Frequently Asked Questions

How does family therapy work? 

Family therapy takes the view that families have their own strengths and that from time to time things can happen that can diminish that strength and lead to more dysfunctional behaviour amongst some or all family members.   In addition difficult patterns of communication can arise that may interfere with how members feel understood and accepted within the family group. A Family therapy approach supports families to work on their understanding and communication of one another and by exploring family beliefs and the influence of family history new understandings and ways of interacting can emerge that can change behaviours and lead to greater family equilibrium and harmony.

Do all family members need to attend family therapy?

No, not at all and it is not a good start to insist that everyone must attend.   It is very common for some family members to feel apprehensive about the idea of attending therapy with their family.  They may feel embarrassed, exposed or fear being blamed for something.  In fact it is quite possible for family therapy to be extremely helpful with only one or two of the family present. In general, most people want to know what has been said about them and this will encourage them to attend the session after all.

Can certain members of the family attend sessions on their own? 

Yes of course.  In fact, depending on how the therapy is progressing,  it can be really helpful to have different members of the family attend together or on their own in addition to whole family sessions. 

Do you work with families who are going through the family court system?

Yes I do.  I have much experience of this kind of work and I am fully aware of how upsetting and damaging the process can be, particularly when it is prolonged by ongoing court hearings and CAFCAS interviews for the children.  I take a “Family Ties” approach to working with high conflict separating parents and families.  This approach was pioneered by the Anna Freud Centre in London and offers a way of supporting parents to change the patterns of conflict that have arisen, in order to promote the needs of their children. 

Couple therapy 

Do you work with same sex and/or trans couples? 

Yes.  I am experienced in working with same sex  and trans couples and individuals.  While it is important to treat all couples as emotional systems, it is also very important to acknowledge that the experience of trans and same sex couples is, unfortunately, still likely to be influenced by some negative attitudes that continue to persist in society today. I therefore do not assume that the external pressures on such couples is the same as it is for heterosexual couples.

Do you work with couples when there is or has been violence?

Yes, I do work with couples where there has been violence but I make it very clear that if the violence is ongoing then I would need to contact the appropriate authorities in order to ensure that the necessary safeguarding measures are in place.  In my experience, the advent of violence within a couple relationship can be a deeply shaming experience for one or both parties and to maintain secrecy around it, can be damaging to all concerned.

Do you work with couples who are thinking about or wanting to separate?

Yes I do and I have supported a number of couples to acknowledge that the relationship no longer works for them and how they can continue to communicate well in order to separate and work through what can be a very upsetting and disruptive process.

Do you work with separating couples who are involved in the family court system?

Yes I do.  I have many years of experience working with couples and their family at different stages of the legal process.  Sadly, many family courts will recommend family therapy very late in the proceedings which is most unfortunate because by that stage a huge amount of money and upset has already  been expended which could have been avoided, had the therapy been introduced at an earlier time. 

Do you work with couples online?

Yes I do.  I have worked with a number of couples online due to their preference or because the time or distance would make it too difficult for us to meet in person.  In some cases couples are located in different places or in different countries but as long as the time agreed is convenient for all parties, this has not yet proved to be a problem. 

Neurodivergence (ND) – Autism (ASC) and ADHD 

Do you offer behaviour management sessions for children, young people and adults with ND?

Not as such.  In my experience as a CAMHS therapist the best support is through intensive home sessions with a one-to-one behaviour specialist from an Autism based organisation.  However, I do work with individuals and families who are trying to find the best ways to support a family member with an ND diagnosis.  This can focus on how best to understand their different needs and how to adapt parenting expectations in order to help individuals cope with the additional stresses that tend to accompany ND, such as heightened anxiety; communication deficits; low mood; stress; a sense of feeling overwhelmed and sensory overload, to name but a few.

Is it necessary to include siblings in family sessions with a young person with an ND diagnosis?

It is not so much that it is necessary, but rather that it is incredibly helpful as the sibling may offer a really helpful fresh perspective on what is happening in the parent/child dynamic.  They may also feel resentful that their sibling is receiving so much more attention than they are.  It needs to be highlighted that siblings have needs too and their wellbeing can suffer if they are forever feeling side-lined and overlooked in the family.

Can you work with anxiety, intrusive thoughts, self-harm and procrastination? 

These are some of the most common issues that arise when someone has a diagnosis of ND and I have developed a range of different ways of supporting people to manage these difficulties.

Do you liaise with a young person’s school/college if they are having difficulties? 

Yes, this is something that I can do by writing letters of support or attending meetings.  I generally charge for these additional tasks but it can make a huge difference to the outcome if there is a clinician present to represent their mental health and ND needs.

Frequency of sessions

Does therapy have to be weekly?

Not at all.  When working with individuals weekly sessions can work well, particularly if there are some ongoing issues that need close attention.  In couple therapy weekly sessions to start with may also be helpfu to give space to explore some of the issues, but as the therapy progresses this can usually move to every two or three weeks.  Again with family work, some weekly sessions in the early stages of therapy are useful but thereafter family change needs some time to be allowed to take place and so a larger gap of two or even three weeks between sessions can work better.