Family-focused therapy (FFT) is a treatment designed to help people with bipolar disorder and their families work together toward recovery. It can also be helpful for other mental health conditions, like schizophrenia.
The program combines psychoeducation, communication training, and problem-solving skills to help families overcome mental health conditions together.
Research shows that when combined with medication, FFT can reduce relapse and improve overall outcomes for people with serious mental health conditions.
Family involvement is often a key part of treatment for people who live with a mental health condition. Especially if the person who’s diagnosed is a minor or still lives at home, it can be essential for family members to understand exactly how to support them in their recovery.
Family-focused therapy (FFT) is a structured family-based treatment program that’s mostly used with people with bipolar disorder and their families. If you or a family member lives with bipolar disorder (or another mental health condition), FFT can help you learn how to manage its symptoms together.
How family-focused therapy works
Research shows that FFT (together with medication) can be more effective for managing bipolar disorder than medication or individual therapy alone.
It’s important to note that FFT is different from traditional family therapy. The term “family therapy” refers to any type of therapy that involves family members. Family therapists typically focus on helping all family members resolve conflict and improve their relationships.
In addition, family-focused therapy is different from functional family therapy, another treatment method that uses the acronym “FFT.” Functional family therapy focuses on providing in-home family therapy for youth in the juvenile justice system.
FFT is more about helping family members of people with mental health conditions — most commonly bipolar disorder — learn how to best support the person with the condition. In one study, the goals of FFT were defined as helping the person and their family with:
Making sense of the experiences connected to bipolar disorder, for the person experiencing it and their family
Accepting the possibility of future episodes and ongoing vulnerability
Understanding why mood-stabilizing medications are necessary for symptom control
Learning to separate the person’s identity from the symptoms of bipolar disorder
Recognizing stressful events that could trigger relapses and finding ways to cope
Restoring healthy family or marital relationships after an episode of illness
FFT is a structured therapy program. It consists of 21 sessions over the course of 9 months. Sessions are broken up into three stages, outlined below.
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1. Psychoeducation about bipolar disorder
This stage focuses on helping the whole family learn about bipolar disorder. Families learn about bipolar disorder symptoms, warning signs, and common triggers. The therapist encourages both the person with bipolar disorder and their family to share their experiences of the person’s past episodes. Then, they help everyone build a shared timeline of what happened.
Toward the end of this stage, families put together a relapse-prevention plan that includes things like early warning signs, likely triggers, and concrete steps they can take if symptoms return.
This portion consists of weekly sessions for three months.
2. Communication enhancement therapy
Once the bipolar disorder symptoms have stabilized, the focus of FFT shifts to practicing new ways of talking and listening as a family. In this stage, families learn skills like expressing positive feelings, active listening, making clear requests, and communicating negative feelings without blame.
Role-plays are often used so family members can try out new skills with the therapist’s coaching. For example, a parent might practice listening as their child describes a depressive episode then paraphrasing what they’ve heard.
This portion consists of weekly and then biweekly sessions for three months.
3. Problem-solving skills training
In the final stage, families learn how to overcome real-life challenges that can come up with bipolar disorder. Examples include managing chores, keeping appointments, or disagreements about finances or treatment.
Families will work on identifying specific problems that might come up and brainstorming possible solutions together. The therapist will guide them through weighing pros and cons and agreeing on an action plan. Families practice these steps in session, then apply them at home.
This portion consists of biweekly and then monthly sessions for up to three months.
Signs your family would benefit from FFT
Although FFT was originally created to help people with bipolar disorder and their families, research shows it can also be helpful for psychotic disorders (like schizophrenia). It may also be helpful for youth with depression.
Your family may be a good fit for FFT if:
One of your family members lives with bipolar disorder, schizophrenia, or another serious mental health condition that’s affecting the family unit.
The family member with the mental health condition is already receiving their own treatment.
All family members are willing and able to participate in weekly/biweekly sessions for up to nine months.
You want practical tools to improve communication, problem-solving, and daily interactions at home.
Your family has experienced high levels of conflict or stress connected to mental health episodes.
You’re looking for a structured program that complements medication and other treatments.
Getting started with family-focused therapy
If you or a family member lives with bipolar disorder, schizophrenia, or another mental health condition that significantly impacts your family, FFT can help. But because it’s such a specialized treatment method, it may take more steps to get started with FFT than it typically takes for more traditional individual or family therapy.
Here’s how to approach it:
Talk to your family. Make sure that everyone is on board to participate in sessions, including (and especially) the person who lives with the mental health condition.
Ask for a referral from your existing provider. If you’re already working with a mental health practitioner, let them know you’re interested in participating in FFT. They may be able to connect you with a therapist trained in this approach or point you to a treatment center that provides it.
Check insurance. Before starting treatment, it can be a good idea to make sure your insurance plan will cover FFT.
Continue other treatment as prescribed. Working with your providers and adhering to medication will greatly support treatment outcomes. FFT doesn’t replace medication and other forms of treatment. Psychiatric medication is one of the most effective forms of treatment for bipolar disorder. So if you’ve been prescribed medication, continue taking it as you work through FFT sessions.
Commit to attendance. For FFT to be effective, all family members need to participate consistently. Missing sessions can slow down progress and make it harder to apply the skills you’re learning together. If you’re unsure who falls under the umbrella of “family” given your current family structure, clarify with the program director.
Practice skills at home. Between sessions, families are encouraged to practice learned skills in real-life situations. This helps reinforce what you’re learning and makes the changes stick long term.
Families often come in feeling stuck in rigid patterns. Over time with FFT, it’s common to see more emotional safety in the home. Members feel more seen, conflicts de-escalate faster, and there’s a stronger sense of teamwork rather than opposition.
Ashley Ayala, LMFT
Clinical reviewer
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Family-focused therapy can help families work together to manage mental health challenges and strengthen your relationships. If FFT feels like the right fit for your family, a trained therapist can guide you through each step of the process.
At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best.
Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.
Saya Des Marais
Saya graduated with her Master in Social Work (MSW) with a concentration in mental health from the University of Southern California in 2010. She formerly worked as a therapist and motivational interviewing trainer in community clinics, public schools, mental health startups, and more.
Her writing has been featured in FORTUNE, GoodRX, PsychCentral, and dozens of mental health apps and therapy websites. Through both her clinical work and her personal OCD diagnosis, she’s learned the importance of making empathetic and accurate mental health content available online.
She lives in Portland, Oregon but you can find her almost just as often in Mexico or in her birthplace, Tokyo.
Ashley Ayala, LMFT
Ashley is a Licensed Marriage and Family Therapist who specializes in generational healing and family dynamics. Ashley has worked in schools, clinics, and in private practice. She believes that people’s relationships, including our relationship with ourselves, greatly shape our experiences in life.
Ashley is committed to empowering others to show up authentically and deepen their self understanding. This passion stems from taking a critical lens on her own life story and doing inner healing. One of her favorite quotes is “Be yourself and the right people will love the real you.”
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