Family therapy often focuses on family relationships, interactions, and recurring patterns, while family counseling may focus on a specific concern or practical challenge. Both can support healthier communication and family relationships.
According to the American Association for Marriage and Family Therapy’s 2025 MFT Industry Workforce Study, 93% of marriage and family therapists reported offering telehealth in 2025, while the share of practices operating exclusively online increased by 21% between 2022 and 2025. But before you book family therapy online, it is worth understanding what you’re actually signing up for. The terms “therapist” and “counselor” can refer to professionals with different licenses and training, so it is important to check the provider’s credentials and scope of practice. The type of support each one offers can look pretty different once you’re sitting in the (virtual) room.
Objective: This guide breaks down the differences between family therapy and family counseling, including their focus, approach, and what online sessions may look like, so you can choose the right kind of support for what your family is actually going through, whether that’s a rocky patch after a move, a teenager who’s stopped talking to anyone, or a divorce that’s reshaping how everyone communicates.
Table of Contents
Key Takeaways
- Family therapy is a form of psychotherapy that looks at relationships, interactions, and behavioral patterns within the family system.
- Family counseling may focus on a specific family concern, communication challenge, or practical issue. The provider’s license, training, experience, treatment approach, and the goals of care are more useful indicators of what support they can provide than the word “counseling” alone.
- Telehealth is now an established way to access behavioral health services and may improve access, convenience, and continuity of care for some patients.
- The best fit is determined by your family’s problems, treatment goals, the training of the therapist, and whether you require continuing psychotherapy, focused advice, or other forms of assistance.
- Family therapy may be part of a broader treatment plan when a family member is also receiving individual mental health care or another specialized service.
What Is Family Therapy?
Family therapy typically looks at the bigger picture – how relationships and interactions within the family connect to what one person is going through, as well as the family’s overall functioning.
A teenager’s anxiety can shift the way parents talk to each other. Ongoing arguments between parents can take a toll on the kids. A major loss, divorce, remarriage, or relocation can change family roles and create tension that no one knows how to address.
Family therapy looks at these relationships, patterns, and interactions together.
Family therapy may involve:
- Parents and children
- Teenagers and caregivers
- Siblings
- Couples within a larger family system
- Blended families
- Adult children and parents
- Different family members at different points in treatment
Importantly, not every family member needs to attend every session. The therapist may recommend different combinations depending on the family’s goals and circumstances.
What Is Family Counseling?
Family counselling usually assists family members in dealing with particular problems by providing emotional support, practical advice, communication skills and problem-solving.
The American Psychological Association describes family counseling as providing information, emotional support, and practical guidance for problems faced in the family context.
For example, a family may reach out for counseling when they are dealing with:
- Parenting challenges at home
- Ongoing communication problems
- Frequent arguments between siblings
- Difficulties adjusting after a divorce or separation
- A child’s behavior becoming harder to manage
- Stress after a major change in the family
- Concerns about caring for a family member who is ill
- Tension that keeps coming up but never seems to get resolved
Not every professional uses the word “counseling” the same way. Some clinicians use the terms “family counseling” and “family therapy” interchangeably. Others use counselling for shorter-term, more solution-focused treatment.
So, the title alone does not tell you exactly what treatment will look like. The therapist’s training, technique, therapy goals and your family’s requirements matter more.
Family Therapy vs Family Counseling: What Actually Changes?
The two services overlap considerably, which is why people often use the terms interchangeably. The clearest difference is usually the depth, focus, and goals of the work, rather than a strict dividing line.
| Family Therapy | Family Counseling |
| Often focuses on relationships, interactions and repeating patterns in families | May focus on a specific family concern, transition, or practical challenge |
| Can address how individual concerns affect the wider family system | Can provide guidance, emotional support, and problem-solving |
| May involve ongoing psychotherapy depending on the family’s needs | The length of care depends on the provider, treatment goals, and family’s needs |
| Can involve different family members or combinations of family members | May involve parents, children, partners, or other family members |
| The provider’s therapeutic approach and license determine the scope of care | The provider’s license, training, and approach determine the scope of care |
Neither option is automatically “better.” The right approach depends on what your family is experiencing.
For example, a family dealing with a recent move may benefit from focused support around adjustment and communication. If a family is suffering continuous conflict, a strained relationship between parents and children, or recurring problems with communication, they may choose to explore family therapy with a qualified mental health professional.
When Should You Consider Family Support?
You do not have to wait until a family relationship reaches a breaking point.
Professional support may be worth considering if:
- That same dispute continues to recur over and over again, never settled.
- Family members are not openly talking with each other anymore.
- Disagreements about parenting create a constant strain.
- The emotional or behavioural health challenges of a child are influencing the entire home.
- A divorce or separation is bringing new challenges.
- Grief or trauma strains family bonds.
- A large move, sickness, financial stress or other life transitions have changed familial relationships.
- One person’s mental health concerns are affecting the wider household.
- One person’s mental health concerns are affecting the wider household.
Asking for help is not an admission that your family has failed. Sometimes it simply means you want a structured, neutral space where everyone can be heard.
How Does Family Therapy Online Work?
For families managing work schedules, school commitments, childcare, or different locations, family therapy online can make it easier to participate consistently.
The U.S. Department of Health and Human Services notes that telehealth can expand access to behavioral health services and support convenience and continuity of care.
An online family therapy session may include:
- Initial assessment – The therapist finds out why the family is there, who’s involved, and what each person hopes to improve.
- Shared goals – The family and therapist agree on realistic priorities for treatment.
- Guided conversations – The therapist helps family members talk to each other without the session turning into another argument.
- Pattern identification – Repeated conflict or communication cycles get easier to spot.
- New strategies – Family members practice healthier ways to listen, respond, set boundaries, and solve problems.
- Ongoing review – Progress and remaining challenges are discussed as therapy continues.
And there are privacy issues for online sessions too. Telehealth providers may also have an emergency plan to verify the patient’s location and determine what to do if a crisis happens or if the connection is lost.
For some families, factors such as a young child’s needs, severe conflict, safety concerns, or lack of privacy at home may make in-person care a better fit. The treating clinician can help determine which format is appropriate for your family.
How to Choose the Right Family Therapist
Choosing a therapist is about more than finding someone who has an available appointment. Look for a licensed practitioner whose experience and approach to therapy are a good fit for the needs of your family.
If you are searching for the best therapists in Los Angeles, consider asking:
- Does the therapist regularly work with families like ours?
- Are children or teenagers part of their practice?
- What family-therapy approaches do they use?
- Will every family member need to attend?
- How are confidentiality and privacy handled?
- Is online therapy available?
- Does the practice accept your insurance?
- What happens during the first session?
And remember that the right provider may depend on where the primary concern lies. If the main issue is between romantic partners, for example, a couples therapist in Orange County may be more appropriate than a provider whose primary focus is parent-child or whole-family dynamics.
Likewise, if a family member is dealing with significant depression and is exploring treatment options beyond traditional therapy, you may encounter practices that also provide TMS treatment in Los Angeles. TMS is a separate treatment approach and should be evaluated based on the individual’s clinical needs rather than treated as a substitute for family therapy. Los Angeles Therapy Institute, for example, offers both family therapy and TMS services as part of its broader mental-health practice.
Ready to Create Healthier Conversations at Home?
Family conflict can become exhausting when everyone feels unheard, misunderstood, or stuck in the same cycle. You do not have to figure out the pattern alone.
Los Angeles Therapy Institute provides family therapy alongside child and adolescent services, couples therapy, and individual mental-health care. Its practice offers both in-person services and telehealth across California.
A consultation can help you understand whether family therapy is the right starting point and what type of support may fit your family’s situation.
Frequently Asked Questions
How many people need to attend a family therapy session?
That varies by family. Some sessions include everyone in the household, while others rotate between one-on-one time and group sessions, based on what the therapist recommends.
Does insurance cover family therapy or counseling?
What you get covered depends on your health plan, provider, diagnosis and service. Before you start treatment, call your insurance company and the therapy practice to check what’s covered and what you’ll have to pay out of pocket.
Can family therapy help if one family member needs TMS treatment in Los Angeles?
Yes, family therapy can run alongside individual treatment when it makes sense. TMS is a separate, distinct treatment, so whether it’s right for someone should be decided by their own treating clinicians.
What's the difference between family therapy and couples therapy?
Couples therapy focuses on the relationship between the spouses, and family therapy focuses on relationships and interactions among family members. Family therapy can involve parents, children, siblings, partners or other family members, depending on the circumstances.