Therapists I

How do family therapists negotiate their relationships with their own families?
What do family therapists do when their families ask for professional opinions, or when they see their family members make choices or manifest behaviors that will probably have negative repercussions? How do family therapists figure out how to respond to family requests for professional opinions or therapeutic advice, even though the law in every state stipulates that therapists do not maintain dual relationships (ie., provide therapy to people with whom they have friendships or to whom they are related)?
These are questions that I have had for a long time and that I tried to find answers for through research interviews. In order to get these answers, I interviewed 15 practicing family therapists and analyzed their responses. The results came together in the most interesting ways.
In order to come to an understanding of the way that therapists negotiate their family requests, all of the interviews were recorded and transcribed. Themes that were recurring were coded and subthemes were identified. I'll explain what I found by quoting the research participants. Their comments illustrate the major findings from the study and I will explain these over the next couple posts. A word that came up over and over in the participants' remarks was Therapize so I named my developing research article, Don't Therapize Me! Family Therapists as Family Members. Here is what I found:
Marriage and family therapists (MFTs) reported distinct ways that they responded to family requests for professional input.
1. Some therapists gave overt advice to their family members and friends:

“I find that my family comes to me with a lot of questions…I’ve been able to help with a diagnosis or two. A lot of the interventions that we use with our children are…kind of strategic" (strategic family therapy--a clearly delineated approach).

“There are times when [my wife] really does need some direction from me. I’ll just take over, and now... "I’m not your son or your husband. I’m…in charge here, so let’s do this.”"
“[my sister] called me for some just brotherly advice, which really became professional advice from a brotherly person.”

These MFTs didn't appear to think twice about giving professional opinions regardless of the law or professional ethics. Compare this with the individuals who opted to give covert advice to family and friends:

“I mean, there are some little things I’ll do but …people won’t know that I’m “doin’ them” therapeutically.” (This gave me the creeps!)

“I’m not nearly as obvious that I’m therapizing” with reflective listening. I’m a little more covert, when I’m parenting or rephrasing…When I’m therapizing I’m probably not as verbal, …and in regular conversation I have a tendency—I can interrupt sometimes.”

“We might give a book that we found so helpful.”

So obviously, therapists in this group decided that they should give some help to family members but didn't feel right doing it outright. Perhaps they were "just being helpful" vs. "therapizing." That certainly seemed to be what they thought they were doing.

Then we have individuals who flatly refused to provide any insight, advice, or discussion about issues that might provide useful to family members or friends:


“I could save my kids some grief and heartache probably by directing them in a different way, but I don’t do that.“

“ …I am a firm believer from doing years of therapy that … it’s more damaging to try to help them when they don’t want to be helped. So you just have to figure out how to live with the pain, which is a lot of what life is: figuring out how to live with the pain.” This last comment was particularly poignant and the man's gaze lingered on me for a long time. "You know what I mean, don't you?" he asked.

The fourth group of therapists were your everyday people whose relational style with their family members was without therapeutic overlay. Their focus was on just playing the role of a brother, sister, mother, or father:

“I would say, as your brother who loves you and is concerned about you, do you know what you’re doing?”

“So my children…sometimes ask me what I think about things…I have to keep it simple and only talk about what they ask. If I give my reasoning process or what I think is the background on the issue, it’s “Ma, you’re therapizing!”” This latter form of relating to family strikes me as the more healthy and the least disruptive for everyone involved, regardless of the way the therapists think or the insight they have.

Are therapists able to turn off their brain and just be average people? I'll talk more about this in the next post.