Tips For Successful Family Therapy

For most my life, my mom and I have had a turbulent relationship. Vague reassurances from others that “everyone has family problems” never helped with our nonsensical fighting or how I felt. I never knew what to do, but I knew it had to stop.

Family relationships are sometimes responsible for life’s biggest conflicts. They’re often complicated and can span decades. For many, it’s the steady drip of unresolved arguments and personality clashes that leave lasting feelings of resentment and bitterness. But there is a way to work through this. There is a hopeful course of action—it’s called family therapy.

Giving It A Chance

Family therapy is a collaborative and inclusive process which focuses on the family as a unit. Family therapists are skilled in dealing with a variety of conflicts whether it involves communication issues, estrangement, financial problems, divorce, a death in the family and more.

There might be a time before starting therapy when you won’t want to go. I certainly didn’t. My mom certainly didn’t. The pains of having to sift through years of battles wasn’t appealing. But without confronting the past, we are bound to repeat the same mistakes. Therapy may lead to the resolution you’ve been searching for. It’s important to give it a chance.

Finding The Right Therapist

I knew that the family therapist I chose was effective because within our first few sessions, I felt comfortable. I knew I would be able to open up to her. And I never dreaded talking in session. She also brought up Narcissistic and Borderline Personality Disorder in regards to my mother. This helped me to trust my therapist and her expertise even more, because she was able to spot that early on.

If you feel that a therapist is not effective, it’s okay to keep looking. In my experience, most therapists don’t take it personally. In fact, they encouraged my family to find the right fit for us. Your comfort level and ability to open up are essential in a therapeutic relationship.

Over time, your therapist will learn your family’s communication style. Some families are louder than others, while some fill the minutes with silence. Certain family members may be withdrawn at tense moments, while others might be aggressive. Your therapist will be see these differences and guide each of you accordingly.

How To Have Effective Therapy Sessions

A typical therapy session is 50 minutes, once a week. It’s a short amount of time to work through a lot of issues among multiple people. In order to best use your time with your therapist, here are a few tips to have effective sessions.

  • Prepare prior to therapy. Each family member should jot down questions or issues they would like to discuss.
  • If there is one family member you don’t get along with, carefully decide what you’ll say to them when you have your chance to speak.
  • Remain strong and respectful.
  • Speak calmly.
  • Try not to argue.

You may feel as though your family will never resolve long-standing conflicts. But it is possible. With listening and restraint, your family can reaffirm its bond and clear up old disagreements and hurt. Or you may decide it’s time to move on. For me, the decision to lessen contact with my mother, while controversial to some, was the right choice. I am no longer consumed with guilt about not being able to get along. Without therapy, I know I would still have an extremely close and volatile relationship with her.

Because it was such a positive and powerful experience for me, I always recommend family therapy to others. Even the more exhausting and uncomfortable sessions were necessary. Without them, I wouldn’t have been able to identify toxic patterns of behavior, understand my depression, or take control and realize what I needed to do in order to change my life.

There is nothing to fear about family therapy—it’s a safe place to work through negative feelings and move forward. Any decisions you make with your family will be based off careful discussion and thought. When I look back now, I know I wouldn’t have made the same choices without the support of my therapist.
Amanda C. Dacquel is a mental health writer and advocate. In 2014, she started to share mental health experiences, resources and news. You can connect with her at

Holiday Magic Is Made By Women. And It’s Killing Us.

I have yet to send out my Christmas cards this year, but the various steps necessary to complete this task have been weaving through my mind for months. I booked a session with a photographer at the end of August. I picked out and shopped for outfits for the entire family in October. In November, the actual photoshoot took place, but not before a flurry of back-and-forth emails deciding on time and place while factoring in the weather.

The photos will be in soon. Perhaps there will be a clear winner, but the most likely scenario is that I will spend hours deciding which child’s “weird face” picture is the most palatable to send to grandparents. They can never just smile, no matter how much coaxing and bribing is involved. Then I will spend time carefully picking out the right photo card and figuring out just the right holiday message before ordering. I’ll have to check my address book, contact a handful of people for updates, decide who is getting a card, order stamps, hand-write addresses until I have carpal tunnel and lick envelopes until my tongue is swollen.

Of course, I could forgo this emotional labor and take the cards off my list entirely. It would free up a little mental space in an already hectic time, but it would also come with the consequence of disappointed relatives. I know because I actually did skip the holiday cards one year. My elderly aunt was heartbroken not to receive one. My husband’s grandparents were left without a set of great-grandchildren pictures to hang on the mantle. I had failed not only in the emotional labor of orchestrating the Christmas card, but also in considering the expectations and feelings of others.

“Women already perform the bulk of emotional labor … but during the holidays, this work ramps up.”

Women already perform the bulk of emotional labor ― the psychological phenomenon of unpaid, often unnoticed labor that goes into keeping everyone around you comfortable and happy. But during the holidays, this work ramps up. There are more mental lists to juggle, more commitments on the calendar to keep track of, more tasks to delegate. There is more pressure to make things magical for those around you. It takes a lot of unseen and underappreciated effort to keep everything humming along smoothly.

Melody Wilding, a licensed social worker and coach who helps clients overcome challenges like emotional labor, says that a tendency to put too much on our plates and let self-care slip is often par for the course during the holidays.

“Putting pressure on yourself to have or create the ‘perfect holiday’ can send your stress skyrocketing, and overcommitment can quickly lead to exhaustion and burnout,” she told HuffPost.

How to manage the stress of emotional labor this time of year

I certainly try to keep self-care in mind during the holidays, usually taking on a yoga routine and drinking lots of decaf green tea to combat the stress. But the overwhelm still gets me. While it’s up to my husband to put up the lights and trim the tree, the vast majority of the holiday planning falls to me.

It’s me who puts the parties and potluck dishes on the calendar, keeps track of the winter coat drive, plans the get-togethers with both sides of the family, expends the mental energy of figuring out gifts for everyone. It’s exhausting, and seems unending (at least until after the new year rolls in). Normally this level of productivity would make me feel like a rockstar, but during this time of year, it simply feels like I’m falling short.

Experts say that this type of intense pressure can lead to perfectionism ― and in its most extreme form, perfectionism can be associated with mental health issues. Research has linked perfectionism with anxiety, depression and even thoughts of self-harm.

“Question the voice of your inner critic that says you’re not good enough.”


I’m not one to strive for perfection, but during the holidays it’s so easy to point out those spots where it would be feasible for me to do more. We could go chop down our own Christmas tree, but I’ve never actually gone ahead and planned a trip. I could learn to use my sewing machine and make a festive table runner and napkins. I could make a beautiful gingerbread house from scratch if I really tried hard. I find myself thinking I’m probably doing enough, but I feel like I could be doing more.

Wilding says a solution to that irrational feeling might be stepping slowly away from Instagram. It’s advice that makes sense: Studies show excessive social media use is linked with increased feelings of lonelinessanxiety and depressive symptoms.

“Social media makes it seem like everyone else’s life is perfect and enchanted … except yours,” she said.

Wilding recommends taking the time you’d otherwise spend surfing Facebook and use it for more restorative activities (so probably not baking gingerbread houses from scratch, unless you’re really, truly into that sort of thing). There is plenty of emotional labor to be done without seeking out more. It may be best to reevaluate what you do, drop some commitments and choose to only do the emotional labor that you genuinely value.

“Question the voice of your inner critic that says you’re not good enough,” Wilding said.

That voice is usually wrong, Wilding stressed. So when it crops up, head in the opposite direction.

“Don’t be afraid to drop a ball, or two,” Wilding said. “You’ll discover the world won’t end, and in fact, will encourage other people to start picking up their share of responsibility.”

By Gemma Hartley

Getting Older Veterans Proper Care

In an era of ongoing armed conflict, the impact of posttraumatic stress disorder (PTSD) is more widely recognized than it was 40 years ago when veterans were knee-deep in the atrocities of the Vietnam War. In fact, PTSD wasn’t even recognized as a mental illness until 1980.

While the disorder is more visible today, we usually only see young, male veterans representing all veterans experiencing PTSD. But there’s still a large population of Vietnam veterans who have been struggling with PTSD symptoms for over four decades, often with little support.

recent article by The Family Institute at Northwestern University highlighted the ongoing impact of PTSD in older veterans, and how we can ensure they receive the unique types of support and interventions they need.

What Older Veterans Need

Diagnosis has typically been delayed in older veterans, which means some have been struggling for decades. These heroes face age-related events that could trigger an exacerbation of symptoms—like retirement, the loss of a loved one or changes in health.

Due to their unique needs, some experts suggest older veterans might benefit from a counseling approach that integrates the following:

  • An approach that embraces the veteran’s story and affirms their feelings
  • Technology that increases access and decreases isolation (such as telehealth)
  • An affirmation of the realities of both the trauma and the resulting symptoms of PTSD
  • Peer support

Encouraging older veterans to embrace the benefits of therapy and counseling can be a challenge, so they may prefer to work with professionals who were/are also a member of the military in order to feel a sense of camaraderie.

Delayed-Onset PTSD In Older Veterans

About 31% of male American veterans who served in Vietnam experienced PTSD at some point in their lifetime, according to the National Vietnam Veterans Readjustment Study. A 2013 study on the long-term effects of the conflict found that approximately 1 in 10 veterans who served in Vietnam experienced PTSD 40 years later.

This is called delayed-onset PTSD. Although most people experience symptoms of PTSD within a few months after a traumatic event, sometimes it can be years before someone experiences the full spectrum of their symptoms.

Dr. Dawn M. Wirick, daughter of a Vietnam veteran and a veteran herself, counsels older combat veterans and has seen the effects of delayed trauma: “What they end up telling me is down the road, when they retire, once they aren’t so busy, they start having recurring nightmares.”

There are a variety of complex factors that can lead to delayed-onset PTSD. Some of the main reasons why it was so prevalent among Vietnam veterans were:

  • They were drafted
  • The conflict itself was highly unpopular (so they were reluctant to talk about it)
  • The troops were often treated poorly when they returned home

Additionally, as is the case for most men, they were told to “man up” and be strong, so expressing sadness was viewed as a sign of weakness. In result, many veterans repressed their feelings. This created more complex psychological reactions to their time in combat, andrepressed feelings often find their way to the surface much later.

Older veterans need proper treatment to overcome these long-term effects of living with PTSD. Coming to terms with events that occurred decades ago is no easy task, but access to effective counseling can help validate what they are feeling, eliminate the sense of isolation and begin the healing process. Coming to terms with events that occurred decades ago is no easy task, but access to effective counseling can help validate what they are feeling, eliminate the sense of isolation and begin the healing process.


If you are a veteran in need of help or are concerned about a veteran in your life, visit the Veterans Crisis Line website or call their 24/7 hotline at 1-800-273-8255.


Colleen O’Day is a Digital PR Manager and supports community outreach for 2U Inc.’s social work, mental health, and speech pathology programs. Find her on Twitter @ColleenMODay.

Making The 2018 Mid-Term Elections About Mental Health

Throughout NAMI’s history, mental health advocates have shaped laws, increased funding and promoted research to address the inequalities and injustices facing people with mental illness in our country. In the last two years alone, NAMI advocates sent hundreds of thousands of emails to Capitol Hill and made countless phone calls and visits to their representatives in nationwide efforts to pass mental health reform (the 21st Century Cures Act) and to stop dangerous health reform proposals that would have hurt people with mental illness.

We’ve made progress, but we still have further to go. NAMI’s members have an opportunity in the 2018 mid-term elections to vote more mental health champions into office. From district attorneys to county officials to governors to members of Congress, every elected official plays a role in determining what services and supports are available to people with mental illness—and there’s never been a better time to cultivate mental health champions.

NAMI members are instrumental in helping raise policymakers’ and candidates’ awareness of mental health issues by sharing stories that help make those issues real. The goal in talking with candidates is not to convert them—it’s to converse with them. As a nonpartisan, nonprofit organization, NAMI seeks only to educate politicians. This is how we develop trusting, invaluable relationships on both sides of the aisle, rather than being just another special interest group.

When speaking with a candidate, share a fact or two and let the person know how important mental health care is to you. Asking open-ended questions gives candidates a great opportunity to reveal their thoughts and share their visions for improving mental health care. Here are some policy positions that might help you identify whether a candidate is a mental health champion.

What Policies Should A Mental Health Champion Support?

1. Increasing The Availability Of Mental Health Services And Supports

Approximately 1 in 5 adults in the U.S. experiences a mental health condition, yet more than 60% of those adults go without treatment. We need more access to quality mental health services and supports, especially for underserved groups like our nation’s veterans and people living in rural and frontier areas.

How do you know if a candidate is committed to increasing the availability of mental health services and supports? Ask them how they would improve mental health care. A mental health champion would invest in:

• Expanding access to mental health care, including for veterans and people living in rural and frontier areas;

• Supporting health insurance protections that cover mental health care at the same level as other health care;

• Ensuring Medicaid coverage for people with mental illness based on income to make sure people can afford the care they need;

• Increasing supported housing programs that offer stable, safe and affordable housing for people with mental illness; and

• Growing supported employment programs that help people with mental illness get training, search for jobs and be successful in the workplace.

2. Promoting Early Intervention For Mental Illness

Approximately half of all mental health conditions begin by age 14, and 75% begin by age 24. Every young person who experiences a mental illness deserves to realize the promise of hope and recovery. And the quicker a young person gets quality services and supports, such as first episode psychosis (FEP) programs, the better their recovery outcomes.

Ask candidates how they would increase early intervention for mental health conditions. A mental health champion would support:

• Increasing FEP programs, which provide recovery-focused therapy, medication management, supported education and employment, family support and education, case management and peer support;

• Promoting school-linked mental health services for youth, which bring mental health professionals into schools to provide mental health care to students; and

• Integrating mental health care into primary care settings to increase early identification and treatment of mental health conditions.

3. Ending The Jailing Of People With Mental Illness

About 2 million Americans living with mental illness are jailed each year—mostly for non-violent offenses. Unfortunately, a person experiencing a mental health crisis is often more likely to land in jail than in a hospital. Mental illness should not be treated like a crime. Instead, people with mental illness who are in crisis should be diverted into effective treatment options.

Ask candidates how they would address the jailing of people with mental illness. A mental health champion would support:

• Expanding Crisis Intervention Teams (CIT), a community policing model that helps law enforcement divert people to mental health treatment instead of jail;

• Ensuring that mobile crisis response teams can intervene and effectively de-escalate mental health crises; and

• Increasing Assertive Community Treatment (ACT) teams that provide intensive, wraparound treatment and support to people with serious mental illness.

When candidates hear from NAMI members about the importance of mental health care, they listen. We need more elected officials like this who understand and support mental health issues—officials who are committed to funding the services and supports people with mental illness need to be safe, stable and on a path toward recovery. You can do your part by engaging in a dialogue with candidates and voting for people who will become tomorrow’s mental health champions.