Family Therapy During and After a Separation or Divorce

One of my specialty areas is conducting family therapy in family systems where custody is shared across two homes during or following a separation or divorce. According to the Association of Family And Conciliation Courts, if a family has involvement with the legal system at any point during treatment, this treatment is considered Court-Involved Family Therapy. Because custody can be reassessed in Massachusetts at any point while children are under 18, I take into account that divorced families may be considered court-involved at some point. And due to the complexity that court involvement adds to therapy, I have a model for this type of work that is different than typical family therapy.

an intake process for treating these families that is different from my typical family therapy model.

any treatment provided to a parent, child, couple, or family

Any mental health professional providing psychotherapeutic treatment of a parent, child, couple or family who is, at any time during the treatment, involved with the legal system.

If that's the case your co-parent would also have to consent to family therapy even if they are not involved in the work.  But, as a general rule, therapy is much more effective when both parents are involved, so I do encourage both parents to be involved on some level even if primary treatment goals revolve around just one parent.

Even if parents are not actively involved in litigation, this is considered Court-Involved Therapy according to the Association of Family And Conciliation Courts because of the potential court involvement to address custody concerns. To some extent, the stress that court involvement takes on a family, especially children, is unavoidable and a part of the transition process of divorce. Sometimes it can be reasonably amicable and other times pro-longed court-involvement or adversarial court-involvement can lead to exceptional levels of stress. This stress can look differently in different families- sometimes showing up as social-emotional or behavior problems in the children, sometimes as parent-child contact problems, and sometimes all of the above. In my career as a family therapist I have learned that a subset of families with court-involvement need a specialized approach that includes the entire family and consultation with attorneys to be able to move forward following divorce. Court-Involved Family Therapy (CIFT) is a multi-modal approach intended to improve all relationships in a family system. It is a complex process that I break down into very small, manageable, and individualized steps based on the family’s specific needs.

Approach

I draw upon a variety of therapeutic approaches when conducting CIFT services. These are grounded in a strengths-based philosophy, family systems education and experience, as well as specialized training in how court involvement impacts children. Before working with court-involved families I spent years doing trauma and grief work with children and adults, and I bring that trauma-informed perspective to this work. My first goal in working with any family is helping create an emotionally safe environment within our sessions so that you feel supported enough to make changes that may be difficult. I incorporate CBT, DBT, solution-focused, ego states, narrative and interpersonal approaches into my work.

Requirements

Due to the complex nature of families where custody is shared, I require the following before committing to work with a family:

  • Agreement of both parents to be involved in the process. Even if the most apparent difficulties exist within one relationship in the family (for example between one parent and one child), these relational problems exist within a family system. Every part of the system can play a role in improving the overall system. Family therapy is a voluntary process and, even if a court order exists, I will only see a family if both parents consent to be part of the process.

  • Because my role as a therapist is not a custody assessor, a detailed parenting plan needs to be in place. If the final parenting plan is not in place, an agreed upon step-up parenting plan with clear benchmarks to move up or down needs to be. This is not my role and being asked to fulfill this role compromises the work of therapy.

  • Flexibility in regards to scheduling. All attempts will be made on my end to hold sessions with children outside of school and activity times as I understand most children are reluctant already to engage in this work. However, I can’t guarantee on the front end that that will always be possible. Individual parent sessions and co-parent sessions will typically be held between the hours of 9am and 3pm.

  • I prefer to do this complex work in Hingham, MA, especially sessions that include children. However, if telehealth or a hybrid approach is preferable for your family we can discuss that as an option.

  • Because this work tends to be behavioral in nature, I do often recommend that family members also be engaged in individual therapy to do some of the deeper work that supports those behavioral changes required in this process.

Process

Step 1: Initial Paperwork. Initial paperwork completed by each co-parent provides the first step of the screening process and at no cost to the co-parents. The paperwork helps me assess whether family therapy is suitable to address specific concerns and whether I have the capacity at that time to provide the appropriate level of support.

Step 2: Intake Interviews with each co-parent individually. If the goals or the family system seem especially complex or conflictual, I may also request meetings with Attorneys, Parenting Coordinator, or other clinicians involved with the family before agreeing to move forward.

Step 3: Recommendation Letter. At the conclusion of the intake interviews, I will suggest either moving forward with specific treatment goals in the context of family therapy or specific recommendations of what needs to be in place before family therapy would be a suitable approach. My recommendations are family-specific and based on goals each co-parent mentioned in the intake interviews.

Step 4:

At this point, family systems that

The suitability of family therapy to address concerns in each specific family is continually assessed, as families with court-involvement tend to hold a great deal of complexity. If family therapy seems appropriate at that point, I will conduct an intake phase consisting of:

  • Review of relevant court documentation (GAL reports, separation agreements, relevant court orders, etc)

  • Meeting individually with each co-parent

  • If warranted, meeting with the attorneys of both co-parents, Parenting Coordinator, and other therapists already involved with family members

At the conclusion of this process I will issue a recommendation letter that either suggests moving forward with specific treatment goals in the context of family therapy or specific recommendations of what needs to be in place for the family before family therapy would be a suitable approach.

Should we move forward after the intake phase, expect 2-3 sessions weekly for various subsets of family members. This typically begins with individual sessions to build rapport with parents, then children. After rapport is built, then various subsets will be included in sessions (sometimes siblings, sometimes co-parents, sometimes parent/child). Once treatment goals are met, frequency of sessions will decrease as new treatment goals may or may not be determined. Therapy is terminated when treatment goals are met or if therapy goals are not met and it becomes clear that other support (legal methods, individual therapy, etc) is needed before family therapy can be effective.

To encourage transparency and accountability amongst co-parents I issue periodic written Status Updates. These typically include information on how we are progressing towards treatment goals, difficulties that we are facing and recommendations on how to proceed. I also consult regularly with other involved clinicians (such as individual therapists or parenting coordinators).

One aspect of CIFT that differs from traditional therapy is that this process is non-confidential within the family members and consulting professionals. This does not mean that everyone is entitled to know what others share in individual sessions. It means that I am permitted to use my clinical judgment to share information amongst family members and consulting professionals when it will help us reach our treatment goals more efficiently. I do this thoughtfully, strategically and while protecting the privileged information of the children.

Costs

Reviewing the initial screening paperwork from both co-parents is provided at no-cost. This is the first step in determining if family therapy is an appropriate treatment approach.

A non-refundable $1200 flat fee is required to move forward with the intake process.

If it is determined that your family would benefit from CIFT after the intake phase, I require a $3600 retainer to begin regular meetings with family members. CIFT services are billed at a rate of $250 per hour. Time spent conducting therapy sessions, emailing with co-parents regarding clinical matters, documenting, and consulting with other professionals is time that will be billed for. As you move through your retainer I will supply regular statements and cost estimates. It is likely you will need to replenish your retainer as it takes time to reach treatment goals.

I am not in-network with insurance companies, but if you would like me to provide superbills for therapy sessions I will do so. Both parents need to be in agreement that it is in the family’s best interest for one child in the family to have a diagnosis (required for insurance reimbursement) and be in agreement on the process for seeking reimbursement before I will agree to issue superbills. Keep in mind that insurance companies will not reimburse for time spent documenting, emailing, or consulting with other professionals.

Next Steps

If you are interested in pursuing CIFT services, please click here to inquire about my current availability. If I have space, I will send intake paperwork for each co-parent to fill out. After review of the intake paperwork, I will require payment before scheduling attorney meeting and individual meetings with each co-parent.