Wajdi Akef Fakhoury, LMFT 148333
16 N. Marengo Ave. #501. Pasadena, CA 91101
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Support for the Relationships, Roles, and Pressures Shaping Family Life
Families make countless adjustments around communication, sensory needs, emotional regulation, safety, routines, appointments, school, work, services, and daily responsibilities. Some adaptations are necessary and supportive. Others develop gradually in response to stress, urgency, or repeated crisis and can leave people exhausted, disconnected, resentful, overresponsible, or unsure of what can change.
Over time, the family may become organized around preventing the next problem. Conversations narrow to reminders, logistics, conflict, and what needs to happen next. One person may be identified as the source of the difficulty, while the roles, expectations, and interaction patterns surrounding them receive less attention.
Family therapy at Samar looks at the entire pattern. The goal is not to decide who is at fault. It is to understand how neurodevelopment, mental health, communication, relationships, caregiving demands, culture, and outside systems are affecting everyone involved.
When the Whole Family Has Been Adapting
Family members may be responding to the same situation from very different positions.
A parent may be trying to prevent harm or prepare a child for the future. The neurodivergent family member may experience that same effort as pressure, control, or a lack of trust. One caregiver may believe more structure is needed, while another sees that expectations have already exceeded the person’s capacity.
Siblings may understand why attention is distributed unevenly and still feel overlooked. Adult children may want greater autonomy while continuing to need meaningful support.
These tensions are not resolved by determining whose experience is correct. Family therapy creates a place to understand what each person is responding to, what the current pattern is protecting, and what it is costing the family.
Reasons families seek therapy
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Communication differences that repeatedly lead to misunderstanding.
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Recurring conflict, escalation, shutdown, or crisis patterns.
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Disagreement about expectations, accommodation, independence, safety, privacy, or boundaries.
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Difficulty distinguishing inability, overload, avoidance, refusal, and lack of clarity.
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Caregiver exhaustion, resentment, guilt, grief, anxiety, or chronic vigilance.
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Sibling concerns involving unequal attention, overresponsibility, resentment, or future expectations.
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Conflict between parents, partners, or caregivers about how to respond.
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Transitions involving school, work, health, housing, services, relationships, or adulthood.
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Tension around money, transportation, household responsibilities, decision-making, or privacy.
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Cultural, religious, linguistic, or intergenerational differences in how disability and mental health are understood.
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Conflicting recommendations from clinicians, schools, agencies, programs, or other providers.
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Difficulty discussing future planning without the conversation becoming frightening, controlling, or avoidant.
Understanding the Pattern Around the Problem
A referral may begin with one person's behavior, diagnosis, or distress. That concern may be important, but it rarely exists in isolation. Samar looks at the interaction among neurodevelopmental and mental health needs, communication and processing, sensory load, trauma and grief, caregiving roles, autonomy, family rules, outside systems, and cultural context.
The purpose is not to minimize individual responsibility. It is to understand enough of the context that responsibility can be defined fairly and change can be realistic.
Preserving the Neurodivergent Person's Voice
Family therapy should not become a meeting in which everyone speaks about the neurodivergent family member while that person has little influence over the conversation. Participation may need to be adapted through direct questions, additional processing time, visual supports, written choices, concrete examples,
alternative communication, or individual preparation before a family session.
At the same time, preserving one person's voice does not require minimizing the impact on parents, partners, siblings, or caregivers. Family therapy makes room for everyone's experience without turning one person into the family's problem.
What Family Therapy May Include
Clarifying roles, expectations, responsibilities, and what is being assumed rather than discussed.
Creating plans for overload, shutdown, escalation, return to the conversation, and repair.
Translating broad concerns into specific requests that another person can understand and act on.
Addressing resentment, grief, guilt, fear, or chronic vigilance.
Developing agreements that account for actual capacity and support needs.
Crisis
Prevention
Preparing for difficult conversations, transitions, or changes in care.
Psychoeducation
The goal is not to eliminate disagreement. It is to help the family communicate more accurately, respond more coherently, and repair more reliably when things go wrong.
Families With Adult Children
Family therapy is not limited to parents of children or adolescents. Adult family systems may be working through independence and ongoing support, money and benefits, housing, health care and decision-making, dating and privacy, caregiver aging, sibling involvement, or long-term planning without silently assigning responsibility.
These conversations can become polarized between independence and protection. Therapy can help the family move toward clearer expectations, more honest planning, and support that does not erase the adult family
member's agency.
Involving Other Supports
With appropriate consent, selected sessions may occasionally include caregivers, residential providers, case managers, school personnel, or other clinicians when their participation is directly relevant to treatment. The purpose is not to turn therapy into a standing care-team meeting; it is to address a specific area of confusion, reduce contradictory responses, clarify roles, or improve continuity across settings.
Session Options
In-person appointments are available in Pasadena, CA
Secure telehealth appointments are available
throughout California.
Fees and Insurance
Family therapy sessions are $275.
Samar Neurodivergent Therapy Center is an out-of-network practice and does not participate directly with insurance plans. Upon request, Samar can provide a superbill for possible out-of-network reimbursement. Coverage and reimbursement vary by plan; clients should confirm benefits directly with their insurer.
Learn more about Samar Neurodivergent Therapy Center Fees and Policies