Family therapy referral (Referral for family and systemic psychotherapy)
A talking therapy where family members meet together with a trained therapist to understand difficulties, improve communication and support each other, often used to help a child or young person.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Family therapy is a talking therapy where family members meet together to understand difficulties, improve communication and support each other, often to help a child or young person.
- It is not about blaming parents; it looks at patterns and builds on a family's strengths, and it is not a substitute for protective action where someone is unsafe.
- Change builds gradually over a number of sessions; it is available on the NHS (often through CAMHS) and privately, ideally with a suitably qualified, registered therapist (for example UKCP).
- If any family member talks about self-harm or not wanting to be here, get help: 999 or A&E in an emergency, Samaritans 116 123, Papyrus HOPELINE247 0800 068 4141, text SHOUT to 85258, or YoungMinds Parents Helpline 0808 802 5544.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
Helps family members understand each other and communicate better
As a substitute for protective action where there is ongoing abuse or where a family member is unsafe.
Understanding what is happening, who is involved, and what the family hopes for. The therapist draws out everyone's perspective.
Regular review of progress together, with the work adjusted as things change.
Understanding what is happening, who is involved, and what the family hopes for. The therapist draws out...
Exploring relationships, communication and patterns. Talking openly can feel emotional at first; that is normal.
Families try new ways of relating and responding at home. Sessions are often spaced apart to allow time for this.
Communication and relationships often improve and difficulties ease. Progress is reviewed together and the work...
What is a family therapy referral?
Family therapy, also called systemic therapy, is a talking therapy where family members meet together with a trained therapist. Rather than seeing a problem as belonging to one person, it looks at how relationships, patterns and communication within a family affect everyone, and how the family can help each other.
It is often used to support a child or young person, for example where there are difficulties with behaviour, mood, anxiety, eating, school, or coping with illness, loss or family change. It can involve parents, carers, children, siblings and sometimes wider family, with different people attending different sessions.
It is important to understand what family therapy is and is not. It is not about blaming parents or finding fault; it is about understanding patterns and building on a family's strengths. Different family members may see things differently, and a good therapist respects all those perspectives.
Family therapy is a recognised, evidence-based approach for a range of difficulties. It usually takes a number of sessions, and change tends to build gradually rather than happening in one meeting.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Family and systemic psychotherapy
The main approach: sessions with family members together, exploring relationships, communication and patterns, and finding constructive ways to support one another.
Family-based treatment for specific difficulties
Structured family approaches used for particular conditions, for example family-based treatment for eating disorders, where parents play a central role in supporting recovery.
Parent and carer sessions
Some sessions may involve only parents or carers, for example to think about how best to support a child or to work on co-parenting.
Sessions with a young person
A young person may be seen with the family, and sometimes individually within the work, with their growing need for privacy respected.
Preparing for your programme
- If a family member is at immediate risk or in crisis, seek urgent help first; family therapy is not for emergencies.
- Usually you are referred by a GP, CAMHS or another professional, though some services allow self-referral; ask how to access it locally.
- Think about what your family would most like to be different, and what already works well.
- Be open to the idea that everyone's view matters, including the children's.
- Mention any individual difficulties or diagnoses, and any other professionals involved.
- Check the therapist is suitably qualified and registered (for example registered as a systemic/family psychotherapist with the UKCP).
- Talk to children in an age-appropriate way so they know what to expect and that it is not about blame.
What happens
Family therapy usually begins with an initial session to understand what is happening, who is involved, and what the family hopes for. The therapist asks questions to explore relationships, communication and patterns, and to draw out each person's perspective, including the children's.
Sessions are a safe, structured space to talk together in ways that might be hard at home. The therapist helps family members listen to and understand each other, notice patterns that keep difficulties going, and find new, more helpful ways of relating and responding. The focus is on the family's strengths and resources, not on blame.
Who attends can vary between sessions: sometimes the whole family, sometimes parents or carers, sometimes a young person. Some services use a team behind a screen or in the room to offer reflections that can open up new ideas. Therapy may be in person or online.
Sessions are often spaced a few weeks apart to give the family time to try things between meetings. Progress is reviewed together, and the work is adjusted as things change. Where family therapy is part of wider care, for example alongside individual therapy or treatment for a specific condition, the different parts work together.
Is this programme right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- As a substitute for protective action where there is ongoing abuse or where a family member is unsafe.
- In an emergency or where there is immediate risk, which needs urgent help rather than routine therapy.
- Where key family members are unwilling or unable to take part, so the approach may need rethinking.
- Where an individual problem clearly needs its own assessment or treatment first or alongside.
Delay or rearrange if…
- There is an immediate safety emergency; deal with that first.
- A family member is too unwell or in crisis to take part and needs their own support first.
- Safeguarding concerns need investigating and protective action taken before family work.
- Important information about a child's health, development or safety has not yet been gathered.
Alternatives to discuss
- Individual therapy for a young person or another family member.
- Parenting support and advice where the main need is managing behaviour.
- Structured treatment for a specific condition (such as family-based treatment for an eating disorder).
- Couples or relationship counselling where the focus is the adult relationship.
- Support from school, and watchful waiting with support for milder difficulties.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Helps family members understand each other and communicate better
- Looks at difficulties in the context of relationships, not just one person
- Builds on a family's strengths and shared resources
- Can reduce conflict and improve support at home
- Useful for a wide range of difficulties, ages and situations
- Can support a child or young person's recovery alongside other treatment
Risks & complications
- Talking openly as a family can feel uncomfortable or emotional, especially at first
- Change is gradual and takes a number of sessions
- Different family members may see things very differently
- Sessions take time and may need arranging around school, work and childcare
- Some family members feeling reluctant, blamed or defensive
- Difficulty getting everyone to attend or engage
- The first approach not helping enough, needing a change of plan
- Sensitive issues surfacing that need careful handling or additional support
- Safeguarding or safety concerns coming to light that must be acted on
- Family therapy not being appropriate or safe in certain situations, such as ongoing abuse, where it should not replace protective action
The most important point is that family therapy is not about blaming anyone; it is about understanding patterns and building on strengths. It can feel exposing at times, and it works gradually. It is not appropriate as a substitute for protective action where there is abuse or where someone is unsafe. Check the therapist is suitably qualified and registered, ask how everyone's views and confidentiality are handled, and what happens if it is not helping.
Published figures to discuss
It would be misleading to attach success percentages to family therapy, because outcomes depend on the difficulties involved, who is able and willing to take part, and the family's circumstances. Family and systemic therapy is a recognised, evidence-based approach for many difficulties, but it is not guaranteed to work for every family and is not an instant fix. The most important safety point is that family therapy is never a substitute for protective action where someone is at risk.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Conflict temporarily increases | Common early therapy experience | Difficult conversations can feel more intense before patterns change. | Guide sourcesClinical context |
| Domestic abuse or coercive control missed | Safety-critical | Joint sessions may be unsafe when there is violence, coercion or fear; safeguarding assessment comes first. | Guide sourcesClinical context |
| Young person's confidentiality misunderstood | Common consent issue | Therapists should explain what is shared, what remains private and what must be disclosed for safety. | Guide sourcesClinical context |
| Family therapy used instead of individual/crisis care | Avoidable | Psychosis, severe depression, eating disorder risk, self-harm or safeguarding concerns may need additional specialist pathways. | Association for Family Therapy and Systemic Practice (AFT)aft.org.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery. 'Afterwards' means trying new ways of relating between sessions, the gradual change that builds over a number of meetings, and reviews that keep the work on track.
- Feeling emotional or exposed when talking openly together, especially early on
- Gradual, uneven progress with better and harder sessions
- Different family members feeling differently about the work
- Needing time between sessions to try new ways of relating
- Some sensitive topics taking time and care to talk about
Aftercare
- Try the new ways of communicating and responding between sessions; this is where much of the change happens.
- Keep attending agreed sessions, and let the therapist know if someone is struggling to take part.
- Be patient with each other; change takes time and is rarely a straight line.
- Support any individual treatment a family member is also having.
- Look after each person's wellbeing, including the parents' and carers'.
- Use the plan made at the end of therapy, and a route back to help if difficulties return.
- Keep crisis numbers handy: 999 or A&E in an emergency anywhere in the UK; Samaritans 116 123; Papyrus HOPELINE247 0800 068 4141; text SHOUT to 85258. For urgent mental-health support in England, Scotland or Wales, call 111 and choose the mental-health option. In Northern Ireland, call Lifeline on 0808 808 8000, or contact your GP out-of-hours service.
- A shared idea of what the family wants to be different
- Sessions arranged around school, work and childcare
- An age-appropriate explanation given to children
- The therapist's qualifications and registration checked (for example UKCP)
- Agreement that everyone's view matters and it is not about blame
- Crisis numbers saved in phones
- A plan to review progress and a route back to help
⚠ Get urgent help if…
- Any family member talks about suicide, feeling hopeless, or not wanting to be here: call 999 or go to A&E now
- A child or young person discloses harm or feels unsafe at home
- Self-harm by a child, young person or other family member
- Conflict escalating to the point of feeling unsafe
- Sudden, severe changes in a child's mood, eating, sleep or behaviour
- For urgent but non-emergency support: Samaritans 116 123, Papyrus HOPELINE247 0800 068 4141 (under 35s), text SHOUT to 85258, YoungMinds Parents Helpline 0808 802 5544. For urgent mental-health help in England, Scotland or Wales, call 111 and choose the mental-health option; in Northern Ireland, call Lifeline on 0808 808 8000, or contact your GP out-of-hours service
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
Family therapy can help families understand each other better, communicate more openly, reduce conflict, and support a child or young person's wellbeing and recovery. A good outcome is a family that feels more able to talk, listen and respond helpfully, with the original difficulties eased.
It is not a quick fix and does not work the same way for every family, and outcomes depend on the difficulties involved, who is able to take part, and how willing everyone is to engage. Family therapy is often one part of wider care rather than the whole answer, and it is not a substitute for protective action where someone is unsafe.
The understanding and communication skills built in family therapy can keep helping long after sessions end. Families do, though, go through new challenges and changes, such as adolescence, illness, loss or separation, and old patterns can resurface. Many families find that a short return to therapy, or simply remembering what helped before, gets them through later difficulties. As children grow, the way the family relates naturally evolves.
Related tests, treatments or support
Family therapy is often used alongside other support, such as individual therapy for a young person, treatment for a specific condition like an eating disorder or depression, parenting support, or input from school. Where a child is having their own treatment, family therapy can help the whole family support recovery. The different parts of care should be coordinated so they work together.
Follow-up & long-term care
Progress is reviewed together during the work, with sessions adjusted as things change. Where family therapy is part of wider care, there will be coordination with other professionals involved. At the end, the family should have a sense of what has changed and how to keep building on it, with clear advice on when and how to seek help again.
- Keep using the communication and problem-solving skills learned together
- Make time to talk and listen as a family, especially at stressful times
- Return for a short course of further sessions if old patterns resurface
- Support each family member's wellbeing, including parents and carers
- Keep a clear route back to help if difficulties return
Repeat, follow-on and what comes next
- If the first approach does not help enough, the plan or who attends may be changed.
- Family therapy may be combined with individual therapy or treatment for a specific condition.
- Difficulties can resurface at later life stages, and a short return to therapy may help.
- The work is reviewed together and adjusted as the family's situation changes.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Regular review of progress together, with the work adjusted as things change.
- Clear handling of confidentiality and everyone's perspectives, including children's.
- Coordination with any individual treatment or other professionals involved.
- A plan at the end for keeping up changes, with a route back to help.
- Clear information on who to contact, and crisis routes if anyone is ever unsafe.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The therapist's training, registration and experience
- The number and length of sessions and how often they are held
- Whether a reflecting team is used and whether sessions are in person or online
- How many family members attend and any separate parent or young-person sessions
- The depth of initial assessment and any reports or liaison
- Follow-up sessions and coordination with other treatment
- The therapist's qualifications and registration (for example UKCP) and experience
- How many sessions are recommended, at what frequency, and over what period
- Who is expected to attend and how varying attendance is handled
- How confidentiality and everyone's views, including children's, are handled
- What assessment, review and coordination with other care are included
- How urgent concerns are handled out of hours, and the cancellation policy
On the NHS? Family therapy is available on the NHS, often through CAMHS, when clinically indicated; private family therapy may be used for choice or speed, with the same systemic approach.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Allowing the work to feel like blaming one person, usually a parent or the child.
- Not being clear about confidentiality, including how a young person's privacy is handled.
- Not explaining that change is gradual and takes a number of sessions.
- Not checking the therapist's qualifications and registration.
- Using family therapy where protective action is what is actually needed.
Marketing red flags
- Promising to 'fix' a family or guaranteeing results.
- Therapy from unqualified or unregistered practitioners.
- Pressure to keep paying for open-ended sessions without review.
- Suggesting family therapy instead of acting on safety or safeguarding concerns.
- Blaming one family member rather than working with patterns and strengths.
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- Is family therapy the right approach for our situation, and why?
- Who would usually attend sessions, and how often would we meet?
- What are your qualifications and registration (for example UKCP)?
- How are everyone's views and confidentiality handled, including the children's?
- How will we know if it is helping, and what happens if it is not?
- How does this fit with any individual treatment a family member is also having?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my programme, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this programme not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
What is family therapy?
Is family therapy about blaming the parents?
Does the whole family have to come every time?
Can we get family therapy on the NHS?
How long does it take?
Will my child be seen on their own?
Is family therapy ever not the right approach?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Association for Family Therapy and Systemic Practice (AFT) NHS — Talking therapies and counselling UKCP — Find a systemic and family psychotherapist Royal College of Psychiatrists — Psychotherapies (for parents and carers) YoungMinds — Parents Helpline (0808 802 5544) nidirect — urgent and emergency care services nidirect — GP out-of-hours service NHS England — NHS 111 mental-health crisis support NHS inform Scotland — urgent mental-health help NHS 111 Wales — mental health and wellbeing nidirect — mental health emergency / Lifeline
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Psychological and family support · Child and adolescent mental health assessment · Parenting support and advice · Eating disorder assessment · Depression in children and teenagers