First Session

When first meeting family members, I listen with empathy and openness to each member in order to understand the issues that the family is presently struggling with. I observe the choice of body positioning on the couch or chairs, I notice body language and facial expressions. Before a word is exchanged, this gives me many important clues as to the hierarchy in the family, the power struggles, the emotional distancing. Each family member will be respected, listened to concerning his or her interpretation of each situation or problem that has brought them in.

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Assessment

A family therapist finds out what is happening in people’s lives right now. After quiet observation of the interaction in the room, I gather relevant information while observing all family members, young and old, dealing with one another. I ask questions about the issues they are struggling with in terms of current difficulties, issues in the family they were born into, physical and emotional health, social stressors, coping skills and power struggles.

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Integration of Information

I pay special attention to sequences and patterns of behavior in the family; how when one member talks, the others listen and respond. I expect that a problem involves more than one person and is in response to current or recurrent situations. Toxic patterns, boundaries, conflicts, closeness, distance are tracked during sessions. Symptoms change because family life changes over time depending on stages of development, life cycles, individual issues experienced by every member of the family. This influences their family dynamics as a whole.

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Treatment Process

At the beginning a primary problem will surface and will require immediate attention. It is essential thereafter to focus the treatment on the problems that are the most troublesome to the family’s functioning, causing disruptive behaviors. I engage every member of the family to participate in the resolution of the target problem.
The objective is shared with the family. We aim for a shift, a change in the way people deal with each other. This will take time and small steps will be applauded on the way to achieving the agreed upon long term goals.
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My Role

My role is to open up communication around the significant areas; the family’s operating principles, its rules, rituals, structures that frequently break down in times of crisis. I challenge your assumptions, help you understand the use of an “identified patient” within a family system and guide you to focus more on the family as a whole. This hopefully encourages the process of engagement while lowering the anxiety levels and opening the dialogue for relief of the symptoms within the family system.

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