What Is Family Constellation Therapy?

In family constellation therapy, people unrelated to the client take on the roles of various family members and act out dynamics related to the client’s concerns. It's a form of expressive therapy intended to help the client work through a concern or develop insight into a conflict.

Types of Family Constellations

Because a traditional family constellation is a group, family constellation therapy is usually done in a group setting, but therapists also provide it on a one-to-one basis when appropriate.

Family Constellation Therapy in a Group Setting

The therapist directs the family members’ posture, position, and words, although sometimes the activity involves minimal talking. The client might interact directly with their relatives in the constellation or stand aside and watch the interactions unfold.

Family Constellation Therapy With an Individual

In an individual setting, the client might use a sand tray and toys or figurines to represent their various family members. Similarly, art therapy techniques help clients draw their family groups and indicate the various dynamics within the family.

Individual family constellation therapy doesn't involve the client in role play with other people. Instead, the therapist and client work together over time to map out relationships and uncover patterns.

Techniques in Family Constellation Therapy

In a group setting, therapists typically use drama therapy with the other people in the group to create the family constellation. The client can observe interactions between members in real time to gain insight, or they might role play interactions with group members to practice a confrontation or address a past trauma. This type of role play can be a form of psychodrama.

Individual family constellations can include drawing, painting, or using objects to represent family members. The therapist can point out their own observations and will encourage the client to look for patterns and relationships that the client had not previously considered.

How Family Constellation Therapy Can Help

Family constellation therapy helps clients clarify and work on many types of issues. For example,

• The client wants to break dysfunctional or harmful patterns in their relationships that might be related to dynamics that they learned from their family of origin.
• A couple wants to understand each other’s history and how their families of origin affect what they each bring to the relationship.
• The client wants to confront an abuser from childhood who is deceased, unreachable, or unsafe to contact.
• The client wants insight into patterns from childhood that continue to affect their mental health.

Family constellations are not limited to specific diagnoses. However, they can be particularly beneficial for those working through childhood trauma, the death of a relative, or various mental health diagnoses, including depression and anxiety.

Benefits of Family Constellation Therapy

Clients sometimes experience catharsis following this intervention because it allows them to work through conflict, trauma, and difficult experiences in a safe environment.

Focusing on patterns and dynamics they had not previously considered helps clients develop greater insight into their behaviors. This can lead to healthier communication and more fulfilling relationships.

Family constellations also create a powerful space for processing traumatic events from the client’s past.

Effectiveness

Psychological researchers have extensively studied family constellation therapy as an evidence-based treatment for various mental health concerns.

Although data about overall treatment outcomes are mixed, family constellation therapy has been found to help reduce feelings of stigma around mental health and neurodivergence; specifically, parents of autistic children can work through feelings of stigma using this approach.

Things to Consider

Family constellations can be intense, and participation might bring up strong feelings or memories related to traumatic or stressful events. Clients considering this treatment intervention should ensure that they feel comfortable with their therapist and ask any questions or present concerns they have about doing the family constellation.

Clients need to consider whether they feel comfortable doing a family constellation with a group of people whom they likely do not know. If they feel safer with an individual approach to the family constellation, the therapist can provide them with options for creating their family constellation with objects or toys.

Clients should also have a self-care plan in place to ensure that they can cope with any emotions brought up by the family constellation in a healthy way. Clients will often require ongoing therapy following the family constellation exercise to address traumas, memories, and upsetting dynamics that came up during this activity.

How to Get Started

If you are already in therapy, you can ask your therapist if they feel equipped to utilize the family constellation in your treatment. If they are not properly trained, you can ask them about referrals to groups that offer this intervention, or they can provide you with interventions that could offer the same benefit and fall under their scope of practice.

If you want to work through dysfunctional family experiences and develop insight into how patterns within your family have shaped you, or you hope to make positive changes in your relationships going forward, a family constellation can be a helpful part of your treatment plan.