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How Online Family Therapy Can Support Cross-Cultural Families

Some family disagreements reflect a wider pattern rather than one isolated argument. Questions about school, friendships, privacy, faith or family responsibilities may involve different expectations, communication styles or personal experiences.

This article is for cross-cultural and multilingual families raising children or teenagers in the UK and Ireland. Families may include parents who migrated, children born or raised locally, mixed-background parents, stepfamilies, international families, interfaith households or relatives who maintain connections across countries.

These experiences vary considerably. A Nigerian-Irish family, a Pakistani-British family, a Polish family in Ireland or a Somali family in London may have very different relationships, values and circumstances.

Cultural differences do not automatically create conflict. Many families navigate them comfortably. Others may seek support because of recurring disagreements, emotional distance or difficulties communicating.

Online family therapy may offer a structured space to explore these concerns, provided the approach is appropriate for the family and everyone can participate safely.

What makes cross-cultural family life complicated?

Cross-cultural family life may include strengths such as multilingual communication, connections across communities, flexibility and shared traditions. These vary between families, and no family needs to demonstrate particular strengths or difficulties because of its background.

Families can also experience challenges that have little or nothing to do with culture.

Conflict may involve ordinary developmental changes, disability or neurodivergence, financial pressure, housing, discrimination, parental separation or other circumstances.

A family's cultural background should therefore be considered as one part of its circumstances, not an automatic explanation for disagreement.

Different generations may adapt differently

Family members may adapt differently across language, school, work, friendships and cultural practices. A child may be more familiar with one setting while a parent is more confident in another. Age, opportunities, discrimination, support and individual preferences can all influence these experiences.

For example, a teenager may feel comfortable navigating school friendships but find it difficult to communicate with relatives who speak another language.

A parent may be confident managing employment and family responsibilities but unfamiliar with particular aspects of their child's social environment.

These differences are not necessarily problematic.

However, misunderstandings may arise when people interpret the same situation differently.

A parent might think, “I am trying to protect you.”

A teenager might respond, “You do not trust me.”

A parent might worry about losing a meaningful family tradition.

A young person might feel that their individual preferences are not being recognised.

These are possible perspectives, not fixed positions associated with particular generations or cultural backgrounds.

Differences in adaptation are not necessarily a problem. The relevant questions are how family members experience them and whether they contribute to distress, restriction or repeated conflict.

Language can affect family communication

Language can influence how family members express emotions, share memories and participate in conversations.

Some families use several languages at home. Children may understand a heritage language but prefer another language when discussing school or personal concerns.

Parents and caregivers may also have different language preferences.

These differences do not necessarily reduce closeness.

For some families, using several languages provides flexibility and opportunities for connection. For others, particular conversations may require additional explanation or support.

Some children help relatives with everyday language tasks and experience this as useful or connecting. Others feel burdened, particularly when the responsibility is frequent, high-stakes or involves sensitive adult information. The impact depends on the task, the child's age, available support and how much choice they have.

Children should not be expected to interpret therapy sessions or sensitive safeguarding discussions for adults.

Where needed, the clinician should arrange an appropriately qualified interpreter, explain their confidentiality obligations and check that everyone can understand and participate.

Language preferences may differ within the family. The therapist should ask each person rather than assume that a heritage language or English is best for everyone.

Family members may understand values differently

Words such as respect, privacy, independence, responsibility and success can carry different meanings.

One parent may understand respect as listening carefully to family advice. A teenager may associate respect with being allowed to explain their perspective.

A caregiver may see privacy as a practical matter, while a young person may consider it an important part of growing independence.

These differences can occur within families of any cultural background.

Rather than assuming disagreement reflects incompatible values, it may help to ask what each person means.

For example, a discussion about privacy might reveal concerns about online safety, trust, personal space or age-appropriate independence.

Understanding these specific concerns is more useful than deciding that one cultural perspective is correct.

Common concerns cross-cultural families may bring to therapy

Families may seek support because of recurring arguments, communication difficulties, changing relationships or concerns about a child or teenager.

The reasons for seeking help should be understood individually rather than attributed to cultural background.

Parent-teen disagreements

Teenagers may want more independence regarding friendships, dating, clothing, social media, school choices or time outside the home.

Parents may have concerns about safety, peer relationships, discrimination, religious values or others' opinions.

Family members may have different concerns about safety, belonging, privacy and growing independence. Understanding those concerns can help, but a protective intention does not make every rule or response appropriate.

For example, a parent may restrict certain activities because they are concerned about safety. The teenager may feel that the rule is unclear or disproportionately restrictive.

Where appropriate, the family can discuss the practical concern, the young person's developmental needs and whether an alternative arrangement would be reasonable.

Agreements should reflect the child's developmental needs, rights and safety. Humiliation, violence, coercion or rejection should not be treated as cultural differences to negotiate.

A therapist should not assume that parents need to become less strict or that teenagers need to become more obedient.

The appropriate response depends on the actual behaviour, its consequences and the needs of those involved.

Different parenting approaches

Parents and caregivers may disagree about discipline, emotional expression, education or daily routines.

One may prefer detailed rules, while another may favour greater flexibility. These differences can reflect upbringing, temperament, previous experiences or the child's individual needs.

In some families, cultural or religious values may also influence expectations.

Disagreement does not automatically mean either caregiver is behaving harmfully.

However, inconsistent or confusing expectations may create difficulties when children do not know which rules apply.

It may be useful to discuss which expectations are essential, where flexibility is appropriate and how caregivers can respond consistently without ignoring individual needs.

When concerns involve harmful discipline or safeguarding risks, the priority must be protection rather than compromise.

Identity and belonging

Some children and teenagers in cross-cultural families have questions about belonging.

They may identify with several cultural backgrounds or feel connected to different communities in different ways.

A young person may be proud of their heritage while preferring not to participate in every family tradition. Another may actively seek stronger connections with relatives, languages or religious practices.

Neither experience is inherently problematic.

Difficulties may arise when someone feels pressured to demonstrate a particular identity or when their preferences are repeatedly dismissed.

Parents may also experience questions about identity, especially when family traditions change across generations.

These conversations can benefit from curiosity and respect rather than expectations about how someone should identify.

For families exploring these questions, identity and belonging may be a relevant topic.

Family expectations and emotional pressure

Children and teenagers may experience expectations around education, behaviour, responsibilities or future plans.

Some expectations provide useful structure and encouragement. Others may become difficult when they exceed a young person's abilities or leave little room for individual needs.

For example, a teenager may feel responsible for helping younger siblings while managing schoolwork.

A child may worry about disappointing parents when academic results fall below expectations.

The family may need to consider whether responsibilities are appropriate for the child's age and circumstances.

It can also be important to distinguish between encouragement and repeated criticism, or between ordinary family help and responsibilities that place excessive demands on a child.

When these concerns affect relationships, family expectations and personal boundaries may provide further context.

What happens in online family therapy?

Online family therapy may offer a structured space to discuss recurring difficulties, explore communication patterns and consider changes that could improve family functioning.

Before beginning, the therapist should assess the family's concerns, strengths, goals and safety.

They should also consider whether joint family sessions, caregiver appointments, individual meetings or another service would be appropriate.

Not every family member needs to attend every session.

The format should reflect the participants' ages, communication needs, willingness to participate and individual circumstances.

Different perspectives can be explored

Family members may experience the same event differently.

A parent may remember feeling concerned about a child's safety. The teenager may remember feeling criticised or misunderstood. A sibling may have experienced the disagreement from another perspective.

Understanding these accounts can help identify where expectations differ.

Children and teenagers should have age-appropriate ways to contribute. Depending on their age and needs, this might involve play, drawing, communication aids or a private conversation where appropriate.

They should not be pressured to disclose sensitive experiences in front of relatives.

Understanding different experiences can guide change, but action to protect someone from harm should not wait until everyone agrees about what happened.

A therapist should not treat all perspectives as equally responsible when abuse, intimidation or neglect is involved.

Recognising recurring interaction patterns

Families sometimes develop familiar responses to disagreement.

For example, a parent may become more directive when worried, while a teenager withdraws from the conversation.

The parent may interpret withdrawal as unwillingness to cooperate. The young person may experience further questioning as pressure.

Understanding a recurring pattern may help identify changes each person can make.

However, culture should not automatically be used to explain these interactions.

Some rules may be influenced by fear or previous experiences. Exploring that context can be useful, but it does not excuse harmful behaviour or remove an adult's responsibility to change it.

A relational approach does not mean everyone is equally responsible for a problem. Children must not be made responsible for managing adults' emotions or preventing abuse.

Developing practical agreements

When the family can discuss concerns safely, therapy may provide an opportunity to consider practical arrangements.

These might involve:

  • screen use and online activity;
  • schoolwork and daily routines;
  • privacy and personal space;
  • friendships and social activities;
  • household responsibilities;
  • family visits and celebrations;
  • language preferences;
  • communication during disagreements.

Agreements should be appropriate to the child's age, development, needs and safety.

The aim is not to make everyone behave identically or eliminate all disagreement.

Where it is safe to discuss differences, clearer agreements may reduce uncertainty and conflict.

Consent, participation and confidentiality

Before therapy begins, the clinician should explain the purpose of treatment, who will participate and how decisions about consent will be made.

For children and teenagers, this includes considering their understanding, seeking their meaningful agreement and checking any required permission from someone with parental responsibility or guardianship.

Rules differ across UK jurisdictions and the Republic of Ireland, and may depend on age, competence, legal arrangements and the type of care.

A parent paying for therapy does not, by itself, resolve every question about consent or access to information.

If parents are separated or there are relevant court orders, the clinician should clarify the arrangements before treatment starts.

Confidentiality also needs particular attention when several family members participate.

The therapist should explain confidentiality and its limits in language each participant can understand.

This includes how records, emails and individual conversations are handled; what information may be shared within the family; and circumstances in which safeguarding or legal duties require disclosure.

Parents should not assume that every private conversation with a young person will be reported back.

Equally, a young person should not be promised absolute secrecy.

Any arrangements for separate appointments need to be explained before sensitive information is shared.

The clinician has professional confidentiality responsibilities, but cannot guarantee that relatives will keep everything discussed in a joint session private outside therapy.

Families should understand these limitations before deciding whether the proposed format is suitable.

Respecting parents while maintaining accountability

Some parents may worry that therapy will criticise their parenting or dismiss their cultural or religious values.

A culturally responsive therapist should not make those assumptions.

Parents may want to discuss migration experiences, discrimination, work demands, family responsibilities or concerns about their children's wellbeing.

These circumstances may provide important context.

However, avoiding shame does not mean avoiding difficult feedback.

The therapist should support accountability and necessary changes while respecting each person's dignity.

Understanding why someone behaved in a particular way does not automatically make the behaviour acceptable.

When online family therapy may be useful

Online family therapy may reduce travel and scheduling barriers and widen access to appropriately qualified clinicians. Whether it offers sufficient privacy or is clinically suitable depends on the family's circumstances.

For families living in the UK and Ireland, remote sessions may be convenient when travel is difficult, schedules are demanding or local access to specialist services is limited.

Families may also wish to work with a professional who has experience of multilingual households, migration, discrimination or particular family concerns.

However, online access does not automatically establish that a therapist is appropriately qualified or authorised to provide services in every location.

Privacy and participation at home

A home environment is not always private.

Before sessions, the clinician should establish who is present, whether anyone could overhear or monitor the conversation, and whether each participant can speak without consequences afterwards.

Headphones alone do not guarantee privacy.

A teenager may be uncomfortable discussing certain concerns if a parent is nearby. A parent may also need privacy to discuss sensitive matters.

The therapist should assess whether the home environment allows safe participation or whether another arrangement would be more appropriate.

Planning for technical problems and emergencies

Online family therapy also requires practical planning.

The family and clinician should agree what to do if the connection fails, someone becomes distressed or a safety concern arises.

The clinician needs appropriate contact and location information and a plan for local assistance.

Any recording or use of transcription tools should be discussed explicitly rather than assumed.

Families should understand what information is collected, how it is stored and who may access it.

These arrangements are particularly important when children and teenagers participate.

Family members joining from different locations

Family members may sometimes join from different locations, subject to clinical suitability and the provider's ability to work appropriately in every jurisdiction involved.

For example, a family may have one parent living in Ireland and another participant temporarily staying in the UK.

Before arranging a joint session, the provider should confirm whether remote participation from those locations is appropriate and permitted.

Different locations may also create additional questions about consent, confidentiality, safeguarding responsibilities and emergency arrangements.

Choosing between family and individual support

Thera's online couples and family therapy may be relevant for families seeking support with communication, repeated disagreements or changing relationships.

However, joint sessions are not always the most appropriate option.

Individual support may be appropriate alongside or instead of family sessions.

Family therapy is not a substitute for assessment of significant depression, self-harm, eating difficulties or other concerns requiring specific treatment.

Where several professionals are involved, coordination should follow clear consent and information-sharing arrangements.

When family therapy may not be the first step

Family therapy is not always the appropriate starting point, particularly when someone may be at risk of harm.

Safety assessment should consider abuse or intimidation between adults, harm to a child, sibling harm and risks linked to information disclosed during sessions.

The therapist may need to speak with family members separately before deciding whether joint work is safe.

When there is coercion, abuse or fear

If a family situation involves violence, coercive control, threats, severe intimidation, forced marriage pressure, abuse or neglect, the priority is safety.

These risks can occur in families of any cultural, religious or socioeconomic background.

They should not be understood as characteristics of cross-cultural or migrant families.

Where there is credible fear of retaliation, do not require confrontation, a family meeting or disclosure to the person causing harm as a condition of receiving support.

Individual assessment, safeguarding advice, specialist domestic abuse services or other appropriate support may be safer than bringing everyone into the same therapeutic setting.

A culturally responsive therapist should recognise family values and relationships without minimising danger.

When safeguarding action is necessary

Some concerns require action beyond family therapy.

Suspected abuse or neglect may require safeguarding action even when there is no immediate emergency.

Confidentiality limits and reporting responsibilities should be explained.

In the UK, concerns about a child's safety may require contacting the appropriate local children's social care service or another safeguarding authority.

In the Republic of Ireland, Tusla – Child and Family Agency provides guidance on reporting concerns about abuse or neglect.

You do not need to prove that abuse has occurred before seeking safeguarding advice.

Where a child is in immediate danger, contact local emergency services.

What research suggests

Research does not suggest that differences in cultural adaptation automatically cause family problems. A 2025 systematic review of 98 records found that more than half of the included studies reported no association between parent-child acculturation gaps and the child, parenting or family outcomes examined. The meaning and effects of these differences depend on their context (Shukla et al., 2025).

A systematic review of 37 papers found encouraging evidence that videoconferencing can be feasible, acceptable and beneficial for couple and family interventions. However, it did not conduct a meta-analysis and covered varied populations and treatments. It does not establish that online therapy is equally suitable for every family or specifically effective for all cross-cultural families in the UK and Ireland (de Boer et al., 2021).

A French qualitative study involving 21 participants from eight families explored experiences of a specialist transcultural psychotherapy service. Participants described perceived improvements in communication and valued elements such as interpreting and consideration of cultural history. This was not a controlled trial or a study of ordinary online family therapy (Carretier et al., 2020).

Together, these findings support considering language, family relationships and individual circumstances in care. They do not justify treating culture as the cause of conflict or promising that family therapy will resolve it.

Families can change without losing who they are

Cross-cultural family life does not require everyone to share identical values, languages or experiences.

Parents and children may have different expectations while maintaining meaningful relationships.

Some families manage these differences comfortably. Others may need support with communication, changing responsibilities or particular concerns affecting a child's wellbeing.

The appropriate response depends on the family's circumstances.

For some, clearer everyday agreements may be sufficient. Others may benefit from individual therapy, family sessions, practical support or specialist healthcare.

Safety, consent and the needs of children must remain central.

Support may help families communicate differently, while recognising that progress varies and some situations require other forms of care.

You can explore more articles on family relationships, identity and emotional wellbeing on the Thera blog.

You can also browse Thera's therapist directory to learn about available professionals, their qualifications and their approaches.

Before arranging family sessions, confirm that the provider can appropriately offer care in the relevant country, has suitable experience where needed, and can explain consent, confidentiality and safeguarding arrangements.

If you have questions about accessing online therapy, you can arrange a free discovery call when it is safe and private for you to make contact.

Family relationships can change over time. The aim is not to erase difference, but to find appropriate support for the particular people, relationships and concerns involved.

References

Carretier, E., Grau, L., Mansouri, M., Moro, M. R., & Lachal, J. (2020). Qualitative assessment of transcultural psychotherapy by adolescents and their migrant families: Subjective experience and perceived effectiveness. PLOS ONE, 15(8), Article e0237113. https://doi.org/10.1371/journal.pone.0237113

de Boer, K., Muir, S. D., Silva, S. S. M., Nedeljkovic, M., Seabrook, E., Thomas, N., & Meyer, D. (2021). Videoconferencing psychotherapy for couples and families: A systematic review. Journal of Marital and Family Therapy, 47(2), 259–288. https://doi.org/10.1111/jmft.12518

Shukla, S., Smith, R. J., Burik, A., Browne, D. T., & Kil, H. (2025). When and how do parent-child acculturation gaps matter? A systematic review and recommendations for research and practice. Clinical Psychology Review, 117, Article 102568. https://doi.org/10.1016/j.cpr.2025.102568

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017). https://www.apa.org/ethics/code

British Association for Counselling and Psychotherapy. (n.d.). Confidentiality – what complaints tell us. https://www.bacp.co.uk/about-us/protecting-the-public/professional-conduct/what-complaints-tell-us/confidentiality/

Health Service Executive. (2024). HSE National Consent Policy. https://www2.healthservice.hse.ie/organisation/national-pppgs/hse-national-consent-policy/

National Health Service. (2022, December 8). Consent to treatment – Children and young people. https://www.nhs.uk/tests-and-treatments/consent-to-treatment/children/

Tusla – Child and Family Agency. (n.d.). How do I report a concern about a child? https://www.tusla.ie/children-first/parents-and-guardians/how-do-i-report-a-concern-about-a-child/

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Nour Saleh

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