People sometimes tell me that their family needs therapy, but nobody in the family would ever agree to it.

My advice: Do it without them.

I know that sounds like nonsense. How can you figure out who to blame without the whole family participating? How can you help people see where they’re wrong? How can you tell them what to fix when they’re not a part of the conversation?

I can’t, but that’s OK. Those aren’t the things I do, anyway. It’s not my job to point the accusing finger of blame or to prescribe miracle cures. My job is to get to know you, to understand your stories as individuals and as a group, and to explore possible small changes that should lead to larger, positive changes in the family system. How we do that is by exploring not only the problems but also what’s going well. We call these moments “exceptions to the problem behavior,” but maybe we ought to call them, “stuff you do most of the time but don’t notice because things are going well when you do them.”

Still, don’t we need more than one family member to help create positive change? Ideally, yes, but it’s not necessary. That’s because the family is a system. (If you’re a regular reader of my blog, you can skip this paragraph; you’ve heard this before.) A system is simply a pattern of communications, behaviors and reactions to those behaviors that happen over and over again. For example, if a kid habitually leaves his dirty boots in the kitchen instead of the mud room, his mother might habitually react by getting mad and yelling at him. If she starts to get really angry, then Dad will jump in to calm Mom down, like he always does. And when Dad jumps in, then Sister … well, you get the idea.

To create change, we don’t need 10 people on the edge of their seats (although they’d all be welcome). We just need one person willing to break the pattern. If that person changes what they do, everyone else has to change their reactions, too.

For example, I had one client who sought therapy because of a relative’s relationship with Depression. The relative had a life change that damaged how he saw himself, and she worried that Depression would never let him go. He also refused to join us for sessions. But we continued exploring ways that she could change how she reacted to him. She started concentrating on the positive things he did, and she worked piece by piece to help him see he still had value. Gradually, Depression loosened its hold on him even though he never participated in a session

One final thought – often, teens are the ones who refuse family therapy. That’s OK; much of my family work involves just the parents, anyway. But if you really want your teenager to participate in family therapy, just say this: “You don’t have to take part, but we’re doing it anyway, and we’ll be talking about you.”

Works almost every time.

(Carl Grody, LISW-S, works with families at Grody Online Family Counseling based in Columbus, Ohio. Carl has 12 years of experience working with kids, teens, families and couples. He’s a trained group leader in the Incredible Years parenting program, and he’s the family therapy columnist for Columbus Parent magazine. For an appointment with Carl, call 614-477-5565 or schedule directly online at