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  • Writer's pictureEleni Paris


“Family therapists view the therapeutic relationship as a means to an end rather than as an end in itself. Family therapists see beyond the problematic patterns in the family to the potential healing power of family relationships.” Joseph Micucci

As a licensed marriage and family therapist, I have the background and training to work with relationships as part of the sessions, which often entails having more than one person in the room, such as couples and families. The growth process between two or more people in the room is hard to articulate, as it is multi-faceted and unique to the couple/family, but they are inspiring. These therapy experiences can range from working with couples on marital issues to working with parents seeking guidance with their children (and possibly including their children in sessions, as well) to working with adult children addressing family-of-origin problems with their siblings and parents.

Although I specialize in and enjoy working with each of the above relationship descriptions, some of the most unique and often very moving therapy journeys of my professional career involve family therapy with all adults.

Having a family of three or more adults entering therapy to address long-standing family-of-origin issues or ones that develop with in-laws and extended family is not as typical as one can imagine. Why is this? People may have become set in their ways; they may believe no one can make changes anymore; the thought of addressing their disappointments head-on may feel impossible, and sometimes, they are unaware that family therapy is a possible solution.

What might happen if a family chooses to address their challenges as one and enter therapy? Here are some things to keep in mind regarding family therapy as adults, followed by a case scenario example.

  • Family therapy does not necessarily mean that you are always attending a therapy session simultaneously. It is common and helpful to have individual and dyad-type meetings with your therapist as they get to know you all and determine the best path forward.

  • The concept of "family systems" involves interactional behaviors that influence one another and is at the core of family therapy work. It is relationship-based and relationship-focused.

  • You are about to begin something unique and a gift to all. Addressing issues together as a family takes work. Still, when you are committed to the process and work toward your desired goals (and perhaps goals you've hoped to achieve for many years), you can experience rich changes in your most important relationships.

  • Even when you are all together in therapy and feeling uneasy at times, know that your therapist will consider the proper timing for discussing specific topics, communication and conflict-resolution techniques, the implementation of creative solutions, and the step-by-step process toward growth.

  • The therapist's role may fluctuate throughout the process, from an observer to a teacher, a collaborator, a mediator, an uniter, a challenger, and a team player. As the therapy expert/artist, the therapist can be creative throughout the journey to help in any and all necessary ways.

  • Trust the process. You are embarking on something that no one can take away from you. If you learn new things about yourselves and one another and repair what has been damaged or lost, it is a win/win, and you may gain more than you ever imagined.

Case Scenario

Judy and her husband, Bill, are very concerned about their son and daughter-in-law's parental struggles. John and Mary have a 10-year-old son, Chris, with medical issues, and they are struggling financially and emotionally. Whenever Judy and Bill visit with them, they tend to argue with John and Mary about how they handle certain situations with Chris, as he often has behavior issues stemming from his medical challenges. John and Mary used to take Judy's and Bill's advice on things, but lately, they have shut them out and have asked them to give them more space as they navigate all before them regarding Chris' situation. Judy and Bill feel hurt and are not sure how to help anymore.

John decided they should all seek family therapy because the stress of his family situation, in conjunction with his distressed marriage and conflicts with his parents, has brought about tremendous pressure and friction for all of them. So, he placed the call for a consultation. The therapist, Sarah, encouraged a consult call with his parents, followed by two separate initial sessions, including one with him and his wife and one with his parents. The therapist shared that from there, it would be clearer if a subsequent family session is warranted or if any other separate sessions are needed beforehand.

John and Mary met with Sarah and immediately felt at ease, knowing they would have space to share all they were experiencing. They were not ready to meet together with their parents yet and realized how helpful it was to process their feelings with Sarah. It was nice to have someone who listened, had a sincere interest in helping them achieve their goals, and was knowledgeable in the family therapy process.

Sarah's next appointment was with Judy and Bill, who were slightly reluctant to enter the therapy process. Still, they were pleased that John wanted to improve their family communications and rebuild their relationships. They felt comfortable, as well, with Sarah and were happy to have their own space to share their concerns. It gave them some hope that they might resolve the issues which had transpired lately.

After their initial sessions and after discussing the comfort levels with both couples, it was apparent that they were ready to dive in for a family therapy session. They wanted to address their issues as soon as possible and were eager to hear from one another. Sarah shared some themes she noticed from meeting with them and began by setting parameters around how they will communicate more effectively during therapy sessions. She highlighted how they all shared the same concern for Chris' health and that so much of their conflicts revolved around fears and worries about his behaviors, future, and unknowns. As Sarah shared this, the family began to feel how this common thread bound and challenged them.

In addition to hearing this outside perspective and experience from Sarah, she shared how to communicate their concerns effectively and coached them as they addressed one another directly. John began by addressing his father first and was very emotional as he spoke. Sarah helped him articulate his feelings so that Bill could then reflect back on what he heard from John. Active and sincere listening is critical to these kinds of exchanges.

A lot happened in just this one conversation: Bill learned more about John's anger and frustrations toward him; he had a deeper understanding of John's sadness and fears regarding his son; and he felt John's sincere desire to be in a better place with their relationship. John felt that his father was emotionally present during their discussion and felt that Bill grasped the full extent of what he's been feeling, which allowed him to build more trust and help bring down the wall he has used to protect himself lately.

Although this particular session honed in on the exchange between Bill and John, Mary and Judy also chimed in at the end as they reviewed some key points; they knew their turn would come to voice their concerns. They were fully engaged and supportive, and felt relieved that this first step occurred.

They left this session having an experience they knew they could not have had otherwise. It may have been a small step, but it also felt significant as they all agreed to meet again next week. Sarah encouraged them to ponder the themes they reviewed and what each took away from their first session, understanding that it is a step-by-step process.

After approximately eight sessions, they cleared up misunderstandings, decided on ways to support one another, practiced much of what they learned, and became more unified and emotionally closer. They felt grateful for their therapy journey and knew that this was ultimately important for not only their relationships and family as a whole, but they knew it was a lifelong and unique gift for Chris.

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