Preventing Relapse in Traumatized Families: The Troubleshooting Technique

by drmadmin // Dr. Scott Sells

Relapse occurs when our clients initially get worse before they get better. It is like stretching a rubber band that will snap back as soon as we let go. Over time, a child’s problem symptoms (i.e., self-harm, aggression, anxiety, extreme disrespect, etc.) that are caused by a traumatic event often become the new normal in…

Relapse occurs when our clients initially get worse before they get better. It is like stretching a rubber band that will snap back as soon as we let go. Over time, a child’s problem symptoms (i.e., self-harm, aggression, anxiety, extreme disrespect, etc.) that are caused by a traumatic event often become the new normal in a family. This means that family members begin to accommodate their lifestyle around the child’s problems. For example, parents stop setting consistent limits for fear that it will create more anxiety or siblings grow resentful as their emotional needs are ignored.

Therefore, when the family trauma therapist realigns the family, it is scary, stressful, and leads to initial resistance within the tension point of “I want to change, but I don’t want to change”. In turn, this tension can lead to relapse until both the traumatized child and their family can hang on long enough to settle into a new lifestyle without the drama of the trauma. If the therapist fails to prepare the family for relapse, family members are caught off guard and are likely to end treatment prematurely.

How to Prevent Relapse

There are no shortcuts in the family systems trauma treatment process. The healing process cannot be rushed. Our experience at the Family Trauma Institute indicates that it takes a minimum of 30 days of consistent application of the new Trauma Playbook(s) before permanent change in the child’s problems is possible. During this 30-day transition period, the risk for relapse is high for both the child and family.

 The Troubleshooting Technique 

To counter this risk, the FST | Family Systems Trauma Model uses the technique of a “troubleshooting checklist” to handle relapses if they occur.  A trauma playbook is used with the entire family. The Family Systems Trauma (FST) therapist offers suggestions that will either lead into role plays (“We will practice today how to talk to your son”) or problem-solving (“If a family member forgets to show up on Saturday or Sunday, just remind them for next week”). As part of the troubleshooting technique, the FST therapist will actively suggest countermoves by writing them in the playbook template immediately prior to the session. Without suggestions, the family is often lost on what to do. The session can easily digress into an unproductive brainstorming session. Within the session itself, these suggestions can always be rejected, altered, or modified by the family. However, the benefit is that it provides both therapist and family quick footing for next steps.

An Important Note

Using the troubleshooting technique, relapse is communicated to the traumatized family as a normal part of the healing process. And because of this fact, one must proactively prepare for it. Unfortunately, we find that troubleshooting is the most unused technique in mental health treatment by therapists. If troubleshooting is used at all, it is done after a relapse has already occurred rather than proactively implemented beforehand. Or troubleshooting is verbal and rarely typed up in a systematic step-by-step table format with practice role plays as needed. As a result, the traumatized child and family are left unprepared and without any concrete tools to counter relapse or “what will you do if…” curveballs to derail the trauma playbook.

This problem is further exacerbated because a traumatized family is often burnt out and brittle before treatment even begins. The family does not have the time or energy to bounce back or reboot quickly after a relapse. As a result, the family will often end treatment prematurely out of frustration or falsely believe that the trauma treatment is not working. This is why the Family Trauma Institute devoted three entire chapters (Chapters 11, 12, and 13) on troubleshooting and relapse prevention in Treating the Traumatized Child: A Step-by-Step Family Systems Approach. It is critical that trauma therapists master the troubleshooting technique to prepare the family for relapse before it happens, not after.

Final Thoughts

Trauma treatment is difficult even on our best day. But without troubleshooting we risk setting up our traumatized families for failure. Relapse is normal. We can use this troubleshooting checklist technique as a clear and visual road map to empower our families with the problem-solving tools they need to weather the storm. We can then turn to our families with confidence that they have the tools they need to hold on for the next 30 days and beyond if needed to bring about permanent healing. In turn, the traumatized child is greatly relieved. Through the troubleshooting checklist, everyone’s roles in the family are clear and everyone has a stake in the healing process. It is not on the child’s shoulders alone to change, but an entire village.

For more information on FST techniques, join the Family Trauma Institute’s upcoming webinar.

Click here to register

Scott P. Sells, Ph.D., MSW, LCSW, LMFT, is the author of three books, Treating the Tough Adolescent: A Family-Based, Step-by-Step Guide (1998), Parenting Your Out-of-Control Teenager: 7 Steps to Reestablish Authority and Reclaim Love (2001), and Treating the Traumatized Child: A Step-by-Step Family Systems Approach (2017). He can be contacted at spsells@familytrauma.com or through LinkedIn.

Dr. Scott Sells

Dr. Scott Sells

Dr. Scott Sells is the founder of the Family Trauma Institute and developer of the FST | Family Systems Trauma model.
Read Dr. Sells’ bio.

74 thoughts on “Preventing Relapse in Traumatized Families: The Troubleshooting Technique”

  23. Thank you, I have just been searching for information approximately this topic for a while and yours is the best I have found out so far. However, what in regards to the bottom line? Are you certain concerning the supply?

    Reply

  45. Framing relapse as a normal part of healing, especially during the first 30 days of consistently applying a Trauma Playbook, can help families interpret resistance without abandoning treatment. Preparing specific countermoves before a session also seems more useful than waiting for an unstructured brainstorming process after difficulties arise. When old family photographs are used to support reflection or storytelling, a resource such as prompt para restaurar fotos antiguas may help preserve those visual records.

    Reply

  54. The point that relapse can emerge during the first 30 days of applying a new family “Trauma Playbook” is especially practical, because it frames resistance as something to anticipate rather than evidence that treatment has failed. The troubleshooting checklist also offers a useful structure for turning difficult moments into specific role-play or problem-solving steps, much like the guided process in animal face type.

    Reply

  59. The way this subject is presented makes it easy to understand how relapse can affect traumatized families during recovery. The focus on proactive troubleshooting, preparation, and practical strategies offers helpful perspective on supporting families through challenging stages of treatment.

    Reply

  60. Very helpful blog that explains the challenges of trauma recovery and the importance of having proper strategies in place. I appreciated the focus on troubleshooting techniques, family support, and practical approaches that can help create a stronger path toward healing and positive change.

    Reply

  61. This was useful perspective on trauma recovery,i love the idea of preparing families for setbacks in advance and using a practical troubleshooting plan instead of treating relapse as a complete failure, checklist gives families concrete steps to work through difficult moments instead of feeling lost when problems resurface!

    Reply

  63. The idea of treating setbacks as something to prepare for, rather than as proof that treatment failed, is interesting. I also think the practical focus on writing down possible “what if” situations makes sense because stressed families may not remember verbal advice when things get difficult. A checklist can give structure, but it probably needs enough flexibility so it doesnt become another rigid rule for an already overwhelmed family.

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  67. This is a very useful post! It is true that when the illness returns (a relapse occurs), having a plan ready in advance—that is, using ‘troubleshooting techniques’—is the best way to help families navigating such difficult situations, rather than panicking.

    Reply

  68. I liked the idea of having a simple checklist to help families deal with problems when they come up again. Being prepared for these difficult times can make things easier and help everyone stay focused!

    Reply

  71. The idea of treating setbacks as something to prepare for, rather than as proof that treatment has failed, is an interesting shift in perspective. I think the checklist approach could also help families remember what to do when emotions are high and nobody is thinking clearly. One question I had is how therapists decide which possible “curveballs” should be included beforehand, since every family will have different triggers and routines. Having a written plan seems more practical than trying to remember advice during a stressful moment.

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  72. I found the troubleshooting approach especially practical because it prepares families for setbacks instead of treating relapse as failure. Having clear steps, role plays, and shared responsibilities can make the healing process feel more manageable and consistent.

    Reply

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