Family Therapy

This is very often the hardest part. Typically, there is a designated organizer in the family. Sometimes the family identifies this individual, and sometimes it’s by default that one person is concerned and organized enough to reach out. Part of our work in an intake call is to speak to this question and address specifics. Logistical issues are usually intertwined with ambivalence or straight-up reluctance to dig into the work. We get creative with the family organizer(s) about how to increase the chances of getting everyone in the room. That said, sometimes we begin with those who are ready to participate and, then, organize a process in which the more reluctant family members might join. It’s also sometimes the case that certain family members are persistent in their desire not to participate. This doesn’t mean the family can’t be helped, though there is work to do to hold space for that person in their absence.

Absolutely. One of the great discoveries for us at the beginning of COVID was the normalization of online therapy, which allowed family members to work together without the obstacle of distance. Therapy licensure laws can be tricky, but the good news is that only one member of the family in treatment needs to reside in New York State.

This is a great question to discuss in an initial call with a senior family therapist. We frequently get questions about the age of an individual or whether spouses or partners should participate. There’s simply no hard rule, and these are questions that need nuance. Often, we’ll begin with a smaller subsection of a family and then discuss that question together as we move forward. While we strive to be as inclusive as possible, there are often reasons not to have everyone involved or, at least, involved at the start of family therapy.

Our default position is that it’s generally best to have as many people in the family show up to the first session as possible. However, there are good reasons not to do this when certain kinds of conflict exist, when there’s a history of secret keeping, or when certain individuals are young and we want some time to decide in what ways they ought to be involved in the broader treatment.

We often meet with individual members of the family separately to gain additional insight into issues that have been discussed in treatment in order to more deeply assess complex family issues. This is not a hard rule, however. The work is always customized to each family.

Our general practice is to be as inclusive as possible. However, anyone who shows up to treatment needs to be sober and prepared to work together toward a common goal of creating healing and repair within the family. We’re not shy about engaging with individuals who struggle with drugs and alcohol or discussing with family members their response to a member’s substance abuse. This work can be done both with and without that individual in the treatment.

Yes. This is perhaps the most common area of family therapy in which we engage, both with the involvement of parents and in some instances without.

Lots of families come to us because they have significant conflict, which can involve harsh language and loud voices. Some of this needs to be tolerated, but there are limits. This is an area in which the therapist’s skill and leadership are vital. If you have specific concerns, please discuss them in your initial call.

Yes and no. On the one hand, when a family doesn’t acknowledge harm and breaches in trust and the misdeeds that occur within families, they can grow, fester, and make you sick. On the other hand, that doesn’t mean everything has to be talked about. Family therapy is usually organized around an issue that a family wants to address. The question of how much history we take on is a matter of defining and redefining the parameters as we go. This needs to be consistently negotiated, and often, families show up on different pages with different expectations.

While we don’t set a fixed number of sessions going in, family therapy is generally short-term, with families coming to us with a specific piece of work. It’s not uncommon for family therapy to function as a kind of assessment for particular combinations of people within a family. As a full-service group psychotherapist practice, we are able to provide referrals to providers of individual therapy, couples therapy, sibling therapy, and therapy for kids and teens, when necessary.

In our work with children and teens, we always insist on some parental involvement in the treatment. In some cases, a good deal of involvement. When there is a recognition that a problem is dynamic among individuals in a family, beginning with family therapy is often quite meaningful. However, our therapy with kids and teens always has an element of family work, and our family therapy that involves kids and teens often has an element of individual work. The specific setup is incredibly individualized for each family.