[00:00:00] Marie Vakakis: Some families look fine from the outside. Everyone’s doing what they’re supposed to do. Meals are on the table. Maybe kids are going to school, but behind closed doors, tension can be constant. Conversations can become arguments. One person gets labeled as the problem. Where everyone else is walking on eggshells and they come to us often with one person in the room and expecting us to fix it.

 

[00:00:25] Marie Vakakis: I’m Marie Vakakis and this is Inside Social Work, where we dive into real conversations, real stories, hard topics, and the moments that shape us and the work that we do. This episode was originally recorded for the Mental Work podcast with Dr. Bronwyn Milkins. It was such an insightful and practical conversation, and I thought it would really fit on the Inside Social Work Podcast.

 

[00:00:45] Marie Vakakis: So I wanted to share it with you here as well. We talk through a fictional family case and use it to explore what family therapy can actually look like in practice. We unpack how to assess family dynamics, how to work with conflict in the room. And [00:01:00] why? Seeing the whole system matters, especially when it feels like your client is stuck in patterns beyond their control.

 

[00:01:05] Marie Vakakis: If you’re only working with individuals, this episode is full of ideas, helpful ideas or suggestions of how to start thinking more systemically. I share some of the ways that I integrate family focus work into my sessions, and how you might start to do this too without needing to go back and do another Master’s if you’re.

 

[00:01:22] Marie Vakakis: Interested in this kind of work and you want to keep building your confidence, check out my online training called Family Work Without Freaking Out. It’s designed to help you understand family systems, set boundaries, and feel more equipped to work with parents and carers alongside young people. I also offer group supervision and one-on-one supervision.

 

[00:01:38] Marie Vakakis: So if you are supporting young people working in private practice or feeling unsure about where to go next in your clinical work, you might like to join one of those groups. And if you are based locally to me in Footscray, in the western suburbs of Melbourne, we’ve got a youth mental health professional networking group through the MHPN where you can connect with other local practitioners, share resources, and we meet every couple of [00:02:00] months in set or Footscray or Yar, depending.

 

[00:02:03] Marie Vakakis: So I’ll pop a link to that in the show notes as well. And you can register with the MHPN. It’s free to attend, and you can come and meet me and some other folk as well. You can find details about upcoming events and training at my on my website, mariva kakas.com au, or send me a message and say hello.

 

[00:02:20] Marie Vakakis: LinkedIn’s probably the best place to get me. Now let’s get into today’s episode. I hope you enjoy it and take away something useful that might help you reflect on your own work with more than one in the room.

 

[00:02:34] Bronwyn Milkins: Hello, mentor Workers. You are listening to the Mentor Podcast, your companion to early career psychology. I’m your host, Bronwyn Milkins. We know in psychology that we mostly deliver individual therapy, and that’s what we’re trained to do most of the time, like if we go through uni, the focus is very much on individual therapy, and there might be a mention of couples therapy if you’re lucky in a single lecture.

 

[00:02:59] Bronwyn Milkins: [00:03:00] Then when we go into our internships, again, it’s usually very individual focused, but what if something else is more appropriate for our clients? What if that thing is family therapy? Here to help us unpack that is our guest, Marie Vakakis. Hi Marie. Hello. Thanks for having me back. My pleasure. So Marie was on an earlier episode where they talked to us about family therapy and working with young people and their systems.

 

[00:03:27] Bronwyn Milkins: And Marie, could you just remind listeners who you are and what your nons psychology passion is? 

 

[00:03:33] Marie Vakakis: I’m Marie Vakakis. I’m an accredited mental health social worker and couples and family therapist. I have a practice in Melbourne called the Therapy Hub, and then I have a training and consultancy business mariva carcass.com.

 

[00:03:46] Marie Vakakis: So I sort of bring together working with individuals and families all into the one place. 

 

[00:03:53] Bronwyn Milkins: Wonderful. Thank you so much, Marie for coming back on and listeners, today what we’re going to do is we are going [00:04:00] to present to you a hypothetical case study. And then we’re gonna get Marie’s help in unpacking how to conceptualise it, how to think about what’s happening for the family, coming up with some potential strategies to help the family, talking about potential problems that might arise and how to overcome them.

 

[00:04:21] Bronwyn Milkins: By the end of it, hopefully you should feel a bit more confident or just even knowledgeable. For me, I know very little about family therapy. It’s something that I’m interested in, but just because I don’t work with her, it’s like, you know, I’ve got a million other things to learn, so I’m really interested in this episode.

 

[00:04:36] Bronwyn Milkins: Okay. And Marie, does that sound good to you? 

 

[00:04:39] Marie Vakakis: That sounds like a supervision, but with a fake client. 

 

[00:04:42] Bronwyn Milkins: Yes, it does. Yeah. So for in preparation for this episode, what I did was I asked Cha GPT to write me out a case study. Uh, I think Cha GPT knows that I live in Australia, so I tried to make it local. But anyway, let’s get started.

 

[00:04:56] Bronwyn Milkins: The Williams family resides in Melbourne, Australia. [00:05:00] The family comprises Michael, 48 years old, a dedicated high school teacher, Lisa, 45 years old, a part-time graphic designer. They’re till children. Olivia 17 and Ethan 14. On the surface, the Williams family appears to be leading a content life, but beneath the facade lies a complex web of issues that has prompted them to seek family therapy.

 

[00:05:21] Bronwyn Milkins: Chat. GPT got a bit ominous. Okay, let’s see what’s happening. Michael, passionate about his teaching career has been grappling with work related stress leading to fatigue and emotional exhaustion. Lisa, while managing her graphic design work and household responsibilities, it feels a growing sense of disconnect from Michael.

 

[00:05:38] Bronwyn Milkins: The couple’s communication has dwindled and they find themselves caught in repetitive arguments that go unresolved. Olivia, a senior in high school, is preparing for uni and feels overwhelmed by academic pressure. The stress has strained her relationship with her parents, and she often feels unheard and misunderstood.

 

[00:05:55] Bronwyn Milkins: Ethan in the midst of adolescence is struggling with its own set of challenges, [00:06:00] including issues with self-esteem and difficulty expressing his emotions. The household atmosphere has become tense and the family unit once tightly knit, is now strained most of the time. No family member can speak to each other without an argument breaking out.

 

[00:06:16] Bronwyn Milkins: Recognising the need for intervention. The Williams family decided to seek the help of a family therapist. They hope to rebuild communication, address the individual challenges each family member is facing, and ultimately restore a sense of unity and support within the family. The issues they bring to therapy include strained spousal communication, parental stress, impacting the children, and the need for a more connected and understanding family and environment.

 

[00:06:41] Bronwyn Milkins: I can read out parts of that again if you need it. Obviously that was a big info dump. 

 

[00:06:46] Marie Vakakis: No, I think that’s good. Um. I think we’re, I mean, do you have any initial questions for me? Like how would we kind of get this started? 

 

[00:06:54] Bronwyn Milkins: The first thing that runs through my mind, having been trained in this very individual lens of [00:07:00] seeing therapy and interventions, is, well, why not just grab Michael and his wife Lisa?

 

[00:07:06] Bronwyn Milkins: Why not just put them in couples counseling, put the kids in individual therapy and bam, there, there we go. Like, why? Why would we consider family therapy as an intervention? 

 

[00:07:16] Marie Vakakis: Well it’s, it’s interesting because you could do a combination of that when you are working with the family. But I think, and I guess following on from our original conversation when we looked at this is it doesn’t always have to be perfect pure family therapy to be thinking about the impact of family.

 

[00:07:34] Marie Vakakis: So if you’ve got Olivia as a client, and I’ll go with her because that’s the age group that I would mostly see. It wouldn’t be very helpful to be teaching her. Breathing techniques and basic CBT and diffusing from negative thoughts. If you’re using act. If she’s going home and her parents are in distress, they can’t communicate properly, they’re feeling anxious, they’re overwhelmed.

 

[00:07:57] Marie Vakakis: Maybe the comments that they make further exacerbate her [00:08:00] distress. We are focusing on one piece of, of the puzzle. It’s the person who’s probably got the least amount of power or one of the least amount. So if she’s self-harming, for example, just trying to teach her coping strategies without looking at how do mom and dad respond?

 

[00:08:16] Marie Vakakis: Are they approachable? When she’s feeling overwhelmed, do they get so anxious and overwhelmed that it exacerbates her distress? So we’re looking at these patterns. So when we’re looking at a, at the family system, we have to look at that, that relational component. 

 

[00:08:31] Bronwyn Milkins: That makes sense to me because in the case study it says that Olivia’s preparing for uni feels overwhelmed by academic pressure.

 

[00:08:37] Bronwyn Milkins: And then it also says that the family can’t talk to each other without an argument breaking out. So let’s say we did teach Olivia, like, okay, let’s make space, so that discomfort, that overwhelm that you feel about uni. You can let it be there and you don’t have to respond to it straight away. Whereas if she goes home, if the parents are like, have you thought about what you’re doing for uni?

 

[00:08:58] Bronwyn Milkins: Like, we need to sit down [00:09:00] and talk about your uni choices here and what you’re prioritising, that strategy would come into conflict with that. 

 

[00:09:06] Marie Vakakis: Potentially. And also each person will be focusing on what they want the other person to do instead of the role that they play within that system. 

 

Ah. So 

 

[00:09:14] Marie Vakakis: you might have mum or dad just saying, if only you could just do this, then we would be fine.

 

[00:09:18] Marie Vakakis: Yeah. And then you might have Olivia saying, if they would just get off my back, then I would be. Okay. So we’re also looking at this level of emotional maturity that. Each person can start to take some responsibility for how they respond or how they react or how they show up in that dynamic. Mm. It’s like a dance move, right?

 

[00:09:39] Marie Vakakis: Like you can’t choreograph a two person dance on your own. You need that other person there. 

 

[00:09:44] Bronwyn Milkins: That makes sense. So with, with this, like, are we getting all four of them in the room at the same time or is it. Olivia with the parents or the parents themselves? Like how do you decide who to have in the room with family therapy?

 

[00:09:59] Marie Vakakis: It [00:10:00] depends on how the referral comes and whether people are asking straight for straight family therapy. So if this family contacted us and saying We wanna come as a family, we might do a bit of a brief session. It might even just be on the phone to sort of say, what are you, what are you needing? What’s kind of happening and then sort of maybe figure it out.

 

[00:10:19] Marie Vakakis: ’cause if they’re like, oh, we’re all coming because we wanna fix Ethan. Like, well, maybe that’s still valuable. I, I feel like I would be equipped enough to hold space for that. I’d say, look, let’s all come in. And then, you know, if Ethan’s coming in being like, I don’t know why everybody’s here. This is, you know, we, we’d work with that in the room and I would have in that first session.

 

[00:10:38] Marie Vakakis: Why now? What’s happened? What’s triggered this most recent help seeking. Session or time, like what, what’s, what’s happened? Did someone have a fight? Did someone storm it? Like actually understanding why now is really helpful because the family families have their own resources and something throws the equilibrium out [00:11:00] sometimes and we wanna see how we bring that back together.

 

[00:11:03] Marie Vakakis: So we see patterns across. Transitions, like developmental milestones, a death in the family. Great. Going from primary school to high school, from high school to uni, like these kind of big transitions can sometimes take families a bit of time to find their balance again. So it would be really understanding why now, what are they hoping to get out of it and understanding, like you would for individual therapy, you might phrase it differently, but what are their goals for treatment?

 

[00:11:32] Marie Vakakis: What would it look like if a after a few sessions this was helpful. 

 

[00:11:38] Bronwyn Milkins: That’s, that’s a really good point. Yeah. Because in the case study we don’t actually have a why now? So you’re saying that some of the why nows you might see is that there’s an external event. So say there’s a death in the family or people are going through life transitions and then it places strain on the family.

 

[00:11:57] Marie Vakakis: It, it could. Yeah, absolutely. And that’d be part of the [00:12:00] case conceptualisation. So you would be formulating a bit of a plan and you would be reworking it in your mind to think about, you know, what’s the background, what’s happened recently? What are some key milestones that have happened over time that might relate to that particular distress or particular, um, concern that the family has?

 

[00:12:19] Marie Vakakis: He’d be looking at the family structure. Are they separated, divorced, blended family? Like what’s happening? And then the way everybody interacts gives you information, it’s already showing you are they enmeshed? Does someone talk over somebody else? Can you see how their attachment styles play out in the room?

 

[00:12:38] Marie Vakakis: Like all of this is really rich information. Does someone take up a lot of space? Does someone not have a voice at all? All of that is information that you won’t be able to get if you’ve just got one person there. 

 

[00:12:52] Bronwyn Milkins: Mm. That sounds like a lot. You know, when I’m working with an individual client, I am [00:13:00] thinking how they interact with me.

 

[00:13:01] Bronwyn Milkins: So sometimes I’m like, are they not saying much or are they being agreeable with me, or are they talking over me? And I look at that relationship dynamics, but I’ve only got, I guess, three relationships to keep track of the relationship they have with themselves, our relationship, and then my relationship with myself.

 

[00:13:22] Bronwyn Milkins: In a family situation that’s like at least four different relationships. I’m wondering, could you take us through like. A basic way, if possible, of conceptualising a family. It, 

 

[00:13:37] Marie Vakakis: it’s hard ’cause there’s no one basic way, but there are some patterns that we look out for. So it might be something like a distance of pursuer.

 

[00:13:46] Marie Vakakis: It could be that every time one person says something, the other retreats. So we might be looking at themes and coming at it with curiosity. It might even be saying, can I just pause you there, Michael? When [00:14:00] I see Lisa try to express what she’s feeling, I get the sense that you are really frustrated what’s happening for you right now?

 

[00:14:07] Marie Vakakis: You get to interrupt that and bring new information into the system. So it could just be Olivia. Every time mom tries to show she’s understanding, I see you get really angry that she. It sounds like you feel like she’s maybe belittling you, like what’s happening there for you, and you get to translate some of those moments live in the session.

 

[00:14:30] Marie Vakakis: So even just looking at how each person responds and being able to say, is that what you meant by that, Lisa? When you asked Olivia, how did school go? Were you meaning to be interrogative? She’s like, no, no, I didn’t. You know? So you get to really notice those patterns. 

 

[00:14:49] Bronwyn Milkins: And is this something that you write down?

 

[00:14:52] Bronwyn Milkins: I guess like for yourself, you’re quite an experienced family therapist, so you’ve done a lot of training and you supervise [00:15:00] family therapists. Maybe when you start it out, is this something you would write down or is it now more something you keep tracking your head? 

 

[00:15:08] Marie Vakakis: I still do a combination of both. I have a number of like case note templates that I’ll, I’ll use depending on who’s presenting to me.

 

[00:15:16] Marie Vakakis: So if it’s a couple or individual or a family, and I’ll still kind of drop down notes in particular categories. So if you are, you know, if you’re very attachment based, you might have some of those fields already kind of pre-made and you just, you get to tick which box it is. Like you get to have some of those tools depending on your particular background.

 

[00:15:36] Marie Vakakis: When I was studying family therapy, we had the benefit of a lot of the sessions were recorded so you could go back and re-watch them and sort of notice some of those things. And you have people watching you live. So you get that constant live feedback as it’s happening, which is very overwhelming at times.

 

[00:15:53] Marie Vakakis: Yeah. But really helpful. 

 

[00:15:55] Bronwyn Milkins: Yeah. So I guess where we’re up to is really the assessment. [00:16:00] It’s like. If we brought the Williams family in for a session, we’d wanna be looking at these dynamics between them picking up on patterns and themes, really getting a sense of the why now and their goals. Is that right?

 

[00:16:15] Marie Vakakis: Yeah. And then I would be looking at, like you do with some individuals, you’d have some miracle question, like if the problem was resolved overnight, what would be different? You can ask questions around what have you already tried? What are you hoping would be different this time? So sometimes that can be really helpful and having young people sort of say, I, when I hear mom and dad fight, this is the impact it has on me.

 

[00:16:41] Marie Vakakis: Or, you know, you get to hold space for that. It’s not that you are being a, an umpire or referee, but you really set up that system to sort of trust you and not as coming, like that power over as an expert, but actually saying. There’ll be times where I will interject. Is [00:17:00] that okay? Can I have permission to interrupt you if I feel like we’re getting off track when someone says something, I might pause things there.

 

[00:17:07] Marie Vakakis: I might make note of something to come back to. Is it okay if I interrupt? So you’re seeking permission to, to interject or to pause or to paraphrase so you can capture some of those things live. So I’ll give you an example. I mean, this is a very common sort of presentation. Um, you know, that. Two parents, two children kind of scenario where I had a family where every time the young person would speak, I, I would see the parents get quite activated and it, it kind of was a light bulb moment where I was like, oh, you perceive their tone as rude?

 

[00:17:48] Marie Vakakis: And the parent was like, yeah. I’m like, that’s interesting because they use that same tone with me. They’re not. Being rude. I think that’s just their tone and that you could [00:18:00] see the whole family be like, they’d never thought of that before. 

 

Mm. You know, 

 

[00:18:03] Marie Vakakis: I see it a lot with maybe some of my autistic clients where they might be quite maybe frank in their communication style or quite direct, and the parents are getting very activated by that.

 

[00:18:15] Marie Vakakis: They’re thinking they’re, they’re being combative or they’re being sassy or being rude or argumentative. And the young person is completely confused. And then I have them in the session and I see them talking, and then I can comment on the parent’s response. Like, oh, when, let’s just say it was Ethan who was presenting that.

 

[00:18:32] Marie Vakakis: Like when Ethan says this, I sense something’s happening for you. What’s going on? And they can say is being really rude or is being aggressive, and I might be able to offer. More information by saying actually he speaks like that when it’s just the two of us, or, I don’t think that’s where it’s coming from.

 

[00:18:50] Marie Vakakis: Can I check in with you, Ethan? So we get to bring in more information really like live into the system. 

 

[00:18:59] Bronwyn Milkins: Maybe [00:19:00] something that, a theme or a pattern that you would conceptualise in families, like a series of misunderstandings or. Expectations that aren’t, I guess, fair or unkind from parents to kids of young people.

 

[00:19:18] Bronwyn Milkins: Um, and then maybe the goal of family therapy is helping them understand each other from a different perspective. 

 

[00:19:27] Marie Vakakis: I 

 

[00:19:27] Bronwyn Milkins: think that’s 

 

[00:19:28] Marie Vakakis: definitely one of the goals. There’s so many different modalities of family therapy and it would be like if we were. Talking about individual therapy, like you would have, you know, EMDR therapy, schema therapy, CBT, we have all these modalities.

 

[00:19:42] Marie Vakakis: Family therapy has all these different modalities as well. 

 

[00:19:47] Bronwyn Milkins: Could you tell us what a few of those are? ’cause I literally know I’ve heard of Bowen and then I, and then my mind is like blank and there’s a tumbleweed. 

 

[00:19:56] Marie Vakakis: There’s systemic therapies. There are strategic therapies. We [00:20:00] have sort of, there’s narrative therapy that comes in, like family therapies, but if we’re looking at couples, then that’s a whole different ballgame game where we have EFT and Imago and Gottman.

 

[00:20:10] Marie Vakakis: There’s experiential, so there’s structural, there’s solution focused, there’s different things, and each one has slightly different ways of conceptualising what’s happening in the system. 

 

[00:20:21] Bronwyn Milkins: What’s your favorite one? I quite like Bowen. 

 

[00:20:24] Marie Vakakis: I work from that probably more, but that felt the most natural for me.

 

[00:20:28] Bronwyn Milkins: Yeah. 

 

[00:20:28] Marie Vakakis: And then like with individual therapy, I might borrow tools from other practices where it’s like, well, like you, I might pinch that kind of that. Question from this, or I like that assessment tool and, and bring sort of things in. But my overarching model is looking at Bowen with an attachment sort of lens.

 

[00:20:46] Marie Vakakis: ’cause that also fits in nicely with my couple’s therapy. 

 

[00:20:49] Bronwyn Milkins: Yep. And I don’t mean to make the podcast an exam, but like with putting you on the spot, but, but could you just tell us like what Bowen therapy is like? [00:21:00] Yeah. 

 

[00:21:01] Marie Vakakis: Oh, now you are putting me on the spot. Sorry. No, that’s okay. Um, Dr. Murray Bowen was a psychiatrist and he was looking at how people respond.

 

[00:21:11] Marie Vakakis: In particular, I think it was around psychosis. I’m trying to think. It might have been. And he sort of looked at the patterns of maturity and how it’s that real focus of. The relational component and what we bring to something rather than the blame on someone else. So it’s really around focusing on the bit that we can control in different relationships.

 

[00:21:35] Marie Vakakis: And then there’s different sort of tools and techniques around that. There’s that sort of this, trying to find this balance of togetherness and a need for autonomy. So differentiation in a healthy way. So it’s not being like if you’re fighting against something. Or you are completely pulling away.

 

[00:21:55] Marie Vakakis: Neither of those Is that sort of healthy, mature, differentiated adult? 

 

[00:21:59] Bronwyn Milkins: [00:22:00] That sounds like I would. I was wondering whether it’s a common thing in family therapy for families to come in and be like, they are the problem. Like the young person is the problem, or X is the problem. If only X did things differently, then things would be better.

 

[00:22:16] Marie Vakakis: Yeah, and there’s a really great article, people can look it up. It’s by Dr. Jenny Brown. It’s called, we don’t need your help, but can you please fix our children? And, um, we’ve spoken about it on my podcast, a very similar topic, but actually for parents, and I’ve spoken on her podcast, the Parent Hope Project, about a similar thing, but it can be very much that everything would be fixed if this person just got fixed.

 

[00:22:40] Marie Vakakis: Yeah. And that, again, it’s that that’s not really differentiated. It’s not that togetherness and separateness, it’s not allowing space to grow. But also maintaining connection. So those are the ones that if we just kept focusing on individual work, we’re feeding into that belief that that person’s the problem, that they’re [00:23:00] the identified patient.

 

[00:23:02] Bronwyn Milkins: Yeah, because I’m imagining a situation like, let’s say that. The why now for the Williams family, let’s say it’s like Olivia stayed out past her curfew and then she got grounded. She thought that was unfair, so she ran away and stayed at a friend’s house for a week, and then Ethan didn’t talk to his parents for a week, and then they all didn’t talk to each other, and that was their like, why now?

 

[00:23:29] Bronwyn Milkins: It’s like, okay, we are not functioning as a family. Maybe the parents would come in and be like, well, if Olivia just stuck to the rules that have always worked, um, then this would never have happened 

 

[00:23:43] Marie Vakakis: if you were working with Olivia and that was she was dropped off to you and mom’s like, I’m just gonna come in quickly and just let you know what’s happening.

 

[00:23:51] Marie Vakakis: Can you get her to be more, I don’t. Obedient, how would you start that as an individual session and then maybe I can share what I might do? [00:24:00] 

 

[00:24:00] Bronwyn Milkins: I think I would try and get a sense of Olivia’s perspective and I guess like as an individual practicing from a humanistic standpoint, I would have, I, I mean, I always say this to my client that I’m on their team.

 

[00:24:13] Bronwyn Milkins: It doesn’t mean that we won’t have difficult conversations. In that original initial session, I would be really trying hard to understand Olivia and her sense that she’s un unheard, misunderstood, that this was unfair, and then maybe for interventions going forward, I might try and recommend how she can.

 

[00:24:35] Bronwyn Milkins: Assert her autonomy and communicate as best she can with parents who maybe or maybe not will change or be receptive to her asserting her autonomy and then acceptance around that. Maybe her parents won’t change or maybe they will, and how she can cope with that. That sounds really good. That’d be my best guess.[00:25:00] 

 

[00:25:00] Bronwyn Milkins: Yeah. 

 

[00:25:01] Marie Vakakis: Yeah. And then, and then if in between sessions mom keeps emailing you saying, why isn’t she listening? Why isn’t she responding to curfew? 

 

[00:25:09] Bronwyn Milkins: Oh my God. Um, I’d probably set some boundaries with the parent, um, and I’d tell them that, that, like, I might tell Olivia that mom’s really concerned about this.

 

[00:25:20] Bronwyn Milkins: Like, I don’t keep secrets. So Mom has shared her concerns in this email to me. Might tell mom that things could be, if I’m persisting with individual, I would say maybe mom, we can talk, um, at the end of the session individually about your concerns. I don’t know what I do actually ’cause I don’t, I don’t work in that way, but I wonder if, like, I would be like, um, I wonder if I would talk with mom about how seeing Olivia as the problem is, is furthering her, her alienation from the family or something.

 

[00:25:50] Marie Vakakis: So you’re already, some of it’s already sort of, it overlaps because that might be a common presentation is very, it’s not as common for people to present with family as family therapy [00:26:00] because I know in the states it, it does come under a lot of the insurance companies here. It’s not Medicare rebated and a lot of people, it’s just not a popular or well-known sort of modality.

 

[00:26:12] Marie Vakakis: So I would be looking at that. Let’s say it’s that dynamic. Making sure you don’t get triangulated in. Oh, okay. So that you are then the the good guy or the bad guy in this, right. Because then it’s, oh, my therapist said, oh, but you are not doing this. So we really want to make sure that we don’t get stuck in that system.

 

[00:26:29] Marie Vakakis: And then also looking at what role does maybe dad play in this? Because if mom’s then fighting with Olivia, and then what does dad do? So sometimes it’s actually those first few sessions might be in saying. I’m still doing my assessment. I’m trying to understand where you get stuck in your communication, and I know you have different priorities or different things you’d like to get out of the session.

 

[00:26:52] Marie Vakakis: It’d be great if you could bear with me. I will come back to all of your concerns. At some point it will take some time, you know, sort of use [00:27:00] an analogy or metaphor or something that talks around how you do your assessment, if that is what’s needed to keep their expectations, uh, at bay of what you can and can’t achieve.

 

[00:27:10] Marie Vakakis: And then it might be, okay, so what happens then? Okay. And then when Olivia does slam her door, what does mom do? And then where’s dad when this happens? Okay. And then what happens to Ethan? So it might be that sometimes you map it out on a whiteboard in front of people. Sometimes you’re just writing notes.

 

[00:27:27] Marie Vakakis: But it’s really starting to trace the process and trying to see what happens at each stage. And you might have to overt something like. Look, I can’t get anybody to follow any rules or anything like that. What I’m hoping to do is to get you all feeling more connected, or that even if Olivia makes some mistakes, that she still feels like you love her.

 

[00:27:49] Marie Vakakis: So you, you, you’re trying to kind of see what’s, what’s conditional on her behavior? Is love being withdrawn? Is she feeling criticised? Can the parents hold this ability to be like, [00:28:00] I’m unhappy with your behavior and I also love you. You know, there’s so many different things that could be happening that you’re trying to unpack and understand.

 

[00:28:09] Bronwyn Milkins: I guess one thing that comes up for me is I’m like, given that there’s so much to unpack and maybe so many concepts to go through with families, how long does family therapy typically last and how long do people come to sessions for? Like, do they expect a one session fix and then they’re like, I can’t believe that we’re still here five sessions later.

 

[00:28:31] Marie Vakakis: Some, some do, and there is some research that Latrobe Uni or the Ovre Center has done around single session family therapy that has shown some promising results. Okay? It really depends on knowing their expectations and what they’re hoping to get out of it. So I’ve worked with families who an episode of care might be until one particular symptom is reduced, and then things go back to, this is good enough.

 

[00:28:58] Bronwyn Milkins: So like let’s say with the Williams [00:29:00] family, if they could just have a conversation and it doesn’t lead to an argument, would that be an okay goal for family therapy? Like is that good enough? If that’s, 

 

[00:29:13] Marie Vakakis: if that’s their goal? Yeah, that it’s really for, even in the goal setting, that might be information, right?

 

[00:29:19] Marie Vakakis: If mom’s like, I just want everybody to want to spend time together. It might be sort of, well, you’ve got two teenagers who are differentiating, seeking their autonomy. They might not want to spend as much time with you. That might be mom’s need. So then you might be looking at her maturity. What’s that?

 

[00:29:39] Marie Vakakis: What’s that’s serving? What’s her need there that’s being met or not being met? Is she focusing too much on the children instead of in the marriage? Are there stories or experiences in her past that’s maybe leaving her to. Overcompensate in an area that she wished she had. So there’s room to, to examine or, or kind of shine a spotlight [00:30:00] on some of those different areas and be curious, like, where does that come from?

 

[00:30:05] Marie Vakakis: Tell me more about that. Does that remind you of something that happened to you as a, as a child or, you know, going in with this idea that families are doing the best they can with what they’ve got, and I’ve yet to have a parent come in who really wants to get it wrong. So even going with, I can see that you’ve done everything you know how to do, and I wonder if when you get overwhelmed and you get scared, you come across as a bit more assertive.

 

[00:30:34] Marie Vakakis: Would that be fair to say? Okay. So then when you’re assertive, Olivia interprets that as critical. Is that right? Olivia? Okay. So when you feel criticised, what happens for you? And then when you do that, then what does mum do? So sometimes you get to put words to that and create some of that empathy, because sometimes scared people act really cold or they overcompensate.

 

[00:30:59] Marie Vakakis: So sometimes you [00:31:00] can bring attention to those different components of the conflict or that pattern. Yeah. And that sometimes, sometimes that can be enough to, to, to settle the system where they’re like, oh. So when mom does this, it’s not because she thinks I’m crap or irresponsible, it’s because she’s scared.

 

[00:31:19] Marie Vakakis: Then they might be able to compromise or negotiate from a different position. 

 

[00:31:25] Bronwyn Milkins: Developing that empathy, which can be a sign of emotional maturity, seems to be important. Yeah. So with the Williams family, let’s say their goal is that they just wanna all get along. Like they just wanna be able to. Each other’s presence, they just wanna be in the kitchen.

 

[00:31:43] Bronwyn Milkins: And if someone says, pass me the milk, it’s not gonna be an argument that breaks out. So they wanna have better communication. The parents, they wanna feel respected. Let’s say that that’s their two main goals. These are probably [00:32:00] fairly common goals that you might see in family therapy. Yeah. Yeah. How would we.

 

[00:32:08] Bronwyn Milkins: Approach that in general, is it building the empathy? Like do we have any other, I guess, interventions or techniques at our disposal? Yeah. Again, you, it’s, you can 

 

[00:32:18] Marie Vakakis: observe it happening, so then, you know, which sort of pattern or trait is, is, is regular for that family. But for example, when it comes to spending time together, one of the things that I hear quite often and I’ve observed prob personally, professionally, I hear it in like.

 

[00:32:37] Marie Vakakis: Out and about when I’m having dinner, like people will won’t say, they won’t say something like, I really wanna spend time together. Is, is there something we can do that’s just us? They’ll say something like, it’s so nice of you to finally join us. And they use that, that tone or out of guilt. It’s like, oh, so your friends are more important than us, aren’t they?

 

[00:32:58] Marie Vakakis: Mm. And [00:33:00] that doesn’t make people wanna spend time with you. Yeah. So sometimes I might even comment on that process of like, well, how are you actually asking? Because I know if someone said that to me, I’d be like, well, I don’t want to now. Yeah. Or it, it gets your, gets you activated in more, maybe combative or argumentative.

 

[00:33:21] Marie Vakakis: You’d be like, well, I spent time with you last week. And then it’s like, it starts to feel like a chore. So I think it’s very different to come at it from a point of vulnerability of I really wanna spend time together. I appreciate you’ve, you know, you’re growing up, you’ve got your friends. Is there something we can do once a fortnight or once a month?

 

[00:33:40] Marie Vakakis: Or can we have, uh, can Thursday nights be family night? Then you can come up with some practical solutions. But if you’re coming at it straight away from that, you never spend time with us anymore or. Look how good your sister is. She hangs out with us. Like if you’re doing comparisons, passive [00:34:00] aggressive, you’re criticising, you are using maybe threats or guilt, that’s not a helpful strategy.

 

[00:34:06] Bronwyn Milkins: What if in the family there is a culture where we don’t share feelings of vulnerability, and that’s a pass down message from their parents. Is, is that something that you might have a look at in family therapy? It’s like what are the rules of our family and what are the allowable things and not allowable things?

 

[00:34:29] Marie Vakakis: It depends how much time I had. Like that would be a really great piece to actually do some psychoed around. Some families don’t absorb it that way, so it might be very experiential where if that’s your hypothesis, then you might say, okay, so Olivia, when mom said it’s because she misses, you wanna spend time with you.

 

[00:34:50] Marie Vakakis: How did that sound? What’s it like hearing mum share some more feelings with you? So you might get. Lisa to realise [00:35:00] the benefit of sharing feelings by focusing on the impact it’s had on Olivia. So you could be teaching them through the process as you, instead of just saying like, we all have meta emotions, so we have beliefs about feelings.

 

[00:35:12] Marie Vakakis: Yeah. And so that, that might be, you know, and I do that in parenting courses, like in tuning into teens or when we are, we are looking at understanding those concepts. Yeah. But in the room it could just be, and if it’s between Michael and Lisa, like. Lisa, when Michael says, I’m actually feeling like I dunno where to start and I’m overwhelmed, what’s it like for you to hear that so you can teach them the value of it by showing them the impact it has live?

 

[00:35:39] Marie Vakakis: Yeah, and if they really struggle to articulate it, then you might offer that. Okay. So what I’m actually hearing, and, and feel free to correct me if I’m wrong, is you’re really scared and. When I heard you make those comments to Olivia, they were coming from a place of fear and worry and you, you know, [00:36:00] you can bring that down and then if mom’s nodding or you know, it’s like, no, it’s actually something else.

 

[00:36:05] Marie Vakakis: But let’s say she says, yeah, that’s right. It’s like, Olivia, what’s it like to know that mom’s actually really scared and you can bring it down and so you can teach it live. 

 

[00:36:17] Bronwyn Milkins: That sounds like really powerful teacher to teach at life. And it, it just struck me actually that how I would think about that is a lot of process, comments.

 

[00:36:27] Bronwyn Milkins: So I guess here and now comments, and I remember when I was starting out as a psychologist, that was really hard for me to, to do that. Um, I either thought that, well, I either missed the moment, so it’s like something would happen and then I’d say something and I’d be like, crap, I missed that. Um, and then I wouldn’t know how to come back to it, or I’d say something and then get it wrong and be like, I’m never doing that again.

 

[00:36:54] Bronwyn Milkins: Um, but I guess like, is, is that right? Like a lot of what you do in family therapy [00:37:00] can be like here, it’s like about the here and now and the process that’s happening in the room. 

 

[00:37:05] Marie Vakakis: Absolutely. And I think even if you go in just with that, that’s a really powerful intervention in itself 

 

[00:37:11] Bronwyn Milkins: because yeah, it really, rather than doing the psycho ed, like you say, it really demonstrates to them in real time the interaction between each other.

 

[00:37:20] Bronwyn Milkins: Yeah. Yeah. Is there anything else that you might consider for this family? 

 

[00:37:28] Marie Vakakis: If it was a family that presented like this, I would have them all in at the start and then. It sounds like if the parents aren’t really on the same page, then I might recommend further sessions, be just a couple. 

 

[00:37:42] Bronwyn Milkins: Oh, okay. Sure. 

 

[00:37:43] Marie Vakakis: And so then I would be looking at either exclusively couples therapy or.

 

[00:37:50] Marie Vakakis: Couples therapy with the family, still being the client. So it really kind of depends on whether I’d be doing a full sort of couples therapy assessment and looking at all the [00:38:00] areas of their relationship and their trust and commitment. And I use the Gottman method quite a lot in my assessment. So I, you know, whether I look at all of that or whether I have several sessions and sort of still bringing it back to their parenting distress.

 

[00:38:14] Marie Vakakis: So it, it can really depend on what’s the bit that they want to focus on and improve. 

 

[00:38:21] Bronwyn Milkins: And just a practical question with that, if the family is the client and then you’re having sessions with just the couple, do you as the therapist see them as the family and the couple, or is there some reason why you would need to seek a, a separate therapist for the couple versus the family sessions?

 

[00:38:41] Marie Vakakis: I think it depends on your modality and and how you practice. I would take it case by case for some, I might sort of, if it’s very clear, and we’ve had this, you know, a number of times at the practice where parents brought in a child and I’m like, their child is re reactive to the couple’s anxiety, so I actually don’t need to see them ever again.[00:39:00] 

 

[00:39:00] Marie Vakakis: The work between the two of you is the most beneficial here, and so it would be around how you set up. The consent process, how you talk about who’s the client, how you sort of, you know, if it’s full family work, you might be saying, I’m not keeping secrets. I’m not being pulled into these things. But then if, you know, in the parent session, they’re talking about a, I don’t know, a recent miscarriage or a health scare, it might be that you’re saying, look, I’m not going to hide that from your children.

 

[00:39:27] Marie Vakakis: I’m not gonna blurt it out, but we can’t keep those secrets. So you’re, you’re really using your judgment. On how to bring that up. And if you’re doing that kind of in-depth family therapy, you’d hopefully have more extensive family therapy training, a family therapy supervision, more sort of guidelines around sort of the ethical considerations of that.

 

[00:39:47] Marie Vakakis: So if we bring it back to the, you know, psychologists or therapists who work individually trying to conceptualise a bit more systemically. You might, might not need to be thinking about it in that sort of detail just [00:40:00] yet. 

 

[00:40:00] Bronwyn Milkins: Okay. That makes sense. And I guess if people are unsure about what to do in that situation, it’s a good idea to seek supervision.

 

[00:40:07] Marie Vakakis: Oh, absolutely. I mean, I, I would be seeking supervision consistently as part of your reflective practice, whether that be weekly, fortnightly, monthly, like whatever it is that you feel you need to improve your, your skills too. Case conceptualised to have your diagnosis or differential diagnosis, like you would be wanting that as part of your practice anyway.

 

[00:40:28] Bronwyn Milkins: Totally. Yeah. I’m just wondering, this is a, a, a, a different question, but let’s say like with this family, with the Williams family, like they have come in and they’re like, every time we talk to each other, we get into an argument. So, unless they’re all being very performative, it might be reasonable to expect that they’re gonna have an argument in the therapy room.

 

[00:40:51] Bronwyn Milkins: Someone says something and then it, it sets off, it triggers somebody else, and then they’re in an argument. Uh, do you A sit back, watch the argument, [00:41:00] B, stop it before it gets out of hand. C something else? 

 

[00:41:04] Marie Vakakis: I would do a mixture of all of them at different stages. So maybe the first few sessions I would let it kind of play out as long as it’s still safe and just observe what happens and then actually share later on like, thank you for letting me see how tricky things get.

 

[00:41:22] Marie Vakakis: This gives me an idea of where you get stuck. Okay, cool. So I would say that being able to, to witness this. You know, you might ask someone like if it’s, you know, between Michael, Lisa and Olivia and Ethan’s, they’re going like, oh, far. Yeah. And it’s like, Ethan does this, is this what happens at home? Yeah.

 

[00:41:40] Marie Vakakis: And does Lisa normally, uh, does mom normally yell at Olivia? Yeah. And does Olivia storm out? Yeah. So this pretty much happens. You’re not kind of filtering it. For me, it’s like, no. Okay. And then you might turn to the family like, thank you. I can see this gives me so much information. Of where you’re getting stuck.

 

[00:41:58] Marie Vakakis: I can see some of the [00:42:00] things that you’re really trying to do that aren’t landing the way you hope. This has given me something to think about and bring to our next session so you can sort of use that as part of your assessment. And in couples SE and Gottman, um, couples therapy in particular. That’s actually forms part of the assessment is to get them to reenact or bring in an argument and not, and not intervene.

 

[00:42:21] Marie Vakakis: Just let it, and you would ideally videotape that as well so you can re-watch it later or watch it with the couple and use that as part of the formulation. 

 

[00:42:31] Bronwyn Milkins: Wow, I didn’t know that. That’s really interesting. Would you say as a family therapist, like I know some people. They inside themselves, they feel very activated when they hear people raise their voices because of their family history.

 

[00:42:45] Bronwyn Milkins: Um, they might not like hearing raised voices or arguments. How would you recommend someone who is a therapist who has that, like, help themselves? I guess 

 

[00:42:56] Marie Vakakis: it’s really important because the, the, the family in front of [00:43:00] you can only differentiate as much as the therapist is, and so. You need to have a stance of non-reactivity.

 

[00:43:08] Marie Vakakis: So if there are particular areas that evoke a response in you, you have to get supervision for that. And you might even need therapy. 

 

[00:43:16] Bronwyn Milkins: Yeah, yeah, totally. 

 

[00:43:18] Marie Vakakis: And little bits of that could provide information that is relevant to the system around. I find that I have that response. Is that because I felt like Olivia, my mom always was hypercritical, or is it okay so I can sense this thing in mom, I wanna explore that a bit more.

 

[00:43:37] Marie Vakakis: So you can, you have to keep a practice of knowing yourself and I dunno about you or your listeners, but I wouldn’t ever go and see a therapist who wasn’t in their own therapy or hadn’t had their own therapy before. 

 

[00:43:49] Bronwyn Milkins: No, we love therapy on this podcast and we’ve talked about it in episodes, therapists in therapy.

 

[00:43:54] Marie Vakakis: Yeah. Yeah. I think it’s really, you don’t want someone who hasn’t experienced the discomfort of totally both being there. [00:44:00] Yeah. You want, I want, I’d want to know that someone is willing to do the tough stuff that they’re telling me to do. 

 

[00:44:05] Bronwyn Milkins: 100% 

 

[00:44:06] Marie Vakakis: and they’re able to, you know, get their shit under. 

 

[00:44:10] Bronwyn Milkins: Yeah, no. And yeah, we’ve talked about it in the therapist and therapy episode, but you know, it’s so valuable to be the person in the hot seat who has to be vulnerable, go through difficult emotions, and face the discomfort of perhaps like changing approaches and behaviors and knowing how difficult it is.

 

[00:44:29] Bronwyn Milkins: It gives you a whole different perspective as well as helps yourself. 

 

[00:44:32] Marie Vakakis: Yeah. And you can then bring that information back into another session, like if you really did feel like you got something wrong. Then you can say, last session I was really taken aback by what Lisa said to Olivia. I wanna revisit that for a moment.

 

[00:44:48] Marie Vakakis: And so you, you might wanna revisit that or you might need to find some support to figure out what is it about that interaction that evoked a response in you and are you siding too much [00:45:00] with one or the other? Yeah. Are you, are you holding this, this, you know, multi-directional, like this impartial stance?

 

[00:45:08] Marie Vakakis: Or are you aligning with each one? Because that’ll change what you ask. It’ll change how you say things. If you’re a parent who’s struggling with a teenager, who’s trying to individuate, this might be evoking for you. Like, oh, how dare they? Or what a little, you know, so and so. Yeah. Or vice versa if you were the teenager who felt micromanaged and you might be taking that sense.

 

[00:45:28] Marie Vakakis: So you want to have this, this neutral position in a way. 

 

[00:45:32] Bronwyn Milkins: Yeah, totally. And one. Last question I have about that is, um, I, I bet this happens ’cause I don’t see couples either, but like, I’m just wondering if this happens in family therapy where somebody’s like, let’s say there’s like a, a remark under someone’s breath and they’re like, yeah, she never has a goal at Olivia.

 

[00:45:51] Bronwyn Milkins: Like, Olivia’s the perfect one. She loves Olivia Olivia’s the favorite, and then the family perceives that you have a favorite. What would you do there? [00:46:00] 

 

[00:46:00] Marie Vakakis: So if someone like Ethan was sort of like, oh, here we go again. 

 

[00:46:04] Bronwyn Milkins: Yeah, like, Olivia’s getting all the attention or like, you know, Olivia’s getting the compliments, then, then that might be an indication 

 

[00:46:11] Marie Vakakis: of one of the things that the family really struggles with.

 

[00:46:14] Marie Vakakis: You might be like, yeah, I can see how, because Olivia’s got a lot going on right now. She seems to take a lot more of mom and dad’s attention and yeah, most of the session has been about what she’s struggling with, so. Can I, can I come back to you? Like, what’s that like for you? And, and you can make some guesses.

 

[00:46:32] Marie Vakakis: Like, sometimes I kind of guess, you know, it’s like, oh, it sounds like you’re working really hard and no one’s noticing that you’re trying your best to be a good student. Or, you know, you, you can find that, that nugget of something hopeful or optimistic and sort of bring that to the attention. Like, or sometimes it’s, you know.

 

[00:46:52] Marie Vakakis: One kid doesn’t get the attention because parents are like, oh, thank God you are the easy one. 

 

Mm. And so 

 

[00:46:57] Marie Vakakis: then they squish down their feelings. So you [00:47:00] might, if you notice that in the session, you might be documenting that in your case notes as part of your conceptualisation. So it could be, you know, let’s say we, we found a, Lidia had a, uh, early childhood, uh, acute illness.

 

[00:47:12] Marie Vakakis: And so the parents had become really fixated on her because she was very unwell. You can see that there might be some hyper vigilance there, and they might be like, oh, cool. Ethan was born with no defects, no congenital heart thing. Whatever the illness was. Yeah. So he’s all good. And then he might learn, oh, when I have a need, it doesn’t get noticed.

 

[00:47:32] Marie Vakakis: When I need something, it’s overlooked. No matter how hard I try, it’s not enough. So that might have shaped how he adjusts and adapts. So then you might have some sessions where it’s like Olivia just, he sits there silently and you’re like. What’s going on for you? This is what I’m noticing, and, and you can kind of draw the attention to that person.

 

[00:47:53] Marie Vakakis: So it really sort of depends on your case conceptualisation and I would be drawing a sort of [00:48:00] genogram, looking at the relationships, noting down some of those interactions, jotting down some of those things as key quotes, and then thinking about how do you bring that into the system? What’s most useful or what’s going to.

 

[00:48:14] Marie Vakakis: Kinda loosen up something that might improve something somewhere else. It might be what’s a low hanging fruit like you’ve gotta make your assessment there. That 

 

[00:48:23] Bronwyn Milkins: makes a lot of sense. Sounds good. With family therapy, do you see that in general it’s quite helpful for your clients? I guess I’m just thinking like, it sounds so hard and obviously it does require some unique training to be able to do it.

 

[00:48:43] Bronwyn Milkins: I’m wondering, yeah, like does it work? 

 

[00:48:47] Marie Vakakis: It does. And I think, I can’t remember who’s who said this quote. It’s something in the lines of what’s, what’s hurt or broken in relationship can only be healed in a relationship. So you could do [00:49:00] all the individual sessions you want with one person, and it might not actually have any impact if the.

 

[00:49:09] Marie Vakakis: If what’s hurt them or what the damage was done was in relationship, so it might not be in that relationship, but you see that parents will be bringing into sessions issues that are triggered or activated by their partner from their childhood, so that can be healed in relationship. There’s so much power in that happening live there with you.

 

[00:49:34] Bronwyn Milkins: Absolutely. Yeah. And I often, that’s the perspective I take for, uh, gaining a secure attachment. Earning a secure attachment. I’m like, this needs to happen either in the therapeutic relationship or in your relationship that you have that’s important to you outside of therapy. Either way, like this, healing takes place through a relationship.

 

[00:49:49] Bronwyn Milkins: Yeah, exactly. 

 

[00:49:50] Marie Vakakis: Yeah. But also you give them a chance to share things that they might think are implied. When I first started, I was at your most [00:50:00] basic, it might be I had a deck of strength cards. It might be something as much as at the end of the session, I would bring a parent in and say, all right, so we’ve been working on self-esteem and self-confidence, and one of the things that I’d like to do is get you to pick out five strengths for your child and an example of how they’ve used each one.

 

[00:50:20] Marie Vakakis: Wow. And so it might be something as small as that, and maybe that young person has never heard that their parents say, I think you’re brave. You’re really funny with examples. Yeah. If it was with a couple, I might do something like, can you each share with me something you really admire about the other person and an example that comes to mind?

 

[00:50:41] Marie Vakakis: Or, I’d like you to share three things that you really appreciate about your partner. So sometimes I get to scaffold. Bring in some of those good things that some families maybe don’t say, or they think they’re implied, or life gets so busy it’s just not part of their daily [00:51:00] vernacular. And that in itself can be really helpful because you could spend all your time with Olivia doing all the strength-based stuff that you want, but someone else saying those things about her, someone that’s a, you know, a primary attachment figure can be really helpful.

 

[00:51:18] Bronwyn Milkins: Some of the best, oh, some of the nicest moments I’ve shared with clients has been when they’ve done like a strengths-based activity and they’ve taken it home and the homework has been to get their partner to really say that their strengths are, and the examples, and then they’re like, I framed it. It was really awesome.

 

[00:51:36] Bronwyn Milkins: Like, I loved hearing it, you know, it’s, it’s something I look at when I go out the front door now. Um, yeah, it’s really powerful hearing it from a, from an attachment figure. 

 

[00:51:46] Marie Vakakis: Yeah, so you can, you can start 

 

[00:51:47] Bronwyn Milkins: off 

 

[00:51:49] Marie Vakakis: in, in a very gentle way, introducing family or the system into individual therapy. It doesn’t have to be a full go do a family therapy masters.

 

[00:51:59] Marie Vakakis: Yeah. Um, [00:52:00] I’m talking to you specifically. Yeah. 

 

[00:52:03] Bronwyn Milkins: I 

 

[00:52:03] Marie Vakakis: suspect you’re like, you’ve already been googling which courses. 

 

[00:52:06] Bronwyn Milkins: Well ’cause yeah, it’s something of interest to me, but like from what we discussed last time, it is like, I am hearing what you’re saying, like you don’t actually need to go do a full on Master’s in family therapy.

 

[00:52:16] Bronwyn Milkins: There are some courses like, you know, short PD that you can do to upskill, or even if you get a textbook and then you get the regular supervision, like you can actually introduce these sort of family therapy concepts and. Yeah. Like way of practicing into your practice. 

 

[00:52:33] Marie Vakakis: Yeah, absolutely. And, and starting to think about reflecting on your own stuff as well.

 

[00:52:38] Marie Vakakis: So all of that is really useful. You don’t feel like you have to get it perfect to start your first session thinking about the family. 

 

[00:52:48] Bronwyn Milkins: Yeah. So Marie, I feel like we’re coming towards the end of this episode. Was there anything that we have not addressed that you think would be good for the listeners to hear?[00:53:00] 

 

[00:53:01] Marie Vakakis: I think for me, I, I would always be thinking about the family and where possible drawing even with individual clients, a genogram just to get a bit of a lay of the land. And then I also kind of try and kind of figure out who’s in their household. So if it’s a housemate, like I wanna sort of understand what’s happening relationally and, and getting a bit of a sense of that.

 

[00:53:24] Marie Vakakis: And that can be a really helpful sort of start, is to think about. What are the, the resources for that person? Who are the other people? And if they sort of comment on, oh no, no one talks to dad anymore, or there’s a, you know, you might think, well, there’s a cutoff there. I’m just gonna hold that in mind and, and starting to sort of map out what might be happening.

 

[00:53:44] Marie Vakakis: Because the more I learn about systems and relationships, the more, I think some of our responses that we pathologize as a mental illness make so much sense when we think of someone’s experience and what’s happened to them. And it, it, it just doesn’t feel right [00:54:00] for me anymore to think about it exclusively as this is a mental illness.

 

[00:54:04] Marie Vakakis: This is the diagnostic criteria that fits neatly into the DSM, and this is the pharmacological therapy. This is the structured treatment, and then you’re going to be amazing. I can’t, I can’t ignore the impact of relationships and family or partner or kids when working with that anymore. 

 

[00:54:21] Bronwyn Milkins: And I think that’s really wonderful because sometimes we do downplay and quite often psychology like we do, we, we prioritise the DSM diagnosis over perhaps assessing more thoroughly the relationships.

 

[00:54:34] Bronwyn Milkins: So yeah, I think that’s really important and something for all of us to take away the importance of these dynamics, 

 

[00:54:42] Marie Vakakis: or even both, because let’s say you’ve got a really clear, 

 

I don’t know. 

 

[00:54:48] Marie Vakakis: Arachni phobia. Okay. We can diagnose it. We know that maybe EMDR might be really great, but if you’re going camping with your family of Christmas, how they respond to your [00:55:00] fear of spiders might exacerbate that.

 

[00:55:03] Marie Vakakis: Totally. Maybe you avoid going, because you don’t know how to say, I’m scared of spiders. So there’s still a relational component to a very clear diagnosis. Mm-hmm. And so that can be where you help someone set. Boundaries, expectation. Maybe they need to come in and say, I know that you don’t think that there’s such thing as a fear of spiders.

 

[00:55:23] Marie Vakakis: It leaves. It leaves this person feeling like you don’t support them, don’t love them. And I know as a parent you don’t want that. So sometimes you can, you can even just think about how everyone reacts to that. ’cause it would be the same for a physical health issue. 

 

[00:55:37] Bronwyn Milkins: Very important things to consider. Yes.

 

[00:55:39] Bronwyn Milkins: You’ve given me a lot to think about and I think a lot for listeners to think about as well. I hope this was a good primer for you listeners, and thank you so much bere for coming on the podcast. It’s been such a pleasure to have your expertise and time. Thank you so much. We really appreciate it. 

 

[00:55:52] Marie Vakakis: No worries.

 

[00:55:53] Marie Vakakis: And maybe we have another case, maybe not. So that catch JBT makes some really funny words. It’s really [00:56:00] great. 

 

[00:56:00] Bronwyn Milkins: Yeah, it does. Yeah. I just love the, like beneath the facade lies a complex web of issues. That was so funny. Yeah. But if, 

 

[00:56:09] Marie Vakakis: if people want some resources, I would encourage them to look up. And I think I mentioned it in the last one, uh, I don’t know if it was before, after we recorded or not, but Diane Gahar, ge, HART, she’s got a book called Mastering Competencies in Family Therapy.

 

[00:56:23] Marie Vakakis: Awesome. She has an online YouTube series. Jenny Brown has some really great resources at the Parent Hope Project and her book, growing Yourself Up is also really great. I’ll be interviewing her on my podcast actually this week, so I’m rereading. Awesome. That book and like scribbling or highlighted notes and stuff.

 

[00:56:41] Bronwyn Milkins: Wow, that’s so cool. And so Marie, tell us what your podcast name is in case listeners wanna look it up. Yeah, so it’s called This 

 

[00:56:47] Marie Vakakis: Complex Life and it’s all conversations around mental health, wellbeing, relationships. Not necessarily targeting therapists. So it’s the sort of thing that I hope can be a companion to therapy or [00:57:00] each episode on its own can be a standalone sort of self-help, food for thought kind of episode.

 

[00:57:06] Marie Vakakis: And, uh, for actual people wanting to do training, my website, mariva cargas.com has some current events coming up and some on-demand training all around. Working with young people, with families, sort of structuring the counseling sort of session and a number of things that I’m releasing in 2024.

 

[00:57:25] Bronwyn Milkins: Fantastic. Well, thank you so much again, Marie, for coming on. Um, it’s been a real pleasure to have you and thank you listeners for listening. Have a good one and catch you next time. Thanks for listening to Mental Work, the podcast for early career psychologists. If you’re loving the show and don’t wanna miss an episode, press follow on your podcast listening app.

 

[00:57:47] Bronwyn Milkins: If you wanna show us some love, consider sharing the episode with a friend or giving us a five star rating and review in your podcast app. If you want to show us some extra love, join our Patreon for as little as $1 a month at [00:58:00] patreon.com/mentor Work podcast. This really helps to keep the podcast alive.

 

[00:58:05] Bronwyn Milkins: Want to keep the conversation going, have a cool idea for an episode, or just wanna say hi. Send me an email, or join the Facebook page by clicking on the links in the show description. See you next time.