Family Therapy
When the whole household is managing the same thing
Families do not usually arrive because of one person. They arrive because of a pattern that everybody is inside and nobody can see the edges of.
Sometimes one person is clearly struggling and everyone else has arranged themselves around it. Sometimes nobody is in crisis and the house has just stopped working.
The first conversation is free and it lasts 55 minutes.
Open seven days a week.
What families bring here
- Addiction in the family. Gambling, alcohol, drugs, gaming, pornography, spending. This is a specialism of this practice rather than something we also do. When a family has organized itself around somebody else’s use, that arrangement outlasts the use, and undoing it is its own piece of work.
- Adult children who have not launched. Twenty-four, at home, and stuck. Parents who cannot tell whether they are helping or preventing. This is one of the most common calls we take and it is far less unusual than the families making it believe.
- Brain injury, stroke or a diagnosis in the family. When one person’s health event reorganizes everybody’s role and nobody chose the new arrangement. Frequently the parents or the adult children need the session more than the person who was ill.
- Aging parents, and the decisions that come with them, including the ones siblings disagree about.
- Boundaries. A word used to mean many things. We will find out what you mean before doing anything with it.
- Conflict that has calcified. Two people who have not spoken in three years, and everybody else managing the seating.
- Blended families, and the particular complexity of loyalty running in several directions at once.
How family therapy actually works
Not everybody has to come, and not everybody has to come every time.
We usually start with whoever is willing. That is often a parent on their own, and useful work can be done from there even if nobody else ever attends. Where the whole family comes, sessions tend to alternate between the group and smaller combinations.
Nobody is put on trial. A family session where one person is the identified problem and everyone else is there to describe them does not work, and we will not run it that way.
Nobody is told what to do. Not in the first session, not ever. The work goes into understanding what the family is actually managing, which is usually not what the family thinks it is when it calls.
Sessions are an hour, in our Tigard office or by secure video anywhere in Oregon. Video suits families spread across the state, and it means an adult child in Bend can be in the same session as parents in Portland.
We work with adults, and with young people from sixteen
We do not see children. From sixteen we will, and most of the families we work with are adults throughout: partners, adult children, parents of adult children, and aging parents.
If the person who needs to be in the room is younger than sixteen, we are the wrong practice and we would rather say so on this page than after you have called. We can point you toward someone who is right. A sixteen or seventeen year old holds their own say over what is confidential in Oregon, which changes how a family session runs, and we will talk that through with you before anybody books.
Who you would see
Family work here is taken by two of our clinicians.
- A licensed clinician whose addiction credentialing is the reason families with substance use or gambling in them come here specifically.
- A Marriage and Family Therapist Associate whose training is specifically in family systems.
Our other clinicians work with individuals, including individual members of a family who want their own hour.
What this costs
Family sessions are $245 with a licensed clinician and $210 with a supervised associate.
Insurance and family therapy have a complicated relationship. Insurers pay for the treatment of a diagnosed condition in one person, so family sessions are sometimes covered when they are part of that person’s treatment and sometimes not covered at all. We will tell you which applies to you before your first session.
We are in network with Kaiser, PacificSource, Cigna, Aetna, and United Healthcare and Optum, and with Medicare, both Open Card and in-network Advantage plans. Regence Blue Cross Blue Shield is expected from 1 October 2026 and Moda from 15 October 2026, both for associates as well as licensed clinicians. For the Oregon Health Plan we can bill Open Card, but not the coordinated care organizations, and most OHP members are enrolled with a CCO rather than Open Card. There is no sliding scale.
Questions people ask
Does everybody have to come?
No. We start with whoever is willing, and often that is one person.
My adult son will not get help. Can I come on my own?
Yes, and this is one of the most common reasons families call. We cannot make somebody else change. We can work on what you have control over, which is usually more than it feels like from inside it.
How do I set boundaries with an adult child without cutting them off?
That is exactly the work, and the answer is different for every family, which is why the honest response here is that it takes a conversation rather than a rule.
Is family therapy the same as everybody having individual therapy?
No. Individual therapy works on a person. Family therapy works on the arrangement between people, which is a different thing and sometimes the thing that actually needs to move.
Will you tell my parents what I said?
We will be clear at the start about what is shared and what is not, and everybody in the room will know the rules before anybody talks. That conversation happens first, not later.
How long does it take?
Shorter than people expect, often. Many families do a defined piece of work over a few months rather than an open-ended arrangement.
Can we do it by video if we are in different places?
Yes, and it is one of the better uses of video therapy. Everybody joins from where they are.
Book a free 55 minute consultation
An hour, at no cost, with a clinician rather than an intake screener.
Book online · In person in Tigard, by video anywhere in Oregon