Families come to therapy for a variety of reasons. As a result, therapy can take several shifts and the session format is sometimes dependent upon who is in the therapy room. At times the conversation in the therapy room can be chaotic. Family members may interrupt one another. Children may talk over their parents, or parents may not provide their children an opportunity to speak during the session. Another example of chaos in family communication patterns might be family members switching from topic to topic. When a topic becomes too difficult for families members to continue discussing, a chaotic environment might allow family members to switch from topic to topic, wrestling with their discomfort. At other times, therapists may feel as if they have to pull teeth to get family members to talk in front of one another; yet family members may not feel safe talking to one another. They may expect to be attacked after sharing feelings or perspectives on family events. In any of these scenarios the therapist may have a difficult time facilitating conversation.