Family and systemic psychotherapist

This occupation is found in the NHS, adult, children and young people’s social care services, independent practices, private health and care facilities, charitable organisations, and educational institutions. Family and systemic psychotherapists may work with a specific population, for example, children and young people, adults of all ages, or people with learning disabilities. They may provide family and systemic psychotherapy in a particular work setting, such as mental health or social care.

The broad purpose of the occupation is to help individuals, families, couples and wider networks to find ways to help each other when one or more members are struggling with mental health, relational and or behavioural difficulties. Family and systemic psychotherapists may provide therapy for whole families, parts of families, individuals, couples, or other significant relationships. They will typically explore the beliefs, behaviours, and relationships within the family to facilitate and engage members to share understanding and views with each other. This can enable the various individuals to better understand the issues they are experiencing that are causing concern and explore ways forward that work for them.

Family and systemic psychotherapists draw on systemic approaches, theories and techniques with their clients and their networks to understand and address issues causing concern. This can help families to improve communication between members and with significant others outside of the family by making interactions more effective and productive. Improved communication can help individuals and families make important changes in the way they relate to each other and assist in resolving persistent patterns of conflict.

Typically, family members are seen together for therapy sessions, but family and systemic psychotherapists may work with individuals, couples, or combinations of family members. This depends on who is available and what the presenting and emerging concerns are. Clients can be seen in mental health or social care consulting rooms and sometimes in their own homes. They can also be seen in formal family therapy clinics and in training contexts.

The clients that family and systemic psychotherapists engage may be experiencing high levels of distress. This may manifest in a range of ways such as depression, anxiety, acts of self-harm, high expressed emotion or eating disorders. Family and systemic psychotherapists will undertake a detailed initial assessment discussion with their clients focusing on complex, sensitive and personal information related to their mental health difficulties. This will also require the therapist to undertake and complete risk assessments, risk formulation and risk management for their clients. From this they will then be required to draw upon this complex assessment material to provide verbal and written systemic formulations that will support evidence-based interventions for the individual, couple, or family they are working with.

In their daily work, an employee in this occupation interacts with the wider team in the organisation within which they are embedded, along with external professionals and networks. This may include:

• medical practitioners, psychiatrists, psychologists, paediatricians, nurses, occupational therapists, administration and other hospital staff
• psychotherapists: art psychotherapists, cognitive behavioural therapists, child psychotherapists, cognitive analytic psychotherapists
• community and specialist social workers, such as fostering and adoption
• NHS and social care managers
• schools and college staff
• probation service, police officers and youth offending services
• palliative care staff
• staff in mental health charitable organisations
• charities
• housing benefit staff

An employee in this occupation will be responsible for:

• acting autonomously within agreed limits set by the protocols of their employing organisation and in negotiation with their supervisor
• implementing a range of systemic interventions for individuals, families, couples, their wider networks and professional networks
• providing formal written reports on their work as well as other keeping accurate records
• autonomous liaison with internal clinical colleagues and outside agencies
• co-constructing with each client a realistic and appropriate care plan within the resources of the employing organisation
• co-constructing with each client a systemic risk assessment, the accuracy and appropriateness of which will be regularly appraised, monitored, and updated over time
• participating in and contributing to multidisciplinary meetings, team meetings, child safeguarding case conferences, reviews, and network meetings
• adhering to and working with relevant clinical and ethical frameworks and codes of practice
• participating in and contributing to both managerial and clinical supervision
• contributing to service evaluations
• contributing to the organisation’s training agenda
• contributing to leadership, providing feedback on systemic psychotherapy within the organisation
• participating in personal learning, identifying areas of personal strength and learning needs, seeking, and responding to support and feedback
• maintaining up to date knowledge in their field of practice and taking part in continuing professional development