In the fall of 2023, I moved to San Francisco to begin my practicum, working within the shelter system alongside individuals experiencing severe mental health challenges, substance use disorders, and transgender women living with AIDS. The work was new to me, and I would be lying if I said I wasn’t nervous. What I did have, however, was a deep desire to help others and an ability to connect with people whose life experiences were very different from my own.
Very quickly, I learned that the shelters where I worked functioned much like families. There were natural hierarchies, helpers who stepped up to support others, and individuals who needed extra care and attention due to their unique needs. Guests held one another accountable, and like any family system, there were disagreements, apologies, and moments of repair. Everyone played a role, and each person’s behavior affected the people around them.
Families and communities are living systems that require flexibility and compassion as they adapt to meet the needs of each member. While we all need a sense of independence and personal agency, true growth happens when we balance that independence with healthy boundaries and clear expectations—not by isolating ourselves or cutting people off when mistakes happen.
As a family systems therapist, I understand that treating an individual often means considering the entire system around them. This includes family relationships, but also the broader networks that influence our lives: work, friendships, community, and society. These interconnected systems can be both beautiful and complex, but understanding their influence is essential to meeting our clients’ needs in meaningful ways.
At Anew, our therapeutic community approach reflects this belief. We recognize the many systems that shape our clients’ lives and work to create meaningful, sustainable change. This approach emphasizes community, accountability, inclusion, and a strong sense of belonging.
Importantly, these values extend beyond our work with clients and families. Within our own team, we strive to embody the principles of therapeutic community by supporting one another, offering feedback when needed, and encouraging growth. We don’t just teach these values—we actively practice them in the way we work with one another, and with our clients. I feel blessed every day to be a part of this wonderful community of teachers and healers.
Carie Howard
Licensed Associate Marriage and Family Therapist
Anew Treatment Center