4 Ways Family Therapists Get Stuck (& What To Do About It)

This week, I’m sharing four ways therapists can get pulled into a system without noticing, plus some questions that can help us find our way back.

I don’t know about you, but one of my biggest struggles is not taking sides when I’m working with couples or families.

After years of doing this work, I’ve become very aware of what I now call my ‘Connection Compass’.

It’s like having a compass that points toward the person I’m leaning toward in the room. I don’t judge myself for this—my cold, frozen English heart is still human—but I use it as a reminder to get curious about what’s happening and to recentre myself.

I worked with a couple in which one partner had all the signs of Borderline Personality Disorder in men (there are some very different symptoms, btw watch my video if you're curious), and the connection compass was pointing dramatically away from him. I share this because it’s sometimes a struggle to bring myself back to center and be neutral or more balanced when my countertransference is so activated. Most often, it’s not so obvious, and it takes continuous work to notice more subtle shifts in the direction it points, especially when I genuinely like the family or couple in my office.

I wish I could give you a step-by-step guide to developing your own Connection Compass, but it’s such an intangible idea that I didn’t even have words for it until I started writing this. What I can say is that when we don’t notice our lack of neutrality, at least two things tend to happen.

1. When a parent explains that their teenager is oppositional, and that the school agrees, and there’s a signed release to talk to the psychiatrist, who also agrees, there’s a distinct pressure on you to agree too, and your connection compass may no longer be pointing north towards neutrality.  
2. If this teenager is also rude, difficult, or unhelpful in your office, you might be even more inclined to agree, and the arrow on your connection compass will spin away from them.

By the time everyone has shared their perspective and you’ve met the identified patient, the case often feels like it has a plot, a villain, and a role set aside for you. Unfortunately, that role can end up being just another person who couldn’t help, which is often when teens are sent to residential treatment or wilderness programs.

I saw frequently as a therapist and Clinical Director of such a treatment center, and wish I could report a perfect track record of not falling into this trap, but often the unit of treatment is not just the family. It’s an entire system that extends beyond the family, including schools, psychiatrists, coaches, therapists, and even, once, a hairdresser,  who have gathered around a problem and are trying to define it, manage it, or make it go away.

When we accept the family’s version of the problem as the whole truth, we become part of their system too. We lose our outside perspective, and it gets much harder to help. There are lots of ways this can happen, but here are four of the most common—with a World Cup theme, sorry.

1. Own Goal
2. The Wrong Team
3. The Substitute
4. Caught in the Formation

House Keeping!

1. Consultations: I've had a few random emails asking if I do consultation calls, the answer is 'Why yes, I do!'. I have been slammed for the past two weeks, but am coming up for air- you can email me [email protected] to set up a time.
2. Group Consultation Calls with four-six people in is something I'll be launching as part of The Family Systems Collective, which is yet another reason you should join. It's a FREE online community in which I share content, answer questions and where I'll be doing LIVE WORKSHOPS very soon. You read it here first. 
3. The Podcast - I may live to regret starting this, but you can find it on Spotify, Apple and Amazon by searhing for 'Family Systems In 15 Minutes'

1. Own Goal

We score an own goal when we forget that the system is bigger than just the people in the room. I once worked with a family and struggled because I didn’t realize Grandma was a key co-parent, even though she wasn’t in therapy.

We can’t always bring everyone into sessions, especially if it’s a teacher or someone from school, but we can at least be aware of them and try to reach out. Sometimes, people we wouldn’t expect—like a church leader or a former clinician—have a big influence too.

These people don’t need to have bad intentions; they just have an influence on the family that we need to notice.

That’s why I love making family maps—and I could talk about them all day! If you want to learn more, check out the free videos in The Family Systems Collective, or look into Advanced Family Mapping for a deeper dive.

Try asking:

• Who else has an opinion about what is happening?
• Who is already trying to help?
• Whose approval matters when this family makes a change?
• Who is not in the room but somehow appears in every decision?

2. Playing Offside

There’s often someone in the system who is most eager for you to join in on their view of the problem, and it’s rarely the IP and sometimes not even the caregiver who called to schedule the appointment either. It could be the school or the doctor who is insisting on something happening with the family or the IP.

This is where you drift offside and mistake compliance for commitment, so you make the run, you intervene, you set the homework, and you’re all in. However, the desire for change isn't among the people in the room; it’s with someone who isn't on the pitch.

You’ll spot this when attendance turns erratic or the directives you set don’t get taken up, and every intervention lands with the enthusiasm of me watching a baseball game (which, despite these sporting names, is not at all high).

Before you do, it's worth asking:

• Who first decided this was a problem?
• Who wants it to change the most?
• What does each person think they've agreed to do here?
• What would happen if nothing changed?

3. The Substitute Player

If you accept the family’s version of the problem without mapping out everyone’s roles, you end up as their substitute player. You might take the same position as the last therapist or join the team against the identified patient.

If the ‘evil teacher’ at the last school was blamed for the child not attending, and you start insisting the child go, you become the new ‘evil teacher’. I once met a couple looking for a new therapist. When I asked about their last experience, one partner said it was because the therapist didn’t agree the other was the problem. She was basically looking for someone to take her side and wanted me to fill that role. I didn’t get the client, by the way.

Useful questions include:

• What have previous providers or other people said is the problem, and who agrees most?
• Who experiences previous providers or other influential people as intrusive or controlling?
• What role are they hoping you will take over?
• Are you receiving information or being recruited onto a team?

Sometimes the best thing to do is include the referrer in an early conversation. Other times, it helps to ask each family member how they see the referral before accepting anyone’s version as the official story.

4. Caught in the Formation

This is the most uncomfortable one. You’ve probably heard of it, and it’s also the hardest to notice.

Right now, I’m supervising a therapist who’s three sessions into their first private practice client. In our first supervision, I learned the client had experienced serious boundary violations as a child. By the third session, the therapist was baffled as to why the client was angry after being asked about what kind of porn they watched. I was also confused about why the therapist asked this, but you’ll have to take my word that  there was some context to it. The bigger point was that this therapist missed the repetition, someone in authority being intrusive and crossing boundaries.

If you’re working with a family where one parent is focused on a child’s homework struggles and the other parent is off playing golf, it would be a mistake to join the worried parent and child in focusing only on homework. If the other parent keeps golfing instead of coming to therapy, you’re just repeating the same pattern, not changing it, and you would have been drawn into their formation.

When that happens, feeling stuck isn’t just about the family. It also tells you something about the team you’ve created together.

If a case is going nowhere, it's worth asking yourself:

• Whose account do I believe most quickly?
• Who do I protect, interrupt, explain, or avoid?
• Who has become peripheral since therapy began?
• Does the system with me in it now have the same shape as when they started therapy?

That last question can be a little humbling, but it might save you months of trying harder and harder interventions.

Redraw The Map Before You Try Another Technique.

Don’t think the answer is to stay detached or develop a cold, frozen English heart like mine. We still need to join and connect with the family; that part is essential.

Our job is to join the family while staying curious about the whole system, including our own place in it, and to let our connection compass move instead of getting stuck on one person.

So when a case feels stuck or you feel lost, try not to rush for a new worksheet, a clever reframe, or a more impressive question. Make a family map instead—maybe even two or three, including one with yourself in it.

Ask who is actually in the system, not just who is in the room with you.

Find out who wants what.

Look at the alliances that arrived with the family, and then check whether the therapy itself has started to copy the pattern.

Sometimes the intervention is noticing what the family has already invited us to become and how it’s influencing that connection compass.

Until the next time,

Oliver