Family Therapy

If you have arrived here without reading the posts My Therapeutic Philosophy and Individual Therapy, I encourage you to go back and read those first for some context around this piece.  

What is family therapy?  

Family therapy consists of sessions between myself, the client, and a combination of family members and/or caregivers that last about 50-90 minutes. That may include one or both parents, siblings, or any primary caregiver for the client, such as a custodial grandparent, aunt, cousin, foster parent, or any person who is responsible for being the client’s primary attachment figure.  

First session – Setting boundaries 

Before the client engages in family therapy, we will conduct the process of an intake through an individual session. Read more about that here. Once I have assessed the client and their needs, we will determine the need, frequency, and dynamic of family therapy. For very young children, that will look like more frequent family sessions with the caregiver present. As children get older, the frequency of family sessions may decrease.  

For all therapy to be effective, felt safety and consent are necessary. We’ll spend some time that first session setting some boundaries for everyone involved so each person is aware of what is productive and counterproductive during session. I’ll have my own suggestions, as well as ask both the client and caregiver for any needs they have to feel safe. Again, depending on age, developmental level, and who is in the room, these boundaries will vary. It may be things like not interrupting while someone is speaking, asking the other person for permission before doing something like borrowing a crayon, or keeping corrective statements to a minimum. Frequent boundaries in sibling sessions are keeping hands to ourselves and refraining from name-calling. Setting boundaries doesn’t mean these things won’t happen! And in-fact, it provides an excellent in-the-moment learning opportunity when they do. But having these agreed-upon rules for interaction helps families learn new skills for being together in ways that increase bonds, safety, and trust.  

For all clients, we'll identify some initial goals for family therapy specifically, and these goals can and will change throughout our time together!  

First few sessions – identifying the patterns 

The first few sessions of family therapy will often include a lot of observation of how the client and their family member(s) interact so we can identify the patterns of behavior where things go both wrong and right. Conflict, disagreement, emotional dysregulation, and challenging moments are all expected during family therapy.  

Ongoing sessions – rewiring relationship patterns 

It’s important for the things that happen at home to also happen within session so they can be identified and addressed. No relationship is free from challenges - if we never engage in conflict, how will we learn the skills to de-escalate and resolve it? If we’re only attempting these news skills when conflict is heightened and there is not a neutral party to interrupt it, old patterns tend to become more ingrained. Family therapy is really practice within a safe space for making mistakes together so everyone can work on what we call “repair.” We’ll also work on things like co-regulation between client and caregiver. When we practice these things outside of crises, they soon become second nature.  

Family sessions will include a variety of interventions based on each client’s needs. For young children, that may look like engaging in imaginative play, making art, reading books, or engaging in structured games to process events and learn new skills. They will also be incorporating skills learned in individual therapy into family session.  

Any time we engage in family therapy, we’ll incorporate what the client has learned about conflict resolution, boundaries, how our brains work, emotional regulation skills, emotion identification, relationships, secure attachment, and put that learning into action. 

Clients may also find family therapy a useful time to verbally process challenges in their personal lives or within the family system with their caregivers. It may be a safe place for clients to talk about a traumatic event, stressors like divorce or blending of families, their needs within the parent/child relationship, or ideas they have about themselves as they become more independent.  

Therapeutic process and change 

Family therapy is tough but rewarding work. No one, especially a child of any age, wants discord within their family system. And no parent I’ve met yet wants to do any harm to their relationship with their child. However, many dysfunctional behaviors from both the child and adult may have developed as a response to stress within family system. It is my professional stance that children are not solely responsible for managing their emotions and behaviors. Raising children is a hands-on task, which is why family therapy can be an incredibly important tool for becoming a healthy and engaged parent.  

While the caregiver is not my client, they may find they are doing much of their own work to be able show up for their child in a way that fosters safety and security. There may be fear, sadness, or shame around trying a new way of parenting. Caregivers often repeat patterns from their own childhood, both because their brains are already wired for enacting a familiar parent/child interaction, and for lack of knowledge of any other ways to parent. I work to create a shame-free environment that allows caregivers to become empowered with knowledge, skills, and a safe place to practice becoming a parent who feels dependable, confident, and engaged. This may include the parent working one-on-one with me from time-to-time, reading supplementary books or articles, or seeking their own therapy to untangle patterns from generations past.  

I’ll end with a quote that beautifully illustrates the work of families and change -  

“As we weave the tapestries of our lives, we gradually begin to see our designs from a wider angle of years. We may or may not be pleased with what we see. Yet, no design – not in the living world – is carved in stone. We have the gift of free will to change our designs as we wish. We are each a thread in the tapestry of our human family. Our outcome is woven of endless possibilities, because we can choose from a universe of endless possibilities. Every person can make a difference. Each thread is a possibility, chosen by the design of divine imagination. Our life-time designs arise from our divine gifts, unique talents, desires, thoughts, choices, and actions. At times, old choices – old threads – wear out. We see the past while we live in the present, and we can replace the old...with new ideas, new choices, and new actions. We can view the future through today's eyes, and time blends all experiences, dark and light, into an awareness of authentic joy.” - Steve Brunkhorst