Prepare for a useful family session
For clinicians and staff helping adults and their chosen family members or supporters prepare for a treatment-related meeting. Help participants understand the purpose, raise questions and leave with a clear next step.
Use alongside your service’s clinical, consent and privacy procedures. This organizer does not train staff to deliver family therapy, assess safety, obtain consent or decide disclosure. It is not an adolescent or mandated-treatment workflow.
Confirm the purpose and who should participate
First identify the responsible clinician and the meeting's purpose: general education, practical care planning, or clinical family therapy. Tell participants which it is, who will lead it and what can realistically be addressed. Do not advertise a planning meeting as family therapy.
SAMHSA recommends assessing whether family counseling is appropriate, including violence and other safety constraints, and honoring the client's choices about family involvement. [1] Use your established clinical assessment and safeguarding process before arranging a joint session. A completed worksheet is not a safety assessment.
If someone reports fear, coercion, threats or violence, route that concern privately to the responsible clinician through your safety process. Do not turn it into an agenda item for joint confrontation. SAMHSA cautions that joint counseling can be dangerous where intimate partner violence has occurred and tells staff to stay within their training. [1] Do not delay urgent action to complete this guide.
- Clarify participation. Through the service's consent process, confirm the adult's preferences, each person's role and which participants are agreed. Someone providing a ride is not automatically an invited participant or authorized recipient of information.
- Make attendance workable. Check the time, location or connection instructions, interpreter and accessibility needs. Confirm what the service can provide. For a remote meeting, explain the service's procedure for identifying everyone present and checking privacy.
- Offer preparation separately. Give each willing participant the family-session worksheet. Invite one priority and questions about privacy or participation. Let people choose what to share. Do not require them to hand over their personal notes as the price of attending.
Explain privacy before asking for personal details
Use your approved explanation of what can be discussed, who may receive information, what becomes part of the record and the relevant limits. Explain how to request a private conversation and what happens to concerns received separately. Do not promise that a note can never be seen by the patient or that everyone in a group will keep it confidential.
Receiving a concern and disclosing patient information are separate actions. HHS explains that HIPAA does not prevent providers from listening to family concerns. [2] Receiving information does not itself authorize sharing patient details back. Apply your current procedures for consent, substance-use records and other applicable requirements. This FAQ alone does not resolve them.
Original staff response: “You can tell us your concern through our usual process. Before we discuss patient information, I need to check what we are permitted to share. I can also explain general resources available to family members.”
Help the clinician establish a workable agenda
At the opening, the clinician confirms the purpose, participation and privacy questions. Explain how someone can pause or request a separate conversation. Ask what each person hopes to understand or decide. The worksheet supports preparation. The clinician remains responsible for the session and its boundaries.
Fictional example: Rather than “Make them understand how wrong they are,” a participant brings: “We disagree about rides. I want to understand the appointment schedule and what help I can offer.” The meeting may clarify a practical next step without resolving the relationship conflict.
End with the actual agreement and an open task
Use the worksheet's follow-up box to separate what was agreed from what remains unresolved. Name who will act, by when, and the service contact if that step stalls. Check what each person is permitted to receive before giving out copies. Keep required clinical documentation in the existing record.
Fictional follow-up: Lee can provide Tuesday's ride. Thursday is unresolved. Pat will check the transport option and call by the agreed time. The clinic number is on the person's copy. No transport booking is confirmed yet.
AHRQ recommends checking the clarity of an explanation by asking people to describe the plan in their own words. They can use their notes. [3] Ask: “Using your copy, what happens next, what is still waiting, and who will you contact?” Clarify and check again if needed.
Save the family preparation worksheet
Offer a readable paper copy or help save and reopen the completed PDF. Let the person choose a safe place to keep it. The HTML guide is also available without an account. Offer What Support Do I Need as a Family Member? for a supporter's own needs, or Family Boundaries Without Punishment when that is their chosen task. Family support does not depend on gaining access to someone else's treatment information.
Gather feedback from both groups
Use the prepared usability-session guide and fictional details. Ask patients and family participants to locate the meeting's purpose, a way to raise privacy questions, and the unresolved transport step. Observe whether they can retrieve a usable saved or printed copy. Do not ask them to disclose personal treatment experiences to complete the task.
Separately, ask staff to work through a family request for records, a participant wanting a private conversation and an unresolved ride. Check whether they distinguish receiving from disclosing information, route clinical concerns appropriately and assign follow-up. Discuss a fictional report of fear as a staff routing task, not a staged confrontation between participants.
Record task completion, confusion, staff time and requested changes. No sessions have been conducted and no effectiveness or improved family outcomes are claimed. Use your service’s clinical and privacy procedures when adapting the workflow.
Sources and limits
The workflow, examples, follow-up labels and usability tasks are original adaptations. The sources below support specific principles, not approval of this toolkit.