Systemic Therapy in London & Online

Psychological well being is very much linked to how our systems (e.g., family, friends group) function. For example, it might be hard for you to change individually if you live in a family which supports and evokes your maladaptive behavioural patterns. Systemic therapy points to the structure and cohesion of the systems you belong to and how you can work on yourself, individually or with others, within those systems to improve your collective and personal well-being. 

Systemic therapy emphasises that a family or any other group you belong to is a system, often consisting of various subsystems which are established over time and which significantly affect the way you. 

After finding a systemic therapy professional, you’ll start working on your relationships and your functioning as an individual and as a member of various groups. Here at Therapy Central, we have psychotherapists who can help you and other people to improve your mutual relationships and start re-thinking your previous relationship patterns. Contact us for a free 15-minute consultation and start your systemic therapy in London & Online.

Systemic Therapy in London & Online

What is Systemic Therapy?

Systemic Therapy Basics

A systemic therapist considers all the contexts that affect one or more individuals – couple relationships, nuclear family interactions, wider family interactions, culturally-based group memberships, and even socio-economic factors [1]

Systemic therapy can take the form of individual, one to one therapy, but also potentially involve numerous individuals in therapeutic work, for example family or group therapy. Although systemic therapists highlight the importance of numerous contexts (e.g. family, office, friends group, neighbourhood community, etc.) to which we belong, they don’t underestimate the value of an individual as an independent agent. 

Systemic Therapy and Maintenance of Issues

Psychological issues don’t exist in a vacuum. Much as they affect you and are affected by your responses, psychological issues also exist in a social universe where other people react to them and also act towards them. This is why systemic therapy offers a whole new insight into our struggles. Here’s an example of looking at depression from a systemic therapy perspective:

Let’s say that you’re struggling with depression and you decided to start systemic therapy. Your therapist will help you discuss your negative feelings as they occur in a variety of contexts (e.g. family, work, friends group, etc.) and what meaning and function the depression might have in these contexts. For instance, within a family, your difficult feelings may become a stronghold of your parents’ tendencies to patronise you and act towards you in a condescending manner. 

It happens that a person’s psychological issue, for instance depression, obtains a specific meaning within a family. For instance, even though your parents are naturally caring and encouraging towards you, they can inadvertently (e.g. unconsciously) contribute to your depression being maintained as this enables them to continue to help you and to care for you. In this scenario, their unconscious belief may be about seeing you as better off being dependent on them than independent. The exact opposite can also happen – your parents believing that you should be completely independent and that unless you’re able to be a go-getter, solving all your issues on your own, they will have all the right to reject you. 

In addition, within your work environment, depression can become a reason for your coworkers to start avoiding you, as a result of misunderstanding your feelings; they might believe that you’re trying to reduce your workload on purpose or that you’re trying to get more time off, whereas you’re simply not feeling well. And then, because they didn’t properly understand your issues, your coworkers might start spreading rumours or simply being detached from you. In a different scenario but within the same work context, depression can be a way for you to express your lack of satisfaction with your current role. The feelings of meaninglessness, lack of enthusiasm, and low energy may be the result of monotony of work and feeling a lack of opportunities to progress. 

In short, Systemic Therapy will help you better contextualise your feelings within the contexts of your life, understand how other people react to your feelings, but also how they are, inadvertently or otherwise, contributing to them. But how do systemic therapists come to such conclusions? This is what we’ll talk about in the  following sections.

Is systemic therapy only for families/groups?

No, individuals too can attend systemic therapy. Whereas group therapy with, for instance, family members, has its benefits, systemic therapy for individuals can also help you improve your well-being and gain new insights into the meaning behind the issues you are experiencing. Attending individual systemic therapy where you’re able to discuss your distress as it takes place within the important contexts you belong to (family, friends, work, etc), has the potential to bring change to yourself personally, as well as the systems you’re embedded into. The following systemic therapy techniques, which are used within group systemic therapy, can also be used within individual systemic therapy. 

Systemic Family Therapy Techniques

Circular questioning

One of the basic systemic therapy techniques, circular questioning [2], highlights the very essence of systemic therapy reasoning – within families (and other systems too), the feelings, behaviours, and beliefs of all members are interconnected in a circle, not in a linear causal pattern. This is why a systemic therapist will ask circular questions to see how you react to a certain event. A circular question, for instance, “Who, besides you, is the most affected by your issues?”, is about your relationships with others, and how the struggles you are experiencing are connected to other people.

Circular questions (e.g. “How do you imagine your partner feels when you tell them you have no time to speak to them because you’re busy?”), can also be used to explore our own thinking about others’ emotions, thoughts, and behaviours. One of the most important goals of circular questioning is to bring insight into what you think about other people and more specifically what you think about their thinking. A typical circular question “When you spend long periods feeling angry with each other, what do you think your husband thinks? Is he frustrated, sad, angry, anxious, or anything else?” is made with this goal in mind. 

We can also use them to see how an issue changes through time – “Compared to how people treated you before, how do they treat you now?” In this context, circular questioning allows you to explore your pessimism or optimism about the future, and your thinking about the past.

How Effective is Systemic Therapy?

According to research, systemic therapy is a very effective approach. A recent meta-analysis of the most important studies [4] on the effectiveness of systemic therapy up to 2020 showed that a great majority of people involved in systemic therapy experience an improvement in general mental well-being. Depending on the context and adherence to therapy, the success rate of systemic therapy can go well over 90%.

Does Online Systemic Therapy Work?

The short answer is yes! Online systemic therapy is an effective way to treat psychological issues, with a growing body of research suggesting that we can treat a variety of issues via online systemic therapy [5]. In the previous section we’ve seen that systemic therapy in general is effective in treating mental health issues, and recently a systematic analysis of studies of online therapy showed that when the approach and principles of systemic therapy are delivered online, they can have the same beneficial effects as when they are delivered in-person, whether we’re talking about individual or group systemic therapy [5].

If this sounds familiar, you should get help as soon as possible. Chronic insomnia is particularly difficult to treat because mental health difficulties typically cause it. If you’re affected by anxiety, feeling alert might prevent you from getting sleep, increasing the stress even more. In the end, you might become trapped in a so-called vicious cycle of insomnia. When you can’t fall asleep, you might worry about waking up tired, which produces anxiety that your mind might begin to associate with sleep.

When is the right time to start systemic therapy?

The right time to start systemic therapy is as soon as you notice that the issues you’re experiencing are starting to affect you significantly, so that one or more spheres of your life (e.g. family, relationship, work, leisure, etc.), are affected. 

You should also consider starting systemic therapy when it becomes evident to you that the issues you’re experiencing are appearing mainly in the context of relationships with other people. For instance, if you have an anger management issue primarily because of the amount of frustration you experience in the relationship with your spouse, systemic therapy will help you better understand the viewpoint of the other person (and your own viewpoint) and what role anger plays in your relationships, and look at ways to make positive, sustainable changes. 

Moreover, individual systemic therapy can be an interesting alternative in case you’ve tried other individual therapeutic approaches but didn’t experience significant improvements because the context itself wasn’t addressed within your previous individual therapy.

What are the Advantages of Systemic Therapy?

  • Systemic therapy helps you make meaningful changes by considering the various contexts in which your issues appear. The struggles you are experiencing exist in contexts such as family, work collective, neighbourhood community, etc., which is why learning more about the contextual meaning of your struggles can help you improve your well-being by prompting meaningful changes.
  • It encourages deeper understanding of your struggles and what roles they have in your marriage, family, work group, etc; systemic therapy is the farthest away from pathologisation – the “problem” isn’t situated exclusively within you, but in various contexts and interactions you’re a part of. Systemic therapy can thus feel very normalising and validating, which can strongly contribute positively to your wellbeing.
  • Systemic therapy is very flexible when it comes to the number of people involved. Namely, you can attend it individually, with your partner, family members, friends, etc. It can be couple or family therapy, but it can also be an individual therapy. The basic theory of systemic therapy remains the same whether it’s applied in the individual or group context – it will inevitably focus on your relationships and how your issues appear in the wider social context (e.g. family or spousal relationship). 
  • Systemic therapy will likely not only improve your well-being, but has the potential to also improve the well-being of the people with whom you have close interactions. 
  • Systemic therapy, whether in its individual or group form, will bring new insights to the way you think about your relationships, and will offer actionable steps to improve these relationships in the following ways:
  • Improving communication – quite often we make our lives more complicated simply by communicating in a non-effective way. Our systemic therapists will help you to identify your communication problems and improve your communication with the help of, for instance, assertiveness training.
  • Improving empathy – this goes for both empathising with yourself and other people as well. It’s not unusual that we lack understanding and patience for ourselves and other people. Systemic therapy will encourage deeper understanding of yours and others’ actions, leading to a crucial realisation that while most people do bad things, most people don’t necessarily want to or aren’t even aware they are acting in bad ways.

Bringing new insights to your thinking about the past – a lot of people carry a heavy baggage from the past. By reinterpreting past events and past relationship issues that are affecting you in the present, systemic therapy will open up a way for future changes.

What Issues can Systemic Therapy Help with?

Systemic therapy can be used to treat a variety of psychological issues. Keep in mind that within this approach a psychological struggle is not situated within an individual, but regarded as a product of the interactions within a certain social context (e.g. family):

  • Depression
  • Bipolar
  • Eating disorders
  • Substance use disorders
  • Schizophrenia
  • Anxiety disorders
  • Trauma
  • Child and adolescent mental well-being
  • Parenting issues
  • Physical health problems and psychosomatic issues

How long does Systemic Therapy Last?

Individual systemic therapy sessions will last usually 50 minutes. At times, a systemic therapy session could last up to 90 minutes, depending on context (i.e., individual therapy, couples or family/group therapy). It lasts in general between 6-20 sessions which means you’re likely to notice positive and significant changes in this timespan. 

More severe issues might need longer therapeutic work, but you’re likely to eventually see improvements if your issue is one that can be alleviated and worked through in therapy. We recommend regular check-ins with your therapist to discuss progress and the plan to move forward.

Common Concerns about Systemic Therapy

Systemic Therapy is too relativistic

It’s true that the individual nature of psychological issues is relativised to a certain extent within this approach. Although most modern individual therapies abstain from pathologising clients, they still consider the individual as the main protagonist of therapeutic improvements. 

Certain problems can appear even within well-functioning families. But even in this case systemic therapy is helpful because it can improve the collective understanding of the presenting issue. 

It’s too demanding for Family Members

When systemic therapy is practised with a family, some family members may find systemic therapy too demanding – they might think that they don’t have to go to therapy because they are not the ones who have any issues. This is exactly the sort of matter that can be discussed within a systemic therapy session. It’s possible that the family members who are most reticent about family therapy are the ones who, perhaps inadvertently, contribute most to issues. 

It’s too Unstructured

Compared to, say, CBT, systemic therapy might look a bit unstructured. However, systemic therapy can become more or less structured depending on your needs and the therapist you’re working with.  

Our systemic therapists work flexibly and integratively. This means they’re able to integrate principles and techniques of various therapy approaches (e.g., Systemic, CBT, Psychodynamic), to adapt the work to your unique situation. Thus they’ll be able to increase or decrease the structuredness of therapy (e.g. coming up with individual ‘homework’ or a list of tasks for each family member) if this is something that you want or that you and your therapist feel would be helpful to your situation.

Is Systemic Therapy the Right Choice?

Generally speaking, if you’re experiencing significant psychological issues that affect your functioning in one or more areas (i.e. social, intimate, professional), starting psychotherapy is likely to be a good choice. Systemic therapy can be used to better understand and tackle a variety of psychological issues, both as an individual or group approach. 

Is It the Right Choice for Individual Therapy?

Systemic therapy, as an individual approach, is likely to be beneficial to you if:

  • You’re willing to consider psychological issues under a new light; we are living in increasingly individualistic cultures and the effect of contexts we live in (e.g. family, work, culture, etc.) can sometimes be ignored or their effect underestimated. This is why it can be beneficial to consider the importance of your relationships to other people and how they contribute to you as a person.
  • You are ready to critically and objectively examine the role of other people in your life – systemic therapy requires a balanced approach to how you think about your relationships.  
  • If you feel ready to try to change the contexts you’re living in. One of the basic ideas of systemic therapy is that there can be no profound changes to individuals without changes to broader systems. And while it can be a bit hard to change wider systems such as culture, you can likely start to bring some positive changes to your family or your office. 

Is it the Right Choice for Group or Couples Therapy?

  • In case other people are attending therapy with you, the group’s acceptance of the principles of systemic therapy is crucial. If your family members (or, say, your partner) are not committed to improving your and their well-being, systemic therapy might not produce the desired outcome. 
  • You want to improve your family as well – systemic therapy is not only about you, it’s about everyone involved; your well-being depends on the well-being of others. The therapeutic focus might not always be on you – but on your relationships with other people, how they react to your struggles and how you respond to theirs.
  • Availability of everyone involved – once again, the following caveat too is only relevant if other people are attending therapy with you. Namely, it will take a certain amount of scheduling and planning to get everyone involved. The therapist will be helpful in this respect, but the effectiveness of systemic therapy still depends on the availability of your family.

How we like to Practise Systemic Therapy in London at Therapy Central?

Our systemic therapists are flexible and will pay great attention to tailor each session to your specific needs. Most of our systemic therapists are also trained in a variety of therapeutic approaches, and are able to offer therapy which is comprehensive and integrative. For instance, your systemic therapist can, for the most part, focus on the family dynamics and work with the group, in case you’re attending group systemic therapy. If you’re seeing the therapist with family members, your practitioner might sometimes decide to discuss certain topics on a one-on-one basis with each family member. 

Systemic therapy also has the individual form where the therapist works with only one client. Moreover, when relevant, the family therapist might introduce CBT-style homework such as behavioural experiments or journaling, or integrate elements of other approaches to suit your specific needs. 

The most important aspect of psychotherapy is how it helps you (and groups you belong to) make positive and sustainable changes. Psychotherapeutic integration is often helpful to reaching this goal.

Our Therapists Specialised in Perfectionism Therapy

All of our therapists are qualified psychologists, psychotherapists or counsellors registered with several professional bodies. These include the Health and Care Professions Council (HCPC), the British Psychological Society (BPS), as well as BACP, UKCP and BABCP.

Get professional help and Perfectionism Therapy in London or Online today. Contact us for a free 15 min consultation with an expert therapist to see if our help would fit your needs.

Dr. Yasmeen Jaina

Counselling Psychologist

Dr Joanne Warren

Clinical Psychologist

Anita Sommers


Dr Lara Lopes de Jesus

Counselling Psychologist

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The Therapist l had was absolutely brilliant with me. He had patience with me and bit by bit l gained a little of confidence to try and get out and go on the buses.

He deserves an award and if l could l would in the beginning l thought how is this person going to get me back on public transport but he did he gave me the confidence l lost and now have back.

I will never forget him and what he has done for me. I wish him nothing but the best in his life.



My therapist was excellent. I highly recommend her and I am truly thankful for my sessions, I left feeling confident and positive.

The mental tools, systems and approaches I have been able to develop with her and use in my life have been hugely beneficial.

Thank you to all at Therapy Central.



The Therapist really gave me the space to talk and express my feelings and fears in a very comforting environment.

She was there not only to listen, but challenge my thinking, guide me during the uncertainty I was experiencing and give me useful and practical tips to improve my mental health and wellbeing. Highly recommended!



Working with the therapist has been a life-changing experience. Each session has been invaluable, helping me gain a good understanding of CBT methodology enabling me to incorporate ways to combat stress and anxiety in my daily life.

The Therapist shows that she really cares and has the ability to make you feel calm whilst discussing any personal issue. 


Fees & Insurances

Therapy, Counselling and CBT sessions are 50 minutes long and are usually held at regular weekly time slots.

15 Minute Initial
Phone Consultation

£80 - £125
Psychological Therapy/
Counselling (Self-funded)

£115 - £150
Couples Therapy/
Family Therapy

Covered by
Your Private Healthcare Insurance Provider

Our therapists are registered with several insurance providers, such as AXAPPP, Simplyhealth, Bupa, Aviva, Cigna (UK/US), and WPA. If you wish to use your personal or employee private healthcare insurance to cover your sessions, please highlight this in your contact form below.

Systemic Therapy in London & Online

If you’re looking to gain a better insight into how your relationships contribute to you as a person but also to your struggles, here at Therapy Central we have systemic therapists who will help you gain insight into your unique circumstances, and support you in making the crucial changes to bring more fulfilment and balance to your life. Our therapists are oriented towards psychotherapeutic integration, and they will be able to effectively implement strategies and techniques coming from other psychotherapeutic approaches they’re trained in, to address your unique, specific situation and needs. 

Get professional systemic therapy in London today and online. Contact us for a free 15 min consultation with a systemic therapist to see if our help would fit your needs. You can also get in touch via email at or call us at (+44) 020 348 82797.

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    What happens after I make an enquiry?

    After receiving your enquiry we’ll contact you to organise a FREE phone consultation. You will be able to tell us more about your specific circumstances and needs and ask any questions you have. Then, if you want to proceed with therapy or counselling, we’ll match you with the therapist(s) with the best expertise to help you with your challenges and send you a list of their available appointment slots. If you’re satisfied with one of these, we can then go ahead and book your first appointment. You can also request to work with a specific practitioner and, depending on availability we’ll try accomodate this.

    What happens at my first appointment with the therapist?

    Your first session will likely be different than future appointments. You and your therapist will get to know each other and will begin to build a working alliance. It will be a chance to have the confidential space to express your circumstances, feelings and thoughts and being listened to with depth, attention, empathy and without judgement . Your therapist will likely ask you more about your reasons for seeking therapy, and any symptoms you’re experiencing. You may also be asked questions about your past and the history of your issues, as well as how they currently impact your life in the present. Finally, your first session may be a powerful place to discuss what you would like to achieve with therapy and agree on the length, methods and approaches of treatment.

    Is online therapy effective?

    If you choose online over in-person therapy rest assured that this has been proven to be just as effective as regular face to face therapy, and in some cases even more effective. In addition, choosing online therapy brings additional benefits, for example avoiding longer waiting times, greater flexibility with appointments and you won’t need to travel to our practice. You can enjoy online therapy from the comfort of your home.

    How long the Therapy/counselling sessions last?

    Therapy/counselling sessions last 50 minutes and are held at regular weekly time slots. On occasions we are able to allow some flexibility. This can be discussed with your therapist.

    Do you offer reduced rates/concessions?

    We offer low-cost rates to people with a low income, unemployed or students. Please let us know in your enquiry if you would like a concession rate and how you qualify for this. Depending on the availability of our therapists, we’ll do our best to accommodate your request.

    Do you have a cancellation policy?

    We have a 48 hours no-fee cancellation policy. However you will be charged for sessions missed without giving the full notice.

    Our Practice in Central London

    Our comfortable and confidential therapy rooms are conveniently located 3 min walk from Oxford Circus station, in Central London (see map below). Change starts with Talking!


    [1] European Association for Psychotherapy (n.d.). Systemic Family Therapy. 

    [2] Brown, J. (1997). Circular questioning: An introductory guide. Australian and New Zealand Journal of Family Therapy, 18(2), 109-114.

    [3] Tomm, K. (1989). Externalizing the problem and internalizing personal agency. Journal of Strategic and Systemic Therapies, 8(1), 54-59.

    [4] Carr, A. (2020). Evidence for the efficacy and effectiveness of systemic family therapy. The Handbook of Systemic Family Therapy, 1, 119-146.[5] McLean, S. A., Booth, A. T., Schnabel, A., Wright, B. J., Painter, F. L., & McIntosh, J. E. (2021). Exploring the efficacy of telehealth for family therapy through systematic, meta-analytic, and qualitative evidence. Clinical child and family psychology review, 24(2), 244-266.

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