Coaching Toward Better Family Relationships

This week’s guest blog is by Ronald B Cohen, MD, a Psychiatrist and Marriage and Family Therapist from Great Neck, NY. Dr. Cohen is a Fellow of the American Psychiatric Association and an Affiliate Member of the American Academy of Marital and Family Therapy.

In 2001, Betty Carter & Monica McGoldrick two of the most-respected authors, teachers, and clinicians in the field of family therapy, published Advances in Coaching: Family Therapy with One Person, detailing 25 years of research into the theory and techniques of “coaching” individuals to change themselves in the context of their family of origin. The technical term “coaching” refers to preparing and acting for change in the individual’s natural system of relationships.

In contradistinction to traditional individual therapy, coaching focuses on real world behavior with significant others rather than the in-session therapeutic relationship. It is not the interaction with the therapist but rather the individual’s relationships with their family of origin that is of utmost value. Although this approach is regarded as one of the major modes of intervention in family therapy, the actual methods and techniques are not widely understood nor often implemented effectively. Techniques for helping individuals deal with difficult family relationships are not widely known by most individual therapists.

The goal of coaching is to help individuals proactively define themselves in relationship to others in their families without emotionally cutting off or giving in. The process of change is built upon ownership of one’s emotional reactions to old triggers and interactions. Coaching, or family therapy with one person, offers individuals a process for making change in their relationships even without the participation of other family members.

As a therapeutic coach, I help people plan and strategize. I begin by training individuals to become observers and researchers of their role in their family‘s patterns of behavior, what the anthropologists refer to as being a “participant observer”. The information and interactions are then reviewed and we talk about what kind of responses they got, what worked and what didn’t, and where they got stuck. Then we plan what they might do different next time in order to get a response that is more in line with what they are looking for.

The process then moves to helping individuals bring their behavior more in line with their deepest beliefs, even if this means upsetting family members by disobeying family “rules.” An important part of the coaching process is to help people develop realistic expectations when moving toward changing their part in the family dance. This includes being prepared to respond productively even if unfortunately the other person reacts unfavorably.

Coaching teaches the possibility of dealing with differences without losing connection, which is one of the primary developmental tasks for a young adult. If you are tied up with all of the stuff and rules and roles of your family of origin, it is really hard to figure out who you are and what you want to do with your life.

Coaching is “differentiation in action,” guiding people through a process of changing their own participation in unsatisfying family relationship patterns. It is a conscientiously thought through approach to establishing a unique one-to-one relationship with every individual in the family system.

This post was written by Ronald B Cohen, MD, a Psychiatrist and Marriage and Family Therapist from Great Neck, NY. Dr. Cohen is a Fellow of the American Psychiatric Association and an Affiliate Member of the American Academy of Marital and Family Therapy. As a consultant specialist, Dr. Cohen provides clinical supervision, and confers with individual therapists and other health care professionals and organizations to help them consider how adding family therapy sessions to the treatment program is both restorative and proactive as improvement is long lasting. 

 Dr. Ronald B. Cohen graduated summa cum laude, from Brandeis University and The Albert Einstein College of Medicine. In addition to his psychiatric residency training, Dr. Cohen was educated at the Psychiatric Epidemiology Program of the Columbia University Joseph L. Mailman School of Public Health. Subsequently Dr. Cohen completed the four-year core postgraduate training program in Family Systems Theory and Therapy at The Family Institute of Westchester

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