Including Family Members, Partners, & Friends in Therapy Sessions

Including supports in therapy

Including Loved Ones in Therapy Sessions

Including loved ones in your therapy session might feel like an invasion of your privacy and counterintuitive, but in most cases, it is an excellent way to advance your progress in meeting treatment goals.  Even research demonstrates improved outcomes when you include supports in your sessions.  We call these support sessions to reflect that they are not couples, family or partner sessions.  You are still the client and the ultimate focus is on you. 

Couples marriage therapy intensive

Why Support Sessions Work
Some things to keep in mind:  Firstly, though it may seem intrusive, such sessions are facilitated by your therapist.  You are not alone.  Secondly, there are ground rules for these sessions.  Thirdly, the interactions occur with your prior consent and with preparation. 

The Benefits of a Support Session
These are just some of the more common benefits to these collaborative sessions:

  • An opportunity to practice relational skills.
    • Learning how to set boundaries is one of the more important things you can do to repair relationships, manage overwhelm and prioritize your self-care.
    • Assertiveness is one of those skills that many of us miss in formative years and overcorrect when we become more self-aware. Practice can help you become more effective in getting your point across without risking full-blown alienation.
    • In your automated daily routines, it’s easy to engage in important interactions in a reactive and familiar pattern where nothing really changes and things get worse. In the controlled setting of session, we can slow down time to notice important relational cues and assess their meaning.  If you don’t catch important cues, your therapist is there as witness and interpreter.
    • Sometimes the disconnect between family members, spouses or friends is so profound because individuals lack the know-how to make repair. A supported session can help break the ice.
  • Educate supports.
    • Education can help take the spotlight off you as the “problem.” It is not uncommon that loved ones have misguided expectations regarding therapy.  They often think of therapy as something that will “fix” you fairly quickly and some loved ones might even see you as the sole cause of any chaos, disconnect or issues.  In a way, your seeking treatment can be viewed as the validation that “everything is your fault.”

      In reality, many of our issues are rooted in complex dynamics.  In these dynamics, defense mechanisms, unresolved trauma and lack of insight or skills among all parties can run rampant.  Unchecked, our vulnerabilities play out on in the relational field and issues escalate or remain unchanged. 

    • When loved ones are informed about therapy, trauma and various other conditions that affect mental health and well-being, they are more likely to offer genuine and helpful support. Creating a supportive environment is one of the more therapeutic things you can do to increase your daily functioning.  It can also increase hope and resilience.
  • Generalize in-session learning.
    • A common phrase you will hear uttered in sessions at Urim Recovery, is that the point of therapy is not to stack up “good session,” but to be able to implement what you learn in your sessions in your everyday life. You enter treatment to transform your life, overcome challenges and feel empowered to live a purposeful life that manifests your potential.  That can’t be done in a 50 minute session.  Support sessions are a way of including your life “out there” in the session.  Your therapist can witness and address the actual issues discussed in therapy as a result of having more context.

The Nuts and Bolts of a Support Session
Starting Point
Ideally, the starting point for a support session is to let loved ones know that you are in therapy.  This can be a source of some anxiety for any number of personal reasons.  In general, keeping things simple and sweet usually works.  It’s important that your support not feel “set up.”  That is not the point of a support session, and it would not be effective or helpful.  The best way to proceed is to remember that no matter the outcome, you are inviting a loved one as support for you.  Keeping the message that simple will suffice in most cases.  Your therapist can help you frame that request and work on any internal or external barriers that might be in play.

Sign a Release of Information
To protect your confidentiality and get the ball rolling on your support session, remember to sign a release that outlines permissible discussion and allows your therapist to conduct the support session. Your loved one can’t simply turn up to a session without some guidance in place and they cannot schedule a session as a separate client.

What to Discuss in The Session
Once you have decided to include your support in a session, you will need to sign a release that allows your therapist to interact in the session.  These sessions are often about boundaries, general information about therapy and some education about certain diagnoses.  It is not uncommon to also discuss relationship dynamics and skills for more effective communication.  It is often not necessary to go into detail about your opinions or trauma.  It is wise to discuss the parameters of what will be discussed in one or more sessions prior to the support session.  

A support session need not be a single event. In fact, multiple support sessions can help develop secure attachment and a supportive environment for long term well-being.
Family members engaging in video conference support session

Ground Rules For Support Sessions
The ground rules of a support session include:

  • One person speaking at a time.
  • No name-calling
  • Making “I” statements.
  • Listening openly without trying to anticipate what you want to state next.
  • Staying present.
  • Taking responsibility for one’s needs and clearly communicating these needs.
  • No advice-giving.


The Resistant Nay-Saying Skeptical Family Member

Successful Outcomes
Of course, just because we invite loved ones to a support session, doesn’t mean that they will be, well, supportive.  Fortunately, the success of a support session is not contingent on a family member’s approval of you, your therapy or therapy in general.  

If your assumption was that a successful outcome was one in which months or years of disagreement, shortsightedness, disconnection, trauma or chaos was dependent on a support session, perhaps your expectations were unrealistically high.  While agreement, support, love, affection and understanding by loved ones are hopeful outcomes, they are not the only indicators of success.  Keep the following in mind:

  • You are the client. Not your loved one. This is your therapy.  While it is nice for others to accept our boundaries, their acceptance of your boundaries is not the focus of whether you might set them.  Their healing is also not the focus.  This is not their therapy session.
  • Sometimes our loved ones have never been exposed to healthy communication styles.  Simply exposing family members, partners or close friends to ground rules based on respect and psychoeducation regarding the benefits of therapy, might be the start of a loved one’s own therapeutic journey or personal growth.
  • People learn at different speeds and when they are ready.

If you are hesitant about having a therapy session in which you include your supports, remember, most of them go very well.  Share your concerns with your therapist. You may need to sound your fears out loud.


Skepticism and resistant loved ones in PTSD treatment support sessions

Prepare Your Supports in Advance
Introducing your loved one to information on trauma, attachment and therapy is a great way to prepare your support practically and psychologically for the session.  You might also provide them with a link to the Urim Recovery Journal where they can peruse common issues that are addressed in treatment.  This invites participants to “hit the ground running” and also lower defensiveness.

Below are some links to information to help your loved one prepare for joining your therapy session:

You can find other soundbites related to preparation for therapy here .  Stay in tune with issues related to your well-being and mental health right here in the Urim Recovery Journal updated 2x a week.

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