Family Systems Therapy: What Is It, and Why Does It Work?

Brian Leidal is a clinical therapist for adolescent boys and young adults at Open Sky. In this Q&A, he explains what family systems therapy is, why we use it at Open Sky, and how it empowers the entire family system to shift toward healthier dynamics.  

What is family systems therapy?

Family systems therapy is based on psychologist Murray Bowen’s family systems theory, which holds that individuals are inseparable from their network of relationships. Family systems considers how every member of the family unit is connected in some way. The family system is like a web with a bunch of strings attaching every family member to each other. When one person reacts one way, it then pulls a string to another person, and they react or respond in some different way. That’s something I watch for within the family, how one individual’s behavior affects the next person affects the next person. There’s a ripple effect through these strings within a family system. 

Why is the family systems approach effective?

We emphasize the family systems approach here at Open Sky because it’s particularly helpful for families in distress. It’s essential that we have a basic understanding of how our behaviors impact the people in the rest of our environment. Particularly in our digital age, we lose touch with the fact that our actions impact other people. The internet is a wonderful thing, and it helps us connect with those we love from a distance, however, there’s something that’s lost when it’s our sole form of communication. 

For parents, their relationship with their child changes over time as the child grows and develops. What was once an appropriate intervention for a five-year-old isn’t necessarily the right intervention for a fifteen-year-old and especially isn’t the right intervention for a twenty- or twenty-five-year-old. It may seem obvious, but for most of the parents I work with, they’re still trying to grapple with how their relationships with their children are changing. Young people are trying to differentiate themselves from their family of origin. They’re trying to become their own individuals. It’s a developmentally appropriate struggle, but the process is often bumpy, and sometimes it requires intervention on the scale of Open Sky.  

Are families or students ever resistant to this approach? How do you respond to that?

The students who come to Open Sky often feel like they’re the scapegoat of their family. That causes them to instinctually respond with something like, “It’s not about me. It’s all of you who messed me up.” Initially, they blame their parents and don’t take accountability for how they’re impacting the family system. Students often want a sense of power and control over their environments and futures. I try to teach them that the ultimate form of power and control is that they get to choose how they react to external triggers. An external trigger could be a parent scolding them, and their power lies in recognizing that an upsetting thing happened, and they get to choose how to respond to it. This is something that students are sometimes resistant to because it interrupts the narrative of, “It’s not my fault.” Because if that doesn’t turn out to be true, if it turns out that they’re responsible for how they react, it means that they’re responsible for their decisions and their livelihoods. That can be an intimidating but ultimately empowering realization.  

It also helps students to understand that they’re not the only one working on changing the family dynamic. It’s often remarkable to listen to the students and watch their reactions when they learn that their parents are involved and engaged in a parallel process. For example, when parents come onto phone calls with their children after a month or six weeks and they share an “I feel” statement or they use reflective listening, I often see students’ eyes go wide. They’re really impressed because their parents are changing alongside them.  

For parents, sometimes they will say something like, “Fix my kid. They just need to get in line.” I don’t see this very often at Open Sky, but in those instances, I work to invest parents in making changes in themselves. Our research shows that students who return to a family system that hasn’t changed are more likely to relapse into the behaviors that brought them to us in the first place. That’s why Open Sky has so many components of our program that engage and involve parents. 

What does parent involvement look like at Open Sky?

There are many different opportunities for parents to get involved while their child is at Open Sky. They include:  

Weekly Clinical Update Calls

Parents work most directly with the clinical team. We have weekly phone calls with parents to provide guidance and update them on their child’s progress.  

Parent Coaching

Parent coaching focuses specifically on supporting the parents’ growth. Working with a family services therapist, parents address issues within the family system and practice vital mindfulness, emotional regulation, and communication skills.   

Wellness Weekend 

Wellness Weekend is a Friday, Saturday, Sunday affair where parents learn skills and participate in programming that is very similar to what their child is experiencing in the field. This is where I often see slightly resistant parents get it. They leave understanding how to take care of themselves and communicate with their child more effectively.  

Monday Night Calls

The Monday night parent call is an opportunity for parents to connect with other families at Open Sky. Many parents often report that they feel isolated because they just don’t know how to talk to family and friends who don’t understand what they’ve been going through. When they connect with parents who do understand the experience, that’s when they feel like they have a community behind them.  

Family Pathway Workbook

The Family Pathway is a comprehensive workbook that guides family members through a series of assignments that parallel and complement the work the student is doing in the field. The Family Pathway supports both personal and family growth.  

Family Pathway Class

The Family Pathway Class is an opportunity for parents to learn more deeply about the therapeutic foundations of treatment at Open Sky. They learn and practice the same concepts that the students are learning and practicing in the field. 

Family Quest

By the time Family Quest rolls around, families have been working intentionally on making changes in a parallel fashion to their child. Family Quest is when those two parallel lines come together. They’ve been building a pyramid, and Family Quest is the capstone right on top. It helps them feel a sense of accomplishment and hope that things can change in the larger family system. 

Additional Resources

Families also have access to a 24-hour parent portal, weekly photos of their child in the field, a dedicated family care coordinator, educational blogs and podcasts, a meaningful graduation experience, alumni events, and a robust social media presence. The family is the centerpiece of each student’s treatment at Open Sky, and it is important to us to offer the most comprehensive family experience possible. Visit our website for a complete list of our menu of family services. 

How do families communicate while at Open Sky?

The primary way families communicate is through weekly letters. I think the most important thing about writing letters is that it slows down reaction times. There are several days that take place between sending a letter and receiving a letter and then responding to that letter. It’s built-in emotional regulation. Impact letters are a big intervention that happen within the first two to three weeks of a student’s stay at Open Sky. Receiving impact letters is often an eye-opening experience for the student in the field because they may not have ever known that their family members felt a certain way. They may not have known how much of an impact their behaviors had on the family system as a whole. Many students may read and then re-read these letters. 

An example of this built-in emotional regulation recently happened within my team when a student in the field received impact letters from his parents, including his stepfather. His initial reaction was anger because he didn’t think his stepfather knew him well enough to write an impact letter. He responded with defensiveness. Then he took time to read the letter again and came to the conclusion that he was actually angry with himself. He realized his stepfather did know him. His stepfather saw and understood him. The student was angry with himself because he had assumed they didn’t have a good relationship, and he realized how much he had contributed to the family dysfunction.  

As things like impact letters come out, there’s a natural deepening to the conversation between parents and children and their siblings. Then we bring in phone calls. Phone calls allow for a more immediate response, which can be scary, but usually there are several weeks built in before the phone call in which students and families are practicing this emotional regulation.  

How are other members of the family system, like siblings, involved?

I’m often encouraging siblings to write impact letters to their siblings who are in the field. That’s one of the primary ways siblings can engage in something like a parallel process. I’ve also led plenty of Family Quests where siblings were a critical part of the process because they often bring a sort of X factor to the experience. There can be this dynamic where there’s almost a standoff between the student at Open Sky and their parents. Then the sibling comes in, and they very frequently share important, powerful reflections on the parent-child dynamic that the child at Open Sky and their parents hadn’t realized. There’s a huge opportunity for siblings to add great value to the therapeutic process.   

Do you have any words of wisdom or advice for families who are considering Open Sky for a loved one?

The first thing parents and families need to ask themselves is, “Can we as a family continue to live this way?” Many of our clients come to us because they’ve tried so many different things and they’re at a loss for what to do. Perhaps the family relationships and dynamics have become intolerable, or maybe the identified patient – the student who comes to Open Sky – has progressed to the point where there’s a risk of life. So that’s the first, biggest question families should ask: “Can we continue to live this way?”  

If the answer is no or not for much longer, then families should next ask themselves, “What am I willing to do to make meaningful change?”  That’s what family systems comes down to. Not only is it about finding treatment for the child coming to Open Sky, it is also about families being able to take a courageous look at themselves and put in the work alongside their loved one.