The word family comes from the Latin familia, indicating a group of people who are ‘familiar’. Contemporary society is characterised by changes in family structure. Traditionally, a family might be considered to be composed of a mother, a father and child(ren) with grandparents living nearby who provide help with child-rearing. In recent decades the idea of this traditional family structure has been challenged in many ways. Mobility, often driven by study and or work, has resulted in grandparents sometimes being remote from parents and their children and no longer participating in child-rearing to the extent that they may have previously. Increased social acceptance of separation, divorce and re-partnering has given rise to blended families, wherein children growing up within  the same family may not have the same biological parents. And increased social acceptance of same sex relationships and the fluidity of gender means both parents may be of the same sex and or same gender.

Dr Weston works with family clients in a number of different scenarios, with two scenarios the most frequent. Firstly, when members of the family are unhappy about the way in which they are interacting and the whole family is seeking ways in which they can be happier and more content together; this could be termed ‘family as client’. Secondly, when one member of the family is struggling and other family members are seeking to provide help and support; in the scientific  literature this scenario is sometimes referred to as working with the family to support ‘the identified patient’. In both scenarios issues of attachment styles and rejection sensitivity are often important. Frequently the ‘identified patient’ will identified by issues such as depression, anxiety, distress (e.g. related to bullying, abuse, addictions, eating problems and so on) and sometimes personality problems. And these issues can sometimes play a part in ‘family as client’ wherein one or more members of the family are suffering with these kinds of issues.

Family as Client

In this scenario understanding the patterns of attachment within the family and the ways in which different family members interact often provides the key to understanding what is and isn’t working for the family. In particular understanding what are termed ‘negative interaction cycles’ and how these play out between different family members can help the family understand how to be happier and more content together. From this type of understanding and interaction within the family, new solutions to old problems can emerge.

Family as Client with Identified Patient(s)

This scenario is frequently the case with young people who are experiencing problems. By definition, anyone under the age of eighteen years of age is subject to child protection. In working with anyone under the age of eighteen years of age it is essential to have a parent to work with to address any child protection concerns. Ideally, helping parent(s) to help their child(ren) creates a more ‘robust’ family, wherein the family is much more able to help-itself and the individuals within the family.

Research at this service to December 2018 suggested improvements in depression can occur through family work. Following are improvements seen for four clients, average age 16 years (range early teens to early twenties) after an average of nine sessions:

family dep

This naturalistic research showed on average a large improvement for symptoms of depression during family counselling.

Research at this service to December 2018 suggested improvements in anxiety can occur through family work. Following are improvements seen for three clients, average age 18 years (range early teens to early twenties) after an average of thirteen sessions:

family anxiety

This naturalistic research showed on average a large improvement for symptoms of anxiety during family counselling.

Please note past performance is no guide to the future and there are no guarantees about outcome in therapy.

Confidentiality

Sometimes during family work it can be helpful to work with the family as a whole, substructures of the family (e.g. parents, children, etc.) and individuals (e.g. the identified patient) on their own. In addition to the usual confidentiality policy the following policy also applies:

It is important for the integrity of our work together that I cannot hold secrets from other members of the family, since each person in the family is equally my client. Sometimes individuals may request separate sessions from the family (e.g. to work something through on their own before sharing with another, a request for additional support, etc.) and this is ok, provided that all parties agree and that anything shared with me may at my discretion be shared with other(s) in the family. The qualifier ‘at my discretion’ is to reflect the fact that at times I will need to exercise clinical judgement as to the timing of sharing information. If one person insists on something not being disclosed to (an)other in the family that which has been shared with me, I will usually need to terminate our work together, since I would then be unable to treat each individual equally.

You can contact Dr Tony Weston on 01223-894896 (phone is answered by a receptionist 24/7) or email him at tony.weston5@btinternet.com to make an initial appointment…