Clinical Guidelines for Working With Stepfamilies: What Family, Couple, Individual, and Child Therapists Need to Know

• DOI: http://doi.org/10.1111/famp.12321
• Author: Patricia L. Papernow
• Published date: 01 March 2018
• Date: 01 March 2018

Clinical Guidelines for Working With Stepfamilies:

What Family, Couple, Individual, and Child

Therapists Need to Know

PATRICIA L. PAPERNOW*

This article draws on four decades of research and clinical practice to delineate guideli-

nes for evidence-informed, clinically sound work with stepfamilies for couple, family, indi-

vidual adult, and child therapists. Few clinicians receive adequate training in working

with the intense and often complex dynamics created by stepfamily structure and history.

This is despite the fact that stepfamilies are a fundamentally different fam ily form that

occurs world-wide. As a result many clinicians rely on their training in first-time family

models. This is not only often unhelpful, but all too often inadvertently destructive. The

article integrates a large body of increasingly sophisticated research about stepfami lies

with the author’s four decades of clinical practice with stepfamily relationships. It

describes the ways in which stepfamilies are different from first-time families. It delineates

the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider

positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds,

and change. (3) Issues of parenting, stepparenting, and discipline often divid e the couple.

(4) Stepcouples must build a new family culture while navigating previously established

family cultures. (5) Ex-spouses (other parents outside the household) are part of the family.

Some available data are shared on the impact of cultural and legal differences on these

challenges. A three-level model of clinical intervention is presented: Psychoeducational,

Interpersonal, and Intrapsychic/Intergenerational Family-of-Origin. The article describes

some “easy wrong turns” for well-meaning therapists and lists some general clinical guide-

lines for working with stepfamily relationships.

Keywords: Individual, Couple, and Family Therapy with Stepfamily Members; Therapy

with Stepchildren; Parenting and Discipline in Stepfamilies; Clinical Work with

Stepcouples; Stepparents; Stepfamily Challenges

Fam Proc 57:25–51, 2018

Stepfamilies must form intimate relationships within a profoundly different infrastruc-

ture that can pose significant challenges for all concerned. The distress can be intense.

The divorce rate for stepcouples is slightly higher than for first-time couples (Teachman,

2008). The issues arise not only in couple and family therapy, but in individual therapy

with adults and children, either as the primary focus, or as significant (but often unac-

knowledged) background to other concerns. Well-informed, systemically focused he lp can

make a big difference.

Clinical work with step relationships can be daunting. The good news is that a

large body of increasingly sophisticated research (Ganong & Coleman, 2017a, 2017b,

*Director, Institute for Stepfamily Education, Hudson, MA.

Correspondence concerning this article should be addressed to Patricia Papernow, 6 Westridge Road,

Hudson, MA 01749. E-mail: ppapernow@gmail.com.

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Family Process, Vol. 57, No. 1, 2018 ©2017 Family Process Institute

doi: 10.1111/famp.12321

in this issue; Pasley & Garneau, 2012; Pryor, 2008; Stewart, 2007) and four decades

of clinical practice (Browning, 2017; Browning & Artfelt, 2012; Papernow, 1987, 1993,

2008, 2013, 2014, 2015b; Visher & Visher, 1979, 1996) provide substantial guidance

about how to help stepfamilies meet their challenges. The bad news is that few clini-

cal programs provide training in therapy with stepfamily relationships and only two

clinical books on stepfamily relationships have been written in the last two decades

(Browning & Artfelt, 2012; Papernow, 2013). As a result many therapists lack a solid

understanding of stepfamily dynamics. All too often, even experienced therapists rely

on first-time family models, leading them to inadvertently offer misleading, and some-

times even destructive, “guidance.”

Given the numbers, this is a problem. A recent Pew Research Center Report finds that

42% of Americans have a close step relationship (Parker, 2011). Twenty-six percent of all

marriages include stepchildren (Stykes & Guzzo, 2015). The number of families, including

stepfamilies, headed by unmarried couples is rising steeply (Martinez, Daniels, & Chan-

dra, 2012; McLanahan, Garfinkel, Mincy, & Donahue, 2010; Parker, 2011). 30% of chil-

dren will spend some time living in a stepfamily before they reach adulthood (Bumpass,

Raley, & Sweet, 1995; Copen, Daniels, Vespa, & Mosher, 2012). While the numbers may

be somewhat higher in the United States, a significant proportion of families all over the

world are stepfamilies (Ganong & Coleman, 2017a). This article provides a framework for

therapy with stepfamily relationships that integrates current stepfamily scholarship with

my own four decades of clinical experience. It begins by delineating what makes stepfami-

lies different. Five major challenges and a three-level clinical model are introduced. Each

of the five challenges is then described in more detail, and some “best practices” for meet-

ing each challenge are outlined on each of those three levels. Throughout, we will look at

available data about the impact of cultural and legal forces, including stigma, on

stepfamily challenges. Finally some “easy wrong turns” and general guidelines for clini-

cians are provided.

HOW STEPFAMILIES ARE DIFFERENT

First, I think it is crucial to understand that stepfamilies must build intimate relation-

ships on a very different foundation from first-time families (Papernow, 2013, 2015b).

First-Time Family Structure

In most first-time families, the adult couple has time alone together without children to

deepen their attachment, build trust, and to establish some habits and rhythms of living

together. Children in first-time families enter their parents’ already-established relation-

ship. Very important, children in first-time families usually enter hard-wired for attach-

ment to both of their parents, and vice versa. Over time, if things go well, attachment

bonds strengthen as does the family’s “middle ground” (Papernow, 1987), their shared

understandings about “how we do things.”

Stepfamily Structure

In contrast, in a stepfamily, the deeply grooved lines of connection lie between par-

ents and their children, not in the stepcouple or in stepparent–stepchild relationships.

So do the established agreements on the “appropriate” cost of a pair of sneakers, and

the definition of “noisy,” or “messy,” or “funny.” Furthermore, at least one parent out-

side the household, dead or alive, is part of the family. This is what I call “stepfamily

architecture.”

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