Working with families as systems can be very challenging. Many therapy interventions and approaches aren’t as successful as they could be if the therapist doesn’t recognise when it is right and necessary to include or exclude family members. In this tip sheet, I offer some inspiration to help you work with families.

Tip #1 Be supportive.

Families get trapped in patterns of behaviour that they have become unconscious of.  When you first start to work with families, be supportive. Explain that patterns develop and because kids don’t come with an instruction manual, all of us are learning how to do it ‘right’.

Tip #2  Have an open mind.

If you have an agenda, or you have already formed an opinion of what is going on before you’ve met them all, chances are, the family members will detect this.  I have counselled many families who have been casualties of family therapy approaches where sadly, the therapist, has had a personal agenda before a family has even got started with them.  Families lose any kind of cooperation or cohesion if the therapist appears to be ‘unfairly’ on someone’s side. Get good quality supervision if you find yourself getting personally affected by the dramas played out in the therapy room.

Tip #3 Be clear.

Be very clear in the therapy room. The family is relying on you to demystify their struggles.  Being clear means not covering things up, not couching your words too carefully so that it looks like you’re hiding your true feelings. Be really clear.  And be brave. You may be the only go-between they have so you need to have courage.

Tip #4 Share your observations.

As you watch the family’s interactions, you need to develop that observer mind and be prepared to share what you witness with them.  If a Dad is getting angry with his son, say what you witness.  Ask the son what he feels when his Dad is like that.  Be prepared that the family system may be quite inflexible and fear based and family members may not be able to speak openly in each other’s company.  Observing behaviours sometimes helps oil that wheel.

Tip #5 Have them in one at a time.

I find it useful to have families in my room in various combinations : ie: child with mother, child with father, child, father and mother, father, mother etc. The reason for this is that you get to hear what cannot be spoken in the family arena and you can offer individual reassurance and subsequently broach difficult subjects much quicker once the family is reunited for the continuation of their therapy.

Tip#6 Understand families need compassion

Rarely do families enjoy conflict and mutual condemnation.  They are all products of their own childhoods and are bringing the best and worst of themselves to their new ‘tribal’ identities.  You need to have compassion for all members of the family even if at times, you have to be compassionately strict with someone.  I have often heard myself asserting at strategic moments to someone that they are not responsible for the other person’s feelings.  You need to be brave, but compassionate.

Tip#7 Understand families as tribes.

I often find myself explaining that families have been formed from 2 tribes coming together and trying to harmonise their expectations and understandings of how things used to work in their own family tribes when they were children. Neither is right or wrong. They are just different. Try and flush this out in therapy and be clear that they are different from each other, not wrong.  It is your job to translate between the tribes so that they can find a common language.

Tip#8 Be sensitive to the energy in the room.

Being sensitive to the energy in the room is really about ‘watching’ what’s going on with your third eye.  This means not just hearing the words, but being very mindful of the quality of the exchanges, the timbre of the voice, the body language, the subtle changes in facial expression, hand gestures, foot tapping, eye movements.  And then use what you are witnessing by reflecting it back to them. In other words, be sure you can sense that a behaviour is upsetting someone as a validation or even contradiction to what is being asserted.  Words are very cheap.  We can fight with words forever.  But the body and its energy never lies. In this way you can make sure you are not overlaying your own interpretation or analysis from your thinking centre, but that you can also gain a deeper sense of what is playing out in front of you.

Tip#9  Be prepared to mention the emperor’s clothes

Many families struggle on one way or another living some kind of lie or illusion that they don’t fully want to admit to themselves.  As a result, their behaviours seem to be constantly compensating for something that they cannot face.  For example, perhaps a father is anxious about disciplining his son and instead of admit that, the family has claimed the child has independent (of them) character faults or issues. This is where mentioning the emperor’s clothes (the popular fable of the emperor’s invisible clothes that everyone was too embarrassed to draw to his attention) is crucially important.  Be mindful of all the above points when you take this step!

Tip #10 How to manage deeply damaged families if working alone in private practice.

If you are working as a private therapist with little extended support, do be mindful of how much you can achieve with deeply damaged families. Family members may drop out, fail to show at times, or be deliberately obstructive and even at times, be litigious.  If this is outside your range as a general therapist, make sure you get some good quality supervision and recognise your own limits. You may not be able to achieve what the family wants because they themselves have no clarity of purpose nor insight into their own system.  While it is part of your job to provide the forum for insight to grow and flourish, remember, you are not a miracle worker.

My approach can be very real and challenging and is aimed at offering insight into family systems fast.   I do not allow families to waffle or stray off track into pointless arguments.  They can do that till they’re blue in the face outside of the therapy room!  This approach is not an easy one to practice as it requires courage and clarity on the part of the therapist. If you would like to know more about how to work like this, you can email me or hear more by joining me on my mind membership and listening into the audio lecture I have recorded on working with families.