Please see the following suggestions for managing Online EFFT sessions with families from Gail Palmer, Kathryn deBruin, Lisa Palmer Olsen, George Faller and Jim Furrow. 

1. Focus on Stabilization: Helping parents and children find their emotional balance.  Navigating the challenges of current demands is essential while repairs and breakthroughs may follow in time.

2. Increase Structure and Predictability: Plan ahead for how you will use the session and divide time between different family members / dyads / triads.  Focus on breaking up sessions into smaller segments especially when children are involved. Keeping a clear and specific focus is essential to containing more reactive moments. 

a.     Sessions with younger children should be shorter in length (10 – 20 minutes) 

b.     Family sessions with adult children require less structure. 

c.     Anticipating need to monitor children is important in planning a session. Especially when younger children are not involved in treatment. 

d.     Plan ahead of escalation and make room for family members to “take a break” to interrupt an escalation or engage a relaxing activity. 

e.     Providing access to therapeutic games may foster engagement of parents with younger children.  

3.     Limit Size: A whole family session should not exceed 4 members and that session should be used for assessment with possible breakout sessions to follow. 

4.     Focus Intensity: Deeper engagement of emotion requires working in smaller dyads and triad and may be too intense for younger children particularly with limited parental responsiveness. 

5.     Keeping Others in Mind:  Care and intention is needed in bringing work done in dyad or triad session back into the family process.  

6.     Leading Sessions:  Therapist needs to lead and direct the engagement with family members – take a more engaged role in terms of energy and focus. The therapist use of voice and non-verbal gestures are important in sustaining family members engagement and directing their attention.  

7.     Caregiver Focus:  Family work should resource parental responsiveness.  Engaging parents first is necessary to support parent’s responsiveness to children’s experiences and needs.

8.     Parental Buy-in:  An initial session with parent(s) is important to support parental buy-in and promote safety needed for a larger family assessment session.   

9.     Technology: 

a.     Speaker View:  Use Zoom speaker view allows for more direct eye contact and face exposure – so that therapist and clients are able to better see other’s emotions and experience. 

b.     Big Screens: For larger family sessions have family connect to large screen TV so all can better see the therapist (keeping in mind confidentiality limitations). 

10.  Using Separate Devices:  Sessions with youth may benefit using their own devices. 

a.     Therapist may want to meet individually first with the child to strengthen alliance and set expectations for sessions. 

b.     Private devices provide opportunity for child to private chat with the therapist during the session if they feel triggered / unsafe. 

c.     When using separate devices having children in separate rooms may be helpful.