The Role of Family in Teen Counseling
Teenagers do not live on an island by themselves, even if at times they might wish they did! Rather they are part of many different systems that make up their social & support network including school, peers, neighborhood, and family.
Teenagers are actively in the stage of development where they are working to understand who they are and differentiate from their family members in many ways. The family system plays a crucial role in healthy teen development, particularly when it comes to teens struggling with mental health challenges. The role of the family is important in teen therapy as it provides a safe landing space for teens during tough or confusing times.
Family therapy is recommended when a family feels “stuck” or that they are repeating the same, unhelpful behaviors over and over again, or just when conflict and interactions between family members have gotten to a point where family members feel unsure of how to move forward. Check out this list of common reasons we see here at Sentier as to why families seek out therapy together.
In addition to a family member (often a parent) seeking out family therapy services, a therapist might recommend family therapy when working with an individual teen client if there are patterns of interaction within the family system that might be hindering progress to the individual treatment plan. Family therapy is tough work. It’s hard and messy and at times, can feel challenging for all members involved. However, these messy parts of the process also lead to beautiful, healing moments of connection and increased sense of safety.
It is encouraging and important to note that 90% of people who participated in family therapy report feeling an overall improvement in their emotional health. Additionally, in the parent-child cases of family therapy, 73% of parents reported seeing an improvement in their child’s overall behavior (Cleveland Clinic, 2022).
Family therapy is unique in that it allows space for families to bring in live emotion … to experience the conflict, the rupture, the hurt, but then to come full circle and have those hurts and wounds addressed within the therapeutic space. This provides a new opportunity for the mind and body to experience a different way of communicating or relating to family members, with the hopes of being able to access these ways outside of the therapy space in day-to-day life. 
The goals of family therapy are unique to each family system, but overarching goals of family therapy include (but are not limited to):
- Restoring and repairing relationships
- Open up communication
- Heal past wounds; address current/past substance use disorders
- Increase safety and security in attachment relationships
- Give all active family members a voice to feel heard and valued
Understanding the Teen’s Perspective
Many adolescents I work with tell me that their parents and family members “just don’t get it” indicating they might feel misunderstood or disconnected from their family. It is important for parents to remember that you do not have to agree with or even fully understand what your teen is going through to show up in supportive, helpful ways.
Teens comes to individual therapy for a variety of reasons however common themes in teen therapy include:
- Academic Pressure.
- Some teens feel intense anxiety and worry related to their academic performance. Without healthy outlets and supports in place, this worry and stress can come out as anger, irritability, or conflict in the family.
- Interpersonal struggles and social dynamics.
- Social interactions and friendships play a uniquely large and important role during adolescence. Parents may view a peer conflict as not that big of a deal, when in reality, the teen may be experiencing high distress or anxiety related to these issues.
- Identity questions.
- Adolescents are actively in the developmental stage of identity vs. role confusion and they often experiment with different activities, relationships, and ideas to create a better understanding of who they are. During this time, many teens can feel confused or insecure about who they are, which can create added stress that adds to tension families sometimes experience during the teenage years.
- Anxiety.
- Some anxiety in a teen’s life is typical and even needed in order to evolve and grow. However, some teens present to therapy with higher levels of anxiety that reach beyond this normal window and impact their ability to function in various areas of their lives. This might look like difficulty making friends, trouble with becoming independent, struggles with concentration and memory, and so on.
- Depression and other mental health conditions.
- According to the CDC, rates of depression among children and teens has increased over time (2018). If a teen is exhibiting depressive symptoms, such as withdrawal, irritability, difficulty getting out of bed, lack of problem-solving skills, low mood, this can have a significant impact on the family functioning and cohesion. Often stress and tension is higher among families where one or more of the children is struggling with mental illness.
All of these areas of struggle can only add to the already complex years of adolescence. It is important for parents and family members to remember that teens are often experiencing events and interactions with more emotion and thought than might meet the eye.
The Impact of a Supportive Family Environment
A supportive, consistent family environment is key to building healthy, independent teens. Support for your teen can look like listening to them when they share things, even when these things might seem small or unimportant. Really attuning to and setting aside time for your teen to feel heard, increases their sense of belonging and worth.
Parents can also create a supportive family environment by allowing teens to have opportunities to build mastery in areas of interest or goals they hope to achieve. This looks like helping your teen take small steps towards something they want, to increase their competence and overall confidence in self. Parents of teens must navigate the balance of fostering independence while still offering age appropriate support and help when needed.
Support can definitely come in the form of caring for a loved one during a tough time. But don’t forget, support can also look like humor, fun and enjoying each other’s company. Use your presence as a supportive tool, especially during times when your teen may not feel like talking or lacks words to express how they feel.
Communication: The Bridge to Support
One of the biggest ways to provide support to your teen is to take inventory of how your family communicates. Ask yourself these questions:
- Is there open communication between parents and children?
- Does my child/teen feel comfortable or able to come to me when they are struggling?
- Do we avoid the tough topics?
- If there is unresolved conflict, do we avoid or repair?
- Do parents communicate clear and consistent boundaries and expectations?
- Is there uplifting communication and times of praise and encouragement or do we mainly communicate criticism or to-do lists?
Effective communication is hard! This is especially hard when working with teenagers who are still developing and growing in their communication skills. I often see parents and teens struggling to come back together after conflicts to work on repairing the rupture and ensuring the connection remains intact.
Tips for improving family dynamics around communication among family members with teens:
- Have a weekly time for the entire family to come together and check in. This might be at dinner one evening, breakfast on Monday morning, or a specific family meeting check-in time. With busy schedules, it can become hard for individual families to actually have time where they are all together to get on the same page for what is upcoming. This time doesn’t have to be long, but create this space with the goal of cohesion and setting expectations for the week. Be sure to allow the children in the family to have a voice in this time too!
- Take time outs. If communication is becoming ineffective: yelling, threats, circling around the same issue with no progress, allow yourself and your teen to take a break. When the fight, flight, or freeze response kicks on during difficult conversations, your brains are no longer in the right state to continue communicating productively.
- Communicate about positive, fun things too! Parents can sometimes become task managers, only checking in on homework, chores, and other obligations. Try to create space for light-hearted, fun, or positive conversations too. Sometimes watching a show together or listening to music can build positive bridges in parent/teen communication.
- One thing at a time. If you have several concerns or topics to address with your teen, be careful not to overload or bombard with too much messaging. Teens often do better with one clear idea or expectation communicated and might shut down if they begin feeling overwhelmed with what you are asking.
- Apologize when appropriate. Parents, you don’t have to be perfect. Read that again. You actually will not be perfect. Let’s normalize that parents are humans too! When you make mistakes in your relationship with your teen, model healthy apologies and repair work. This gives your teen an example of what it might be like to revisit a topic that you might have wished you handled differently.
You can find more strategies for healthy communication among parents and teens here.
What can I expect family therapy to look like?
As mentioned before, the goals of family therapy are unique and specific to each family system, but typically involve a goal to restore and heal broken or difficult relationships. Keep in mind that family therapy can consist of anyone who is identified as part of the family structure and cares about and supports the teen. This might include parents, guardians, and siblings, as well as extended family such as cousins, grandparents, friends, or other caregivers. 
If you’re still on the fence of what it might actually be like to begin family therapy, let me give you an idea of how a family therapy session usually goes. Yes, there will be moments of discomfort! Yes, there may even be tears, eye rolls, or raised voices! But the family therapist never lets it end there. All family members who are willing to participate in the therapeutic process and have an active role in the identified family, are invited to attend.
The family therapist will likely start with the entire family unit to gather information from everyone about their family structure, what they feel the problems in the family are, and what outcomes they’d like to see. From there, the therapist may meet with various dyads, triads, or individuals in the family to learn more about the identified areas of concern. When all family members are present together for therapy, the therapist will help identify patterns or habits that family members often engage in that add to the tension. Then, tools and strategies to break these cycles and try new ways of communicating, relating, and supporting may be practiced and experienced.
There are many different modalities and theories used by mental health professionals for family therapy. You can dive into different types of specific family therapy approaches here.
The Long-term Benefits of Family Support in Counseling
Family therapy can often be short-term and time limited, however the benefits of family therapy can often be seen for long after the therapy has ended. Improved communication, more secure attachment bonds, and improvements in mental health functioning are all long-term benefits that may be sustained after family therapy ends.
Once the obstacles or problems within the family system are clearly identified, and then family members have been given opportunities to practice (in family sessions) ways to work through these problems more effectively together, the work continues outside of the therapy office. Many times once a cycle or repeated behavior is identified, family members are more easily able to address it in healthy ways in their daily functioning.
Family therapy often helps to remove the thinking that there is one problem family member and helps all members to see their unique role and involvement in both the struggles and victories!
Family Therapy: A Collective Journey Towards Healing
Family therapy can be a magical place. Don’t get me wrong…sometimes getting to that magical place requires emotional blood, sweat, and tears, but to experience true connection and safety with family members in the therapy space, can heal wounds and enhance communication moving forward.
If you are reading this and wondering if family therapy might be right for you, I encourage you to view this process as a shared opportunity to strengthen and build on your family relationships and better support your teen, rather than trying to fix all of their problems.
Blog written by Sentier therapist Tana Welter, MSW, LICSW.
Sources:
Cherry, K. (2024, January 16). How family therapy works. Verywell Mind. https://www.verywellmind.com/family-therapy-definition-types-techniques-and-efficacy-5190233
Children’s Mental Health: Data and statistics on children’s mental health. (2023, March 8). Centers for Disease Control and Prevention. https://www.cdc.gov/childrensmentalhealth/data.html
Family Therapy: What is it, techniques & types. (2022, November 20). Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/24454-family-therapy
