A call with one of you
Usually the person who made contact. Who is in the family, what has been happening, and who might realistically come.
Free · about 20 minutes
Family therapy
Sometimes the difficulty is not inside one person.
It lives in the space between people — in a sequence everybody contributes to and nobody chose. Family therapy works on the pattern rather than on the person who happens to be showing it.
In one paragraph
Everyone who can come, in one room, for 75 minutes, usually fortnightly, with someone whose job is to notice the pattern rather than take sides. Six to ten sessions is normal.
Plainly
What actually happens in a family session
Everyone sits in a loose circle. There is no table to hide behind and no seating plan. One therapist asks questions; sometimes a second sits slightly outside the conversation and watches what is happening around it.
The questions are not the ones you are dreading. Far less "how does that make you feel" and far more "when your brother slams the door, what does your mum usually do next — and what does that leave you doing?"
Children are usually asked first, which surprises adults. It sets the tone: this is not a meeting about a child conducted in front of them.
Nobody is put on trial. If a session tips towards prosecution, we stop it, because it is the least useful thing a room like that can do.
When families come
Recognise any of these?
Family work suits difficulties that keep reassembling themselves no matter which individual gets help.
- The same argument, on a loop, for two years
- A separation that the children are managing badly, or too well
- A step-family that has not settled
- Siblings who cannot be in a room together
- A bereavement that everyone is handling privately
- One child’s difficulty has become the whole family’s weather
- A serious illness in the house
- Nobody says anything at meals any more
The shape of it
How family work usually goes
Shorter than individual therapy, more spaced out, and more homework — though we would never call it that in the room.
Scroll sideways, or use the arrow keys
A first family session
75 minutes, often with two therapists. Everyone gets asked what they hope will be different — including the children, first.
£110
We map the pattern
Not "who started it" but what happens just before, who ends up carrying what, and which conversations the family has learned to avoid.
Usually sessions two to four
Something gets tried
Small, specific and testable. Not "communicate better" but "for the next fortnight, Dad does bedtime on Tuesdays and nobody discusses school in the car".
Between sessions
Fortnightly, not weekly
Families need the gap. Change happens at home, in ordinary evenings, not in the therapy room.
Six to ten sessions is typical
A review, out loud
Everybody in the room says what has shifted and what has not. Children are frequently the most accurate witnesses in this conversation.
Then we stop, or continue
Choosing between them
Family work or individual therapy?
Often the honest answer is "start with one and see". These are the rough distinctions we use on the phone.
Individual is usually right when…
- The difficulty travels with the person into every setting
- They need somewhere entirely their own
- There is something they cannot say in front of family
- A bereavement or trauma sits with one person
Family work is usually right when…
- The same scene repeats with different casts
- Everyone is trying hard and it is getting worse
- The household has organised itself around one person
- A change of structure — separation, step-family, a new baby, a death
Sometimes both
- A teenager sees Sam weekly while the family sees Priya fortnightly
- Different therapists, deliberately, so nobody is carrying two roles
- We coordinate; you do not have to relay messages between us
Who leads this work
Priya Raman, systemic & family psychotherapist
Priya works with whole families, parts of families, and families who are not entirely sure they want to be in the same room. She offers evening appointments on Tuesdays and Wednesdays so that working parents can actually attend.
More about PriyaQuestions families ask
Does everybody have to come?
No. Family therapy works with whoever is in the room. Plenty of useful work happens with two people out of five. We will say who we think would help to have there, and then you decide.
Is this about blaming the parents?
No, and if a session starts heading that way we will interrupt it. The interest is in patterns — sequences that everyone contributes to and nobody chose. Blame is not only unkind, it is analytically useless: it stops the conversation at the least helpful point.
We are separated. Can we still do this?
Yes, and it is one of the things Priya does most. Sometimes both parents in the room, sometimes alternating sessions, occasionally with a child present and occasionally not. What we will not do is act as a referee for a court dispute, or write reports for legal proceedings.
Our children are very different ages. Does that work?
It can, and the mix is often the point — a fifteen-year-old and a seven-year-old will say very different things about the same household. We keep sessions varied enough that a younger child is not sitting through ninety minutes of adult conversation.
Why are there two therapists sometimes?
Because a family in a room generates more than one person can track. Often one therapist works with the conversation while the other watches what is happening around it. It is a standard systemic arrangement and it is included in the fee.
How many sessions?
Family work is usually shorter than individual therapy. Six to ten sessions is common, often fortnightly rather than weekly, because families need time between sessions for anything to change.
One person can start this
It does not need to be a family decision to make the first phone call. Most family work here begins with one person ringing up on behalf of everyone else, slightly unsure whether the rest will agree to come.