Understanding the Family Therapy Process

What is the purpose of therapy?

When people are troubled with painful life situations, therapy can be a way to either view those situations differently or to change the way one handles them. Most importantly, therapy is an opportunity to be really listened to and understood.

What is family therapy?

Family therapists believe that troubles show up in the way people relate to one another: The relationship is the focus of therapy. Some family therapists go with the current and insist on pathologizing problems: Since the problem is in the relationship, that relationship must be "dysfunctional." I don't see it that way. To me, neither individuals nor relationships are "sick." I believe people want to behave wholesomely and do the best they can given their own history ("baggage"), current situation, stresses, and support--in short, their context. What appears to be dysfunctional behavior always makes sense to me given this very important context.

How are therapy goals set?

The client decides what is wrong and what is to be accomplished. I do not take advantage of my expertise to direct therapy. My job is to offer the insights of a stranger looking somewhat objectively at you and your family. But you know your life, your desires, and your pain better than I could.

What is the therapist's job?

The therapist helps clients meet their goals. She (or he) helps clients discover their own inner resources and use these resources as the basis for new solutions. The art of therapy is to notice themes and patterns, see things from a different angle, remember seemingly unrelated events that may be important, and generally bring in her own life experience and wisdom to add a new perspective to the one the client already has.

This approach sounds different from psychiatry, psychology, and social work. Is it?

Psychiatry, psychology, and social work are based on the idea that someone is sick and requires treatment. Therapists who do not focus on pathology see symptoms as a result of people's struggles to cope with difficulties--which is the human experience.

Regardless of what you say about everyone being normal and just struggling, our family really has one very sick member. The rest of us are fine. Don't you believe there is such a thing as mental illness?

There have been many studies that find some people do have different brain chemistry. But no one knows what caused that. It is a chicken-and-egg kind of thing. Did it come from the genes? Or, did the emotional behavior of family members get copied by that individual thus causing different brain chemicals to be secreted? Or maybe the so-called sick person reacted to something painful in the family with poor coping skills. Which came first? The fact that some medications sometimes work in conjunction with therapy does not prove anything. If tylenol works for a headache, it doesn't mean I was born with that headache!

If we have someone in the family whose behavior is intolerable, should we all come in for sessions?

I would like to see all of you, at least the first time. Then we can play it by ear. I can work with the "difficult" family member on change while I work with you on coping.

How long should therapy take?

Children are much faster learners than adults and very resilient, I've found. All they want is to be loved, respected, disciplined lovingly, and listened to. If you can do that, you're in and out in one to five visits. Your child(ren) will most likely respond very well whether the problem is depression, hyperactivity, disrespect, uncontrollable behavior, grief, trauma, or even drugs (depending on how long he or she has abused).

Parents do often have difficulties meeting their children's needs for love, discipline, and respect because they themselves were not given these things. This is understandable--how can a person give something when she or he doesn't really know what it is or how to give it? In that case, the therapy can end up centering on the parent's needs for a while, so it can take some time.

I have a personal matter I want to discuss; it has nothing to do with my family. Can I come in alone?

Of course. Family therapists see people individually all the time.

However, it is important to know that studies have shown that often people with a variety of mental health concerns have significantly better improvement when addressed in the family context. Here is a partial list that will surprise you of some things that seem individual but often improve more rapidly in a family context: depression, anorexia, addiction, cigarette smoking. So it is up to you.

Do you see children?

Like adults, children can be either seen alone or with the family. Often a child may need private time with the therapist, but the parents' presence later may be helpful.

I am a single person, not in a relationship. Can family therapy help me?

Yes. A family orientation on my part will help you see the role your family history may have played in your current situation. Putting it into perspective like that takes some of the burden off of your shoulders.

I live on the other side of the country (world). But I like your approach. Can we work together?

Yes, we can work by phone or online.