In January’s column, 6 Tips to Help Parents of Adult Kids Build Strong Relationships, I shared practical advice for strengthening bonds between older clients and their grown children. This month, I want to dive deeper into supporting families when simple tips aren’t enough.
Every year, I receive calls from adult children seeking therapy for themselves, their siblings, and their parents. Similarly, older clients often approach me about working with their adult children—whether for ongoing therapy or a consultation session to address a pressing issue. A common thread in these requests is the challenge of finding therapists who specialize in working with adult families. While there are plenty of resources for families with young children, support for families with adult children is surprisingly sparse. This gap in services highlights an opportunity to bring much-needed attention to these unique dynamics.
Steps to Getting Started
The thought of a room full of adults—whether in your office or on a screen—might feel intimidating, but as marriage and family therapists, we have the foundational training to navigate these sessions. Here are a few key considerations to set yourself up for success:
Initial Contact and Session Goals
Your first contact will likely be with one family member. During this conversation, focus on understanding what brings the family to therapy and clarify the scope of your work together. Some questions to consider include:
Why are they seeking therapy at this time? It’s helpful to ensure that therapy isn’t being used as a way to pressure someone—such as adult children trying to push their parents into making a decision they’re not ready for, or vice versa.
Who will be participating in the sessions? Think of each person who has a role to play in the interpersonal dynamic.
Is everyone willing to attend? If not, explore who is hesitant to participate and the reasons behind their reluctance.
Are they seeking ongoing therapy, a one-time consultation, or mediation for a specific issue? The answer to that question will help you optimize the benefit of the session for each individual.
Do all family members live in the state where you are licensed? If not, you might suggest scheduling extended sessions when everyone is in town for a holiday or family event.
These initial steps help set clear expectations and create a foundation for a collaborative and productive therapeutic process.
Setting the Tone in the First Session
Begin the session by inviting everyone to introduce themselves and share their hopes for therapy. Start with the parents, as that will acknowledge their role as family elders and set a respectful tone. As always, prioritize rapport-building to create a space where every member knows they are seen and heard.
Cultural Sensitivity
Be mindful of cultural norms and expectations. For example, in some cultures, it’s common for a 35-year-old son to live at home until marriage, while in others, this might signal “failure to launch.” Cultural differences can also shape expectations around caregiving and decision-making, especially if adult children are more acculturated than their parents. These dynamics often contribute to family tensions, making cultural awareness essential.
Tailoring Your Approach
Adjust your treatment plan based on the family’s goals and needs. For instance, a one-time consultation for a specific issue might require an extended session. Larger families may also benefit from extended sessions to ensure everyone has time to participate.
Make Sure Expectations Are Realistic
As the family shares what brings them to therapy, take time to clarify their goals. It’s common for family members to have conflicting or overlapping goals, so part of your role is to help them establish a shared focus for treatment. If multiple realistic goals emerge, work together to prioritize where to begin.
This is also an opportunity to explain your role in the therapeutic process. Many families may be new to therapy and might mistakenly expect you to act as an arbitrator or judge, determining who is “right” or “wrong.” Instead, gently guide them toward understanding that therapy is a collaborative space to explore their dynamics and work toward solutions together.
Useful Family Therapy Approaches
The following are some therapeutic approaches that can guide your work with families:
Structural Family Therapy (Salvador Minuchin)
Focuses on family structure, hierarchy, and boundaries. For example, helping adult children respect their parents’ autonomy while sharing their concerns can realign family dynamics in a healthy way.
Bowen Family Systems Therapy (Murray Bowen)
Explores intergenerational patterns and family roles. Genograms can help highlight patterns and encourage more direct communication. Identifying triangles in the family can also reduce conflict and foster connection.
Solution-Focused Brief Therapy (Steve de Shazer and Insoo Kim Berg)
Ideal for families seeking short-term support to address specific challenges. This approach emphasizes solutions over problem exploration, making it well-suited for time-limited sessions.
Narrative Therapy (Michael White and David Epston)
Helps families reframe the stories they tell about themselves and each other. Members can develop more empowering perspectives by externalizing problems and rewriting family narratives.
Cognitive-Behavioral Family Therapy (CBFT)
Focuses on identifying and changing thought patterns that contribute to family tension. This approach is practical and goal-oriented, often resulting in behavioral agreements.
Emotionally Focused Family Therapy (Sue Johnson)
Explores attachment dynamics and underlying emotional needs. By addressing unresolved pain, families can build more secure emotional connections and reduce conflict.
Taking an Integrative Approach
In many cases, blending techniques from these approaches can offer the most flexibility and effectiveness. As therapists, our ability to adapt and tailor interventions to each family’s unique dynamics is one of our greatest strengths.
By embracing the opportunity to work with older adults and their grown children, we can bridge the gap in family therapy services and help families navigate challenges with compassion, clarity, and connection.
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