I hate to say it, in fact it make me feel a bit like I am betraying my profession, but the truth is that mental health services, in my experience, often do little to really help families that are struggling with family issues in a family-based business environment.

Why?

1. Most advisors to family based businesses (legal, financial, and business) try to deal with the family issues themselves or leave it to the family to struggle through.  If they recommend using a "people expert" it is usually a mental health provider who may, or may not, have any experience with family businesses. Most of these referrals are when emotions get out of control. But family dynamics are not limited to families who "publicly air their dirty laundry" or have emotional regulation issues.  Resentments, competitiveness, marginalization, blaming . . . many unhealthy practices occurs in "successful" families as well.

2. Most counselors, who get these referrals, do not have training or experience in family based businesses.  They often are just not trained to think about the complex interplay of ownership-management-family and how each affects the other dimensions.  They may, and often do, understand a lot about the family issues but less, or very little, about ownership or management issues and how they impact family firms. Thus often the focus is on the emotions and the relationships of the family members but if these have their roots in the business decisions, business forms, or ownership challenges they may stumble over these issues or miss them altogether!

3. The "mental health care paradigm" does not support counselors to do the things they often need to do to affectively help these families.  Traditions that limit interventions to one hour a week, the need to provide a mental health diagnosis, working within the constraints of a clinical setting . . . many of the standard elements of health care prevent the flexibility of a deep engagement with the family that can produce superior results. For example, attending family business meetings, doing a family retreat, or engaging the family on-site at the workplace.

4. Often, the clinical setting is reliant on descriptions of behavior not observed behavior.  Often referrals are for one "identified client" who describes the behavior of the other family members and their interactions.   Yes, some work with the family as a system and they will be able to observe some behavior--but it is still in the context of their "lab" or office and not in the family's natural environment.  In addition, if the behavior is specific to management tasks or ownership issues they may again be limited to what is descriptions of that behavior? The counselor, in a clinical setting, dos not have the opportunity typically to watch them conduct employee meetings, talk to the business manager or non-family executive, complete interviews with direct reports . . . cutting themselves off from many sources of good data to help these families.

These are a few of the limitations and issues with referring family based business owners to mental health professionals.  When asked by family members or advisors if it would help to send them to "a counselor" may answer is, "It depends."