How to Choose a Family Therapist
Choosing a family therapist comes down to three things: the right credentials, an evidence-based approach that fits your family's needs, and a sense of fit and trust for everyone involved. A family therapist is a licensed clinician trained to work with families as a system, not just individuals.
Finding the right fit for the whole family can feel daunting, but knowing what to look for makes the process more manageable. This page covers what credentials to look for, different approaches to family therapy, questions to ask a family therapist, how to assess fit, and how to get started.
At-a-glance: How to choose a family therapist
What credentials to look for in a family therapist
Always look for a therapist who is fully licensed and trained in relational or family work. This can include clinicians with the following credentials:
- Licensed marriage and family therapist (LMFT)
- Licensed clinical social worker (LCSW)
- Licensed professional counselor (LPC)
- Licensed professional clinical counselor (LPCC)
- Psychologist (Ph.D./Psy.D.)
LMFTs are the most family-relevant clinicians, as much of their education and training focuses on family dynamics, along with marriage therapy and couples therapy. LCSWs, LPCs, LPCCs, and psychologists can all practice family therapy effectively when they have received additional relational training and clinical hours with families.
You may also see pre-licensed associates listed (credentials like LAMFT, or associate marriage and family therapist). This typically means they are completing supervised clinical hours and do not yet hold an independent license.
For complex family dynamics, fully licensed clinicians are generally preferred. Octave only works with fully licensed family therapy providers.
Credential | What it is | Notes |
|---|---|---|
LMFT | Licensed marriage and family therapist | Trained specifically in relational and family work |
LCSW | Licensed clinical social worker | Can provide family therapy with relational training |
LPC/LPCC | Licensed professional counselor | Can provide family therapy with relational training |
Psychologist (Ph.D./Psy.D.) | Doctoral-level clinician | Therapy and, in some settings, testing |
Pre-licensed associate (e.g., LAMFT) | A clinician completing supervised hours | Not yet fully licensed; Octave uses fully licensed clinicians |
Evidence-based family therapy approaches, and which fits your family
Several evidence-based approaches to family therapy exist, and each suits different family needs. A 2019 review by Alan Carr in the Journal of Family Therapy found substantial evidence supporting systemic family interventions for a range of child and adolescent issues, including conduct problems, emotional difficulties, and eating disorders. The best approach for your family depends on your specific needs and goals.
- Structural family therapy: Developed by Salvador Minuchin, this approach focuses on how a family is organized: its hierarchies, boundaries, and roles. The therapist works to restructure patterns that are not serving the family well. For example, a parent who has taken on a friend role with a teenager may work with the therapist to re-establish a clearer parent-child boundary. Structural family therapy is commonly used to address behavioral problems in children and teens, substance use, and eating disorders.
- Strategic family therapy: This approach takes a direct, goal-oriented stance. The therapist helps the family identify specific problematic patterns and designs interventions to change them. If a family repeatedly escalates arguments during dinner, for instance, the therapist might assign a structured communication exercise to practice at home. Strategic family therapy is commonly used for behavioral problems in children and teens, or in families where substance use, depression, or anxiety are present.
- Systemic family therapy: This approach views problems as part of the family system rather than locating them in one individual. The therapist helps family members understand how relationships, communication patterns, roles, expectations, and cultural context all shape what is happening. Rather than asking, "What's wrong with this person?" the question becomes, "What's happening between these people?"
- Bowen family systems: Based on the work of Murray Bowen, this approach treats the family as an interconnected emotional unit, where one person's behavior can significantly influence everyone else. There is also an emphasis on multigenerational patterns, exploring how dynamics from previous generations show up in the family today. For example, a family that has always handled conflict through avoidance may trace that pattern back several generations and learn new ways to engage directly. Bowen family systems can help with anxiety, chronic relationship stress, and support each family member in developing a stronger sense of self while remaining connected to the family.
- Functional family therapy (FFT): FFT is a structured, short-term therapy originally developed for adolescents with behavioral issues, according to the FFT LLC model description. The therapist assesses the family's interactions and teaches healthier ways to function, including how to communicate, handle conflict, and regulate emotions. A family where a teen is acting out through truancy and defiance, for instance, might learn to replace punitive cycles with structured problem-solving conversations. FFT is commonly used with adolescents dealing with conduct disorder, oppositional defiant disorder, or substance use.
The benefits of family therapy can extend well beyond resolving the immediate issue that brought your family in. All of these approaches can improve how your family communicates, relates, and functions together.
Not sure which approach is most appealing? That's OK. When you consult a family therapist, they will consider your needs and goals when choosing the most appropriate approach.
Note: You might have heard of a type of therapy called Internal Family Systems, or IFS. Despite the name, this is an individual therapy modality that focuses on different "parts" within one person. It is not a modality for families.
One final note: if you are a parent and the main conflict in the family is your relationship with your partner or spouse, such as if your relationship feels toxic, you may want to consider couples therapy rather than family therapy.
Questions to ask a potential family therapist
A few good questions can reveal a therapist's experience, approach, and whether they are likely to be a fit for your family. Many family therapists offer a free brief phone consultation where you can ask questions before scheduling an initial session.
Here are some questions to consider, depending on what matters most to you:
- What is your training, and how long have you been fully licensed?
- What experience do you have with families like ours (e.g., blended families, teens with substance use disorder, estranged family members)?
- How do you handle high-tension and high-conflict sessions?
- Which approach do you use and why?
- Who attends sessions, the whole family or subgroups?
- Do you see individual family members separately? If so, how do you handle confidentiality between family members?
- Do you offer telehealth sessions, in-person sessions, or both?
- How frequently will we meet, and how many sessions does family therapy typically take for situations like ours?
- Which insurance plans do you accept, or what are your out-of-pocket costs?
- What is your cancellation policy?
Having phone consultations with a few different providers can help you gauge what feels right and what does not.
How to judge fit for your whole family
Good fit means rapport with all family members, not just the person who booked the session. Each family member should feel heard and validated by the therapist. Here are some important considerations when assessing fit.
- Neutrality and non-favoritism: A family therapist should never favor one family member or take sides. They must remain unbiased and make everyone feel important, never labeling one family member as "the problem."
- Cultural and identity affirmation: You want a therapist who understands and affirms your family's identities. If your family or certain family members are part of marginalized groups, this is especially worth considering. For example, if you are a family of color, you might want to work with a therapist who shares that background and understands cultural nuances. If one or more family members are LGBTQ+, you might want an LGBTQ+-affirming therapist who can navigate those dynamics.
- Comfort for everyone: Family therapy is a vulnerable process, and it can feel extra intimidating for someone who has not been to therapy before. A good fit with a therapist helps all family members feel as comfortable and safe as possible, so they can open up and participate fully.
- Scheduling and accessibility: Scheduling is more complicated when multiple family members are involved. Consider whether the therapist has availability that works for everyone, whether in-person access is feasible, and whether virtual or hybrid sessions would make attendance easier.
A phone consultation gives you a useful first impression, but it is not the full picture. It may take a couple of sessions to know whether the therapist is the right fit.
After a session or two, you and your family should have a good sense of whether the therapist works for you. Trust your instincts. If something feels clearly off after the first session, do not ignore that.
If the fit is not right, that is not a sign that family therapy will not work. It means you need a therapist who is a better match for your family.
A brief note on safety
Family or couples therapy is generally not appropriate during active abuse, because joint sessions can increase risk for the person being harmed. If there is ongoing abuse or domestic violence, the right first step is individual safety planning and support. Contact the National Domestic Violence Hotline at 1-800-799-7233 for support, safety planning, and advice on next steps.
If someone in your family is in an active mental health crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988. If you are in immediate danger, call 911.
How to find and start with a family therapist
You can search directories online to find family therapists and verify credentials yourself, or you can use a therapy platform that matches you to a provider. You may also consider browsing professional association directories, such as that of the American Association for Marriage and Family Therapy (AAMFT).
Octave is a therapy platform where you can either browse therapists yourself using desired filters, or you can contact the Care Navigation team, which can help find a therapist based on your family's needs. The team can speak with different family members to gain an understanding of different perspectives when choosing a therapist. Octave only works with fully licensed therapists, and the Care Navigation team will verify fit.
Get matched with a family therapist at Octave
How Octave supports you
Every therapist at Octave is fully licensed with an average of 10+ years of experience. Octave does not work with trainees or pre-licensed associates, so your family works with an experienced clinician, not someone still in training. Octave's matching considers your family's specific needs to connect you with a therapist who fits, and 89% of clients report a strong therapeutic alliance with their matched provider.
Most clients pay an average of $28/session through insurance, and 95%+ pay less than $45/session. Forty million Americans are in-network, FSA and HSA are accepted, and matching typically happens within 1-3 business days. Virtual, in-person, and hybrid care is available.
Octave is therapy only; if a family member needs medication or a formal assessment, the Care Navigation team can help point you toward the right external resources and coordinate care. Exact costs vary by plan and are always confirmed before care begins.
Get matched with a family therapist at Octave
Sources
- American Association for Marriage and Family Therapy. About AAMFT. (n.d.). https://www.aamft.org/web/web/About-AAMFT/About-AAMFT.aspx?hkey=0aacbc9a-8282-4b43-b76c-4d9575360639
- Carr, A. (2019). Family therapy and systemic interventions for child-focused problems: The current evidence base. Journal of Family Therapy, 41(2), 153-213. https://onlinelibrary.wiley.com/doi/abs/10.1111/1467-6427.12226
- Cleveland Clinic. (2022). Family therapy: What it is, techniques and types. https://my.clevelandclinic.org/health/treatments/24454-family-therapy
- EBSCO Research Starters. Strategic family therapy. (n.d.). https://www.ebsco.com/research-starters/health-and-medicine/strategic-family-therapy
- FFT LLC. Functional Family Therapy (FFT). (n.d.). https://www.fftllc.com/fft
- Littell, J. H., Pigott, T. D., Nilsen, K. H., Roberts, J., & Labrum, T. K. (2023). Functional Family Therapy for families of youth (age 11-18) with behaviour problems: A systematic review and meta-analysis. Campbell Systematic Reviews, 19(3), e1324. https://onlinelibrary.wiley.com/doi/full/10.1002/cl2.1324
- The Bowen Center for the Study of the Family. Introduction to eight concepts. (n.d.). https://www.thebowencenter.org/introduction-eight-concepts
