Counseling for families often occurs with all members of the family unit present. This may not always be the case. A family member who suffers from alcoholism or drug addiction might not attend sessions, and might actually be the reason why other family members seek out counseling.

Part of the goal of the therapist is to observe interactions between family members. Another part is to observe the perception of non-interacting family members. Thus if two family members get into an argument in a session, the therapist might want to know how the other family members are dealing with the disagreement or the way in which the two fighting members comport themselves.