good and worthy). This requires listening to understand, not to “fix”, challenging your own assumptions, observing patterns, thinking outside the box, being willing to take clinical risks, and most of all: being humble. The families we work with are often placed on the fringes of society and have been viewed through a narrow lens. A lens that tends to see them one-dimensionally. Real respect is a three-dimensional view of all, whether you like what they do or not.
So much of this is about what my heart and soul are doing. So, get comfortable with getting in touch with both. But what about the head? How do we really “DO” respect as a verb in functional family therapy? This is particularly challenging (and exciting) in family therapy, where you have multiple generations with different perspectives on the same issues, loads of love, and loads of hurt. How do we do it when we are challenged, when we are tired, when we are triggered, when we are… human? (As of today, AI has not yet replaced human therapists!)
Knowledge, wisdom, techniques, skill, and heart… You need it all to meet the unique needs of families. Let us focus on therapy techniques for a moment. What comes first in Funtional Family Therapy?
Now that we have broadened our scope in how we see the family, we have listened and engaged, and we have helped reveal more of their vulnerable and beautiful qualities by embodying non-judgment and respect. Where do we go now? Well, since respect is truly a VERB in FFT, not a destination… we have more work to do.
Interpersonal Matching: We must match in language, dress, pacing, and tone to the family’s style, culture, capabilities, and both relational and hierarchical functions from the minute we meet the family. Whew! Respecting a family takes serious focus, training, planning, support, and commitment. This is intense but deeply rewarding work.
Matching/Tailoring interventions in Behavior Change: This can sometimes be very concrete. E.g., let’s say a young person is highly contacting to his caregiver, and I am teaching/practicing emotional regulation. When I develop a regulation technique to address his/her/their trauma response, I will teach it as co-regulation with their caregivers rather than a solitary grounding technique in therapy. This increases the likelihood of success because the young person naturally tends towards contact with their caregiver, and so I am working with how he actually relates to and exists in his world. The skill remains the same… the HOW I teach it is what is going to differ very much between families. Why make people swim upstream? It’s hard enough to do therapy, it’s hard enough to make change… why not make the journey one that fits them smoothly so their focus can be comfortably on learning the skill?
Matching and respect in the final phase of FFT, Generalization: Empowering a family is respect. We work to empower, not create dependency. We look to create connections in the community and improve inter-community relationships that already exist. In this way, we show respect for the family’s natural and real context and help them find a way to be successful within that context. FFT is asking that you do well-thought planning from the start of the phase so that these types of obstacles to success can be avoided. The family has had enough obstacles in life; we don’t want to add to them by not thinking about this family in their context with their resources and their culture, style, functions, and capabilities.
Respect in FFT is a dynamic and relentlessly intentional process. Every time you plan your next session, you are contemplating how you will implement your work in a way that respects and accommodates the family’s natural way of being. It is in seeing dignity and worth despite harsh realities and behaviors. It is in the humility of knowing that your way is just one way to live this life. I think that is why we are seeing a shift away from models of therapy that do not allow for other cultural experiences. FFT LLC and the Functional Family Therapy model have always made that a priority and created tools and space for truly showing a family that they are worthy of true respect.
The quote below speaks to this for me. While I cannot speak every language, I can work hard to speak to someone’s heart by using language and tone, and pacing, etc., that fits who THEY are.
"If you talk to a man in a language he understands, that goes to his head. If you talk to him in his own language, that goes to his heart."
Nelson Mandela
For FFT Therapists: Consider bringing a recent case to your next group supervision. Examine how you matched (or could have better matched) your approach across all three dimensions—interpersonally, interventionally, and contextually.
For Other Family Therapists: Reflect on one family you're currently working with. What would change if you spent the first session focusing entirely on who they are at their core before addressing presenting problems?
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