Family therapy and individual therapy are both evidence-based, effective, and can address mental health concerns, but they work in fundamentally different ways, and choosing the wrong one can significantly slow your progress.
This guide breaks down the real differences between the two, when each approach is most appropriate, and how to make a confident decision based on your specific situation.
What Is Individual Therapy and How Does It Work?
Therapy, or individual therapy, refers to a one-on-one session between a client and a licensed therapist. Therapist sessions are typically scheduled weekly for 45-60 minutes each. The frequency of sessions depends on the client’s individual needs, the severity of the presenting problem, and the length of the therapist’s intervention. Additionally, the therapist must evaluate the client’s progress towards achieving their intended goals before deciding on additional sessions.
Focus of the Individual Therapy
Therapy is primarily focused on helping clients develop insight into their thought processes and associated emotions/behaviors; therefore, the work done in therapy occurs solely within the client. The therapist serves as a facilitator for each client’s exploration of their own thought process and emotion, and ultimately works with the client over time to assist them in developing or changing thought processes or emotions that contribute to harmful behavior patterns.
While there are several different treatment modalities available to clients, the most common include Cognitive Behavioral Therapy (CBT), Psychodynamic Therapy, Acceptance and Commitment Therapy, and Dialectical Behavior Therapy (DBT).
Individual therapy is also conducted on a confidential basis. The fact that it operates as a confidential process is not an afterthought; in fact, it is one of the main reasons therapy works. There are many items that clients hold onto that they have been unable to share with a significant other, parent, or child, and these items need their own space.
What Is Family Therapy and How Is It Different?
In family therapy, at least two family members work with a trained therapist to address family dynamics, communication issues, and behavioral problems. Family therapy is not simply individual Therapy with more than one person in the same room; it uses a different approach altogether.
Family therapy addresses the system of the family (the patterns of interaction that exist between family members over time) as opposed to just the inner world of an individual, as individual therapy would. Family therapists can observe who speaks first, who remains silent, who mediates, and what topics are off-limits in family discussions, and all that data gets documented as clinical information.
Some of the most commonly used, evidence-based treatment modalities include Structural Family Therapy, Bowen Family Systems, and Emotionally Focused Family Therapy, but all share the same core premise: to understand (and hopefully resolve) the presenting problems/issues from an individual perspective, focusing only on the surrounding relationships and dynamics within the family system.
Comparing Family and Individual Therapy
Knowing the differences will enable you to avoid confusing therapy. (If you need family therapy but go to an individual therapist, you won’t have that expectation met; it is important to know.
1. Focus
Individual therapy focuses on the internal experience of a single individual (the client), while family therapy focuses on the relationships among family members.
2. Number of people in the therapy
One individual and one therapist for individual therapy, and multiple family members (including children from as young as 5-6 years old, depending on the situation) in family therapy.
3. Goals
Individual therapy’s goals include symptom reduction, processing past life events, and resolving inconsistencies in personal behavior. Family therapy’s goals tend to be to increase the family’s communication, help the family work through their conflicts, and ultimately help the family change how the family unit functions.
4. Confidentiality
Individual therapy is entirely confidential (however, in family therapy, total confidentiality is not possible; when one person shares something with the group, others present may also hear it).
5. Length of time to complete therapy
Both family and individual therapy can be short- or long-term (with family therapy having shorter solution-oriented goals, as opposed to individual therapy, which will be longer due to addressing the individual’s more complex trauma/possible personality).
Situations in Which Individual Therapy Is More Appropriate
When dealing with challenges unique to an individual, those that exist independently of others or those in which the relationship is not safe to share in the therapy room, individual therapy is often the better place to start.
1. Mental health diagnosis
Mental illnesses such as depression, anxiety, OCD, PTSD, and bipolar disorder all have separate and well-established evidence-based interventions used for treatment. Cognitive-Behavioral Therapy for anxiety is one of the most researched methods of treating anxiety disorders across all the sub-disciplines of psychiatry. There’s a good reason why most mental illnesses are treated in a one-on-one setting.
2. Past Trauma
Processing feelings associated with memories will take time, and people need the ability to progress comfortably towards that goal in a safe environment, which requires privacy and a few trusted people in their lives. Trauma work involving family members, especially if family members are connected to the trauma, is often harmful rather than therapeutic.
3. Shame & Other Emotions
People will often be filled with shame for various reasons, including addiction, disordered eating, sexual orientation, self-worth, etc. When people want to overcome their shame, they often think that talking about it with others will help, but that is not the case. Individual therapy will allow individuals to share things that they’ve never shared before and create an environment that feels safe and comfortable to overcome the shame associated with those issues.
4. Individual Development
People seek individual therapy for many reasons, not only those related to an immediate crisis, such as when someone wants to work on self-awareness, personal growth, improve the overall quality of their relationships, or break patterns that are keeping them from progressing. All of these reasons are virtual forms of therapeutic work that can be accomplished in an individual therapy setting.
5. When a Participant is Now Absent
For example, if one spouse refuses to attend or if a spouse has died, and/or if one or more family members are separated from the couple, then the couple can continue to work with a therapist through individual therapy and be productive.
When Should You Choose Family Therapy?
Family therapy is an option when the problem involves how people interact with one another, not just one person.
1. Communication Breakdown
A family therapist provides a safe space and framework for couples and families to communicate with one another, and enables them to hear one another many times during the initial consultations with the therapist.
2. Adolescent behavioral problems
Adolescent behaviors do not happen on their own. Research suggests that young people who have experienced symptoms such as depression, anxiety, defiance, and avoidance of school are often affected by their home and family. Treating an adolescent alone and without family involvement rarely leads to improvement of symptoms.
3. Eating disorders
Anorexia nervosa in adolescents has shown positive outcomes with family-based treatment (Maudsley method) and is now considered an effective intervention for these adolescents. In this family approach, the family is part of the adolescent’s treatment plan.
4. Addiction and Substance Abuse
Experts from the U.S. Substance Abuse and Mental Health Services Administration report that including family members in treatment for substance use disorders increases engagement with clients, retention in treatment, and positive long-term outcomes for clients with substance use disorders. Addiction has a disorganizing effect on families and, therefore, must be incorporated into the family system/s while undergoing treatment.
5. Life Changes
Transitions due to divorce, remarriage, death, serious illness, or children leaving home disrupt families, no matter how functional they are. Family therapy provides the opportunity for family members to process these changes collectively rather than each person absorbing the change liabilities (or burdens) individually.
Can You Do Both Individual and Family Therapy at the Same Time?
Yes, and for many complex situations, this is the most effective approach.
A teenager might attend individual sessions to process their internal experience while the family attends separate sessions to address how that experience connects to dynamics at home. A person in addiction recovery might work individually on the underlying trauma driving their substance use while also attending family sessions to repair relationships and disrupt enabling patterns.
The research supports this. Combined approaches show better outcomes than either modality alone, particularly for suicide prevention and relapse reduction. Research suggests that combined approaches show meaningfully better outcomes for suicide prevention compared to either modality used alone.
When doing both simultaneously, some coordination between providers is helpful. The individual therapist and the family therapist do not need to share session content, but knowing about each other prevents them from working at cross-purposes.
Questions Worth Asking Yourself Before Choosing Family vs. Individual Therapy
Rather than trying to match yourself to a clinical category, these questions clarify the decision quickly.
1. Does this problem exist when you are alone, or only in specific relationships?
Genuine depression and anxiety persist regardless of who is present. If your distress is specifically situational, tied to your household, a parent, or a partner, the source may be relational.
2. Are the relevant people willing to participate?
Family therapy with a member who is unwilling to acknowledge a problem or unwilling to change has clear limits; a realistic assessment of who will actually show up matters.
3. Is there any safety concern?
If domestic abuse is present, individual therapy comes first. Placing an abuse survivor and their abuser in conjoint sessions before substantial individual work is done can cause harm. This is not a matter of opinion; it is a clinical standard.
4. What does a therapist recommend after hearing your situation?
A single consultation with an experienced clinician who works across both modalities will give you more useful guidance than any self-assessment tool. Ask directly: given what you’ve heard, which approach would you recommend starting with?
The Bottom Line
The most common mistake is choosing based on what feels easier rather than what the problem actually requires. Individual therapy is logistically simpler and emotionally less confrontational. That makes it the default for many people, even when their core issue is relational.
If you are genuinely unsure, a consultation with a mental health professional is the most reliable next step. Describe your situation honestly, ask which approach they would recommend, and pay close attention to whether their reasoning matches your experience. That conversation will tell you more than any checklist.
- This article is for informational purposes only and does not constitute clinical advice or a substitute for professional mental health care.
