family-based treatment (for parents/partners)

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OCD and anxiety affect more than just the person diagnosed. More often than not they affect the whole family. Parents suffer when watching their children suffer. Siblings feel isolated and unseen when one child is the focus of so much of the family’s time, attention, and energy. Partners feel lost and hopeless in not knowing what to say or do when their loved one can’t stop their compulsive behaviors. 

Individual treatment, when the person is open and willing to engage in it, can be life-changing for everyone in the family. However, people aren’t always ready or able to receive their own individual therapy. Or, sometimes, they are only ready for certain aspects, but not willing to engage in aspects that create change, such as ERP. Ambivalence towards therapy is okay, and honestly, is a natural part of the process. But what if other members of the family ARE ready for change? This is where family-based treatment can help. 

I work with family members – parents or partners typically– to provide family-based treatment using a combination of:

• Acceptance and Commitment Therapy (ACT) with a focus on values as a Parent or Partner 
• Family Well-Being Approach (FWBA)
• Supportive Parenting for Anxious Childhood Emotions (SPACE)
• Other approaches that foster communication, understanding, and connection in families

Unlike family therapy or couple’s therapy, the individual loved one is not present for the sessions. The goals of family-based treatment are to:

• learn how to respond supportively to your loved one instead of responding reactively to anxiety
• build your loved one’s autonomy and independence
• improve collaboration and communication in the family
• reduce accommodations which exhaust family members and contribute to the individual’s anxiety cycle

In meeting the goals above, and even without direct intervention, we are meeting the family’s goal of reducing a loved one's emotional outbursts and increasing confidence.

I also provide coaching for parents of children or adults with Autism Spectrum Disorders, as well as delayed-launching adults, who often also experience significant anxiety.

Q: Does family-based treatment really work if the person with the anxiety disorder isn’t involved?

A: The focus of family-based treatment is on changing the patterns and behaviors of family members themselves in order to impact their child or loved one’s anxiety. SPACE has been tested and found to be as effective in treating child anxiety and OCD as direct individual treatment. In my practice I have found family-based treatment to be so effective that I do not work with children unless their primary caregivers are also willing to participate in family-based treatment.

Q: Will family-based treatment help my loved one experience less anxiety?

A: As is often the case with anxiety treatment, it is important to be aware that often the anxiety will increase before it gets better. However, family treatment is about learning how to provide comfort through difficult emotions, not avoiding them. It’s also about shifting focus from relieving discomfort in the short term to learning how to manage difficult emotions in the service of long-term resiliency. 

Q: Isn’t my loved one too old for this? They are not little anymore, and I don’t have that much control over their life. 

A: It’s true that family-based treatment is easier and more straight-forward with parents of small children, but there are lots of things that parents of teens or young adults can do by choosing how to use their presence and resources to persuade, encourage, and support their children. Spouses and other family members also have more impact than they often realize, and once they understand their role in the anxiety-feedback loop, are able to break some of these cycles. 

Q: Does this mean I would be giving up on my loved one getting their own treatment?

A: A person who is coerced into treatment rarely gets much out of it, and in fact, this can be counterproductive. However, many people’s experience in going through family-based therapy is that their loved one becomes more motivated to receive their own treatment, if it is still needed. This is a product of building their autonomy and independence, and increasing their own awareness and insight of the cost of anxiety being in charge of their actions, and improved capacity for being with difficult emotions.