When someone in a family is struggling with low mood or constant worry, everyone feels it. Dinners get quieter, arguments get louder or everyone starts tiptoeing around the same topics. It makes sense to wonder whether the whole family should be part of the solution. This post looks at family therapy for depression and anxiety, what it involves, what the research honestly says, when it tends to be a good fit and when individual support should come first.
This post is general information, not a diagnosis or medical advice.
Why families get pulled into depression and anxiety
Depression and anxiety rarely stay inside one person. According to the National Institute of Mental Health, depression can change the way someone feels and thinks, and it can make everyday tasks like sleep, meals and work harder to manage. The Centre for Addiction and Mental Health notes that anxiety often leads people to avoid situations that trigger their fear.
Families naturally respond to those changes. A parent may start doing more for an anxious child to keep the peace. A partner may take over chores and conversations when their spouse is depressed. Siblings may pull back or act out. These responses come from love, but over time they can keep patterns stuck.
Family therapy looks at those patterns together, so that no one person has to carry the whole problem.
What family therapy for depression involves
In family therapy for depression, the person who is struggling is not treated as "the problem." Instead, the therapist helps the family understand how depression is affecting everyone and how everyone can respond in ways that support recovery.
Sessions might focus on:
Learning how depression affects energy, motivation and mood, so family members take symptoms less personally
Reducing criticism and blame at home
Improving how the family talks about hard feelings
Sharing responsibilities more fairly while someone recovers
Rebuilding moments of warmth and connection
Sometimes the whole family attends. Other times the therapist meets with different combinations, such as a parent and teen, or just the parents, depending on what will help most.
Family therapy for anxiety
Family therapy for anxiety often focuses on what therapists call accommodation, meaning the ways family members change their routines to reduce someone's anxiety in the moment. Examples include answering the same reassurance question again and again, avoiding certain places or speaking for a child in social settings.
A therapist can help the family:
Notice which responses ease anxiety short term but feed it long term
Replace rescuing with calm, confident support
Agree on small, gradual steps toward facing fears
Stay united as a team, so the anxious person hears a consistent message
For parents of teens, our post on anxiety signs in teenagers describes what worry can look like at that age.
What the research says, honestly
The research on family approaches is mixed, and it is worth being plain about that.
A 2023 systematic review and meta-analysis looked at family based therapy for depressive symptoms in children and adolescents. Families in these treatments tended to improve more than comparison groups, but the differences were not statistically significant, results varied a lot between studies and the number of trials was small. The authors called for more research before drawing firm conclusions.
One well-studied model is attachment based family therapy, which aims to repair trust and connection between a depressed teen and their parents. A 2021 trial in Norwegian community mental health clinics compared it with usual care. Teens in both groups improved, but attachment based family therapy did not do better than usual care, and many teens in both groups still had significant symptoms after 16 weeks.
What does that mean for you? Family work is not a guaranteed fix, and it is not clearly better than other kinds of therapy. It can still be a helpful part of care, especially when family conflict, communication or accommodation are clearly part of the picture.
Family therapy for teen depression
Teens are a common reason families look into this kind of support. Family therapy for teen depression often works on the relationship between parent and teen as much as on symptoms. Many teens say they don't feel understood at home, while many parents say they don't know how to reach their child anymore.
A therapist can help both sides:
Talk about hurt and misunderstandings without the conversation turning into a fight
Build trust so the teen feels safer coming to a parent when things are hard
Set expectations around school, sleep and screens that feel fair to everyone
Keep space for the teen's own individual sessions too
Most teens benefit from having some time alone with a therapist, even if family sessions are part of the plan.
When to bring the family in
Bringing the family into treatment may be a good idea when:
Conflict at home is making symptoms worse
Family members don't know how to help and keep getting it wrong
A parent or partner is doing so much accommodating that they are burning out
Everyone wants to understand what is going on and how to support recovery
A young person is struggling and the family wants to work as a team
It may help to start with individual therapy first and add family sessions later. Your therapist can help you decide on the order.
When individual support should come first
Family therapy is not the right starting point for everyone. If there is abuse, violence or ongoing threats at home, the person who is being hurt should get individual support first. Joint sessions can put someone at risk if it isn't safe to speak openly.
Individual support may also come first when someone isn't ready to talk in front of family members, or when the main concerns are very personal.
What a first family session can look like
A first session usually includes:
Introductions and goals. Each person shares what they hope will change.
Mapping the pattern. The therapist asks how depression or anxiety shows up at home and how each person responds.
Setting ground rules. Everyone agrees to take turns, listen and avoid blaming.
Planning next steps. Together you decide who attends future sessions and what to focus on first.
It's normal for a first session to feel awkward. Most families find it gets easier as everyone learns how the space works.
Getting started with family therapy
You can learn more about our family therapy services. We see children from age 6, teens and adults, both in person and online.
Sessions with our therapists range from $130 to $200, depending on the clinician.
Depending on your plan, insurance may cover up to 100% of the cost. Check your plan for the details.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers, including for sessions with an RP (Qualifying). Desjardins is the exception: through TELUS eClaims, we can direct bill Desjardins for sessions with an RSW, RP or psychologist, but not for an RP (Qualifying).
Book a free 15-minute consultation with our admin team to talk about whether family sessions, individual sessions or both would suit your situation.
If you're in crisis: if you or anyone else is in immediate danger, call 911. If you're having thoughts of suicide, call or text 9-8-8 any time.
You don't have to solve this alone, and neither does your family.
Last reviewed: October 2026
Sources
van Aswegen T, Samartzi E, Morris L, et al. Effectiveness of family-based therapy for depressive symptoms in children and adolescents: A systematic review and meta-analysis, International Journal of Psychology, 2023
Waraan L, Rognli EW, Czajkowski NO, et al. Effectiveness of attachment-based family therapy compared to treatment as usual for depressed adolescents in community mental health clinics, Child and Adolescent Psychiatry and Mental Health, 2021
National Institute of Mental Health, Depression
Centre for Addiction and Mental Health, Anxiety Disorders