5 Ways to Provide More Effective Couples Therapy

If you are a clinician looking to begin or improve your practice as a couples therapist, you might experience some trepidation and self-doubt in your ability to help couples. Let me assure you that you are not alone. Many of us interested in including couples therapy among our modalities felt worried and sometimes isolated in our professional communities as we moved into this specialized practice. When I began my clinical practice in the mid-1980s, I had very little exposure to training and supervision in working specifically with couples. Initially I practiced what I called “dart therapy” with couples, where I threw whatever I had at the couple and if it stuck, I called it therapeutic. Most of my professional colleagues were happy to refer their couples to me because they were very reluctant to work with two people in intense conflict in front of them.

So if you want to be more effective than the average generalist therapist in your work with couples, you have to make a commitment to preparing yourself as a couples therapist. Aside from the graduate study, post-graduate supervision, clinical practice, and meeting the criteria for licensure in your state, consider some of the following ideas in your game plan to becoming the best couples therapist in town. 

  1. Don’t try to be a specialist in all areas of your practice. None of us can do everything very well and clients don’t expect us to be experts at everything. If you are just beginning your professional career, spend some time thinking about what you love to do, what you have passion for in your life and create a practice focus that aligns closely with what you love to do in your life. Don’t choose your specialization because it is the popular model among your friends, or because it sounds snazzy, or because you think you will make a lot of money. Therapists rarely succeed in creating lucrative practices unless the motivation behind it is authentic because it takes a lot of commitment and endurance to create a name for oneself. 
  2. In a similar vein, I often advise my students not to take a lot of specialized trainings and certifications beyond their graduate courses in the first couple of years. Resist the competitive atmosphere among graduate students and worries about building your resume. My reasoning for this is as follows:  First, when we are in graduate school or soon after we enter the workforce, we are not good judges of what we are going to excel at. At that point in our career, we may have an inkling of what we are good at and often a better sense of what is a challenge for us. So be patient and pay attention as you work with clients to discover what feels like “effortless learning” to you. It is unique for each of us. Follow your “flow” (as Mihaly Csikszentmihalyi called it) (link to http://cgu.edu/pages/4751.asp ) and it will show you what you should study and embrace as your expertise. Second, the universe and many other circumstances come together to send us more of one type of client than another. There are more seasoned counselors who will tell you they never thought they would be doing X or Y. For example, I did not plan to specialize in couples therapy. I kept being led down that path by the clients I saw in a community mental health center, by the advice from my mentors, and from my own personal struggles in relationships. My task was to show up and say yes to every new opportunity that came my way, and a few years and few hundred hours of training and experience later, I was a couples therapist. 
  3. More than other forms of therapy, couples therapy will trigger and tap into your own relationship history. Whether you are currently in an intimate relationship or not, all of us have been in a variety of attachment relationships in our life. We relate to our clients, especially in moment of high intensity, the way we have been related to. A therapist who was raised in an emotionally detached family will have difficulty working with volatile couples and a therapist who is sensitive to gendered scripts will see them in all her couples. The exception to this is a therapist who has spent time working on their own baggage and have learned or practiced new skills. So, do you own relationship work. Couples are quite sensitive to therapists who are offering suggestions from book learning rather than from life learning. Therapy is like crossing a desert. We can teach clients how to complete the journey with a road map and information but if we have crossed that desert ourselves, we bring a different level of confidence and comfort to our work and our clients can feel it. 
  4. Part of doing your own relationship work is knowing your emotional history and style. Couples therapists have to be willing to work with conflict, intense emotions, and challenging circumstances that have a sense of urgency to them. I work regularly with couples on the brink and when I do, I have to be willing to bring my genuine passion into the room and offer the couple a strong rationale for investing in their relationship. The therapist has to hold the hope for the relationship longer than the couple in many instances. If I am not willing to be active, engaged, and genuine, I am more likely to help the couple separate. Working with committed relationships does not mesh well with therapist neutrality, because working with couples means working with political, moral, and social values. I don’t advocate saving all relationships because I know it is realistic to accept that some relationships are meant to end for the good of everyone involved. However we live in a time of epic divorce rates but I believe we can reduce the number of unnecessary divorces and relationship breakups through our intentional therapeutic work.
  5. Finally if you want to be an excellent couples therapist and make this a central part of your practice, there is one thing you have to do for the rest of your professional career. Consult, consult, consult. Don’t let the licensing board dictate how long you get supervision. Licensing standards are about minimum or entry level competence. To be truly outstanding at what we do, we all need to be constantly sharpening the edge on our tools. Belong to consultation groups, find an informal consultant or supervisor and build an ongoing relationship. Most of us don’t have formal structures for building mentoring relationships in our profession beyond graduate school and post-graduate supervision. To the extent that we are able to get feedback from our peers or mentors, monitor our own reactions to our clients, and constantly challenge our boundaries of knowledge and skills, our clients will thank us by blossoming and enhancing their relationships. There is nothing more satisfying than watching a couple go from distress to delight with each other. 

The best gift we can give ourselves in preparing to become a good couples therapist is the gift of self-care and personal and professional growth. Don’t be discouraged by setbacks and challenges. In my opinion, when we work with couples in a committed attachment or intimate relationship, we are working with the kernel of society. Two adults coming together in a loving bond are where society begins. Through their mutual love and dreams they create a new family, a new home, and from that new family they create the legacy they will leave behind. So our work as couples therapists is absolutely critical to society; we are changing the world one relationship at a time. 

By Dr. Vagdevi Meunier

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