Questions to Ask in Family Therapy
Questions for families starting therapy together. The first few are for the therapist, covering format, confidentiality, and how progress gets reviewed. The rest are questions to bring into the room, ordered from manageable to difficult.
The questions
Open any question for the note
How does family therapy work, week to week?
Why ask it
Knowing the format lowers the anxiety that stops families returning for a second session. Ask about session length, who speaks first, and whether the therapist directs the conversation or lets it run.
Who do you need in the room, and what happens if someone won't come?
Why ask it
Attendance is a common early obstacle. Many therapists will work with whoever attends, and knowing that in advance stops one reluctant person holding up the whole family.
How long do families usually work with you before anything shifts?
Why ask it
Answers vary by approach, and an honest one includes uncertainty. What matters is whether they will review progress with you at a set point rather than continuing indefinitely.
What's confidential between you and each of us, and what gets shared with everyone?
Why ask it
The rules differ between family and individual work, and misunderstanding them causes real harm. Ask specifically what happens to something disclosed in a one-to-one session.
How will we know whether this is working?
Why ask it
Ask for observable changes rather than feelings: fewer shouted arguments, one meal eaten together, a teenager leaving their room. Vague measures make progress impossible to distinguish from fatigue.
What do you need from us between sessions?
Why ask it
Some approaches set tasks at home and others deliberately do not. Knowing which lets you commit realistically instead of quietly failing at homework nobody explained.
What happens if one of us doesn't want to be here?
Why ask it
Reluctance is normal and usually protective. Naming it in the first session, rather than performing enthusiasm, tends to lower the temperature for everyone.
Can any of us talk to you without the whole family present?
Why ask it
Individual sessions alongside family work are common but not automatic. Asking early avoids requesting one later at a moment when it looks like a manoeuvre.
What do you think each of us finds hardest to say in this room?
Why ask it
Asking the therapist rather than each other keeps this from becoming an accusation. It puts the difficult material on the table without anyone having to volunteer first.
When did it start feeling like this between us?
Why ask it
Families often disagree about when things changed, and the disagreement is the useful part. One person may date it to an event that nobody else registered at the time.
What do you each think I don't understand about you?
Why ask it
This invites correction rather than defence. Expect answers about being cast as the difficult one, the reliable one, or the child assumed to need nothing.
When an argument starts, what does each of us do, and who moves first?
Why ask it
Arguments follow a sequence, and the sequence is easier to change than the subject. Ask who raises their voice first, who leaves the room, and who follows them.
What are we not talking about?
Why ask it
The unspoken subject is usually known to everyone: money, illness, drinking, or a family member never mentioned. Asking it in a supported setting is much of the reason for being there.
What did each of us learn about conflict growing up?
Why ask it
Everyone brings a template from their own childhood: shouting, silence, or fast repair. Naming those explains a great deal of the mismatch without assigning blame to anyone present.
What do you need from me that you've stopped asking for?
Why ask it
Abandoned requests reveal more than current complaints. When someone stops asking, they have usually concluded that asking does not work, which is a harder position to reverse.
What do you think I'm blaming you for?
Why ask it
This surfaces attributed blame, which is often heavier than anything anyone actually said. People regularly discover they have been blamed for something they never intended.
What would you like to hear me take responsibility for?
Why ask it
Offering responsibility rather than demanding it changes the direction of a session. Specificity matters, because a general apology tends to land as evasion.
What would an ordinary Tuesday evening look like if this were better?
Why ask it
A concrete picture is easier to work toward than harmony in the abstract. It also tends to reveal how modest people's real hopes are, which is encouraging for everyone.
What is each of us willing to change this week, specifically?
Why ask it
Sessions can produce insight and no change unless someone names an action. Small and specific works better than sincere and broad.
What do you want me to know that you've never said out loud?
Why ask it
Keep this until the room feels safe enough to hold the answer. What comes out is often the reason the family came, and it rarely arrives in the first session.
Before and during family therapy
Practical guidance for the conversation itself
How to use these
- The first nine are addressed to the therapist. The rest are for the room, and work better introduced one at a time with the therapist's help than read out as a list.
- Bring one question you genuinely want answered rather than a list you want covered. Sessions are short, and the important material takes time to reach.
- Write down what you hope changes before the first session. It is easy to lose the original aim once weekly conversation gets going.
What tends to help in the room
- Speak about your own experience rather than the other person's motives. What you did and what you felt is harder to argue with.
- Let the therapist manage the turn-taking. Families arrive with a habitual order of speaking, and interrupting that order is much of the work.
- Expect early sessions to feel worse before they feel better. Material avoided for years tends to surface first.
- Allow silence. Filling it usually means the person who most needs to speak does not get to.
What tends not to help
- Presenting evidence. This is not a hearing, and building a case entrenches everybody.
- Bringing a diagnosis for another family member.
- Repeating something said in session as ammunition afterwards, which is the fastest way to end anyone's willingness to be honest.
- Treating one person as the problem to be fixed. Where that framing holds, the work usually stalls.
Practical matters worth checking
- Cost per session, cancellation terms, and whether any part is covered by insurance or a public service.
- The therapist's training, and whether they are registered with a professional body.
- What happens if the therapist thinks one family member needs separate individual support.
- If there is violence, abuse, or fear of someone who would be in the room, say so to the therapist privately before joint sessions begin. Joint work is not appropriate in those circumstances, and a competent therapist will tell you the same.